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Amanda M, Daniela C, Fernando G, Silvia M, Sofia L, Márcia D, Francisco A, Jeane V, Cármino DS. Association of KIR genes polymorphism and its HLA ligands in Diffuse Large B-cell Lymphoma. CLINICAL LYMPHOMA MYELOMA AND LEUKEMIA 2023; 23:438-445. [PMID: 37105848 DOI: 10.1016/j.clml.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/18/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Non-Hodgkin lymphoma (NHL) is a heterogeneous disease, with each subtype associated with different risk factors. Within this group, diffuse large B-cell lymphoma (DLBCL) can be highlighted, the most common type of NHL.NK cells are key components of the innate immune response and may play an important antitumor role. OBJECTIVE The objective of the present work was to determine the polymorphism of KIR genes in Brazilian patients with DLBCL. MATERIALS AND METHODS Furthermore, we evaluated the association between the polymorphism of these genes and their ligands with the clinical course of the disease. For the study, 112 patients with DLBCL and 222 voluntary blood and bone marrow donors. The genetic material of these samples were extracted for KIR and HLA typing, determination of HLA ligands, determination of the KIR haplotype and search for the deletion of 22 bp in the KIR2DS4 gene. KIR genotype distributions were made by direct counting using 2 × 2 contingency tables using Fisher's exact test. The magnitude of the association was measured by odds ratio (OR) and 95% confidence interval. P values <.05 were considered significant. Overall survival and progression-free survival were assessed with a Kaplan-Meier estimator. RESULTS In the present study, an association of HLA-Bw4 and HLA-Bw480I ligand was found with more advanced stages of the disease. Also, an association of the KIR2DL3 gene with a better response to treatment was found. CONCLUSION With this, we can conclude that the polymorphism of KIR genes and the association with HLA ligands can influence the prognosis of DLBCL, as well as the response to treatment was found. With this, we can conclude that the polymorphism of KIR genes and the association with HLA ligands can influence the prognosis of DLBCL, as well as the response to treatment.Non-Hodgkin lymphoma (NHL) is a heterogeneous disease, with each subtype associated with different risk factors. Within this group, diffuse large B-cell lymphoma (DLBCL) can be highlighted, the most common type of NHL.NK cells are key components of the innate immune response and may play an important antitumor role. The objective of the present work was to determine the polymorphism of KIR genes in Brazilian patients with DLBCL. Furthermore, we evaluated the association between the polymorphism of these genes and their ligands with the clinical course of the disease. For the study, 112 patients with DLBCL and 222 voluntary blood and bone marrow donors. The genetic material of these samples were extracted for KIR and HLA typing, determination of HLA ligands, determination of the KIR haplotype and search for the deletion of 22 bp in the KIR2DS4 gene. KIR genotype distributions were made by direct counting using 2 × 2 contingency tables using Fisher's exact test. The magnitude of the association was measured by odds ratio (OR) and 95% confidence interval. P values <.05 were considered significant. Overall survival and progression-free survival were assessed with a Kaplan-Meier estimator. In the present study, an association of HLA-Bw4 and HLA-Bw480I ligand was found with more advanced stages of the disease. Also, an association of the KIR2DL3 gene with a better response to treatment was found. With this, we can conclude that the polymorphism of KIR genes and the association with HLA ligands can influence the prognosis of DLBCL, as well as the response to treatment was found. With this, we can conclude that the polymorphism of KIR genes and the association with HLA ligands can influence the prognosis of DLBCL, as well as the response to treatment.
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Mihalcea D, Memis H, Balinisteanu A, Vladareanu AM, Mihaila S, Vinereanu D. Myocardial work-A new tool for early detection of rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone chemotherapy induced-cardiotoxicity in hematological patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:377-384. [PMID: 36331055 DOI: 10.1002/jcu.23388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (RCHOP) chemotherapy in non-Hodgkin's lymphoma (NHL) has risk of cardiotoxicity. PURPOSE To determine the role of myocardial work and biomarkers in subclinical diagnosis and prediction of cardiotoxicity. METHODS The 130 NHL patients (52 ± 9 years, 62% men) scheduled for RCHOP, with LVEF>50%, were evaluated at baseline, after third cycle and chemotherapy completion for 3D LVEF, 2D myocardial deformation (longitudinal, radial, circumferential strain - LS, RS, CS) and myocardial work (global constructive work, waste work, work index and work efficiency - GCW, GWW, GWI, GWE). NT-pro-BNP and troponin I were determined. RESULTS After chemotherapy ended, 37 patients (28%) (group I) developed asymptomatic cardiotoxicity (8 mild form, 25 moderate form, 4 severe form); 93 patients (group II) did not. After third cycle, all patients had decreased LS, CS, RS, GCW, GWI, GWE and increased GWW, persistent after chemotherapy completion, with significant changes in group I. After third cycle, GWE and GCW were the best independent predictors for LVEF reduction; GWE decrease with>5% after third cycle predicted cardiotoxicity after chemotherapy completed (91% sensitivity, 94% specificity). CONCLUSIONS In NHL, myocardial work can diagnose subclinical cardiotoxicity and predict LVEF decline. These parameters should be used for sensitive evaluation of myocardial function during chemotherapy.
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Affiliation(s)
- Diana Mihalcea
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
| | - Hayat Memis
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
| | - Anca Balinisteanu
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
| | - Ana-Maria Vladareanu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
| | - Sorina Mihaila
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
| | - Dragos Vinereanu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- Cardiology Department, University and Emergency Hospital, Bucharest, Romania
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Parsons MW, Rock C, Chipman JJ, Shah HR, Hu B, Stephens DM, Tao R, Tward JD, Gaffney DK. Secondary malignancies in non-Hodgkin lymphoma survivors: 40 years of follow-up assessed by treatment modality. Cancer Med 2023; 12:2624-2636. [PMID: 36812123 PMCID: PMC9939160 DOI: 10.1002/cam4.5139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/02/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Survivors of non-Hodgkin lymphoma (NHL) have increased secondary malignancy (SM) risk. We quantified this risk by patient and treatment factors. METHODS Standardized incidence ratios (SIR, observed-to-expected [O/E] ratio) were assessed in 142,637 NHL patients diagnosed from 1975 to 2016 in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Comparisons were made between subgroups in terms of their SIRs relative to respective endemic populations. RESULTS In total, 15,979 patients developed SM, more than the endemic rate (O/E 1.29; p < 0.05). Compared with white patients, relative to respective endemic populations, ethnic minorities had a higher risk of SM (white O/E 1.27, 95% CI 1.25-1.29; black O/E 1.40, 95% CI 1.31-1.48; other O/E 1.59, 95% CI 1.49-1.70). Relative to respective endemic populations, patients who received radiotherapy had similar SM rates to those who did not (O/E 1.29 each), but irradiated patients had increased breast cancer (p < 0.05). Patients who received chemotherapy had higher SM rates than those who did not (O/E 1.33 vs. 1.24, p < 0.05) including more leukemia, Kaposi sarcoma, kidney, pancreas, rectal, head and neck, and colon cancers (p < 0.05). CONCLUSIONS This is the largest study to examine SM risk in NHL patients with the longest follow-up. Treatment with radiotherapy did not increase overall SM risk, while chemotherapy was associated with a higher overall risk. However, certain subsites were associated with a higher risk of SM, and they varied by treatment, age group, race and time since treatment. These findings are helpful for informing screening and long-term follow-up in NHL survivors.
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Affiliation(s)
- Matthew W. Parsons
- Department of Radiation OncologyHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Calvin Rock
- Department of Radiation OncologyHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Jonathan J. Chipman
- Cancer BiostatisticsHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
- Division of Biostatistics, Department of Population Health SciencesUniversity of UtahSalt Lake CityUtahUSA
| | - Harsh R. Shah
- Division of Hematology/Hematologic MalignanciesHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Boyu Hu
- Division of Hematology/Hematologic MalignanciesHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Deborah M. Stephens
- Division of Hematology/Hematologic MalignanciesHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Randa Tao
- Department of Radiation OncologyHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - Jonathan D. Tward
- Department of Radiation OncologyHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
| | - David K. Gaffney
- Department of Radiation OncologyHuntsman Cancer Institute, University of UtahSalt Lake CityUtahUSA
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Fedrigo R, Segars WP, Martineau P, Gowdy C, Bloise I, Uribe CF, Rahmim A. Development of scalable lymphatic system in the 4D XCAT phantom: Application to quantitative evaluation of lymphoma PET segmentations. Med Phys 2022; 49:6871-6884. [PMID: 36053829 PMCID: PMC9742182 DOI: 10.1002/mp.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Digital anthropomorphic phantoms, such as the 4D extended cardiac-torso (XCAT) phantom, are actively used to develop, optimize, and evaluate a variety of imaging applications, allowing for realistic patient modeling and knowledge of ground truth. The XCAT phantom defines the activity and attenuation for a simulated patient, which includes a complete set of organs, muscle, bone, and soft tissue, while also accounting for cardiac and respiratory motion. However, the XCAT phantom does not currently include the lymphatic system, critical for evaluating medical imaging tasks such as sentinel node detection, node density measurement, and radiation dosimetry. PURPOSE In this study, we aimed to develop a scalable lymphatic system in the XCAT phantom, to facilitate improved research of the lymphatic system in medical imaging. Using this scalable lymphatic system, we modeled the lymph node conglomerate pathology that is characteristically observed in primary mediastinal B-cell lymphoma (PMBCL). As an extended application, we evaluated positron emission tomography (PET) image quantification of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of these simulated lymphomas, though the phantoms may be applied to other imaging modalities and study design paradigms (e.g., image quality, detection). METHODS A template model for the lymphatic system was developed based on anatomical data from the Visible Human Project of the National Library of Medicine. The segmented nodes and vessels were fit with non-uniform rational basis spline surfaces, and multichannel large deformation diffeomorphic metric mapping was used to propagate the template to different XCAT anatomies. To model conglomerates observed in PMBCL, lymph nodes were enlarged, converged within the mediastinum, and tracer concentration was increased. We used the phantoms as inputs to a PET simulation tool, which generated images using ordered subsets expectation maximization reconstruction with 2-8 mm Gaussian filters. Fixed thresholding (FT) and gradient segmentation were used to determine MTV and TLG. Percent bias (%Bias) and coefficient of variation (COV) were computed as measures of accuracy and precision, respectively, for each MTV and TLG measurement. RESULTS Using the methodology described above, we introduced a scalable lymphatic system in the XCAT phantom, which allows for the radioactivity and attenuation ground truth to be generated in 116 ± 2.5 s using a 2.3 GHz processor. Within the Rhinoceros interface, lymph node anatomy and function were modified to create a cohort of 10 phantoms with lymph node conglomerates. Using the lymphoma phantoms to evaluate PET quantification of MTV, mean %Bias values were -9.3%, -41.3%, and 20.9%, while COV values were 4.08%, 7.6%, and 3.4% using 25% FT, 40% FT, and gradient segmentations, respectively. Comparatively for TLG, mean %Bias values were -27.4%, -45.8%, and -16.0%, while COV values were 1.9%, 5.7%, and 1.4%, for the 25% FT, 40% FT, and gradient segmentations, respectively. CONCLUSIONS In this work, we upgraded the XCAT phantom to include a lymphatic system, comprised of a network of 276 scalable lymph nodes and corresponding vessels. As an application, we created a cohort of phantoms with lymph node conglomerates to evaluate lymphoma quantification in PET imaging, which highlights an important application of this work.
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Affiliation(s)
- Roberto Fedrigo
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | | | | | - Claire Gowdy
- Department of Radiology, BC Children’s Hospital, Vancouver, BC V6H 0B3, Canada
| | - Ingrid Bloise
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
| | - Carlos F. Uribe
- Functional Imaging, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Arman Rahmim
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 2B5, Canada
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Viral Agents as Potential Drivers of Diffuse Large B-Cell Lymphoma Tumorigenesis. Viruses 2022; 14:v14102105. [DOI: 10.3390/v14102105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Among numerous causative agents recognized as oncogenic drivers, 13% of total cancer cases occur as a result of viral infections. The intricacy and diversity of carcinogenic processes, however, raise significant concerns about the mechanistic function of viruses in cancer. All tumor-associated viruses have been shown to encode viral oncogenes with a potential for cell transformation and the development of malignancies, including diffuse large B-cell lymphoma (DLBCL). Given the difficulties in identifying single mechanistic explanations, it is necessary to combine ideas from systems biology and viral evolution to comprehend the processes driving viral cancer. The potential for more efficient and acceptable therapies lies in targeted medicines that aim at viral proteins or trigger immune responses to either avoid infection or eliminate infected or cancerous cells. In this review, we aim to describe the role of viral infections and their mechanistic approaches in DLBCL tumorigenesis. To the best of our knowledge, this is the first review summarizing the oncogenic potential of numerous viral agents in DLBCL development.
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Song C, Feng Y, Ge F, Zhang Z, Su B. Rituximab combined with GDP regimen can effectively improve the efficacy and immune function of non-Hodgkin lymphoma. Am J Transl Res 2022; 14:6313-6322. [PMID: 36247246 PMCID: PMC9556455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the efficacy of rituximab combined with GDP regimen (gemcitabine + cisplatin + dexamethasone) in the treatment of non-Hodgkin lymphoma and its impact on the immune function of patients. METHODS Clinical data of 88 patients with non-Hodgkin lymphoma (NHL) treated in Affiliated Hospital of Yan'an University from February 2017 to February 2019 were analyzed retrospectively. Among them, 40 patients treated with the second-line regimen (gemcitabine + cisplatin + dexamethasone) were served as the control group, and 48 patients received additional rituximab were as the observation group. The therapeutic effect, incidence of adverse reactions, levels of complement (C3, C4) and immunoglobulin [immunoglobulin (Ig) G, IgM, IgA] before and after treatment were compared between the two groups. Cox regression analysis was used to analyze the prognostic factors of patients. RESULTS The total response rate of patients in observation group was higher than that in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions (hair loss, nausea and vomiting, thrombocytopenia, anemia and bone marrow suppression) between the two groups (P>0.05). After treatment, the levels of C3 and C4 in both groups were lower than those before treatment, and the decrease in observation group were more evident than that in control group (P<0.05). No notable fluctuation was observed in the levels of IgG, IgM and IgA in both groups between before and after treatment (P>0.05). Cox regression analysis found that Ann Arbor stage and pretreatment disease status were the factors affecting the prognosis of patients. CONCLUSION Rituximab combined with GDP regimen has a significant effect on the treatment of non-Hodgkin lymphoma, and Ann Arbor stage and pretreatment disease state are prognostic factors for patients with NHL.
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Affiliation(s)
- Chao Song
- Hematology Department, Affiliated Hospital of Yan’an UniversityNo. 43 Zhongxin Street, Baota District, Yan’an 716000, Shaanxi Province, China
| | - Yanli Feng
- Hematology Department, Affiliated Hospital of Yan’an UniversityNo. 43 Zhongxin Street, Baota District, Yan’an 716000, Shaanxi Province, China
| | - Fanmei Ge
- Hematology Department, Affiliated Hospital of Yan’an UniversityNo. 43 Zhongxin Street, Baota District, Yan’an 716000, Shaanxi Province, China
| | - Zhiyun Zhang
- Hematology Department, Second Affiliated Hospital of Shaanxi University of Traditional Chinese MedicineNo. 5 Weiyang West Road, Qindu District, Xianyang 712000, Shaanxi Province, China
| | - Baoxiong Su
- Hematology Department, Affiliated Hospital of Yan’an UniversityNo. 43 Zhongxin Street, Baota District, Yan’an 716000, Shaanxi Province, China
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Ghosh K, Ghosh K. Monoclonal antibodies used for the management of haematological disorders. Expert Rev Hematol 2022; 15:443-455. [PMID: 35504000 DOI: 10.1080/17474086.2022.2073213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Monoclonal antibodies Ab (MoAb) are increasingly becoming part of therapeutic armamentarium for haematologists and haemato-oncologists. This review brings together commonly used antibodies in one place for brevity and novel understanding. AREAS COVERED Pubmed and Scopus databases were explored focusing on MoAb in clinical haematological practice. Emphasis was given to current review articles. The data base was searched from 1997 till present. 24 different antibodies, most of which are in use were discussed. Antibodies are used for diverse conditions i.e. malignant and benign haematological conditions, treatment at various phases of stem cell transplantation. These antibodies were used both alone or in combination with various chemotherapy, targeted small molecules or as immunoconjugates. Some of the side effect profiles of these antibodies were common and some were unique. Unusual infections or organ dysfunctions were noted. Improved function of antibodies by protein engineering is also advancing rapidly. Dosage, frequency and route of administration depended on the convenience and condition for which the antibody is used. EXPERT OPINION : MoAbs are increasingly used in haematology practice either alone or in combination with other types of therapy for improved out come in various haematological conditions.
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Affiliation(s)
- Kanjaksha Ghosh
- National Institute of Immunohaematology. 13th fl. KEM Hospital MS Building, Parel, Mumbai 400012. India
| | - Kinjalka Ghosh
- Department of Clinical Biochemistry , Tata Memorial Hospital. & Homi Bhaba National Institute. Parel, Mumbai 400012.India
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Zhang XD, Fu XR, Sun ZC, Zhang L, Li X, Li L, Wu JJ, Wang XH, Nan FF, Chang Y, Yu H, Li ZM, Zhang MZ. [Clinical observation of CD19-TANK cells in the treatment of relapsed/refractory B-cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:153-156. [PMID: 35381678 PMCID: PMC8980653 DOI: 10.3760/cma.j.issn.0253-2727.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Indexed: 11/05/2022]
Affiliation(s)
- X D Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - X R Fu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Z C Sun
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - L Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - X Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - L Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - J J Wu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - X H Wang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - F F Nan
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Y Chang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - H Yu
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Z M Li
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - M Z Zhang
- Department of Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
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Schönefeldt S, Wais T, Herling M, Mustjoki S, Bekiaris V, Moriggl R, Neubauer HA. The Diverse Roles of γδ T Cells in Cancer: From Rapid Immunity to Aggressive Lymphoma. Cancers (Basel) 2021; 13:6212. [PMID: 34944832 PMCID: PMC8699114 DOI: 10.3390/cancers13246212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/13/2022] Open
Abstract
γδ T cells are unique players in shaping immune responses, lying at the intersection between innate and adaptive immunity. Unlike conventional αβ T cells, γδ T cells largely populate non-lymphoid peripheral tissues, demonstrating tissue specificity, and they respond to ligands in an MHC-independent manner. γδ T cells display rapid activation and effector functions, with a capacity for cytotoxic anti-tumour responses and production of inflammatory cytokines such as IFN-γ or IL-17. Their rapid cytotoxic nature makes them attractive cells for use in anti-cancer immunotherapies. However, upon transformation, γδ T cells can give rise to highly aggressive lymphomas. These rare malignancies often display poor patient survival, and no curative therapies exist. In this review, we discuss the diverse roles of γδ T cells in immune surveillance and response, with a particular focus on cancer immunity. We summarise the intriguing dichotomy between pro- and anti-tumour functions of γδ T cells in solid and haematological cancers, highlighting the key subsets involved. Finally, we discuss potential drivers of γδ T-cell transformation, summarising the main γδ T-cell lymphoma/leukaemia entities, their clinical features, recent advances in mapping their molecular and genomic landscapes, current treatment strategies and potential future targeting options.
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Affiliation(s)
- Susann Schönefeldt
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (S.S.); (T.W.); (R.M.)
| | - Tamara Wais
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (S.S.); (T.W.); (R.M.)
| | - Marco Herling
- Department of Hematology, Cellular Therapy and Hemostaseology, University of Leipzig, 04103 Leipzig, Germany;
| | - Satu Mustjoki
- Hematology Research Unit Helsinki, Helsinki University Hospital Comprehensive Cancer Center, 00290 Helsinki, Finland;
- iCAN Digital Precision Cancer Medicine Flagship, 00014 Helsinki, Finland
- Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, 00014 Helsinki, Finland
| | - Vasileios Bekiaris
- Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark;
| | - Richard Moriggl
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (S.S.); (T.W.); (R.M.)
| | - Heidi A. Neubauer
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (S.S.); (T.W.); (R.M.)
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Lopez-Santillan M, Lopez-Lopez E, Alvarez-Gonzalez P, Martinez G, Arzuaga-Mendez J, Ruiz-Diaz I, Guerra-Merino I, Gutierrez-Camino A, Martin-Guerrero I. Prognostic and therapeutic value of somatic mutations in diffuse large B-cell lymphoma: A systematic review. Crit Rev Oncol Hematol 2021; 165:103430. [PMID: 34339834 DOI: 10.1016/j.critrevonc.2021.103430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/05/2021] [Accepted: 07/25/2021] [Indexed: 12/17/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL), the most common type of Non-Hodgkin lymphoma (NHL), is a highly heterogeneous and aggressive disease. Regardless of this heterogeneity, all patients receive the same first-line therapy, which fails in 30-40 % of patients, who are either refractory or relapse after remission. With the aim of stratifying patients to improve treatment outcome, different clinical and genetic biomarkers have been studied. The present systematic review aimed to identify somatic mutations that could serve as prognosis biomarkers or as therapeutic target mutations in DLBCL. Regarding their role as prognostic markers, mutations in CD58 and TP53 seem the most promising predictors of poor outcome although the combination of different alterations and other prognostic factors could be a more powerful strategy. On the other hand, different approaches regarding targeted therapy have been proposed. Therefore, mutational analysis could help guide treatment choice in DLBCL yet further studies and clinical trials are needed.
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Affiliation(s)
- Maria Lopez-Santillan
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain; Medical Oncology Service, Basurto University Hospital, Avenida De Montevideo, 18, 48013, Bilbao, Spain
| | - Elixabet Lopez-Lopez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain; Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Spain
| | - Paula Alvarez-Gonzalez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain
| | - Garazi Martinez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain
| | - Javier Arzuaga-Mendez
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain; Hematologic Neoplasm Group, Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, Barakaldo, Spain
| | - Irune Ruiz-Diaz
- Pathology Department, Donostia University Hospital, Paseo Doctor Begiristain, 109, 20014, San Sebastián, Spain
| | - Isabel Guerra-Merino
- Pathology Department, Araba University Hospital, Calle Jose Atxotegi s/n, 01009, Vitoria-Gasteiz, Spain
| | - Angela Gutierrez-Camino
- Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain; Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Spain; Division of Hematology-Oncology, CHU Sainte-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, H3T 1C5, Montreal, Canada
| | - Idoia Martin-Guerrero
- Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Spain; Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, University of the Basque Country, UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain.
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11
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McDonald L, O' Doherty R, Ryan E, Enright H, Dunlea E, Kelliher S, Fortune A, Fay M, Maung SW, Desmond R, Wall C, Kumar S, O' Shea D, Fadalla K, Connaghan DG, Smyth L. Posttransplant Lymphoproliferative Disorder After Solid Organ Transplant: A Heterogeneous, Aggressive Disorder. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:694-700. [PMID: 34148849 DOI: 10.1016/j.clml.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/07/2021] [Accepted: 05/16/2021] [Indexed: 11/17/2022]
Abstract
Posttransplant lymphoproliferative disorder (PTLD) is a rare complication of solid organ transplant. We identified 40 patients diagnosed with PTLD between 2009 and 2020 and analyzed their presentation, treatment strategies, and outcomes. Median age at diagnosis was 52.5 years (range 21.3 to 79). Median duration of immunosuppression was 95 months (range 4 to 292). Diffuse large B cell lymphoma (n = 16, 40%) and Burkitt lymphoma (n = 6, 15%) were the most common histological subtypes. First-line therapy varied. The median number of treatment lines was 1 (range 0 to 4). Sixteen patients (40%) achieved complete response after first-line therapy. Nineteen patients (47.5%) relapsed or progressed and received salvage therapy; 45% were alive at the end of the study period (median survival 52 months; range 1 to 266; 95% confidence interval 0 to 104). Causes of death included lymphoma-related (45.5%), therapy-related (27.3%), and other (27.3%). Five (22.7%) died within 3 months of diagnosis. Pearson's r test identified disease stage (P = .045) and proliferation index (P = .005) as negative predictors of response to frontline therapy. Bone marrow involvement (P = .033) and increased age (P = .018) were significant predictors of survival. Early mortality and poor response to frontline therapy are common, outlining the need for improved treatment strategies.
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Affiliation(s)
- Laura McDonald
- Department of Haematology, St Vincent's University Hospital, Elm Park, Dublin, Ireland.
| | - Roseann O' Doherty
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - Eileen Ryan
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Helen Enright
- Department of Haematology, Tallaght University Hospital, Dublin, Ireland
| | - Eoghan Dunlea
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - Sarah Kelliher
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - Anne Fortune
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - Michael Fay
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - S W Maung
- Department of Haematology, Mater Misericordiae University Hospital, Eccles St, Dublin, Ireland
| | - Ronan Desmond
- Department of Haematology, Tallaght University Hospital, Dublin, Ireland
| | - Catherine Wall
- Department of Haematology, Tallaght University Hospital, Dublin, Ireland
| | - Senthil Kumar
- Department of Haematology, University Hospital Waterford, Waterford, Ireland
| | - Derville O' Shea
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Kamal Fadalla
- Department of Haematology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - D G Connaghan
- Department of Haematology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Liam Smyth
- Department of Haematology, St Vincent's University Hospital, Elm Park, Dublin, Ireland
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12
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Selecting the Optimal CAR-T for the Treatment of B-Cell Malignancies. Curr Hematol Malig Rep 2021; 16:32-39. [PMID: 33630232 DOI: 10.1007/s11899-021-00615-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Chimeric antigen receptor T-cell (CAR-T) therapy is a form of adoptive cellular therapy that has revolutionized the treatment landscape in hematologic malignancies, especially B-cell lymphomas. In this review, we will discuss some of the landmark data behind these therapies and then lay out our approach to utilizing this new therapy. RECENT FINDINGS CD19-directed CAR-Ts are the most common type currently used in treatment of relapsed B-cell lymphoid neoplasms. There are currently three FDA-approved products: axicabtagene ciluecel and tisagenlecleucel for the treatment of relapsed/refractory large B-cell lymphoma and pediatric B-cell acute lymphocytic leukemia (tisagenlecleucel only) and brexucabtagene autoleucel for the treatment of relapsed/refractory mantle cell lymphoma. These therapies are associated with distinctive acute toxicities such as cytokine release syndrome and neurotoxicity and chronic toxicities such as cytopenias and hypogammaglobulinemia. CAR-T therapy provides significant potential in the treatment of relapsed B-cell lymphomas despite current limitations. Several novel CAR cell designs are currently being studied in clinical trials which include tandem CAR-Ts, allogeneic CAR-Ts, and CAR-NK cells.
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13
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Douglas M. Polatuzumab Vedotin for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma in Transplant-Ineligible Patients. J Adv Pract Oncol 2020; 11:521-528. [PMID: 32974076 PMCID: PMC7508255 DOI: 10.6004/jadpro.2020.11.5.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Although 5-year survival rates in the first-line setting can range from 60% to 70%, up to 50% of patients become refractory or relapse after treatment (Crump et al., 2017). The standard treatment for relapsed/refractory diffuse large B-cell lymphoma is salvage chemotherapy followed by autologous stem cell transplant. Nonetheless, over 60% of patients are transplant ineligible, and there is currently no standard treatment option for these patients (Sarkozy & Sehn, 2018). Age, comorbidities, performance status, and disease deemed not responsive to chemotherapy conditioning are various factors potentially disqualifying patients for transplant. There is a strong demand for novel therapies. Polatuzumab vedotin, a targeted immunotherapy, was approved in 2019 by the U.S. Food & Drug Administration for the treatment of relapsed/refractory diffuse large B-cell lymphoma and is recommended by the National Comprehensive Cancer Network for patients who are transplant ineligible. This article reviews the pharmacology of polatuzumab vedotin, along with its performance in clinical trials, financial considerations, and management of adverse effects.
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14
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Singh R, Shaik S, Negi BS, Rajguru JP, Patil PB, Parihar AS, Sharma U. Non-Hodgkin's lymphoma: A review. J Family Med Prim Care 2020; 9:1834-1840. [PMID: 32670927 PMCID: PMC7346945 DOI: 10.4103/jfmpc.jfmpc_1037_19] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/05/2019] [Accepted: 02/19/2020] [Indexed: 01/18/2023] Open
Abstract
Lymphomas constitute the third most common neoplasm in head and neck region arising from the lymphoreticular system. Malignant lymphomas are divided into Hodgkin's disease and non-Hodgkin's lymphoma (NHL). NHL comprises approximately 5% of head and neck malignancies and displays a wide range of appearances comparable with Hodgkin's disease. Hodgkin's and non-Hodgkin's lymphomas are seen in the head and neck region, but extranodal disease, with or without lymph node involvement, is more common among NHL patients. Extranodal involvement includes the areas such as Waldeyer's ring (i.e., the tonsils, pharynx, and base of the tongue), salivary glands, orbit, paranasal sinuses, and thyroid glands. There are several classification systems for categorizing NHL out of which WHO classification for lymphoid neoplasms is mostly followed. This review describes the pathogenesis of NHL and explains some of the important NHL (Marginal zone B-cell Lymphoma, follicular lymphoma, mantle cell lymphoma).
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Affiliation(s)
- Rohit Singh
- Lecturer, Department of Prosthodontics, Crown Bridge and Implantology, Patna Dental College and Hospital, Patna, Bihar, India
| | - Shabana Shaik
- Postgraduate Student, Department of Oral Medicine and Radiology, The Oxford Dental College, Bangalore, Karnataka, India
| | - Bhupender Singh Negi
- Senior Resident, Department of Oral Medicine AND Radiology, Government Dental College Kottayam, Kerala, India
| | - Jagadish Prasad Rajguru
- Professor and HOD, Department of Oral and Maxillofacial Pathology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Pankaj Bajirao Patil
- Assistant Professor, Department of Oral and Maxillofacial Surgery School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed to be University, Karad, Maharashtra, India
| | - Anuj Singh Parihar
- Reader, Department of Periodontology, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Uma Sharma
- Private Practitioner and Consultant Orthodontist, New Delhi, India
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15
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Kim DW, Cho JY. Recent Advances in Allogeneic CAR-T Cells. Biomolecules 2020; 10:biom10020263. [PMID: 32050611 PMCID: PMC7072190 DOI: 10.3390/biom10020263] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 12/19/2022] Open
Abstract
In recent decades, great advances have been made in the field of tumor treatment. Especially, cell-based therapy targeting tumor associated antigen (TAA) has developed tremendously. T cells were engineered to have the ability to attack tumor cells by generating CAR constructs consisting of genes encoding scFv, a co-stimulatory domain (CD28 or TNFRSF9), and CD247 signaling domains for T cell proliferation and activation. Principally, CAR-T cells are activated by recognizing TAA by scFv on the T cell surface, and then signaling domains inside cells connected by scFv are subsequently activated to induce downstream signaling pathways involving T cell proliferation, activation, and production of cytokines. Many efforts have been made to increase the efficacy and persistence and also to decrease T cell exhaustion. Overall, allogeneic and universal CAR-T generation has attracted much attention because of their wide and prompt usage for patients. In this review, we summarized the current techniques for generation of allogeneic and universal CAR-T cells along with their disadvantages and limitations that still need to be overcome.
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