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Holloway KD, Amisha F, Post G, Goraya H. Hairy Cell Leukemia (HCL) Presenting As Severe Acute Respiratory Distress Syndrome (ARDS) With Legionella pneumophila: Coincidence or Causation? Cureus 2023; 15:e48317. [PMID: 38058334 PMCID: PMC10697807 DOI: 10.7759/cureus.48317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 12/08/2023] Open
Abstract
Due to a low index of suspicion coupled with specific growth conditions and non-specific clinical manifestations, Legionella (L.) pneumophila is a frequently misdiagnosed cause of pneumonia in immunocompromised patients, especially those with hematological malignancies. We present a case of severe acute respiratory distress syndrome (ARDS) secondary to Legionnaire's disease in a patient with newly diagnosed hairy cell leukemia (HCL) to highlight the importance of early recognition, diagnosis, and treatment of Legionnaire's disease to reduce morbidity and mortality.
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Affiliation(s)
- Kayln D Holloway
- Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Fnu Amisha
- Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Ginell Post
- Pathology, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Harmeen Goraya
- Internal Medicine - Pulmonology/Critical Care, University of Arkansas for Medical Sciences, Little Rock, USA
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2
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Proskuriakova E, Sakhuja A, Khan S, Shrestha DB, Khosla P. Atraumatic Splenic Rupture as an Unusual Presentation of Hairy Cell Leukemia: A Case Report. Cureus 2023; 15:e40180. [PMID: 37431331 PMCID: PMC10329842 DOI: 10.7759/cureus.40180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
Hairy cell leukemia (HCL) represents a rare B-cell malignancy with 2% of all leukemias and should be differentiated from HCL-like conditions, including HCL-variant (HCL-V) and splenic diffuse red pulp lymphoma (SDRPL). HCL gets its name from the short, thin projections that look like hair on its cells. It is associated with a specific immunophenotypic profile, cytopenia, and splenomegaly. Spontaneous splenic rupture can be a symptom of hematological malignancy such as HCL and is a life-threatening acute emergency. Here, we present a case of a 37-year-old man who presented to the hospital with signs of acute peritonitis and acute anemia and was found to have atraumatic splenic rupture secondary to splenomegaly. He underwent emergent angiography, where the bleeding splenic vessel was identified, and the patient was successfully treated with embolization. Immunophenotypic profile revealed that B-cells were positive for CD11c, CD103, CD25, and CD5, for which he received five days of cladribine and achieved complete clinical remission.
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Affiliation(s)
| | - Anuradha Sakhuja
- Internal Medicine Department, Mount Sinai Hospital, Chicago, USA
| | - Sarah Khan
- Hematology and Oncology Department, Mount Sinai Hospital, Chicago, USA
| | - Dhan B Shrestha
- Internal Medicine Department, Mount Sinai Hospital, Chicago, USA
| | - Pam Khosla
- Hematology and Oncology Department, Mount Sinai Hosipital, Chicago, USA
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3
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Dehghani M, Kashkooe A, Namdari N, Majidi R, Karimi M, Haghighat S, Rezvani A, Safari N. Long-term follow-up of patients with hairy cell leukemia in the south of Iran. Expert Rev Hematol 2023; 16:289-295. [PMID: 36709461 DOI: 10.1080/17474086.2023.2174520] [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: 01/30/2023]
Abstract
BACKGROUND Hairy cell leukemia (HCL) is an indolent chronic lymphoproliferative disorder and first-line treatment with either intravenous or subcutaneous cladribine generally leads to long-lasting remissions. METHOD All 131 patients with hairy-cell leukemia (HCL) were analyzed, with a median follow-up of 91 months. Data is from 2007 to 2020. We evaluated the response rate to cladribine as the first line and the response rate to cladribine with or without rituximab in relapsed patients. Further, we assessed relapse-free survival, complications, and secondary malignancy. RESULTS After a median follow-up of 91 months, the recurrence rate was 24%. The 5-year and 10-year RFS rates were 85% and 66%, respectively. Adding rituximab to 2-CDA leads to a better response rate than just cladribine (90% vs. 27.3%, p-value = 0.002) in the relapsed patients. CONCLUSION HCL patients have long-term survival when cladribine is the first line of treatment. Furthermore, adding rituximab to cladribine leads to a higher response rate.
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Affiliation(s)
- Mehdi Dehghani
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Kashkooe
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Namdari
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Majidi
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Karimi
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Haghighat
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Rezvani
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Safari
- Hematology Research Center, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
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4
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Diagnosis and treatment of hairy cell leukemia as the COVID-19 pandemic continues. Blood Rev 2022; 51:100888. [PMID: 34535326 PMCID: PMC8418384 DOI: 10.1016/j.blre.2021.100888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 02/06/2023]
Abstract
Hairy cell leukemia (HCL) is an indolent B-cell malignancy, usually driven by the BRAF V600E mutation. For 30 years, untreated and relapsed HCL was successfully treated with purine analogs, but minimal residual disease (MRD) remained in most patients, eventually causing relapse. Repeated purine analogs achieve decreasing efficacy and increasing toxicity, particularly to normal T-cells. MRD-free complete remissions (CRs) are more common using rituximab with purine analogs in both 1st-line and relapsed settings. BRAF inhibitors and Ibrutinib can achieve remission, but due to persistence of MRD, must be used chronically to prevent relapse. BRAF inhibition combined with Rituximab can achieve high MRD-free CR rates. Anti-CD22 recombinant immunotoxin moxetumomab pasudotox is FDA-approved in the relapsed setting and is unique in achieving high MRD-free CR rates as a single-agent. Avoiding chemotherapy and rituximab may be important in ensuring both recovery from COVID-19 and successful COVID-19 vaccination, an area of continued investigation.
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Soong D, Kumar P, Jatwani K, Park J, Dogan A, Taylor J. Hairy Cell Leukemia Masquerading as CD5+ Lymphoproliferative Disease: The Importance of BRAF V600E Testing in Diagnosis and Treatment. JCO Precis Oncol 2021; 5:PO.20.00518. [PMID: 34250418 PMCID: PMC8232835 DOI: 10.1200/po.20.00518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/11/2021] [Accepted: 05/07/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Deborah Soong
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL.,Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
| | - Priyadarshini Kumar
- Hematopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Karan Jatwani
- Department of Hospice and Palliative Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jae Park
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ahmet Dogan
- Hematopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Justin Taylor
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL.,Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
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6
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Green-Lott AM, Singaraju R, Liu ML, Ascensao J. Hairy Cell Leukemia and Ground Water Contamination With Industrial Solvents: a Case Report. Mil Med 2021; 185:e1338-e1340. [PMID: 32239156 DOI: 10.1093/milmed/usz484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/05/2019] [Accepted: 01/06/2019] [Indexed: 11/13/2022] Open
Abstract
The industrial solvents benzene and trichloroethylene (TCE) are known carcinogens, and these solvents contaminated the drinking water at Marine Corps Base Camp Lejeune from the 1950s to 1980s. Benzene and TCE are linked to the hematopoietic cancers acute myelocytic and lymphocytic leukemia and chronic lymphocytic leukemia. We report the case of a veteran stationed at Marine Corps Base Camp Lejeune during this period who developed hairy cell leukemia (HCL), a rare form of lymphocytic leukemia. We review his presentation, medical history, solvent exposure, and literature on the carcinogenicity of benzene and TCE. This patient represents a possible link of TCE or benzene to HCL. The case also informs clinicians of the updated epidemiology with regards to clinical findings for HCL.
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Affiliation(s)
- Ashley-Marie Green-Lott
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814
| | - Raj Singaraju
- Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814
| | - Min-Ling Liu
- Department of Pathology, Washington DC Veterans Medical Center, 50 Irving St NW, Washington, DC 20422
| | - Joao Ascensao
- Department of Hematology and Oncology, Washington DC Veterans Medical Center, 50 Irving St NW, Washington, DC 20422
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Kreitman RJ, Pastan I. Development of Recombinant Immunotoxins for Hairy Cell Leukemia. Biomolecules 2020; 10:E1140. [PMID: 32756468 PMCID: PMC7464581 DOI: 10.3390/biom10081140] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 01/08/2023] Open
Abstract
Hairy cell leukemia (HCL) is an indolent B-cell malignancy with excellent initial response to purine analogs pentostatin or cladribine, but patients are rarely, if ever, cured. Younger patients will usually need repeat chemotherapy which has declining benefits and increasing toxicities with each course. Targeted therapies directed to the BRAF V600E mutation and Bruton's tyrosine kinase may be helpful, but rarely eradicate the minimal residual disease (MRD) which will eventually lead to relapse. Moxetumomab pasudotox (Moxe) is an anti-CD22 recombinant immunotoxin, which binds to CD22 on HCL cells and leads to apoptotic cell death after internalization and trafficking of the toxin to the cytosol. Phase I testing achieved a complete remission (CR) rate of 57% in relapsed/refractory HCL. Most CRs were without MRD and eradication of MRD correlated with prolonged CR duration. Patients were often MRD-free after five years. Important mild-moderate toxicities included capillary leak and hemolytic uremic syndromes which could be prevented and managed conservatively. A phase 3 trial met its endpoint of durable CR with acceptable toxicity, leading to FDA approval of Moxe for relapsed/refractory HCL, under the name Lumoxiti. Moxe combined with rituximab is currently being evaluated in relapsed/refractory HCL to improve the rate of MRD-free CR.
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Affiliation(s)
- Robert J. Kreitman
- Laboratory of Molecular Biology, Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
- National Institutes of Health, Building 37/5124b, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Ira Pastan
- Laboratory of Molecular Biology, Clinical Center, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA;
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Abstract
PURPOSE OF REVIEW To summarise diagnostic clinical/laboratory findings and highlight differences between classical hairy cell leukaemia (HCLc) and hairy cell leukaemia variant (HCLv). Discussion of prognosis and current treatment indications including novel therapies, linked to understanding of the underlying molecular pathogenesis. RECENT FINDINGS Improved understanding of the underlying pathogenesis of HCLc, particularly the causative mutation BRAF V600E, leading to constitutive activation of the MEK/ERK signalling pathway and increased cell proliferation. HCLc is caused by BRAF V600E mutation in most cases. Purine nucleoside analogue (PNA) therapy is the mainstay of treatment, with the addition of rituximab, improving response and minimal residual disease (MRD) clearance. Despite excellent responses to PNAs, many patients will eventually relapse, requiring further therapy. Rarely, patients are refractory to PNA therapy. In relapsed/refractory patients, novel targeted therapies include BRAF inhibitors (BRAFi), anti-CD22 immunoconjugate moxetumomab and Bruton tyrosine kinase inhibitors (BTKi). HCLv has a worse prognosis with median overall survival (OS), only 7-9 years, despite the combination of PNA/rituximab improving front-line response. Moxetumomab or ibrutinib may be a viable treatment but lacks substantial evidence.
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Affiliation(s)
- Matthew Cross
- The Royal Marsden Hospital and the Institute of Cancer Research, Sutton, UK
| | - Claire Dearden
- The Royal Marsden Hospital and the Institute of Cancer Research, Sutton, UK.
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Khan AM, Shahzad SR, Najjar S, Foulke L. Disseminated Histoplasmosis with Concurrent Hairy Cell Leukemia. Cureus 2020; 12:e6825. [PMID: 32181070 PMCID: PMC7051120 DOI: 10.7759/cureus.6825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Histoplasmosis is an endemic fungal infection that can lead to disseminated disease, especially in immunosuppressed patients. Hairy cell leukemia is a rare, slow-growing hematological malignancy. Concurrence of histoplasmosis and hairy cell leukemia is extremely rare. We describe a 69-year-old male who presented with fever, dry cough, pancytopenia, multiple pulmonary nodules, and massive splenomegaly. Histoplasma urinary antigen was positive and disease was confirmed by biopsy of lung lesions. Peripheral smear showed 'hairy cells', and bone marrow biopsy revealed findings of hairy cell leukemia. The patient was treated with intravenous amphotericin, followed by oral itraconazole. After the initial treatment of infection, treatment for hairy cell leukemia was started with cladribine. We will discuss the principles of treating disseminated histoplasmosis in the setting of immunosuppression, and hairy cell leukemia with coexisting infection.
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10
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Yılmaz F, Atilla D, Akkaş N, Bülbül H, Soyer N, Demir D, Kiper D, Avcı A, Vural F, Saydam G, Şahin F, Hekimgil M, Özsan N, Durusoy R, Payzın B. Retrospective Analysis of Hairy Cell Leukemia Patients Treated with Different Modalities as First Line: Real-Life Experience Over 20 years. Indian J Hematol Blood Transfus 2019; 35:692-698. [PMID: 31741621 DOI: 10.1007/s12288-019-01132-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022] Open
Abstract
We aimed to analyze the characteristics and response rates of different treatment modalities in hairy cell leukemia patients over 20 diagnosed as hairy cell leukemia (HCL). Clinical data, response rates and survival outcome of the patients who were diagnosed with HCL were retrospectively analyzed. Fifty-two patients with a median age of 50 (28-87) years were enrolled in the study. 38 patients (73%) were male and male to female ratio was 2.7. First line therapy was cladrabine in 36 patients (69.2%). The overall response rate was 97%. CR and PR rates were 86.1% and 11.1%, respectively. Interferon was used in 10(19.2%) patients who were diagnosed before 2000s years. CR and PR rates were 70% and 30%, respectively. Although the CR rates were lower in IFN group, this difference could not be reached statistically significance (p = 0.24). The median follow up was 48 months (12-252). The median OS was not reached and median PFS was 150 months (95% CI, 116-214). The OS at 36 and 48 months were 95.9% and 92.3%, respectively and the PFS at 36 and 48 months were 90.2% and 83.4%, respectively. After the introduction of purine analogues, the fate of the HCL patients have been changed. Cladrabin achieved very high response rates in both young and older patients, in our study. Although relapse still constitutes a problem, another single dose of cladrabine results in good response rates.
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Affiliation(s)
- Fergün Yılmaz
- 1Department of Hematology, Internal Medicine, Marmara University, Istanbul, Turkey
| | - Dilan Atilla
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Nagihan Akkaş
- 3İnternal Medicine, Department of Hematology, İzmir Katip Celebi University, Izmir, Turkey
| | - Hale Bülbül
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Nur Soyer
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Derya Demir
- 4Department of Pathology, Ege University, Izmir, Turkey
| | - Demet Kiper
- 3İnternal Medicine, Department of Hematology, İzmir Katip Celebi University, Izmir, Turkey
| | - Aylin Avcı
- 5Department of Pathology, İzmir Katip Celebi University, Izmir, Turkey
| | - Filiz Vural
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Güray Saydam
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Fahri Şahin
- 2Department of Hematology, Internal Medicine, Ege University, Izmir, Turkey
| | - Mine Hekimgil
- 4Department of Pathology, Ege University, Izmir, Turkey
| | - Nazan Özsan
- 4Department of Pathology, Ege University, Izmir, Turkey
| | - Raika Durusoy
- 6Department of Public Heath, Ege University, Izmir, Turkey
| | - Bahriye Payzın
- 3İnternal Medicine, Department of Hematology, İzmir Katip Celebi University, Izmir, Turkey
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11
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Mitsogianni M, Mitsimponas N, Crespo F, Hartmann KA, Klosterhalfen B, Haase S, Giagounidis A. Concomitant Non-Small Cell Lung Cancer and Hairy Cell Leukemia in a Patient Harboring BRAF-V600E Mutation in Both Tissues: A Case Report. Case Rep Oncol 2018; 11:109-113. [PMID: 29606948 PMCID: PMC5869534 DOI: 10.1159/000486640] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/08/2018] [Indexed: 12/14/2022] Open
Abstract
The BRAF-V600E mutation has been established as a signature alteration occurring almost universally in hairy cell leukemia. Moreover, it can be detected in a small percentage of patients with non-small cell lung cancer. We report the case of a patient with a metastatic BRAF-V600E-mutated lung adenocarcinoma suffering from concomitant hairy cell leukemia. The identification of an identical BRAF mutation in both malignancies raises physiopathological considerations and might offer unique therapeutic strategies for this group of patients.
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Affiliation(s)
- Maria Mitsogianni
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Mitsimponas
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Felipe Crespo
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Karl Axel Hartmann
- Klinik für Strahlentherapie, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | | | - Sabine Haase
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital Düsseldorf, Düsseldorf, Germany
| | - Aristoteles Giagounidis
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Marien Hospital Düsseldorf, Düsseldorf, Germany
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12
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Cheng WY, Zhu YM, Cheng S, Chen YS, Shen Y. Development of B-cell prolymphocytic leukemia in a patient with splenic diffuse red pulp small B-cell lymphoma. Leuk Lymphoma 2017; 59:1990-1993. [PMID: 29199492 DOI: 10.1080/10428194.2017.1405397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Wen-Yan Cheng
- a Shanghai Institute of Hematology, Department of Hematology , Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Yong-Mei Zhu
- a Shanghai Institute of Hematology, Department of Hematology , Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Shu Cheng
- a Shanghai Institute of Hematology, Department of Hematology , Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Yun-Shuo Chen
- a Shanghai Institute of Hematology, Department of Hematology , Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Yang Shen
- a Shanghai Institute of Hematology, Department of Hematology , Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China
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Alfaraj M, Alsaeed H. Hairy cell leukemia: a case report of atypical presentation without splenomegaly. Blood Res 2017; 52:139-141. [PMID: 28698853 PMCID: PMC5503894 DOI: 10.5045/br.2017.52.2.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 09/27/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Mona Alfaraj
- Consultant Hematopathologist, Hematology Section of Medical Laboratory Department, Qatif Central Hospital, Saudi Arabia
| | - Hussain Alsaeed
- Consultant Hematologist, Department of Internal Medicine, Qatif Central Hospital, Saudi Arabia
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14
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Multifocal brain involvement in a patient with hairy cell leukemia successfully treated with rituximab and cladribine. Blood Adv 2017; 1:899-902. [PMID: 29296733 DOI: 10.1182/bloodadvances.2017004697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/26/2017] [Indexed: 11/20/2022] Open
Abstract
Brain involvement, although rare, can occur in HCL.The combination of cladribine and rituximab is a highly effective treatment of HCL with brain involvement.
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15
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Rossi ED, Martini M, Bizzarro T, Schmitt F, Longatto-Filho A, Larocca LM. Somatic mutations in solid tumors: a spectrum at the service of diagnostic armamentarium or an indecipherable puzzle? The morphological eyes looking for BRAF and somatic molecular detections on cyto-histological samples. Oncotarget 2017; 8:3746-3760. [PMID: 27738305 PMCID: PMC5356915 DOI: 10.18632/oncotarget.12564] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/03/2016] [Indexed: 12/12/2022] Open
Abstract
This review article deals with the analysis and the detection of the morphological features associated with somatic mutations, mostly BRAFV600E mutation, on both cytological and histological samples of carcinomas. Few authors demonstrated that some architectural and specific cellular findings (i.e. polygonal eosinophilic cells defined as "plump cells" and sickle-shaped nuclei) are able to predict BRAF V600E mutation in both cytological and histological samples of papillary thyroid carcinoma (PTC) as well as in other carcinomas. In the current review article we evaluated the first comprehensive analysis of the morphological prediction of BRAFV600E and other somatic mutations in different malignant lesions with the description of the possible mechanisms beneath these morphologic features. The detection of predictive morphological features, mostly on FNAC, may add helpful information to the stratification of the malignant risk and personalized management of cancers. Additionally, the knowledge of the molecular mechanism of different oncogenic drivers can lead to the organ-specific triaging selection of cases and can provide significant insight for targeted therapies in different malignant lesions.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Tommaso Bizzarro
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Fernando Schmitt
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
- Department of Medicine and Pathology, Laboratoire National de Santé, Luxembourg
| | - Adhemar Longatto-Filho
- Department of Pathology, Laboratory of Medical Investigation, University of São Paulo School of Medicine, Brazil
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
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