What is Translocation t(14;18) in Follicular Lymphoma?

What is a translocation? 

A translocation is a genetic change in which a piece of one chromosome breaks off and attaches to another chromosome (see image below). Translocations are written in a special format to clearly describe which chromosomes are involved and the exact location on the chromosome that breaks. The translocation t(14;18)(q32;q21) involves chromosomes 14 and 18. The second set of parentheses indicates the precise location of the breakage within each chromosome. The "q" indicates the breakage occurs in the long arm of the chromosome. 
 

Translocations are identified in a study called karyotype, where chromosomes are isolated from a cell’s nucleus. Chromosomes are threads of compressed DNA that carry all the genetic information and transfer it from cell to cell.
 

Why is translocation t(14;18) relevant in follicular lymphoma? 

Follicular lymphoma is a slow-growing non-Hodgkin lymphoma that arises from B-lymphocytes. The chromosomal translocation t(14;18)(q32;q21) is characteristic of follicular lymphoma. Approximately 85% of patients with follicular lymphoma have the translocation t(14;18), which increases the activity of the BCL-2 protein and helps cancer cells survive.
 

Why does translocation t(14;18) matter in follicular lymphoma? 

The number of t(14;18)-positive cells in circulating blood is a marker of lymphoma status. High numbers can be detected at the time of diagnosis, and decreased numbers can indicate a good response to treatment. 

Additionally, slight increases during remission can predict relapse. Therefore, if t(14;18)-positive cells are detected, your doctor might consider restarting treatment. 
Further studies will better our understanding of how cancers develop and find potential applications for knowing which mutations are common, such as determining risk factors, early detection of cancer, and a tailored strategy for treatment options. 

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