[The prognostic value of IGHV gene segment usage in advanced-stage follicular lymphoma with bone marrow infiltration].

Objective

To investigate the prognostic value of immunoglobulin heavy chain variable region (IGHV) gene segment usage characteristics in high-risk follicular lymphoma (FL) patients with bone marrow infiltration.

Methods

The clinical data of 33 patients of FL with bone marrow infiltration diagnosed at Jiangsu Province Hospital from August 2017 to November 2024 were collected and retrospectively analyzed.

Results

Among the 33 enrolled FL patients, 32 (97.0% ) had mutated IGHV, with a median germline identity of 90.7%. The IGHV3 family was predominant (23 cases, 69.7% ), with IGHV3-48 (9 cases, 27.3% ), IGHV3-23 (4 cases, 12.1% ), and IGHV3-66 (4 cases, 12.1% ) as the most frequent segments. Consistent with prior reports, the frequency of IGHV3-48 usage in our cohort (27.3% ) was higher than that observed in other B-cell lymphomas, including chronic lymphocytic leukemia (3.8% ), splenic marginal zone lymphoma (0), and Waldenström macroglobulinemia (2.2% ) (all P value<0.05). Univariate analysis showed that FL patients using the IGHV3-48 gene exhibited higher lactate dehydrogenase levels (66.7% vs 13.6% ; OR=12.7, 95% CI: 1.6-102.3, P=0.017) and a higher proportion of FLIPI-2 score ≥3 (88.9% vs 33.3% ; OR=15.0, 95% CI: 1.6-142.2, P=0.018). Furthermore, patients using the IGHV3-48 gene segment also demonstrated a trend toward an increased risk of disease progression within 12 months (POD12) (44.4% vs 12.5% ; OR=4.8, 95% CI: 0.8-28.9, P=0.087) .

Conclusion

The usage of the IGHV3-48 gene may have certain reference value for early prognostic prediction in FL patients with bone marrow infiltration.