Background: Close association between t(14;18) chromosomal translocation and
lymphomagenesis has been reported in patients with non-Hodgkin lymphoma(NHL). The
t(14;18) causes bcl-2 oncogene to be fused with joining segment of immunoglobulin
gene(JH). The purpose of this study was to investigate the prevalence of bcl-2/JH gene
rearrangement in lymphoproliferative diseases involving bone marrow and its difference
according to the subtypes of NHL.
Methods: Authors examined the bone marrows of 45 patients with advanced-stage
NHL, 6 patients with chronic lymphocytic leukemia(CLL), 1 patient with
angioimmunoblastic lymphadenopathy DNAs were extracted from the stored bone
marrow slides and paraffin-embedded bone marrow biopsy specimens. Nested
polymerase chain reaction(PCR) technique was used for the amplification of bcl-2/JH
fusion gene.
Results: Of 45 NHL patients, 9 showed bcl-2/JH rearrangement by one step PCR
technique. Three additional cases were detected only by using nested PCR technique.
Seven out of 12 PCR positive cases showed 230bp amplification product and the rest
showed various PCR product size from 230bp to 720bp. One case revealed double
amplification bands of 180bp and 430bp simultaneously. The incidence of bcl-2/JH
rearrangement according to NHL subtype was high in diffuse large cell
lymphoma(37.5%).
Conclusion: Bcl-2 translocation is present in 26.7% of NHL involving bone marrow.
Nested PCR technique can increase the detection rate of bcl-2/JH rearrangement,
especially for the cases of diffuse large cell lymphoma. For minimal residual disease
detection of NHL, the bcl-2/JH gene can be used as a molecular marker in t(14;18)
positive patients. Finally, further study on minor cluster region(MCR) and variant cluster
region(VCR) of t(14;18) is required to evaluate the exact incidence of bcl-2/JH gene rearrangement.

Keywords: Bcl-2 gene, Nested PCR, NHL, Bone marrow