Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

REL-positive double minute chromosomes in follicular lymphoma

Leukemia volume 20, pages 1624–1626 (2006)Cite this article

Access through your institution
Buy or subscribe

Determination of specific chromosomal abnormalities plays an important role in the diagnosis, prognosis and management of hematological malignancies. Double minute chromosomes (dmins) are small chromatin bodies consisting of genes that are amplified in an extrachromosomal location. They are the genetic vehicles for amplifying oncogenes and drug-resistance genes. Such gene amplification events are frequently associated with tumor progression. Identification of dmins in hematologic malignancies has been reported primarily in acute myeloid leukemia. Recognized genes in the dmins include MYC oncogene and MLL transcription factor.1, 2 However, the occurrence of dmins is rare in lymphoid malignancies. Specific genetic material in the dmins and their clinical significance in the course of disease progression remains to be determined.

Using a multicolor fluorescence in situ hybridization (FISH) approach, we report here the identification and characterization of dmins in a patient with follicular lymphoma. Our patient is a 50-year-old female. She had a 3½-year history of follicular lymphoma with typical expression of CD10, CD20 and BCL2. She presented in June 2002 with extensive lymphadenopathy and marrow involvement. She received a full course of rituximab–CHOP chemotherapy but had progression 4 months later with development of malignant ascites and pleural effusions as well as recurrent lymphadenopathy. She received two cycles of rituximab–ESHAP and then four cycles of rituximab–fludarabine with treatment ending in September 2003. In December 2003, she received dose-intensive cyclophosphamide (4.5 g/m2) and etoposide (2.0 g/m2), but autologous stem cells could not be mobilized; nonetheless, the patient remained free of lymphoma for about 1 year thereafter. In February 2005, she again developed bilateral effusions and recurrent, bulky retroperitoneal lymphadenopathy. A pleural fluid specimen showed evidence of B-cell lymphoma with expression of CD19, CD20 and monotypic lambda on the malignant lymphocytes. A bone marrow biopsy showed 20–30% involvement with a mixture of small and large malignant lymphocytes. The patient was treated with REPOCH chemotherapy and involved field radiation, responded and has been maintained on rituximab every 2 weeks while awaiting identification of a matched unrelated donor.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Sait SN, Qadir MU, Conroy JM, Matsui S, Nowak NJ, Baer MR . Double minute chromosomes in acute myeloid leukemia and myelodysplastic syndrome: identification of new amplification regions by fluorescence in situ hybridization and spectral karyotyping. Genes Chromosomes Cancer 2002; 34: 42–47.

    Article  CAS  Google Scholar 

  2. Thomas L, Stamberg J, Gojo I, Ning Y, Rapoport AP . Double minute chromosomes in monoblastic (M5) and myeloblastic (M2) acute myeloid leukemia: 2 case reports and a review of literature. Am J Hematol 2004; 77: 55–61.

    Article  Google Scholar 

  3. Zelenetz AD, Cleary ML, Levy R . A submicroscopic interstitial deletion of chromosome 14 frequently occurs adjacent to the t(14;18) translocation breakpoint in human follicular lymphoma. Genes Chromosomes Cancer 1993; 6: 140–150.

    Article  CAS  Google Scholar 

  4. Gilmore TD, Kalaitzidis D, Liang MC, Starczynowski DT . The c-Rel transcription factor and B-cell proliferation: a deal with the devil. Oncogene 2004; 23: 2275–2286.

    Article  CAS  Google Scholar 

  5. Crowley JA, Butler MS, Ronnenburg MJ, Ament CN, Meekins JS, Ning Y . Development of a dual color FISH probe set on chromosome 6q to improve cytogenetic diagnosis of lymphoid malignancies. Cancer Genet Cytogenet 2005; 157: 78–81.

    Article  CAS  Google Scholar 

  6. Weiss LM, Strickler JG, Medeiros LJ, Gerdes J, Stein H, Warnke RA . Proliferative rates of non-Hodgkin's lymphomas as assessed by Ki-67 antibody. Hum Pathol 1987; 18: 1155–1159.

    Article  CAS  Google Scholar 

  7. Satterwhite E, Sonoki T, Willis TG, Harder L, Nowak R, Arriola EL et al. The BCL11 gene family: involvement of BCL11A in lymphoid malignancies. Blood 2001; 98: 3413–3420.

    Article  CAS  Google Scholar 

  8. Houldsworth J, Olshen AB, Cattoretti G, Donnelly GB, Teruya-Feldstein J, Qin J et al. Relationship between REL amplification, REL function, and clinical and biologic features in diffuse large B-cell lymphomas. Blood 2004; 103: 1862–1868.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank our cytogenetics laboratory staff for karyotype analysis. APR is a clinical scholar of the Leukemia and Lymphoma Society. This study was supported by an intramural research grant from the School of Medicine, University of Maryland.

Author information

Authors and Affiliations

  1. Department of Pathology, University of Maryland, Baltimore, MD, USA

    J C Reader, X F Zhao, M S Butler & Y Ning

  2. Department of Hematology–Oncology, University of Maryland and Marlene and Stewart, Greenebaum Cancer Center, Baltimore, MD, USA

    A P Rapoport

Authors
  1. J C Reader
    View author publications

    Search author on:PubMed Google Scholar

  2. X F Zhao
    View author publications

    Search author on:PubMed Google Scholar

  3. M S Butler
    View author publications

    Search author on:PubMed Google Scholar

  4. A P Rapoport
    View author publications

    Search author on:PubMed Google Scholar

  5. Y Ning
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Y Ning.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reader, J., Zhao, X., Butler, M. et al. REL-positive double minute chromosomes in follicular lymphoma. Leukemia 20, 1624–1626 (2006). https://doi.org/10.1038/sj.leu.2404289

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.leu.2404289

Search

Advanced search

Quick links