Gene Array Distinguishes Burkitt's Lymphoma

Gene-array techniques are being used to define genetic patterns of Burkitt's lymphoma. They show the molecular pattern more precisely than current diagnostic approaches and can be used to distinguish Burkitt's lymphoma from diffuse large-B-cell lymphoma.

Burkitt's lymphoma is a rare aggressive B-cell lymphoma that is characterized by a high degree of proliferation of the malignant cells and deregulation of the c-myc gene. Treatments of the different lymphomas differ dramatically and therefore distinguishing between them is crucial. The diagnosis of Burkitt's lymphoma currently relies on the morphology of tumor cells, immunophenotyping, and cytogenic features such as deregulation of the c-myc gene. The difficulty is that there is overlap in all these tests between both types of lymphoma.

Two studies, both reported in the June 8, 2006, New York Journal of Medicine, were successful in distinguishing between Burkitt's lymphoma and large-B-cell lymphoma.
Sandeep Dave, M.D., of the U.S. National Cancer Institute (USA), and colleagues studied tumor biopsy specimens from 71 patients diagnosed with Burkitt's lymphoma between 1986 and 2004, as well as 232 specimens from patients diagnosed with diffuse-B-cell lymphoma. The specimens were reviewed by a panel of expert hematopathologists who found that of the 71 Burkitt's specimens 45 were in fact Burkitt's or atypical Burkitt's. These 45 cases were used to develop a diagnostic test for Burkitt's based on gene expression.

Michael Hummel, Ph.D., of the Charité Hospital of the University of Berlin (Berlin, Germany), using slightly different gene-array techniques, found a "distinctive” molecular signature for Burkitt's consisting of 58 genes, including several targets of the nuclear factor-kappa B pathway.

The microarray method seemed to outperform expert pathologies. The suggestion is that a large number of patients were intensively treated for Burkitt's lymphoma when they really had diffuse large-cell-lymphoma.



Related Links:
National Cancer Institute
Charité Hospital of the University of Berlin