Clinical and biological features of B-cell neoplasms with CDK6 translocations: an association with a subgroup of splenic marginal zone lymphomas displaying frequent CD5 expression, prolymphocytic cells, and TP53 abnormalities

Br J Haematol. 2021 Apr;193(1):72-82. doi: 10.1111/bjh.17141. Epub 2020 Dec 13.

Abstract

A translocation involving the cyclin-dependent kinase 6 (CDK6) gene [t(CDK6)] is a rare but recurrent abnormality in B-cell neoplasms. To further characterise this aberration, we studied 57 cases; the largest series reported to date. Fluorescence in situ hybridisation analysis confirmed the involvement of CDK6 in all cases, including t(2;7)(p11;q21) immunoglobulin kappa locus (IGK)/CDK6 (n = 51), t(7;14)(q21;q32) CDK6/immunoglobulin heavy locus (IGH) (n = 2) and the previously undescribed t(7;14)(q21;q11) CDK6/T-cell receptor alpha locus (TRA)/T-cell receptor delta locus (TRD) (n = 4). In total, 10 patients were diagnosed with chronic lymphocytic leukaemia, monoclonal B-cell lymphocytosis or small lymphocytic lymphoma, and 47 had small B-cell lymphoma (SmBL) including 36 cases of marginal zone lymphoma (MZL; 34 splenic MZLs, one nodal MZL and one bronchus-associated lymphoid tissue lymphoma). In all, 18 of the 26 cytologically reviewed cases of MZL (69%) had an atypical aspect with prolymphocytic cells. Among the 47 patients with MZL/SmBL, CD5 expression was found in 26 (55%) and the tumour protein p53 (TP53) deletion in 22 (47%). The TP53 gene was mutated in 10/30 (33%); the 7q deletion was detected in only one case, and no Notch receptor 2 (NOTCH2) mutations were found. Immunoglobulin heavy-chain variable-region (IGHV) locus sequencing revealed that none harboured an IGHV1-02*04 gene. Overall survival was 82% at 10 years and not influenced by TP53 aberration. Our present findings suggest that most t(CDK6)+ neoplasms correspond to a particular subgroup of indolent marginal zone B-cell lymphomas with distinctive features.

Keywords: CD5; CDK6; TP53; marginal zone lymphoma; prolymphocytic cell.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchial Neoplasms / diagnosis
  • Bronchial Neoplasms / metabolism
  • CD5 Antigens / metabolism*
  • Cell Differentiation
  • Chromosome Aberrations
  • Cyclin-Dependent Kinase 6 / metabolism*
  • Female
  • Genes, p53 / genetics
  • Humans
  • Immunoglobulin Heavy Chains / metabolism
  • In Situ Hybridization, Fluorescence / methods
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism*
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, B-Cell, Marginal Zone / drug therapy
  • Lymphoma, B-Cell, Marginal Zone / metabolism*
  • Male
  • Middle Aged
  • Mutation
  • Phenotype
  • Splenic Neoplasms / pathology*
  • Survival Analysis
  • Tertiary Lymphoid Structures / pathology
  • Translocation, Genetic / genetics
  • Trisomy / genetics
  • Tumor Suppressor Protein p53 / metabolism*

Substances

  • CD5 Antigens
  • Immunoglobulin Heavy Chains
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Cyclin-Dependent Kinase 6