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Blood, 15 January 2004, Vol. 103, No. 2, pp. 695-697.
Prepublished online as a Blood First Edition Paper on September 11, 2003; DOI 10.1182/blood-2003-06-1901.


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NEOPLASIA
Brief report

Prognostic significance of bcl-xL gene expression and apoptotic cell counts in follicular lymphoma

Wei-Li Zhao, Marjan Ertault Daneshpouy, Nicolas Mounier, Josette Brière, Christophe Leboeuf, Louis-François Plassa, Elisabeth Turpin, Jean-Michel Cayuela, Jean-Claude Ameisen, Christian Gisselbrecht, and Anne Janin

From the ERM-0220, Institut Universitaire d'Hématologie, Université Paris VII, Hôpital Saint-Louis, Paris; Service de Biochimie B and CNRS UPR-9051, Hôpital Saint-Louis, Paris; Institut National de la Santé et de la Recherche Médicale (INSERM) U462, Laboratoire d'Hématologie, Hôpital Saint-Louis, Paris; and EMI-U 9922 INSERM/Université Paris VII, IFR 02, Hôpital Bichat-Claude-Bernard, Paris, France.

bcl-xL, a member of the Bcl-2 family, exerts an antiapoptotic effect on lymphocytes. To assess its clinical significance in patients with follicular lymphoma, realtime quantitative reverse transcription–polymerase chain reaction (RT-PCR) analysis of bcl-xL gene expression was investigated in whole lymph node sections and laser-microdissected lymphoma cells of 27 patients. Compared with 10 patients with reactive follicular hyperplasia, the bcl-xL gene was overexpressed in patients with follicular lymphoma at a higher level in microdissected lymphoma cells. The bcl-xL gene level correlated with the number of apoptotic lymphoma cells labeled by terminal deoxytransferase-catalyzed DNA nick-end labeling (TUNEL) assays (r = -0.7736). Clinically, a high bcl-xL level was significantly associated with multiple sites of extranodal involvement (P = .0020), elevated lactate dehydrogenase level (P = .0478), and an International Prognostic Index indicating high risk (P = .0235). Moreover, bcl-xL gene overexpression was linked to short overall survival times (P = .0129). The value of bcl-xL gene expression as a prognostic marker in follicular lymphoma should thus be considered.


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