The Relationship Between The Bcl-2/IgH, IgH Gene Rearrangement And The Diagnosis Of B-NHL Together With Therapy Effect

Objective: To further enhance the molecular diagnostic accuracy and positive rate of B-cell non-Hodgkin's lymphoma (B-NHL), we used the polymerase chain reaction (PCR) method to jointly monitor the Bcl-2/IgH fusion gene and IgH gene rearrangement in the peripheral blood of patients with B-NHL ,and observed the relationship of the two markers with clinical complete remission before and after chemotherapy, to determine whether it can serve as a real-time remission index of in the molecular level.Methods: 49 cases of newly diagnosed B-NHL were studied, including 7 cases of follicular lymphoma, diffuse large B-cell lymphoma in 33 cases, four cases of mantle cell lymphoma, small B-cell lymphoma in 5 cases, based on the use of CHOP chemotherapy, some in conjunction with other treatment. Before and six cycles after the treatment, we apply the one-step PCR method to detection the Bcl-2/IgH fusion gene and IgH gene rearrangement.Results: 49 cases of B-NHL patients at the completion of all treatment, 21 patientsaachieved clinical complete remission, 11 patients achieved partial remission, 5 patients were in stable condition, 12 cases were in disease progression, and the total effective rate of treatment is 65.2%. In the result of pre-treatment test in molecular level, 38 cases have detected IgH gene rearrangement, the positive detection rate is 77.6%; 21 cases of Bcl-2/IgH fusion gene rearrangement has detected, the positive detection rate is 42.9%, positive rate of combined detection of Bcl-2/IgH fusion gene and IgH gene rearrangement is 91.8%. Of 21 cases which achieving complete remission after treatment, four cases with IgH gene rearrangement negative (chi-square value = 0.89 P> 0.05), 2 examples with Bcl-2/IgH fusion gene negative (chi-square value = 0.40 P> 0.05 ).Conclusion: Bcl-2/IgH fusion gene united IgH gene rearrangement as molecular markers is more sensitive than Bcl-2/IgH fusion gene or IgH rearrangement alone, and in complete remission cases, Bcl-2/IgH fusion gene, IgH re - ranked genes were in no significant change before and after chemotherapy, which means on short-term clinical complete remission for patients, the target above should not serve as a real-time molecular index.