To characterise the nature of the cellular origin of the blastic variant of mantle cell lymphoma (MCL-BV), we analysed the immunoglobulin (Ig) heavy chain variable region (V(H)) genes in four cases of MCL-BV. The rearranged V(H)-D J(H) genes were PCR-amplified, cloned and sequenced. In one case, the comparison of the rearranged V(H) gene sequence to known germline V(H) gene templates showed no somatic mutations suggesting a pre-germinal centre B-cell origin for tumour cells. In the other three cases, the V(H) gene sequences showed varied number of point mutations relative to the putative germline V(H) gene sequences but the point mutations were not associated with intraclonal diversification. In one of the mutated cases, the distribution and type of the mutations indicated that tumour cells had been selected by an antigen. Since somatically mutated Ig genes are expressed by B-cells that have reached a germinal centre/post-germinal centre stage of development, these findings suggest that the MCL-BV cell of origin may also be a germinal centre or a post-germinal centre B-cell. Taken together, our findings suggest that the development of MCL-BC may not be restricted to one stage of B-cell differentiation and that they may represent transformants of B-cells at different stages of ontogeny.
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Article Synopsis
- - The study analyzed skin and blood/bone marrow samples from 17 patients with various cutaneous neoplasms, primarily focusing on cutaneous acute myeloid leukemia (c-AML) and different types of dendritic cell neoplasms.
- - A significant finding was that many c-AML patients had shared clonal mutations between their skin and bone marrow, with 70% also showing mutations like NPM1 and KMT2A rearrangements.
- - The results indicate that cutaneous and myeloid neoplasms share common genetic mutations, enhancing the understanding of the relationship between these skin manifestations and underlying blood disorders.
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