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Patients with FL who achieve a response after treatment eventually relapse. This is believed to be mainly attributable to the persistence of lymphoma cells at levels which were previously undetectable¹. In a study in 194 patients with FL, which used PCR to detect the presence of the t(14;18) bcl-2 translocation, 5-year survival in patients negative for t(14;18) bcl-2 lymphocytes (defined as a molecular response) at any follow up point was approximately 75%. The study showed that the most important adverse prognostic indicators were persistence of the t(14;18) bcl-2 translocation and elevated serum  2-microglobulin levels.

Between 35% and 70% of patients with diffuse large B-cell lymphoma (DLBCL) over-express the Bcl-2 protein³. In DLBCL, Bcl-2 protein overexpression (but not the t(14:18) translocation) is associated with inferior survival⁴. However, gene expression profiling studies have shown that DLBCL can be divided into distinct subtypes with different prognoses². Thus while Bcl-2 expression remains an important prognostic indicator, new biomarkers may attain more significance and therapies need to show efficacy in the different subtypes of the disease. 

References

1. Lopez-Guillermo A, et al. Blood. 1998;91(8):2955-60.
2. Rosenwald A, et al. N Engl J Med. 2002 Jun 20;346(25):1937-47.
3. Gascoyne RD, et al. Blood. 1997 Jul 1;90(1):244-51.
4. Gascoyne RD. Curr Opin Oncol. 2004 Sep;16(5):436-41.

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