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Blood, 1 May 2008, Vol. 111, No. 9, pp. 4764-4770.
Prepublished online as a Blood First Edition Paper on January 3, 2008; DOI 10.1182/blood-2007-10-115915.
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Submitted October 9, 2007
Accepted December 18, 2007
Clinical quantitation of immune signature in follicular lymphoma by RT-PCR based gene expression profiling
Richard J Byers*, Ebrahim Sakhinia, Preethi Joseph, Caroline Glennie, Judith A Hoyland, Lia P Menasce, John A Radford, and Timothy Illidge
School of Cancer Imaging Sciences, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
Molecular Diagnostic Centre, Manchester Royal Infirmary, Manchester, United Kingdom
Department of Histopathology, Manchester Royal Infirmary, Manchester, United Kingdom
Tissue Injury and Repair, School of Clinical and Laboratory Sciences, Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
Department of Histopathology, Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
* Corresponding author; email: r.byers{at}manchester.ac.uk.
Microarray gene expression profiling studies have demonstrated immune response gene signatures which appear predictive of outcome in follicular lymphoma (FL). However, measurement of these marker genes in routine practice remains difficult. We have therefore investigated the immune response in FL using real-time PCR to measure expression levels of 35 candidate Indicator genes, selected from microarray studies, to polyA cDNAs prepared from 60 archived human frozen lymph nodes, in parallel with immunohistochemical analysis for CD3, CD4, CD7, CD8, CD10, CD20, CD21 & CD68. High levels of CCR1, a marker of monocyte activation, were associated with a shorter survival interval, and high levels of CD3 with better survival, whilst immunohistochemistry demonstrated association of high numbers of CD68 positive macrophages with a shorter survival interval and of high numbers of CD7 positive T-cells with a longer survival interval. The results confirm the role of the host immune response in outcome in FL and identify CCR1 as a prognostic indicator and marker of an immune switch between macrophages and a T-cell dominant response. They demonstrate the utility of polyA DNA and real-time PCR for measurement of gene signatures and the applicability of using this type of "molecular block" in clinical practice.

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