Cytogenetic mechanisms in the pathogenesis and progression of follicular lymphoma.

A summary of the clinically significant cytogenetic markers in follicular lymphoma is presented in Table 3. It is clear that the use of cytogenetic analysis to evaluate progression and transformation in follicular lymphoma is complicated by the variety and complexity of the chromosomal aberrations present in this disease. Cytogenetic and molecular studies have indicated that the t(14;18) translocation is the prerequisite of a multistep process in the lymphomagenesis of follicular lymphoma; it is usually followed by a long quiescent period during which the B cell population expands and additional oncogenic mutations occur leading to eventual progression and transformation to a highly malignant form. This process can be accomplished by a variety of pathways: Activation of other oncogenes by additional chromosomal rearrangements (e.g. MYC, LAZ3) Deletion and mutation of tumour suppressive genes (e.g. TP53, proposed genes on 6q) Gain of whole or parts of chromosomes, leading to increased expression of important regulating factors (e.g. MDR and T cell receptor genes on chromosome 7) More studies are required to determine which of these pathways, if any, is most important for neoplastic transformation.