1221
Autoradiogram of a Southern hybridisation with DNA probe 27A after amplification of 222 bp Y specific fragment. 222 bp PCR product is indicated PCR products from no DNA; five controls (female DNA), 10-’ to 10-*’ dilutions of 1 fig female DNA with corresponding amounts of admixed male DNA, and one male DNA. false results, so it seems unlikely that such a small window would be reproducible in a larger series of cases because of the known variability of amplification efficiency, and prenatal diagnosis would be very problematic because of the likely variability of the concentration of fetal cells in the maternal circulation during pregnancy. We feel that so long as the risk of contamination of isolated genomic DNA cannot be completely excluded5,6PCR for prenatal sex determination from maternal blood will not be reliable.
Department of Obstetrics and Gynaecology and Institute of Human Genetics,
University of Münster, D-4400 Munster, West Germany and Institute of Human Genetics, University of Bonn
Our results indicate a changing pattern in the presentation of aggressive lymphomas, with an increasing frequency of some unfavourable prognostic factors-notably high LDH and bulky disease. These two variables, together with performance status,l,2 are thought to represent the best prognostic factors in aggressive non-Hodgkin lymphoma and are used in prognostic risk modelsl,3 and identification of different risk groups. The trend toward an increasing frequency of B symptoms and in number of extranodal sites of disease was not significant. The frequency of bone-marrow involvement in group II patients is not easily explained.
WOLFGANG HOLZGREVE DOROTHEE GÄNSHIRT-AHLERT MONIKA BURSCHYK JÜRGEN HORST PETER MINY ANDREAS GAL MARITA POHLSCHMIDT
% DISTRIBUTION OF PROGNOSTIC FACTORS
1 Lo
Y-MD, Patel P, Wamscoat JS, et al. Prenatal sex determination by DNA amplification from maternal peripheral blood. Lancet 1989; ii: 1363-65. 2. Ganshirt-Ahlert D, Pohlschmidt M, Gal A, Miny P, Horst J, Holzgreve W. Ratio of fetal to maternal DNA is less than 1 m 5000 at different gestational ages in maternal blood. Clin Genet (in press). 3. Nakahori Y, Mitani K, Yamada M, Nakagome Y. A human Y chromosome specific repeated DNA family (DYZI) consists of a tandem array of pentanucleotides. Nucl Acids Res 1986; 14: 7569-80. 4. Nakagome Y, Nagafuchi S, Nakahori Y. Prenatal sex determination. Lancet 1990; 335: 291. 5 Lo Y-M, Mehal WZ, Fleming KA. False-positive results and the polymerase chain reaction. Lancet 1988; ii: 679. 6. Kwok S, Higuchi R Avoiding false positives with PCR. Nature 1989; 339: 237-38.
Changing presentation in non-Hodgkin lymphoma SIR,-We have reviewed the pretreatment characteristics of 147 consecutive patients with aggressive non-Hodgkin lymphoma, observed at our institution from 1977 to 1989. The patients were divided into three groups according to time of diagnosis: 39 patients diagnosed between 1977 and 1981 (group I); 52 diagnosed between 1982 and 1985 (group II); and 56 diagnosed between 1986 and 1989 (group III). All patients were treated with current chemotherapy protocols, which included first-generation regimens (CHOP, BACOP) in 1977-84, an alternating programme (CAVBP/DEP) in 1984-1986, and second and third generation regimens (M-BACOD, MACOP-B, COP-BLAM III) from 1986 to 1989. The following pretreatment prognostic variables were recorded: age, stage B symptoms, bulky disease, lactate dehydrogenase (LDH) activity, haemoglobin, bone-marrow involvement, and extranodal sites of disease. Histological subtype was not taken into account because the classification system changed during the study period.’ Performance status was not considered either because of difficulty in assessment in earlier records, where such information was not specifically sought. Results of the analysis are shown in the table. There were significant trends in frequency for age below 40 LDH above 240 IU/1 (p
Autoradiogram of a Southern hybridisation with DNA probe 27A after amplification of 222 bp Y specific fragment. 222 bp PCR product is indicated PCR products from no DNA; five controls (female DNA), 10-’ to 10-*’ dilutions of 1 fig female DNA with corresponding amounts of admixed male DNA, and one male DNA. false results, so it seems unlikely that such a small window would be reproducible in a larger series of cases because of the known variability of amplification efficiency, and prenatal diagnosis would be very problematic because of the likely variability of the concentration of fetal cells in the maternal circulation during pregnancy. We feel that so long as the risk of contamination of isolated genomic DNA cannot be completely excluded5,6PCR for prenatal sex determination from maternal blood will not be reliable.
Department of Obstetrics and Gynaecology and Institute of Human Genetics,
University of Münster, D-4400 Munster, West Germany and Institute of Human Genetics, University of Bonn
Our results indicate a changing pattern in the presentation of aggressive lymphomas, with an increasing frequency of some unfavourable prognostic factors-notably high LDH and bulky disease. These two variables, together with performance status,l,2 are thought to represent the best prognostic factors in aggressive non-Hodgkin lymphoma and are used in prognostic risk modelsl,3 and identification of different risk groups. The trend toward an increasing frequency of B symptoms and in number of extranodal sites of disease was not significant. The frequency of bone-marrow involvement in group II patients is not easily explained.
WOLFGANG HOLZGREVE DOROTHEE GÄNSHIRT-AHLERT MONIKA BURSCHYK JÜRGEN HORST PETER MINY ANDREAS GAL MARITA POHLSCHMIDT
% DISTRIBUTION OF PROGNOSTIC FACTORS
1 Lo
Y-MD, Patel P, Wamscoat JS, et al. Prenatal sex determination by DNA amplification from maternal peripheral blood. Lancet 1989; ii: 1363-65. 2. Ganshirt-Ahlert D, Pohlschmidt M, Gal A, Miny P, Horst J, Holzgreve W. Ratio of fetal to maternal DNA is less than 1 m 5000 at different gestational ages in maternal blood. Clin Genet (in press). 3. Nakahori Y, Mitani K, Yamada M, Nakagome Y. A human Y chromosome specific repeated DNA family (DYZI) consists of a tandem array of pentanucleotides. Nucl Acids Res 1986; 14: 7569-80. 4. Nakagome Y, Nagafuchi S, Nakahori Y. Prenatal sex determination. Lancet 1990; 335: 291. 5 Lo Y-M, Mehal WZ, Fleming KA. False-positive results and the polymerase chain reaction. Lancet 1988; ii: 679. 6. Kwok S, Higuchi R Avoiding false positives with PCR. Nature 1989; 339: 237-38.
Changing presentation in non-Hodgkin lymphoma SIR,-We have reviewed the pretreatment characteristics of 147 consecutive patients with aggressive non-Hodgkin lymphoma, observed at our institution from 1977 to 1989. The patients were divided into three groups according to time of diagnosis: 39 patients diagnosed between 1977 and 1981 (group I); 52 diagnosed between 1982 and 1985 (group II); and 56 diagnosed between 1986 and 1989 (group III). All patients were treated with current chemotherapy protocols, which included first-generation regimens (CHOP, BACOP) in 1977-84, an alternating programme (CAVBP/DEP) in 1984-1986, and second and third generation regimens (M-BACOD, MACOP-B, COP-BLAM III) from 1986 to 1989. The following pretreatment prognostic variables were recorded: age, stage B symptoms, bulky disease, lactate dehydrogenase (LDH) activity, haemoglobin, bone-marrow involvement, and extranodal sites of disease. Histological subtype was not taken into account because the classification system changed during the study period.’ Performance status was not considered either because of difficulty in assessment in earlier records, where such information was not specifically sought. Results of the analysis are shown in the table. There were significant trends in frequency for age below 40 LDH above 240 IU/1 (p
