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Blood, Vol. 95 No. 2 (January 15), 2000:
pp. 619-626
Increased proteasome degradation of cyclin-dependent kinase
inhibitor p27 is associated with a decreased overall survival in
mantle cell lymphoma
Roberto Chiarle,
Leo M. Budel,
Jeffrey Skolnik,
Glauco Frizzera,
Marco Chilosi,
Alessandra Corato,
Gianni Pizzolo,
Jory Magidson,
Alessia Montagnoli,
Michele Pagano,
Brigitte Maes,
Christine De Wolf-Peeters, and
Giorgio Inghirami
From the Department of Pathology and the Kaplan Comprehensive Cancer
Center, New York University School of Medicine; the Institute of
Pathology, Erasmus University of Rotterdam, the Netherlands; the
Department of Pathological Anatomy and Histology and the Department of
Medicine, University of Verona, Italy, the Department of Pathology,
Morristown Memorial Hospital, NJ; and the Department of
Surgical Pathology, University of Leuven, Belgium.
Mantle cell lymphoma (MCL) is an aggressive neoplasm characterized
by the deregulated expression of cyclin D1 by t(11;14). The molecular
mechanisms responsible for MCL's clinical behavior remain unclear. The
authors have investigated the expression of p53, E2F-1, and the CDK
inhibitors p27 and p21 in 110 MCLs, relating their expression to
proliferative activity (Ki-67). For comparison, they have similarly
analyzed low-grade (12 MALT, 16 CLL/SLL) and high-grade (19 DLCL)
lymphomas. p53 was detected more frequently in large-cell MCL
(l-MCL; 5 of 7) than in classical MCL (s-MCL; 13 of 103) and DLCL (8 of
19). In MCL and DLCL, the percentage of E2F-1+ nuclei was high,
correlating with high Ki-67 expression. Most MCLs (91 of 112) and DLCLs
(12 of 19) showed a loss of p27; MALT and CLL/SLL, however, were p27
positive. Reverse transcription-polymerase chain reaction and in vitro
protein degradation assays demonstrated that MCLs have normal p27 mRNA
expression but increased p27 protein degradation activity via the
proteasome pathway. Correlation of MCL p53 and p27 expression with
clinical data showed an association between reduced overall survival
rates and the overexpression of p53 (P = .001), the loss of
p27 (P = .002), or both. Loss of p27 identified patients
with a worse clinical outcome among p53 negative cases
(P = .002). These findings demonstrated that MCL has a
distinct cell cycle protein expression similar to that of high-grade
lymphoma. The loss of p27 and the overexpression of p53 in MCL are
prognostic markers that identify patients at high risk. The
demonstration that low levels of p27 in MCL result from enhanced
proteasome-mediated degradation should encourage additional clinical
trials. (Blood. 2000;95:619-626)

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