CD5+ Diffuse Large B-Cell Lymphoma Consists of Germline Cases and Hypermutated Cases in the Immunoglobulin Heavy Chain Gene Variable Region

  • Naoya Nakamura
  • Shigeo Nakamura
  • Motoko Yamaguchi
  • Ryo Ichinohasama
  • Tadashi Yoshino
  • Tetsuo Kuze
  • Yoshikazu Sasaki
  • Sachiko Yoshida
  • Masafumi Abe


CD5+ diffuse large B-cell lymphoma (DLBCL) has recently been identified as a subgroup with different clinical characteristics from CD5- DLBCL and as having a poorer outcome than CD5- DLBCL. Data regarding differences in gene alteration between CD5+ and CD5- DLBCL have accumulated. In this article, we report an analysis of the immunoglobulin heavy-chain gene variable region (VH) gene in 35 cases of CD5+ DLBCL and compare these cases with those with the germline of the VH gene (GL-VH) and those with a somatically hypermutated VH gene (HM-VH).When the CD5+ DLBCL cases were subdivided with a cutoff value of 98% homology in the VH gene, there were 7 cases (20%) of GL-VH and 28 cases (80%) of HM-VH. The proportion of GL-VH cases in CD5+ DLBCL was more than that in CD5- DLBCL. Although we found no significant difference in pretreatment clinical parameters between the GL-VH and HM-VH subgroups, there was a tendency for the GL-VH subgroup to show lower incidences of elevation of lactate dehydrogenase and >1 site of extranodal involvement compared to the HM-VH subgroup. The overall survival curve of the HM-VH subgroup showed a rapid decline followed by a plateau, whereas that of the GL-VH subgroup declined constantly after 5 years, suggesting that GL-VH disease may not be curable by standard therapies. These findings suggest that CD5+ DLBCL with GL-VH shares clinical features with mantle cell lymphoma, the cellular origin of which has been considered to be pre-germinal center B-cells. We therefore propose that analysis of the VH gene is important for predicting the clinical course of CD5+ DLBCL.

Key words

Immunoglobulin heavy-chain gene PCR Germline Germinal center B-cells CD5 Diffuse large B-cell lymphoma 


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Copyright information

© The Japanese Society of Hematology 2005

Authors and Affiliations

  • Naoya Nakamura
    • 1
  • Shigeo Nakamura
    • 2
  • Motoko Yamaguchi
    • 3
  • Ryo Ichinohasama
    • 4
  • Tadashi Yoshino
    • 5
  • Tetsuo Kuze
    • 1
  • Yoshikazu Sasaki
    • 1
  • Sachiko Yoshida
    • 1
  • Masafumi Abe
    • 1
  1. 1.Department of PathologyFukushima Medical University School of MedicineFukushima
  2. 2.Department of Pathology and Molecular DiagnosticsAichi Cancer CenterNagoya
  3. 3.Second Department of Internal MedicineMie University School of MedicineTsu
  4. 4.Division of Oral PathologyTohoku University Graduate School of DentistrySendai
  5. 5.Department of PathologyOkayama University Graduate School of Medicine and DentistryOkayamaJapan

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