Sandeep S. Dave, National Institutes of Health, Bethesda, MD
Kai Fu, University of Nebraska Medical CenterFollow
George W. Wright, National Institutes of Health, Bethesda, MD
Lloyd T. Lam, National Institutes of Health, Bethesda, MD
Philip Kluin, University of Groningen
Evert-Jan Boerma, University of Groningen
Timothy Greiner, University of Nebraska Medical CenterFollow
Dennis D. Weisenburger, University of Nebraska Medical Center
Andreas Rosenwald, University of Würzburg
German Ott, University of Würzburg
Hans-Konrad Müller-Hermelink, University of Würzburg
Randy D. Gascoyne, British Columbia Cancer Agency
Jan Delabie, Norway Hospital Clinic
Lisa M. Rimsza, Southwest Oncology Group
Rita M. Braziel, Southwest Oncology Group
Thomas M. Grogan, Southwest Oncology Group
Elias Campo, University of Barcelona
Elaine S. Jaffe, National Institutes of Health, Bethesda, MD
Bhavana J. Dave, University of Nebraska Medical CenterFollow
Warren Sanger, University of Nebraska Medical Center
M Bast, University of Nebraska Medical CenterFollow
Julie M. Vose, University of Nebraska Medical CenterFollow
James O. Armitage, University of Nebraska Medical CenterFollow
Joseph M. Connors, British Columbia Cancer Agency
Erlend B. Smeland, Norway Hospital Clinic
Stein Kvaloy, Norway Hospital Clinic
Harald Holte, Norway Hospital Clinic
Richard I. Fisher, Southwest Oncology Group
Thomas P. Miller, Southwest Oncology Group
Emilio Montserrat, University of Barcelona
Wyndham H. Wilson, National Institutes of Health, Bethesda, MD
Manisha Bahl, National Institutes of Health, Bethesda, MD
Hong Zhao, National Institutes of Health, Bethesda, MD
Liming Yang, National Institutes of Health, Bethesda, MD
John Powell, National Institutes of Health, Bethesda, MD
Richard Simon, National Institutes of Health, Bethesda, MD
Wing C. Chan, University of Nebraska Medical Center
Louis M. Staudt, National Institutes of Health, Bethesda, MD

Document Type

Article

Journal Title

The New England journal of medicine

Publication Date

Summer 6-8-2006

Volume

354

Abstract

BACKGROUND: The distinction between Burkitt's lymphoma and diffuse large-B-cell lymphoma is crucial because these two types of lymphoma require different treatments. We examined whether gene-expression profiling could reliably distinguish Burkitt's lymphoma from diffuse large-B-cell lymphoma.

METHODS: Tumor-biopsy specimens from 303 patients with aggressive lymphomas were profiled for gene expression and were also classified according to morphology, immunohistochemistry, and detection of the t(8;14) c-myc translocation.

RESULTS: A classifier based on gene expression correctly identified all 25 pathologically verified cases of classic Burkitt's lymphoma. Burkitt's lymphoma was readily distinguished from diffuse large-B-cell lymphoma by the high level of expression of c-myc target genes, the expression of a subgroup of germinal-center B-cell genes, and the low level of expression of major-histocompatibility-complex class I genes and nuclear factor-kappaB target genes. Eight specimens with a pathological diagnosis of diffuse large-B-cell lymphoma had the typical gene-expression profile of Burkitt's lymphoma, suggesting they represent cases of Burkitt's lymphoma that are difficult to diagnose by current methods. Among 28 of the patients with a molecular diagnosis of Burkitt's lymphoma, the overall survival was superior among those who had received intensive chemotherapy regimens instead of lower-dose regimens.

CONCLUSIONS: Gene-expression profiling is an accurate, quantitative method for distinguishing Burkitt's lymphoma from diffuse large-B-cell lymphoma.

MeSH Headings

Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bayes Theorem, Burkitt Lymphoma, Child, Child, Preschool, Diagnosis, Differential, Female, Follow-Up Studies, Gene Expression, Gene Expression Profiling, Genes, MHC Class I, Genes, myc, Humans, In Situ Hybridization, Fluorescence, Lymphoma, B-Cell, Male, Middle Aged, NF-kappa B, Oligonucleotide Array Sequence Analysis, Survival Analysis, Transcription, Genetic, Translocation, Genetic

ISSN

1533-4406

Rights

From the New England Journal of Medicine, Dave SS, Fu K, Wright GW, et al., Molecular diagnosis of Burkitt's lymphoma, 354, 2431-2442 . Copyright © (2006) Massachusetts Medical Society. Reprinted with permission.

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