Frequent microsatellite instability in non-Hodgkin lymphomas irresponsive to chemotherapy

Leuk Res. 2008 Aug;32(8):1183-95. doi: 10.1016/j.leukres.2007.11.024. Epub 2008 Jan 4.

Abstract

Microsatellite instability (MSI) in haematopoietic malignancies has been controversial. Particularly in non-Hodgkin lymphoma, the data published to date lack unity. Using a unique fluorescent technique, we found MSI in eight (14%) tumours in a panel of 59 carefully selected non-Hodgkin lymphoma patients. Our fluorescent technique also reveals two qualitatively distinct modes of MSI, i.e. Type A and Type B. Based on our previous studies using DNA mismatch repair (MMR) gene-knock out animals, we have concluded that Type A MSI is a direct consequence of defective MMR. MSI observed in non-Hodgkin lymphomas was uniformly Type A, which implies that MMR deficiency occurs in this malignancy. Intriguingly, in non-Hodgkin lymphoma patients treated by CHOP/VEPA-based therapies, response to chemotherapy was significantly worse in those with microsatellite-unstable tumours (p=0.027). As a consequence, the patient outcomes at 1 year after treatment were significantly less favourable in this population (p=0.046), although the survival difference was not statistically confirmed in a longer term. These findings suggest that in some non-Hodgkin lymphomas MMR deficiency may lead to drug resistance in tumour cells and, consequently, to poor patient outcomes. In non-Hodgkin lymphoma, MSI may be a potential biomarker that predicts the tumour response against chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • DNA Mismatch Repair
  • Drug Resistance, Neoplasm / genetics*
  • Female
  • Fluorescence
  • Humans
  • Lymphoma, Non-Hodgkin / genetics
  • Male
  • Microsatellite Instability*
  • Middle Aged
  • MutS Homolog 2 Protein / genetics

Substances

  • MSH2 protein, human
  • MutS Homolog 2 Protein