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Prepublished online as a Blood First Edition Paper on September 11, 2003; DOI 10.1182/blood-2003-06-1901.
Submitted June 13, 2003
Accepted August 24, 2003
Prognostic significance of bcl-xL gene expression and apoptotic cell counts in follicular lymphoma
Wei-Li Zhao, Marjan Ertault Daneshpouy, Nicolas Mounier, Josette Briere, Christophe Leboeuf, Louis-Francois Plassa, Elisabeth Turpin, Jean-Michel Cayuela, Jean-Claude Ameisen, Christian Gisselbrecht, and Anne Janin*
Universite Paris VII, Hopital Saint-Louis, AP-HP, ERM-0220, Institut Universitaire d'Hematologie, Paris, France
Hopital Saint-Louis, AP-HP, Service de Biochimie B and CNRS UPR-9051, Paris, France
Hopital Saint-Louis, AP-HP, INSERM U462, Laboratoire d'Hematologie, Paris, France
Hopital Bichat-Claude-Bernard, EMI-U 9922 INSERM/Universite Paris VII, IFR 02, Paris, France
* Corresponding author; email: anne_janin{at}yahoo.com.
Bcl-xL, a member of the Bcl-2 family, exerts an anti-apoptotic effect on lymphocytes. To assess its clinical significance in follicular lymphoma patients, real-time quantitative RT-PCR analysis of bcl-xL gene expression was investigated in whole lymph node sections and laser microdissected lymphoma cells of 27 patients. Compared to 10 patients with reactive follicular hyperplasia, bcl-xL gene was overexpressed in follicular lymphoma patients with a higher level in microdissected lymphoma cells. Bcl-xL gene level correlated with the number of apoptotic lymphoma cells labeled by TUNEL assays (r=-0.7736). Clinically, high bcl-xL level was significantly associated with multiple extranodal involvement (P=0.0020), elevated lactate dehydrogenase level (P=0.0478), and high-risk international prognostic index (P=0.0235). Moreover, bcl-xL gene overexpression was linked to short overall survival (P=0.0129). The value of bcl-xL gene expression as a prognostic marker in follicular lymphoma should thus be considered.
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