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Blood, 9 April 2009, Vol. 113, No. 15, pp. 3553-3557.
Prepublished online as a Blood First Edition Paper on February 6, 2009; DOI 10.1182/blood-2008-08-174839.


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LYMPHOID NEOPLASIA

Brief Report

Transformation of follicular lymphoma to diffuse large B-cell lymphoma may occur by divergent evolution from a common progenitor cell or by direct evolution from the follicular lymphoma clone

Emanuela Carlotti1, David Wrench1, Janet Matthews1, Sameena Iqbal1, Andrew Davies1, Andrew Norton1, Jason Hart2, Raymond Lai3, Silvia Montoto1, John G. Gribben1, T. Andrew Lister1, and Jude Fitzgibbon1

1 Centre for Medical Oncology Laboratory, Barts and The London School of Medicine and Dentistry, London, United Kingdom; 2 Department of Medicine, University of Alberta and Cross Cancer Institute, Edmonton, AB; and 3 Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB

To investigate the cell of origin linking follicular (FL) and transformed (t-FL) lymphomas, we analyzed the somatic hypermutation (SHM) pattern of the variable region of the immunoglobulin heavy gene (IgH-VH) in 18 sequential FL/t-FL samples and a father (donor) and son (recipient), who developed FL and t-FL, after transplantation. Genealogic trees showed a pattern compatible with a common progenitor cell (CPC) origin in 13 cases. The identification of the t-FL clonotype in the previous FL sample and of the putative CPC sequence in both the FL/t-FL biopsies showed that the intraclonal diversity of FL and t-FL germinal centers (GCs) is more intricate than previously described, and all 3 clonotypes (CPC, FL, t-FL) may occur simultaneously within the same lymph node. On the basis of the father/son model, this CPC must be long-lived, providing a possible explanation for the incurable nature of this disease.


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