Relationship between the mutational status of VH genes and pathogenesis of diffuse large XXXX in @entity6492 .

@entity1 @entity146 @entity5 @entity34242 @entity1072 @entity1892 @entity6492
@entity1 with @entity1072 ( @entity1072 ) may develop diffuse large @entity1892 (DLBL), also known as @entity6492 . Mutational status of @entity34242 (VH) genes have prognostic impact in @entity1072 . @entity1 with mutated VH genes have a stable disease, whereas @entity1 with unmutated VH gene have more @entity146 . The mutational status of CLLs that transform to DLBL is unknown. To reveal whether @entity6492 occurs in CLLs with mutated or unmutated VH genes, we have performed mutational analysis on serial specimens from eight @entity1 . @entity1072 and @entity1892 were identical in five cases and they were different in three cases. Six CLLs expressed unmutated and two cases expressed mutated VH genes. In five of the six unmutated CLLs, the DLBL clones evolved from @entity1072 and the VH genes expressed by DLBLs were also unmutated. In one unmutated and two mutated CLLs, the DLBLs expressed mutated VH genes, but in these three cases the @entity1892 developed as independent secondary @entity5 . These results suggest that @entity6492 may develop in both mutated or unmutated CLLs, but clonal transformation of @entity1072 to DLBL occur only in the unmutated subgroup of @entity1072 .
