1
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Yanagita Y, Tamura H, Noda K, Uehara T, Ikusaka M. Progressive Dysphagia Followed by Sudden Diplegia due to a Posterior Mediastinal Tumor. Am J Med 2024; 137:e67-e68. [PMID: 38280557 DOI: 10.1016/j.amjmed.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Yasutaka Yanagita
- Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
| | - Hiroki Tamura
- Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan
| | - Kazutaka Noda
- Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan
| | - Takanori Uehara
- Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan
| | - Masatomi Ikusaka
- Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan
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2
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Hang H, Zhou H, Ma L. Prognostic factors and clinical survival outcome in patients with primary mediastinal diffuse large B-cell lymphoma in rituximab era: A population-based study. Medicine (Baltimore) 2024; 103:e37238. [PMID: 38394535 DOI: 10.1097/md.0000000000037238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
The goal of this study was to investigate the clinical characteristics, prognostic variables, and survival of patients with primary mediastinal diffuse large B cell lymphoma (PMBCL) in the rituximab era. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify PMBCL patients diagnosed between 2000 and 2019. The Kaplan-Meier (K-M) technique and log-rank test were used to assess overall survival (OS) and disease-specific survival (DSS). The independent prognostic variables for OS and DSS were identified using univariate and multivariate Cox regression analysis. Nomograms were created to predict survival prospects according to identified prognostic indicators. Totally, 841 patients were enrolled with PMBCL. One-year, 5-year, and 10-year OS rates were 93.99%, 85.04%, and 81.76%, and the corresponding DSS rates were 95.27%, 87.37%, and 85.98%. The results of multivariate Cox regression analysis demonstrated that age, years of diagnosis, Ann arbor staging, and chemotherapy were independent prognostic factors for survival. Nomograms designed exclusively for PMBCL were created to forecast the likelihood of 1-year, 5-year, and 10-year OS and DSS, respectively. The Harrell concordance index (C-index) for the nomograms predictions of OS and DSS were 0.704 and 0.733, respectively, which showed the established model harboring powerful and accurate performance. The present study revealed that incidence of PMBCL has been consistently rising over the last 20 years. Simultaneously, survival rates have improved tremendously. Rituximab based immunochemotherapy has emerged as an effective treatment option, leading to enhanced OS and DSS outcomes. Furthermore, the nomograms specifically developed for PMBCL have demonstrated robustness and accuracy in forecasting OS and DSS rates at 1, 5, and 10 years. These predictive tools can be valuable for clinicians in accurately estimating prognosis and establishing personalized treatment plans and follow-up protocols.
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Affiliation(s)
- Haifang Hang
- Department of Hematology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Zhou
- Department of Hematology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Nursing department, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liyuan Ma
- Department of Hematology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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3
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Schubert ML, Bethge WA, Ayuk FA, von Bonin M, Vucinic V, Wagner-Drouet EM, Subklewe M, Baldus CD, Glass B, Marks R, Mougiakakos D, Schroers R, Stelljes M, Topp MS, Wulf G, Kröger N, Dreger P. Outcomes of axicabtagene ciloleucel in PMBCL compare favorably with those in DLBCL: a GLA/DRST registry study. Blood Adv 2023; 7:6191-6195. [PMID: 37603595 PMCID: PMC10582836 DOI: 10.1182/bloodadvances.2023011203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023] Open
Affiliation(s)
- Maria-Luisa Schubert
- Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Wolfgang A. Bethge
- Department of Hematology and Oncology, University Hospital Tuebingen, Tuebingen, Germany
| | - Francis A. Ayuk
- Department for Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany
| | - Malte von Bonin
- Department of Hematology and Oncology, University Hospital Dresden, Dresden, Germany
| | - Vladan Vucinic
- Department of Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | | | - Marion Subklewe
- Department of Hematology and Oncology, University Hospital Munich, Munich, Germany
| | - Claudia D. Baldus
- Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Bertram Glass
- Department of Hematology and Oncology, Klinikum Berlin-Buch, Berlin, Germany
| | - Reinhard Marks
- Department of Hematology and Oncology, University Hospital Freiburg, Freiburg, Germany
| | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Roland Schroers
- Department of Hematology and Oncology, Ruhr-University Bochum, Bochum, Germany
| | - Matthias Stelljes
- Department of Hematology and Oncology, University Hospital Muenster, Muenster, Germany
| | - Max S. Topp
- Department of Hematology and Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Gerald Wulf
- Department of Hematology and Medical Oncology, University Medical Center Goettingen, Goettingen, Germany
| | - Nicolaus Kröger
- Department for Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany
| | - Peter Dreger
- Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - German Lymphoma Alliance and the German Registry for Stem Cell Transplantation
- Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Hematology and Oncology, University Hospital Tuebingen, Tuebingen, Germany
- Department for Stem Cell Transplantation, University Hospital Hamburg, Hamburg, Germany
- Department of Hematology and Oncology, University Hospital Dresden, Dresden, Germany
- Department of Hematology, Cell Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
- Department of Hematology and Oncology, University Hospital Mainz, Mainz, Germany
- Department of Hematology and Oncology, University Hospital Munich, Munich, Germany
- Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
- Department of Hematology and Oncology, Klinikum Berlin-Buch, Berlin, Germany
- Department of Hematology and Oncology, University Hospital Freiburg, Freiburg, Germany
- Department of Hematology and Oncology, University Hospital Erlangen, Erlangen, Germany
- Department of Hematology and Oncology, Ruhr-University Bochum, Bochum, Germany
- Department of Hematology and Oncology, University Hospital Muenster, Muenster, Germany
- Department of Hematology and Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Hematology and Medical Oncology, University Medical Center Goettingen, Goettingen, Germany
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4
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Donzel M, Pesce F, Trecourt A, Groussel R, Bachy E, Ghesquières H, Fontaine J, Benzerdjeb N, Mauduit C, Traverse-Glehen A. Molecular Characterization of Primary Mediastinal Large B-Cell Lymphomas. Cancers (Basel) 2023; 15:4866. [PMID: 37835560 PMCID: PMC10571533 DOI: 10.3390/cancers15194866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Since the description of primary mediastinal large B-cell lymphoma (PMBL) as a distinct entity from diffuse large B-cell lymphomas (DLBCL), numerous studies have made it possible to improve their definition. Despite this, this differential diagnosis can be challenging in daily practice. However, in some centers, PMBL may be treated according to a particular regimen, distinct from those used in DLBCL, emphasizing the importance of accurate identification at diagnosis. This study aimed to describe the histological and molecular characteristics of PMBL to improve the accuracy of their diagnosis. Forty-nine cases of PMBL were retrospectively retrieved. The mean age at diagnosis was 39 years (21-83), with a sex ratio of 0.88. All cases presented a fibrous background with diffuse growth of intermediate to large cells with an eosinophil (26/49, 53%) or retracted cytoplasm (23/49, 47%). "Hodgkin-like" cells were observed in 65% of cases (32/49, 65%). The phenotype was: BCL6+ (47/49, 96%), MUM1+ (40/49, 82%), CD30+ (43/49, 88%), and CD23+ (37/49, 75%). Genomic DNAs were tested by next generation sequencing of 33 cases using a custom design panel. Pathogenic variants were found in all cases. The most frequent mutations were: SOCS1 (30/33, 91%), TNFAIP3 (18/33, 54.5%), ITPKB (17/33, 51.5%), GNA13 (16/33, 48.5%), CD58 (12/33, 36.4%), B2M (12/33; 36.4%), STAT6 (11/33, 33.3%) as well as ARID1A (10/33, 30.3%), XPO1 (9/33, 27.3%), CIITA (8/33, 24%), and NFKBIE (8/33, 24%). The present study describes a PMBL cohort on morphological, immunohistochemical, and molecular levels to provide pathologists with daily routine tools. These data also reinforce interest in an integrated histomolecular diagnosis to allow a precision diagnosis as early as possible.
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Affiliation(s)
- Marie Donzel
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), UFR Lyon-1, Institut National de la Santé et de la Recherche Médicale (INSERM) U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Normale Supérieure de Lyon, 69342 Lyon, France
| | | | - Alexis Trecourt
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | | | - Emmanuel Bachy
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), UFR Lyon-1, Institut National de la Santé et de la Recherche Médicale (INSERM) U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Normale Supérieure de Lyon, 69342 Lyon, France
- Hospices Civils de Lyon, Service d’Hématologie, Hôpital Lyon Sud, 69310 Lyon, France
| | - Hervé Ghesquières
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), UFR Lyon-1, Institut National de la Santé et de la Recherche Médicale (INSERM) U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Normale Supérieure de Lyon, 69342 Lyon, France
- Hospices Civils de Lyon, Service d’Hématologie, Hôpital Lyon Sud, 69310 Lyon, France
| | - Juliette Fontaine
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
| | - Nazim Benzerdjeb
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
| | - Claire Mauduit
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
- Centre International de Recherche en Infectiologie (CIRI), UFR Lyon-1, Institut National de la Santé et de la Recherche Médicale (INSERM) U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Normale Supérieure de Lyon, 69342 Lyon, France
- Institut National de la Santé et de la Recherche Médicale, Centre Méditerranéen de Médecine Moléculaire (C3M), Unité 1065, Equipe 10, 06000 Nice, France
| | - Alexandra Traverse-Glehen
- Hospices Civils de Lyon, Institut de Pathologie Multisite, Hôpital Lyon Sud, 69310 Lyon, France (N.B.)
- UFR Claude Bernard Lyon 1, 69100 Villeurbanne, France
- Centre International de Recherche en Infectiologie (CIRI), UFR Lyon-1, Institut National de la Santé et de la Recherche Médicale (INSERM) U1111, Centre National de la Recherche Scientifique (CNRS), UMR5308, Ecole Normale Supérieure de Lyon, 69342 Lyon, France
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5
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Phan AT, Randhawa JS, Johnston B, Khosravi C, Malkoc A, Arabian S. Primary Mediastinal B-Cell Lymphoma Presenting as Cardiac Tamponade. J Med Cases 2023; 14:277-281. [PMID: 37692368 PMCID: PMC10482599 DOI: 10.14740/jmc4106] [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: 05/24/2023] [Accepted: 07/08/2023] [Indexed: 09/12/2023] Open
Abstract
Primary mediastinal B-cell lymphoma (PMBCL) is a rare subtype of non-Hodgkin lymphoma. Typical symptoms include cough, chest pain, and dyspnea; however, cardiac tamponade as the primary manifestation is exceedingly rare. We hereby present a case of a 34-year-old male with a past medical history of obesity, who presented to our emergency department with a chronic dry cough for 4 months. On admission, computed tomography demonstrated a large 11.1-cm diameter anterior mediastinal mass, and echocardiography demonstrated cardiac tamponade physiology. The patient underwent further workup including pericardiocentesis, subsequent pericardial window, and mediastinal biopsy, which demonstrated histopathology consistent with PMBCL. Our case highlights the importance of a complete and thorough workup for patients with chronic untraditional symptoms. This case is unique in that PMBCL is rarely associated with cardiac tamponade as the primary clinical presentation. Additionally, we recommend an extensive cardiac workup for patients presenting with a large mediastinal mass, as failure to do so may result in patient morbidity and mortality.
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Affiliation(s)
- Alexander T Phan
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Johnny S Randhawa
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Brandon Johnston
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Chayanne Khosravi
- Department of Critical Care Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Aldin Malkoc
- Department of General Surgery, Arrowhead Regional Medical Center, Colton, CA 92324, USA
| | - Sarkis Arabian
- Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
- Department of Critical Care Medicine, Arrowhead Regional Medical Center, Colton, CA 92324, USA
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6
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Donzel M, Fontaine J, Traverse-Glehen A. [Histoseminar: "The contribution of new molecular biology techniques in the diagnosis of lymphoma: myth or reality?"]. Ann Pathol 2023; 43:126-131. [PMID: 36781354 DOI: 10.1016/j.annpat.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 02/13/2023]
Affiliation(s)
- Marie Donzel
- Service de pathologie multi-site, hospices civils de Lyon, centre hospitalier Lyon sud, Site sud, 69310 Pierre-Bénite, France.
| | - Juliette Fontaine
- Service de pathologie multi-site, hospices civils de Lyon, centre hospitalier Lyon sud, Site sud, 69310 Pierre-Bénite, France
| | - Alexandra Traverse-Glehen
- Service de pathologie multi-site, hospices civils de Lyon, centre hospitalier Lyon sud, Site sud, 69310 Pierre-Bénite, France; Inserm U1111, CNRS, UMR5308, CRCL, ENS Lyon, faculté de médecine Lyon-Sud, centre international de recherche en infectiologie (CIRI), université Claude Bernard Lyon-1, Lyon, France
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7
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Eslinger L, Ahmed T, Lodhi SH, Ahmed T. Chronic dysphagia as a presenting complaint for primary mediastinal diffuse large B-cell lymphoma. BMJ Case Rep 2023; 16:e253357. [PMID: 36634994 PMCID: PMC9843212 DOI: 10.1136/bcr-2022-253357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy in adults. It manifests a variable presentation, depending on the tissue in which it arises. Rarely, it can present as dysphagia to solid and liquid foods in primary oesophageal lymphoma with or without B symptoms. We present a case of a 66-year-old man who presented with 3 months of progressive dysphagia with only a mild associated weight loss. This was later found to be caused by DLBCL of the mediastinum causing external compression of the patient's distal oesophagus and gastric cardia. He was treated with one cycle of standard-of-care chemotherapy and subsequently discharged with outpatient follow-up. We emphasise the importance of ruling out life-threatening conditions such as lymphoma in patients who present with dysphagia, as well as the high variability in presentation of DLBCL.
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Affiliation(s)
- Logan Eslinger
- University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Taimoor Ahmed
- Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Samra Haroon Lodhi
- Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA
| | - Taha Ahmed
- Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA
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8
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Schrank TP, Prince AC, Sathe T, Wang X, Liu X, Alzhanov DT, Burtness B, Baldwin AS, Yarbrough WG, Issaeva N. NF-κB over-activation portends improved outcomes in HPV-associated head and neck cancer. Oncotarget 2022; 13:707-722. [PMID: 35634245 PMCID: PMC9131933 DOI: 10.18632/oncotarget.28232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
Evolving understanding of head and neck squamous cell carcinoma (HNSCC) is leading to more specific diagnostic disease classifications. Among HNSCC caused by the human papilloma virus (HPV), tumors harboring defects in TRAF3 or CYLD are associated with improved clinical outcomes and maintenance of episomal HPV. TRAF3 and CYLD are negative regulators of NF-κB and inactivating mutations of either leads to NF-κB overactivity. Here, we developed and validated a gene expression classifier separating HPV+ HNSCCs based on NF-κB activity. As expected, the novel classifier is strongly enriched in NF-κB targets leading us to name it the NF-κB Activity Classifier (NAC). High NF-κB activity correlated with improved survival in two independent cohorts. Using NAC, tumors with high NF-κB activity but lacking defects in TRAF3 or CYLD were identified; thus, while TRAF3 or CYLD gene defects identify the majority of tumors with NF-κB activation, unknown mechanisms leading to NF-kB activity also exist. The NAC correctly classified the functional consequences of two novel CYLD missense mutations. Using a reporter assay, we tested these CYLD mutations revealing that their activity to inhibit NF-kB was equivalent to the wild-type protein. Future applications of the NF-κB Activity Classifier may be to identify HPV+ HNSCC patients with better or worse survival with implications for treatment strategies.
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Affiliation(s)
- Travis P. Schrank
- Department of Otolaryngology/Head and Neck Surgery, UNC, Chapel Hill, NC 27599, USA
- These authors contributed equally to this work
| | - Andrew C. Prince
- Department of Otolaryngology/Head and Neck Surgery, UNC, Chapel Hill, NC 27599, USA
- These authors contributed equally to this work
| | - Tejas Sathe
- Department of Surgery, Otolaryngology, Yale, New Haven, CT 06519, USA
- Current address: Department of Surgery, Columbia University, New York, NY 10032, USA
| | - Xiaowei Wang
- Department of Pharmacology and Bioengineering, University of Illinois at Chicago, Chicago, IL 60612, USA
- Bioinformatics Core, University of Illinois Cancer Center, Chicago, IL 60612, USA
| | - Xinyi Liu
- Department of Pharmacology and Bioengineering, University of Illinois at Chicago, Chicago, IL 60612, USA
- Bioinformatics Core, University of Illinois Cancer Center, Chicago, IL 60612, USA
| | - Damir T. Alzhanov
- Department of Otolaryngology/Head and Neck Surgery, UNC, Chapel Hill, NC 27599, USA
| | - Barbara Burtness
- Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA
- Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA
| | - Albert S. Baldwin
- Department of Medicine, Yale School of Medicine, New Haven, CT 06510, USA
- Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA
| | - Wendell G. Yarbrough
- Department of Otolaryngology/Head and Neck Surgery, UNC, Chapel Hill, NC 27599, USA
- Lineberger Cancer Center, UNC, Chapel Hill, NC 27599, USA
- Department of Pathology and Laboratory Medicine, UNC, Chapel Hill, NC 27599, USA
- Senior authors
| | - Natalia Issaeva
- Department of Otolaryngology/Head and Neck Surgery, UNC, Chapel Hill, NC 27599, USA
- Lineberger Cancer Center, UNC, Chapel Hill, NC 27599, USA
- Department of Pathology and Laboratory Medicine, UNC, Chapel Hill, NC 27599, USA
- Senior authors
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9
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Vendramini E, Bomben R, Pozzo F, Bittolo T, Tissino E, Gattei V, Zucchetto A. KRAS and RAS-MAPK Pathway Deregulation in Mature B Cell Lymphoproliferative Disorders. Cancers (Basel) 2022; 14:cancers14030666. [PMID: 35158933 PMCID: PMC8833570 DOI: 10.3390/cancers14030666] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023] Open
Abstract
KRAS mutations account for the most frequent mutations in human cancers, and are generally correlated with disease aggressiveness, poor prognosis, and poor response to therapies. KRAS is required for adult hematopoiesis and plays a key role in B cell development and mature B cell proliferation and survival, proved to be critical for B cell receptor-induced ERK pathway activation. In mature B cell neoplasms, commonly seen in adults, KRAS and RAS-MAPK pathway aberrations occur in a relevant fraction of patients, reaching high recurrence in some specific subtypes like multiple myeloma and hairy cell leukemia. As inhibitors targeting the RAS-MAPK pathway are being developed and improved, it is of outmost importance to precisely identify all subgroups of patients that could potentially benefit from their use. Herein, we review the role of KRAS and RAS-MAPK signaling in malignant hematopoiesis, focusing on mature B cell lymphoproliferative disorders. We discuss KRAS and RAS-MAPK pathway aberrations describing type, incidence, mutual exclusion with other genetic abnormalities, and association with prognosis. We review the current therapeutic strategies applied in mature B cell neoplasms to counteract RAS-MAPK signaling in pre-clinical and clinical studies, including most promising combination therapies. We finally present an overview of genetically engineered mouse models bearing KRAS and RAS-MAPK pathway aberrations in the hematopoietic compartment, which are valuable tools in the understanding of cancer biology and etiology.
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