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Blood, 15 August 2008, Vol. 112, No. 4, pp. 1374-1381.
Prepublished online as a Blood First Edition Paper on May 28, 2008; DOI 10.1182/blood-2008-01-136465.


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NEOPLASIA

Molecular profiling of pediatric mature B-cell lymphoma treated in population-based prospective clinical trials

Wolfram Klapper1, Monika Szczepanowski1,*, Birgit Burkhardt2,3,*, Hilmar Berger4,*, Maciej Rosolowski4,*, Stefan Bentink5, Carsten Schwaenen6, Swen Wessendorf6, Rainer Spang5, Peter Möller7, Martin Leo Hansmann8, Heinz-Wolfram Bernd9, German Ott10,11, Michael Hummel12, Harald Stein12, Markus Loeffler4, Lorenz Trümper13, Martin Zimmermann2,14, Alfred Reiter2, Reiner Siebert15, for the "Molecular Mechanisms in Malignant Lymphomas" Network Project of the Deutsche Krebshilfe

1 Department of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel/Christian-Albrechts-University Kiel; 2 NHL-BFM Study Center, Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; 3 Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel/Christian-Albrechts-University Kiel; 4 Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig; 5 Institute of Functional Genomics, University of Regensburg; 6 Cytogenetic and Molecular Diagnostics, Internal Medicine III, University Hospital of Ulm; 7 Institute of Pathology, University Hospital of Ulm; 8 Institute of Pathology, University Hospital of Frankfurt; 9 Department of Pathology, University Hospital Schleswig-Holstein, Campus Lübeck; 10 Institute of Pathology, University of Würzburg; 11 Institute of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart; 12 Institute of Pathology, Campus Benjamin Franklin, Charité–Universitätsmedizin Berlin; 13 Department of Hematology and Oncology, Georg-August University of Göttingen; 14 Department of Pediatric Hematology and Oncology, University of Hannover; and 15 Institute of Human Genetics, University Hospital Schleswig-Holstein, Campus Kiel/Christian-Albrechts-University Kiel, Germany

The spectrum of entities, the therapeutic strategy, and the outcome of mature aggressive B-cell non-Hodgkin lymphomas (maB-NHLs) differs between children and adolescents on the one hand and adult patients on the other. Whereas adult maB-NHLs have been studied in detail, data on molecular profiling of pediatric maB-NHLs are hitherto lacking. We analyzed 65 cases of maB-NHL from patients up to 18 years of age by gene expression profiling, matrix comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH), and immunohistochemistry. The majority of the analyzed pediatric patients were treated within prospective trials (n = 49). We compared this group to a series of 182 previously published cases of adult maB-NHL. Gene expression profiling reclassified 31% of morphologically defined diffuse large B-cell lymphomas as molecular Burkitt lymphoma (mBL). The subgroups obtained by molecular reclassification did not show any difference in outcome in children treated with the NHL-Berlin-Frankfurt-Muenster (BFM) protocols. No differences were detectable between pediatric and adult mBL with regard to gene expression or chromosomal imbalances. This is the first report on molecular profiling of pediatric B-NHL showing mBL to be much more prominent in children than suggested by morphologic assessment. Based on molecular profiling mBL is a molecularly homogeneous disease across children and adults.


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