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

Blood. 2009 Apr 9;113(15):3553-7. doi: 10.1182/blood-2008-08-174839. Epub 2009 Feb 6.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bone Marrow Transplantation
  • Cell Transformation, Neoplastic / genetics*
  • Cell Transformation, Neoplastic / immunology
  • Clone Cells / immunology
  • Clone Cells / pathology
  • Germinal Center / pathology
  • Humans
  • Lymphoma, Follicular / genetics*
  • Lymphoma, Follicular / pathology*
  • Lymphoma, Follicular / therapy
  • Lymphoma, Large B-Cell, Diffuse / genetics*
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Male
  • Somatic Hypermutation, Immunoglobulin
  • Stem Cells / immunology
  • Stem Cells / pathology*