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Catueno S, Cuglievan B. Pediatric Lymphomas: Key Concepts and Clinical Approaches for Pediatricians. Pediatr Rev 2025; 46:78-90. [PMID: 39889786 DOI: 10.1542/pir.2024-006547] [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] [Received: 06/10/2024] [Accepted: 09/14/2024] [Indexed: 02/03/2025]
Abstract
Lymphomas are the third most prevalent pediatric cancer following leukemia and brain tumors, representing 10% to15% of all childhood cancers. We can divide lymphomas into Hodgkin and non-Hodgkin lymphomas, with marked differences between these 2 groups. Clinical manifestations can be insidious, and clinicians should have a high index of suspicion when treating patients with lymphadenopathies, weight loss, or prolonged fever. Although refinements in chemotherapy regimens have improved survival for pediatric lymphomas, more recent successful incorporation of targeted therapies offers hope for even better outcomes with fewer late effects. Given the excellent prognosis for many of these patients, it is increasingly important for primary care physicians to recognize and manage potential late effects of therapy, both physical and psychological.
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Affiliation(s)
- Samanta Catueno
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Branko Cuglievan
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
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2
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Harahap AS, Charles S, Ham MF. A Decade of Prevalence and Clinicopathological Insights Into Classical Hodgkin Lymphoma: A Study From an Indonesian Tertiary Hospital. Cureus 2024; 16:e73482. [PMID: 39669843 PMCID: PMC11634568 DOI: 10.7759/cureus.73482] [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: 11/09/2024] [Indexed: 12/14/2024] Open
Abstract
Background Classical Hodgkin lymphoma (cHL) is a lymphoid malignancy originating from germinal center B cells, predominantly affecting young adults. The clinical profile, histologic subtypes, and immunohistochemical (IHC) patterns play crucial roles in diagnosing cHL and predicting prognosis. This study examines the prevalence, clinicopathological features, and IHC patterns of cHL at Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, based on large-scale data collected over a decade. Methods This retrospective analysis included 739 confirmed cases of cHL from 2014 to 2023, identified using hematoxylin and eosin staining and an IHC panel. Data on patient demographics, tumor locations, and stages were collected from medical records. The IHC markers utilized were CD20, CD3, CD30, CD15, PAX5, MUM1, Ki67, and CD45. Chi-square and Fisher exact tests were employed to analyze the distribution of subtypes across different age groups and stages. Result The most affected age group was 20-29 years, comprising 239 cases (32.34%), with a male predominance of 396 cases (53.59%). The majority of tumors were located in nodal areas, accounting for 532 cases (84.31%), while 99 cases (15.69%) were found in extranodal sites, predominantly in the mediastinum. The nodular sclerosis (NS) subtype was the most frequent, accounting for 461 cases (62.38%), followed by mixed cellularity, lymphocyte-depleted, and lymphocyte-rich classical Hodgkin lymphoma. Most cases were diagnosed at early stages (I-III), with NS significantly associated with early-stage diagnosis (OR 3.06, 95% confidence interval (CI) 1.30-7.22). Conclusion The occurrence of HL in terms of prevalence, age, gender, and stage in our study is similar to other Asian countries. Notable correlations were observed between HL subtypes with age and stage.
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Affiliation(s)
- Agnes S Harahap
- Anatomical Pathology Department, Faculty of Medicine, Dr. Cipto Mangunkusumo/Universitas Indonesia, Jakarta, IDN
- Human Cancer Research Center, Indonesian Medical Education and Research Institute, Jakarta, IDN
| | - Stefanny Charles
- Human Cancer Research Center, Indonesian Medical Education and Research Institute, Jakarta, IDN
| | - Maria F Ham
- Anatomical Pathology Department, Faculty of Medicine, Dr. Cipto Mangunkusumo/Universitas Indonesia, Jakarta, IDN
- Human Cancer Research Center, Indonesian Medical Education and Research Institute, Jakarta, IDN
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3
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Lief S, Ansari AZ, Beauti S, Lichtenberg AB, Patibandla S, Gulraiz A, Tirumalareddy RR, Khan M. Hypercalcemia-Associated Hodgkin's Lymphoma Presenting as Normal Pressure Hydrocephalus: A Case Report. Cureus 2024; 16:e71471. [PMID: 39539908 PMCID: PMC11560283 DOI: 10.7759/cureus.71471] [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: 08/01/2024] [Accepted: 10/14/2024] [Indexed: 11/16/2024] Open
Abstract
Hodgkin's lymphoma is a malignancy of the lymphatic system that can rarely present with advanced-stage features such as spinal cord involvement and hypercalcemia. We present the case of a 63-year-old Caucasian male with advanced Hodgkin's lymphoma, presenting with hypercalcemia and symptoms resembling normal pressure hydrocephalus. The patient exhibited gait impairment, altered mental status, and urinary incontinence, forming the classic triad seen in normal pressure hydrocephalus. Laboratory findings revealed leukocytosis, anemia, hypercalcemia, and acute kidney injury. Imaging showed extensive lymphadenopathy, a right adrenal mass, and bone marrow abnormalities suggestive of disseminated malignancy, leading to the decision not to biopsy the adrenal mass due to the strong suspicion of widespread metastatic disease. A biopsy of a mediastinal lymph node confirmed the diagnosis of Hodgkin's lymphoma, with hypercalcemia attributed to paraneoplastic syndrome. The patient's treatment included managing hypercalcemia and administering chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine. This case highlights the importance of considering Hodgkin's lymphoma in patients with atypical presentations and the need for comprehensive diagnostic evaluation, including imaging and laboratory tests. While hypercalcemia in Hodgkin's lymphoma is associated with a poor prognosis, newer therapies like brentuximab vedotin offer promising treatment options for frail patients.
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Affiliation(s)
- Sean Lief
- Department of Internal Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Ali Z Ansari
- Department of Pathology, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Samer Beauti
- Department of Internal Medicine, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Axel B Lichtenberg
- Department of Orthopedic Surgery, William Carey University College of Osteopathic Medicine, Hattiesburg, USA
| | - Srihita Patibandla
- Department of Internal Medicine, Trinity Health Grand Rapids, Grand Rapids, USA
| | - Azouba Gulraiz
- Department of Internal Medicine, Poplar Bluff Regional Medical Center, Poplar Bluff, USA
| | - Rahul R Tirumalareddy
- Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA
| | - Mashaal Khan
- Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, USA
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Abstract
Lymphomas of the eye and ocular adnexa are rare lymphoproliferative diseases of the ocular and ocular adnexal tissue. The incidence of these diseases has been rapidly increasing over the past few decades. The exact pathogenesis remains unknown, but it is postulated to be multifactorial and includes genetic aberrations, epigenetic and environmental factors, infectious agents, and chronic antigenic stimulation. The majority of ocular and ocular adnexal lymphomas are of B-cell origin, except for eyelid lymphomas, which are more often of T-cell type. Lymphoproliferative diseases of ocular and ocular adnexal structures are either primary, when they arise in the eye, orbit, lacrimal gland, eyelid, and/or conjunctiva, or secondary extranodal manifestation of systemic lymphoma. Diagnosis is challenging and requires a multidisciplinary approach involving ophthalmologists, dermatologists, oncologists, and radiation oncologists.
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Affiliation(s)
- Ndidi Enwereji
- Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, Connecticut, USA
| | - Madina Falcone
- Department of Ophthalmology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Katalin Ferenczi
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
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5
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Scott J, Iorfino F, Capon W, Crouse J, Nelson B, Chanen AM, Dwyer D, Conus P, Bechdolf A, Ratheesh A, Raballo A, Yung A, Berk M, McKenna S, Hockey S, Hutcheon A, Scott E, McGorry P, Shah J, Hickie IB. Staging 2.0: refining transdiagnostic clinical staging frameworks to enhance reliability and utility for youth mental health. Lancet Psychiatry 2024; 11:461-471. [PMID: 38643773 DOI: 10.1016/s2215-0366(24)00060-9] [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] [Received: 12/01/2023] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 04/23/2024]
Abstract
Globally, 75% of depressive, bipolar, and psychotic disorders emerge by age 25 years. However, these disorders are often preceded by non-specific symptoms or attenuated clinical syndromes. Difficulties in determining optimal treatment interventions for these emerging mental disorders, and uncertainties about accounting for co-occurring psychopathology and illness trajectories, have led many youth mental health services to adopt transdiagnostic clinical staging frameworks. In this Health Policy paper, an international working group highlights ongoing challenges in applying transdiagnostic staging frameworks in clinical research and practice, and proposes refinements to the transdiagnostic model to enhance its reliability, consistent recording, and clinical utility. We introduce the concept of within-stage heterogeneity and describe the advantages of defining stage in terms of clinical psychopathology and stage modifiers. Using examples from medicine, we discuss the utility of categorising stage modifiers into factors associated with progression (ie, potential predictors of stage transition) and extension (ie, factors associated with the current presentation that add complexity to treatment selection). Lastly, we suggest how it is possible to revise the currently used transdiagnostic staging approach to incorporate these key concepts, and how the revised framework could be applied in clinical and research practice.
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Affiliation(s)
- Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
| | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - William Capon
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Jacob Crouse
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Barnaby Nelson
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrew M Chanen
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Dominic Dwyer
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Philippe Conus
- General Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, CCM, Charité Universitatsmedizin, Berlin, Germany
| | - Aswin Ratheesh
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrea Raballo
- Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
| | - Alison Yung
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University and Barwon Health, Geelong, VIC, Australia
| | - Sarah McKenna
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Samuel Hockey
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Alexis Hutcheon
- Lived Experience Working Group, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Elizabeth Scott
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Pat McGorry
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jai Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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Tugarinov N, Xu E, Kim GH. Diarrhea as the Initial Presentation in a Patient With HIV Diagnosed With Hodgkin's Lymphoma. Cureus 2024; 16:e61361. [PMID: 38947681 PMCID: PMC11214380 DOI: 10.7759/cureus.61361] [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: 05/25/2024] [Indexed: 07/02/2024] Open
Abstract
Hodgkin's lymphoma (HL) is a form of cancer that involves abnormal lymphocyte proliferation which affects the lymphatic system. Patients with HIV are at increased risk of developing HL, despite the introduction of combination antiretroviral therapy. The most common presentation of HL is painless lymphadenopathy with classic constitutional symptoms in advanced disease. Here we discuss a 39-year-old female with a history of HIV on emtricitabine/tenofovir and dolutegravir who presented with four days of worsening diarrhea along with fevers and chills. She had a similar presentation at a nearby hospital four months prior. After initial concern for gastrointestinal infection, an extensive infectious workup was conducted and was negative. After complaints of sore throat and increased confusion during the hospital stay, a CT Chest and Neck revealed diffuse lymphadenopathy. Severely elevated ferritin levels raised concern for secondary hemophagocytic lymphohistiocytosis and prompted expedited ultrasound-guided cervical lymph node (LN) core biopsy and bone marrow biopsy. Ultrasound-guided core biopsy of the LN showed classical Hodgkin's lymphoma of mixed cellularity. The patient was started on doxorubicin, vinblastine, and dacarbazine + nivolumab. This is a case of a patient with HIV who presented with chronic diarrhea of unidentifiable origin and was ultimately diagnosed with classical Hodgkin's lymphoma during her hospitalization and highlights the importance of maintaining lymphoproliferative diseases on the differential in patients with HIV and gastrointestinal symptoms.
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Affiliation(s)
- Nicol Tugarinov
- Department of Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Esther Xu
- Department of Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Grace H Kim
- Department of Medicine, Mercy Medical Center, Baltimore, USA
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Diepstra A, Nolte IM, van den Berg A, Magpantay LI, Martínez-Maza O, Levin LI. Elevated serum TARC levels precede classic Hodgkin lymphoma diagnosis by several years. Blood 2023; 142:1928-1931. [PMID: 37748137 PMCID: PMC10733822 DOI: 10.1182/blood.2023020959] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023] Open
Abstract
Tumor cells in classic Hodgkin lymphoma produce high quantities of the thymus- and activation-related chemokine (TARC). We measured TARC levels in prediagnostic serum samples and found strikingly increased values in the vast majority of patients, as early as 6 years before diagnosis.
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Affiliation(s)
- Arjan Diepstra
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ilja M. Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anke van den Berg
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Larry I. Magpantay
- Department of Obstetrics and Gynecology, UCLA AIDS Institute and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Otoniel Martínez-Maza
- Department of Obstetrics and Gynecology, UCLA AIDS Institute and Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Lynn I. Levin
- Statistics and Epidemiology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
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Kourti M, Papakonstantinou E, Papagianni A, Arsos G, Ioannidou M, Pantoleon A, Antari V, Palabougiouki M, Kouskouras K, Venizelos I, Κoletsa T, Cheva A, Anastasiou A, Totikidis G, Tragiannidis A, Galli-Tsinopoulou A, Hatzipantelis E. Hodgkin Lymphoma in Children and Adolescents of Northern Greece: 25-Year Results and Long-term Follow-up. J Pediatr Hematol Oncol 2023; 45:322-326. [PMID: 36716084 DOI: 10.1097/mph.0000000000002625] [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] [Received: 08/22/2022] [Accepted: 12/03/2022] [Indexed: 01/31/2023]
Abstract
Aim of this study was to evaluate the long-term therapeutic outcome and treatment-related complications in Hodgkin disease. We reviewed the medical records of 93 patients diagnosed with classic Hodgkin lymphoma, treated, and followed-up during the last 25 years. The cohort study included 49 males and 44 females with median age 11.8 years old (range: 3.95 to 17.42 y). The most common subtype was nodular sclerosis in 47/93 (50.5%). B symptoms were present in 15/93 (16.1%). From January 2009 until December 2020, 55 (59%) patients diagnosed with Hodgkin lymphoma were treated according to European Network for Pediatric Hodgkin Lymphoma (EURONET)-PHL-C1 protocol. Concerning outcome, a total of 89/93 patients are alive. Relapse occurred in 7/93. Second malignancies are reported in a total of 5 patients, 3 solid tumors (thyroid cancer, breast cancer, and osteosarcoma), and 2 acute myeloid leukemias. The overall survival and event-free survival for the whole cohort were 95.7% and 83.9%, respectively. Disease-free survival was 92.5%. Although a considerable high fraction of patients with Hodgkin disease can achieve continuous complete remission, they are at a high risk of developing long-term treatment-related complications. High curative rates as well as prevention of late effects can be achieved by implementation of individualized treatment strategies and innovative treatments.
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Affiliation(s)
| | | | - Andromachi Papagianni
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
| | - George Arsos
- Third Department of Nuclear Medicine, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki
| | - Maria Ioannidou
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
| | | | | | - Maria Palabougiouki
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
| | | | | | - Triantafyllia Κoletsa
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, Greece
| | - Angeliki Cheva
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, University Campus, Greece
| | | | | | - Athanasios Tragiannidis
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
| | - Assimina Galli-Tsinopoulou
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
| | - Emmanuel Hatzipantelis
- Children & Adolescent Hematology-Oncology Unit, Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki
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Mahdi Seyedzadeh Sani S, Sahranavard M, Jannati Yazdanabad M, Seddigh Shamsi M, Elyasi S, Hooshang Mohammadpour A, Sathyapalan T, Arasteh O, Ghavami V, Sahebkar A. The effect of concomitant use of Colony-Stimulating factors on bleomycin pulmonary toxicity - A systematic review and meta-analysis. Int Immunopharmacol 2022; 112:109227. [PMID: 36099787 DOI: 10.1016/j.intimp.2022.109227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/06/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Changes in the incidence of bleomycin pulmonary toxicity (BPT) as a result of adding colony-stimulating factors (CSF) to bleomycin regimens has been investigated in numerous studies. We performed a systematic review and meta-analysis to assess the outcomes of these studies. METHODS A systematic search was performed using Pubmed, Scopus, Web of Science, and Embase on April 2021. Studies evaluating the incidence of BPT in patients receiving bleomycin with and without CSF were included. In addition, meta-analysis was performed by pooling odds ratios using R. RESULTS Out of 340 obtained records, our qualitative and quantitative analysis included 3234 and 1956 patients from 22 and 14 studies, respectively. The quantitative synthesis showed that addition of CSF significantly increased the risk of BPT incidence (OR = 1.82, 95 % CI: 1.37-2.40, p < 0.0001; I2 = 10.7 %). Subgroup analysis did not show any association between continent, bleomycin dose, cancer type, type of study, and pulmonary function test with BPT incidence. CONCLUSION This systematic review and meta-analysis showed that co-administration of CSF with bleomycin increases the incidence of BPT. The physicians need to consider this finding while deciding the best strategy for this cohort of patients.
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Affiliation(s)
| | - Mehrdad Sahranavard
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahdi Jannati Yazdanabad
- Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Seddigh Shamsi
- Department of Hematology Oncology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Sepideh Elyasi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, UK
| | - Omid Arasteh
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran.
| | - Vahid Ghavami
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran.
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; School of Medicine, The University of Western Australia, Perth, Australia; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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10
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Huang J, Pang WS, Lok V, Zhang L, Lucero-Prisno DE, Xu W, Zheng ZJ, Elcarte E, Withers M, Wong MCS. Incidence, mortality, risk factors, and trends for Hodgkin lymphoma: a global data analysis. J Hematol Oncol 2022; 15:57. [PMID: 35546241 PMCID: PMC9097358 DOI: 10.1186/s13045-022-01281-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022] Open
Abstract
Background Hodgkin lymphoma is a lymphatic malignancy commonly found in cervical lymph nodes. This study evaluated the worldwide incidence, mortality, associated risk factors, and temporal trends of Hodgkin lymphoma by sex, age, and country. Methods The age-standardised Hodgkin lymphoma incidence and mortality were retrieved from the GLOBOCAN, CI5 volumes I-XI, WHO mortality database, the NORDCAN and SEER Program. The age-standardised prevalence of smoking, alcohol drinking, obesity, and hypertension was also extracted for each country. Trends were tested using Average Annual Percentage Change (AAPC) from Joinpoint regression analysis. Results The Hodgkin lymphoma incidence and mortality were 0.98 and 0.26 per 100,000 in 2020. A higher incidence was observed in high-income countries, while higher mortality was found in low-income countries. Incidence and mortality were associated with GDP per capita, prevalence of smoking, obesity, and hypertension at the population level. Despite the decreasing mortality trend, there was an increasing incidence, especially among females, younger population, and subjects from Asian countries. Conclusions There was an increasing trend in Hodgkin lymphoma incidence, especially among subjects who were female, younger population, and from Asian countries. Further studies are needed to investigate the reasons for these epidemiologic trends. Supplementary Information The online version contains supplementary material available at 10.1186/s13045-022-01281-9.
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Affiliation(s)
- Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR, China
| | - Wing Sze Pang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR, China
| | - Veeleah Lok
- Department of Global Public Health, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Lin Zhang
- School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Wanghong Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Edmar Elcarte
- University of the Philippines, Manila, The Philippines
| | - Mellissa Withers
- Department of Population and Health Sciences, USC Institute On Inequalities in Global Health, APRU Global Health Program, Keck School of Medicine of USC, University of Southern California, Soto Street Building, SSB318G, 2001 North Soto Street, MC 9239, Los Angeles, CA, 90089-9239, USA.
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Room 407, 4/F, Postgraduate Education Centre, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT, Hong Kong SAR, China. .,School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. .,Department of Global Health, School of Public Health, Peking University, Beijing, China.
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11
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Ramdani H, Ayad G, Moueqqit O, Lahmar A, Malki S, Bennani A, Kamaoui I, Benajiba N. What Lies Behind the Cannonball Pulmonary Metastases: Hodgkin's Lymphoma? Cureus 2022; 14:e24351. [PMID: 35607589 PMCID: PMC9123384 DOI: 10.7759/cureus.24351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
The cannonball pulmonary appearance is hematogenous dissemination of various primary tumors but rarely a Hodgkin's lymphoma, a disease that most commonly manifests with lymphadenopathy, often affecting the mediastinum and supraclavicular or cervical lymph nodes. To date, to the best of our knowledge, no case has been reported where the investigation of a cannonball pulmonary appearance led to the diagnosis of Hodgkin's lymphoma. Hence, in our case report, we attempt to highlight the uncommon presentation of this disease in a 14-year-old girl who initially presented with dyspnea before her chest x-ray revealed a cannonball pulmonary appearance, which was later linked with Hodgkin's lymphoma after performing a biopsy of her axillary node.
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12
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Elmaaty A, Darwish KM, Chrouda A, Boseila AA, Tantawy MA, Elhady SS, Shaik AB, Mustafa M, Al-karmalawy AA. In Silico and In Vitro Studies for Benzimidazole Anthelmintics Repurposing as VEGFR-2 Antagonists: Novel Mebendazole-Loaded Mixed Micelles with Enhanced Dissolution and Anticancer Activity. ACS OMEGA 2022; 7:875-899. [PMID: 35036753 PMCID: PMC8757357 DOI: 10.1021/acsomega.1c05519] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 02/08/2023]
Abstract
Cancer is a leading cause of death worldwide and its incidence is unfortunately anticipated to rise in the next years. On the other hand, vascular endothelial growth factor receptor 2 (VEGFR-2) is highly expressed in tumor-associated endothelial cells, where it affects tumor-promoting angiogenesis. Therefore, VEGFR-2 is considered one of the most promising therapeutic targets for cancer treatment. Furthermore, some FDA-approved benzimidazole anthelmintics have already shown potential anticancer activities. Therefore, repurposing them against VEGFR-2 can provide a rapid and effective alternative that can be implicated safely for cancer treatment. Hence, 13 benzimidazole anthelmintic drugs were subjected to molecular docking against the VEGFR-2 receptor. Among the tested compounds, fenbendazole (FBZ, 1), mebendazole (MBZ, 2), and albendazole (ABZ, 3) were proposed as potential VEGFR-2 antagonists. Furthermore, molecular dynamics simulations were carried out at 200 ns, giving more information on their thermodynamic and dynamic properties. Besides, the anticancer activity of the aforementioned drugs was tested in vitro against three different cancer cell lines, including liver cancer (HUH7), lung cancer (A549), and breast cancer (MCF7) cell lines. The results depicted potential cytotoxic activity especially against both HUH7 and A549 cell lines. Furthermore, to improve the aqueous solubility of MBZ, it was formulated in the form of mixed micelles (MMs) which showed an enhanced drug release with better promising cytotoxicity results compared to the crude MBZ. Finally, an in vitro quantification for VEGFR-2 concentration in treated HUH7 cells has been conducted based on the enzyme-linked immunosorbent assay. The results disclosed that FBZ, MBZ, and ABZ significantly (p < 0.001) reduced the concentration of VEGFR-2, while the lowest inhibition was achieved in MBZ-loaded MMs, which was even much better than the reference drug sorafenib. Collectively, the investigated benzimidazole anthelmintics could be encountered as lead compounds for further structural modifications and thus better anticancer activity, and that was accomplished through studying their structure-activity relationships.
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Affiliation(s)
- Ayman
Abo Elmaaty
- Department
of Medicinal Chemistry, Faculty of Pharmacy, Port Said University, Port Said 42526, Egypt
| | - Khaled M. Darwish
- Department
of Medicinal Chemistry, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Amani Chrouda
- Department
of Chemistry, College of Science Al-Zulfi, Majmaah University, Al-Majmaah 11952, Saudi Arabia
- Laboratory
of Interfaces and Advanced Materials, Faculty of Sciences, Monastir University, Monastir 5000, Tunisia
| | - Amira A. Boseila
- Pharmaceutics
Department, Egyptian Drug Authority EDA
(Formerly Known as National Organization for Drug Control and Research
NODCAR) Dokki, Giza 12611, Egypt
| | - Mohamed A. Tantawy
- Hormones
Department, Medical Research Division, National
Research Centre, Dokki, Giza 12622, Egypt
- Stem
Cells Lab, Center of Excellence for Advanced Sciences, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Sameh S. Elhady
- Department
of Natural Products, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Afzal B. Shaik
- Department
of Pharmaceutical Chemistry, Vignan Pharmacy College, Jawaharlal Nehru Technological University, Vadlamudi 522 213, Andhra Pradesh, India
| | - Muhamad Mustafa
- Department
of Medicinal Chemistry, Deraya University, Minia 61111, Egypt
| | - Ahmed A. Al-karmalawy
- Department of Pharmaceutical Medicinal
Chemistry, Faculty of Pharmacy, Horus University-Egypt, New Damietta 34518, Egypt
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13
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Saniasiaya J. Mediastinal lymphoma presenting with asymmetrical chest wall. BMJ Case Rep 2022; 15:e246953. [PMID: 34996771 PMCID: PMC8744107 DOI: 10.1136/bcr-2021-246953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/04/2022] Open
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14
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Ghigna MR, Thomas de Montpreville V. Mediastinal tumours and pseudo-tumours: a comprehensive review with emphasis on multidisciplinary approach. Eur Respir Rev 2021; 30:30/162/200309. [PMID: 34615701 PMCID: PMC9488622 DOI: 10.1183/16000617.0309-2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/08/2021] [Indexed: 12/02/2022] Open
Abstract
The diagnosis of a mediastinal mass may be challenging for clinicians, since lesions arising within the mediastinum include a variety of disease entities, frequently requiring a multidisciplinary approach. Age and sex represent important information, which need to be integrated with imaging and laboratory findings. In addition, the location of the mediastinal lesion is fundamental; indeed, we propose to illustrate mediastinal diseases based on the compartment of origin. We consider that this structured approach may serve as hint to the diagnostic modalities and management of mediastinal diseases. In this review, we present primary mediastinal tumours in the evolving context of new diagnostic and therapeutic tools, with recently described entities, based on our own experience with >900 cases encountered in the past 10 years. Given the mediastinal anatomical heterogeneity, the correct positioning of mediastinal lesions becomes primal, in order to first establish a clinical suspicion and then to assist in planning biopsy and surgical procedurehttps://bit.ly/3p0gsk3
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Affiliation(s)
- Maria-Rosa Ghigna
- Dept of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
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15
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Long-term residential exposure to air pollution and Hodgkin lymphoma risk among adults in Denmark: a population-based case-control study. Cancer Causes Control 2021; 32:935-942. [PMID: 34050843 DOI: 10.1007/s10552-021-01446-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE The etiology of Hodgkin lymphoma (HL) is obscure. Research on air pollution and risk of HL provides inconsistent results. We aimed to investigate the association between long-term residential exposure to air pollution and risk of adult Hodgkin lymphoma in Denmark. METHODS We performed a nationwide register-based case-control study, including all (n = 2,681) Hodgkin lymphoma cases registered in the nationwide Danish Cancer Registry between 1989 and 2014. We randomly selected 8,853 age- and sex-matched controls from the entire Danish population using the Civil Registration System, and identified 20-year residential address history for all cases and controls. We modeled outdoor air pollution concentrations at all these addresses using the high-resolution multiscale air pollution model system DEHM/UBM/AirGIS. We used conditional logistic regression to estimate odds ratios adjusted for individual and neighborhood level sociodemographic variables. RESULTS There was no association between 1, 5, 10, and 20 years' time-weighted average exposure to fine particles (PM2.5), O3, SO2, NO2, or the PM2.5 constituents OC, NH4, NO3, and SO4 and risk of Hodgkin lymphoma. CONCLUSION Residential exposure to ambient air pollution does not seem to increase the risk of developing Hodgkin lymphoma.
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16
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Rash on the Chest of a Woman With Lymphadenopathy: Answer. Am J Dermatopathol 2021; 43:75-76. [PMID: 33337625 DOI: 10.1097/dad.0000000000001559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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DEMİR D, HEKİMGİL M, DEMİR E, BÜLBÜL H, ULUSOY Y, AKAD SOYER N, ANACAK Y, SAYDAM G, ŞAHİN F, ÖZSAN N. Ege Üniversitesi Hastanesi veri tabanında kayıtlı erişkin Hodgkin lenfoma olgularının epidemiyolojik ve genel sağ kalım özelliklerinin retrospektif olarak değerlendirilmesi. EGE TIP DERGISI 2020. [DOI: 10.19161/etd.815325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Alexander V, Shenoy R, Korula A, Koshy M. Intramuscular lymphoma: uncommon presentation of Hodgkin's disease. BMJ Case Rep 2020; 13:13/8/e229826. [PMID: 32847868 DOI: 10.1136/bcr-2019-229826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Extranodal presentation in lymphoproliferative disorders is a well-recognised entity. However, musculoskeletal involvement is extremely rare. We describe the case of a 64-year-old farmer who presented to us with constitutional symptoms of fever, loss of weight and loss of appetite for 2 years and physical examination revealing generalised lymphadenopathy with hepatosplenomegaly. Biopsy of an axillary lymph node showed mixed cellularity variant of Hodgkin's lymphoma. CT of the thorax and abdomen revealed a collection in the right psoas muscle. Guided biopsy of the psoas deposit was suggestive of Hodgkin's lymphoma. PCR and cultures for Mycobacterium tuberculosis tested negative. Here we describe a rare presentation of Hodgkin's lymphoma with intramuscular involvement.
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Affiliation(s)
- Vijay Alexander
- Internal Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Rachana Shenoy
- Internal Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Anu Korula
- Hematology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Maria Koshy
- Internal Medicine, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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19
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A case of nodular lymphocyte predominant Hodgkin lymphoma with unexpected EBV-latency type. Ann Hematol 2020; 100:2635-2637. [PMID: 32683458 PMCID: PMC8440277 DOI: 10.1007/s00277-020-04174-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/09/2020] [Indexed: 11/02/2022]
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20
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Jonjić N, Valković T, Vujaklija DV, Ilijaš KM. Diagnostic challenge of soft tissue extranodal Hodgkin lymphoma in core-needle biopsy: case report. Scott Med J 2020; 66:40-45. [PMID: 32659181 DOI: 10.1177/0036933020941262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hodgkin lymphoma (HL) is an uncommon malignancy usually limited to the lymph nodes and lymphatic system while extranodal involvement is much less common than in non-Hodgkin lymphoma. The current report presents an unusual case of primary classical HL (cHL), nodular sclerosis type with mixed cellularity in buttock soft tissue of 78-year old man. Primary lymphoma of the gluteal muscle is a rare disease and primary cHL is even rarer. In addition, to this unusual extranodal presentation, the present case highlight a diagnostic challenge in fine-needle biopsy masquerading a low grade sarcoma, primarily myxoinflammatory fibrosarcoma or an inflammatory lesion. However, surgical biopsy and immunohistochemistry guided correct diagnosis that was of major interest for further successful treatment.
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Affiliation(s)
- Nives Jonjić
- Pathologist, 112565Clinical Hospital Center Rijeka, Croatia
| | - Toni Valković
- Hematologist, 112565Clinical Hospital Center Rijeka, Croatia
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21
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Siref A, McCormack C, Huang Q, Lim W, Alkan S. Diminished expression of 5hmc in Reed-Sternberg cells in classical Hodgkin lymphoma is a common epigenetic marker. Leuk Res 2020; 96:106408. [PMID: 32659407 DOI: 10.1016/j.leukres.2020.106408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/28/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023]
Abstract
Loss of the epigenetic marker 5-hydroxymethylcytosine (5hmC) has been demonstrated in a variety of neoplasms. Several recent studies have shown epigenetic alteration in Classical Hodgkin lymphoma (CHL), which may impact treatment. We demonstrate near universal depletion of 5hmC in the neoplastic Hodgkin Reed-Sternberg (H/RS) cells in all cases of CHL (49/49). We hypothesized that the addition of vitamin C-a cofactor for the ten-eleven translocation (TET) enzymes which oxidize 5-methylcytosine (5mC) to 5hmC - may replenish levels of 5hmC. The CHL cell line L428 was grown in optimal conditions and then subjected to vitamin C treatment, which demonstrated reduced cell viability as well as caspase activation and increased concentration of 5hmC. A more detailed understanding of the epigenetic landscape of CHL may help guide future therapies.
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Affiliation(s)
- Andrew Siref
- Cedars-Sinai Medical Center, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., Room #4711, Los Angeles, CA 90048-1804, United States
| | - Colin McCormack
- Cedars-Sinai Medical Center, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., Room #4711, Los Angeles, CA 90048-1804, United States
| | - Qin Huang
- Cedars-Sinai Medical Center, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., Room #4711, Los Angeles, CA 90048-1804, United States
| | - Washington Lim
- Cedars-Sinai Medical Center, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., Room #4711, Los Angeles, CA 90048-1804, United States
| | - Serhan Alkan
- Cedars-Sinai Medical Center, Department of Pathology and Laboratory Medicine, 8700 Beverly Blvd., Room #4711, Los Angeles, CA 90048-1804, United States.
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22
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Cencini E, Fabbri A, Santoni A, Mecacci B, Bocchia M. Coexistence of Serum Monoclonal Gammopathy of Uncertain Significance and Hodgkin Lymphoma. Indian J Hematol Blood Transfus 2020; 36:390-392. [PMID: 32425396 DOI: 10.1007/s12288-019-01242-2] [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: 11/11/2019] [Accepted: 12/06/2019] [Indexed: 11/29/2022] Open
Abstract
An uncommon association between multiple myeloma and Hodgkin lymphoma (HL) was observed in some case reports, while an association with monoclonal gammopathy of uncertain significance (MGUS) is exceedingly rare. We have diagnosed 110 HL cases from 2008 to 2018; here we report 4 HL cases associated with MGUS. MGUS was diagnosed before HL (1 case), together with HL (1 case) or after HL (2 cases). M-component was IgG/k (3 cases) and IgG/k and IgG/λ (1 case), MGUS was not influenced by HL treatment (2 cases), raised after therapy (1 case), while in the last case MGUS appeared after ASCT while HL was in complete remission. We suggest to further study a possible link between MGUS and HL and to perform serum immunofixation if protein electrophoresis shows a suspected discrete band. The comprehension of pathophysiology of this association and a possible role of cytokines such as IL-6 and antilymphoma therapies such as nivolumab or ASCT to MGUS development could represent an interesting research field that requires further investigations.
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Affiliation(s)
- Emanuele Cencini
- 1Hematology Unit, University Hospital, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 16, 53100 Siena, Italy.,2Hematology Unit, University of Siena, Siena, Italy
| | - Alberto Fabbri
- 1Hematology Unit, University Hospital, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 16, 53100 Siena, Italy.,2Hematology Unit, University of Siena, Siena, Italy
| | - Adele Santoni
- 1Hematology Unit, University Hospital, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 16, 53100 Siena, Italy.,2Hematology Unit, University of Siena, Siena, Italy
| | - Bianca Mecacci
- 1Hematology Unit, University Hospital, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 16, 53100 Siena, Italy.,2Hematology Unit, University of Siena, Siena, Italy
| | - Monica Bocchia
- 1Hematology Unit, University Hospital, Azienda Ospedaliera Universitaria Senese, Viale Bracci, 16, 53100 Siena, Italy.,2Hematology Unit, University of Siena, Siena, Italy
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23
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Facheris P, Valenti M, Pavia G, Grizzi F, Narcisi A, Costanzo A, Borroni RG. Specific infiltrate of Hodgkin lymphoma at site of cellulitis mimicking secondary cutaneous involvement. J Cutan Pathol 2020; 47:462-465. [PMID: 31769877 DOI: 10.1111/cup.13618] [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] [Received: 08/01/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
Hodgkin lymphoma (HL) usually involves the lymph nodes, but concomitant cutaneous manifestations can also occur. The diagnosis of cutaneous involvement by HL must be supported by specific clinical and histopathological findings. We describe the case of a 56-year-old man recently diagnosed with HL of the left axillary nodes who developed cellulitis of the left trunk. Histopathological examination of a skin biopsy specimen revealed the presence of large atypical lymphoid cells with the same immunophenotype of those located in the lymph node affected by HL. Our case adds to the many cutaneous infiltrations by neoplastic cells during the course of an inflammatory skin disease, namely cellulitis.
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Affiliation(s)
- Paola Facheris
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Mario Valenti
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giulia Pavia
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Fabio Grizzi
- Department of Immunology and Inflammation, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - Alessandra Narcisi
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Antonio Costanzo
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Riccardo G Borroni
- Dermatology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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24
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Qayyum MA, Shah MH. Disparities in Trace Metal Levels in Hodgkin/Non-Hodgkin Lymphoma Patients in Comparison with Controls. Biol Trace Elem Res 2020; 194:34-47. [PMID: 31098833 DOI: 10.1007/s12011-019-01746-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023]
Abstract
Lymphoma arises from cells of the immune system and trace metals augment the immune system and their imbalance may promote immunological disorders including tumorigenesis. The primary aim of the present investigation was to evaluate the levels of essential/toxic trace metals in the nails of non-Hodgkin and Hodgkin lymphomas patients in comparison with controls. The samples collected from patients and controls were digested in the mixture of HNO3-HClO4 and selected trace metals were analysed using flame atomic absorption spectrometry. The results showed that mean concentrations of some elements (Pb, Ni, Cd, Cu and Cr) in nails of non-Hodgkin lymphoma patients were significantly elevated (p < 0.05) than that of the controls whereas mean contents of Pb, Cu, Cd and Cr were observed to be significantly higher in the nails of Hodgkin lymphoma patients compared with healthy donors. Additionally, correlation study pointed out significantly diverse mutual associations of the trace metals among the patients and controls. The present results revealed noticeable disparities in the metal concentrations based on gender, food habits, tobacco use and types/stages of the donor's groups. Overall, the pathogenesis of disease significantly affected the trace metal balance in both patients' groups.
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Affiliation(s)
- Muhammad Abdul Qayyum
- Department of Chemistry, University of Education Lahore, Faisalabad Campus, Faisalabad, 38000, Pakistan
| | - Munir Hussain Shah
- Department of Chemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan.
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25
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Anterior chest wall reconstruction for cutaneous involvement of Hodgkin’s lymphoma. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.592917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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26
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Safety and Efficacy in Relapsed or Refractory Classic Hodgkin's Lymphoma Treated with PD-1 Inhibitors: A Meta-Analysis of 9 Prospective Clinical Trials. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9283860. [PMID: 31950058 PMCID: PMC6948280 DOI: 10.1155/2019/9283860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/01/2019] [Accepted: 11/14/2019] [Indexed: 01/03/2023]
Abstract
Background Classic Hodgkin's lymphoma (cHL) is characterized by the unique biology in which rare Hodgkin-Reed-Sternberg cells propagate an immunosuppressive microenvironment. Checkpoint inhibitors that target the interaction of PD-1 immune checkpoint receptors have demonstrated remarkable activities in various cancers, such as cHL. This study aims to evaluate the safety and efficacy of PD-1 inhibitors in treating relapsed or refractory cHL (rrHL). Methods We searched PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Literature, and Abstracts of Conference proceedings of annual meetings without any language restrictions to limit language bias (up to January 2019) for prospective clinical trials that evaluate PD-1 inhibitors in treating relapsed or refractory cHL. Results A total of 9 prospective clinical trials with 731 patients were included in the meta-analysis. The pooled risks of all-grade and grade ≥3 adverse events (AEs) were 0.86 (95% CI: 0.66–0.98) and 0.21 (95% CI: 0.17–0.24), respectively. The pooled response, complete response, partial response, and stable disease rates were 0.74 (95% CI: 0.70–0.79), 0.24 (95% CI: 0.18–0.34), 0.48 (95% CI: 0.41–0.55), and 0.15 (95% CI: 0.12–0.17), respectively. The pooled 6-month progression-free survival and 1-year overall survival rates were 0.76 (95% CI: 0.72–0.79) and 0.93 (95% CI: 0.90–0.96), correspondingly. Conclusions Our meta-analysis suggested that anti-PD1 monoclonal antibodies improve the outcomes of response and survival rates with tolerable AEs in cHL. However, evidence of immune checkpoint inhibitors for patients with cHL remained insufficient. Well-designed randomized controlled trials or at least nonrandomized trials with a control group should be conducted to confirm the findings of this meta-analysis.
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27
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Völker HU, Becker E, Müller-Hermelink HK, Scheich M. [Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region]. HNO 2019; 68:32-39. [PMID: 31712877 DOI: 10.1007/s00106-019-00781-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Extranodal lymphomas occurring in the head and neck region account for 12-15% of all malignant tumors of this locality. Classical Hodgkin lymphoma (cHL) is a rare subtype, representing around 1% of all lymphomas in Waldeyer's ring. Cases diagnosed in the Reference Centre for Lymph Node Pathology at the Pathological Institute of the University of Würzburg were further analyzed in this study. MATERIALS AND METHODS Histological subtype and EBV association of 21 cases were reviewed in conjunction with clinical data. RESULTS Data of 12 male and 9 female patients with an average age of 51 years (median 45; 35-72) were reviewed. All samples were taken from the lymphatic tissue of the Waldeyer's ring (nasopharynx n = 15, palatine tonsils n = 5, lingual tonsils n = 1). The most common symptoms leading to a consultation with an otorhinolaryngologist were otalgia, swelling, or impaired nasal breathing. Only four patients showed typical B‑symptoms. In 6 cases (29%), an isolated extranodal manifestation was found, 15 patients (71%) showed simultaneous infiltration of cervical lymph nodes during staging, and 6 cases (29%) were EBV positive. CONCLUSION An exclusively extranodal manifestation of cHL in Waldeyer's ring is rare, whereas infiltration of extranodal tissue in the case of a primary manifestation of lymphoma in cervical nodes can occur more frequently and may often remain undiagnosed. Therefore, a specialized ENT consultation could be a reasonable complementary module in tumor staging to determine the correct tumor extent.
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Affiliation(s)
- H-U Völker
- Pathologie, Leopoldina Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Deutschland
| | - E Becker
- Pathologie, Leopoldina Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Deutschland
| | | | - M Scheich
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
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28
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Azriel A, Towner JE, Gaillard F, Box G, Rogers T, Morokoff A. Solitary intraventricular Hodgkin lymphoma post-transplant lymphoproliferative disease (HL-PTLD): Case report. J Clin Neurosci 2019; 69:269-272. [PMID: 31451379 DOI: 10.1016/j.jocn.2019.08.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/06/2019] [Indexed: 11/16/2022]
Abstract
Lymphomas affecting the central nervous system (CNS), both primarily and secondarily, are uncommon malignancies. Immunosuppressed states, including iatrogenic immunosuppression following organ transplantation, are the most significant risk factors for developing primary CNS lymphoma (PCNSL). Post-transplant lymphoproliferative disease (PTLD) is a well described complication following bone marrow or solid organ transplantation. PTLD is usually a systemic disease with occasional CNS involvement. The incidence of CNS involvement in PTLD is low, and the majority of these cases tend to be PCNSL. Hodgkin lymphoma PTLD (HL-PTLD) constitutes only a very small percentage of PTLD. We report a rare case of a primary intraventricular CNS classical HL-PTLD in a male patient, 18 years following renal transplantation. The location allowed for safe neurosurgical intervention which resolved the symptom of elevated intracranial pressure and allowed for induction of a Rituximab-based chemotherapy regimen. Both the ventricular location of the PTLD and Hodgkin Lymphoma PTLD are themselves individually quite rare and have not previously been reported together. The unique location allowed safe neurosurgical intervention which quickly resolved the symptom of elevated intracranial pressure and allowed for induction of a Rituximab-based chemotherapy regimen.
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Affiliation(s)
- Amit Azriel
- Department of Neurosurgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia.
| | - James E Towner
- Department of Neurosurgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Frank Gaillard
- Department of Radiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Australia
| | - Georgia Box
- Department of Radiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - TeWhiti Rogers
- Department of Pathology, The Royal Melbourne Hospital, Victoria, Australia
| | - Andrew Morokoff
- Department of Neurosurgery, The Royal Melbourne Hospital, Victoria, Australia; Department of Surgery, The University of Melbourne, Victoria, Australia
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Abstract
OBJECTIVE. The purpose of this article is to provide a primer for radiologists focused on integrating the radiologic, pathologic, and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL). CONCLUSION. PMLBCL is a unique subtype of lymphoma that poses diagnostic and therapeutic challenges to the fields of radiology and oncology. Knowledge of this distinctive clinical-pathologic entity and its associated imaging and clinical features is critical for radiologists.
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Zaidi A, Gupta P, Rajwanshi A. Splenic space occupying lesions in a young adult. Cytopathology 2019; 31:75-77. [PMID: 31392784 DOI: 10.1111/cyt.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/17/2019] [Accepted: 08/01/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Ariba Zaidi
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecologic Pathology, PGIMER, Chandigarh, India
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31
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Silva DOB, Correia NAA, de Barros FT, de Lima LPO, Morais A, Hassan R, Dellalibera E, de Mendonça Cavalcanti MDS, Muniz MTC. 3' untranslated region A>C (rs3212227) polymorphism of Interleukin 12B gene as a potential risk factor for Hodgkin's lymphoma in Brazilian children and adolescents. Tumour Biol 2019; 41:1010428319860400. [PMID: 31277552 DOI: 10.1177/1010428319860400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Interleukin 12 plays an important role in immunoregulation between the T helper 1/T helper 2 lymphocytes and in the antiviral and antitumor immune response. The aim of this study was to investigate the possible association between the interleukin 12B polymorphism rs3212227 and the risk to develop Hodgkin's lymphoma in childhood and adolescents. A total of 100 patients with Hodgkin's lymphoma and a group of 181 healthy controls were selected at random from a forensic laboratory of the University of Pernambuco. The AA genotype was detected in the controls (53.04%) and the AC genotype was found in the patients (54%). The AC genotype showed an association with the development of Hodgkin's lymphoma (odds ratio = 2.091, 95% confidence interval = 1.240-3.523, p = 0.007). When AC + CC genotypes were analyzed together, an increase in risk of 1.9 times more chances for HL development could be observed (odds ratio = 1.923, 95% confidence interval = 1.166-3.170, p = 0.014). However, there was no association between the AC and CC genotypes of the interleukin 12B polymorphism with the clinical risk group (p = 0.992, p = 0.648, respectively). Our results suggest that the presence of the C allele may be contributing to the development of Hodgkin's lymphoma in children and adolescents.
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Affiliation(s)
- de Oliveira Bárbara Silva
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil.,2 Biological Sciences Institute, University of Pernambuco, Recife, Brazil
| | - Nunes Amanda A Correia
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil.,2 Biological Sciences Institute, University of Pernambuco, Recife, Brazil
| | - Ferreira Thiago de Barros
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil.,3 Faculty of Medical Sciences, University of Pernambuco, Recife, Brazil
| | - Luísa Priscilla Oliveira de Lima
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil.,2 Biological Sciences Institute, University of Pernambuco, Recife, Brazil
| | - Adriana Morais
- 4 Pediatric Outpatient Clinic, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil
| | - Rocio Hassan
- 5 Oncovirology Laboratory, Bone Marrow Transplantation Center, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil
| | - Edileine Dellalibera
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil
| | | | - Maria Tereza Cartaxo Muniz
- 1 Laboratory of Molecular Biology, Pediatric Hematology Oncology Center, University of Pernambuco, Recife, Brazil.,2 Biological Sciences Institute, University of Pernambuco, Recife, Brazil
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Rossi E, Perrone A, Bongini U, Cangelosi AM, Sollai S, Narese D, Defilippi C. Chest Imaging of a rare case of cat-scratch disease in a 2-years-old baby. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 89:585-588. [PMID: 30657130 PMCID: PMC6502092 DOI: 10.23750/abm.v89i4.6070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/25/2017] [Indexed: 11/23/2022]
Abstract
Cat-scratch disease (CSD) is usually a self-limiting infection that in the majority of cases occurs as lymphadenitis in children who have been scratched or bitten by a cat. Rarely, Bartonella henselae is cause of fever of unknown origin (FUO), with dissemination to various organs, mimicking an inflammatory rather than a lymphoproliferative disease. This manuscript will present a case of thoracic manifestations of CSD in an immunocompetent 2-years baby without history of cat contact, with fever of unknown origin, investigated by chest CT and MRI. (www.actabiomedica.it)
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Affiliation(s)
- Enrica Rossi
- Department of Imaging, Bambino Gesù Children's Hospital, Rome, Italy.
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Hodgkin lymphoma at Groote Schuur Hospital, South Africa: the effect of HIV and bone marrow infiltration. Ann Hematol 2018; 98:381-389. [PMID: 30397846 DOI: 10.1007/s00277-018-3533-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/19/2018] [Indexed: 12/14/2022]
Abstract
Human immunodeficiency virus (HIV) is associated with an increased risk of developing Hodgkin lymphoma (HL). South Africa (SA) has the highest HIV prevalence rate in the world. There is currently no outcome-based data for HIV-associated HL from SA. A bone marrow database was compiled of all bone marrow biopsies (BMB) reported at National Health Laboratory Service (NHLS) Groote Schuur Hospital (GSH) between January 2005 and December 2012. Patients who had a BMB performed for staging of HL or where HL was diagnosed on the BMB were included for further analysis. Clinical and laboratory data was extracted from medical and laboratory records. Primary outcome measures included histological subtype, bone marrow infiltration (BMI) by HL, CD4 count, HIV-viral load (HIV-VL), tuberculosis (TB) data, treatment with chemotherapy and 5-year overall survival (OS). The database included 6569 BMB and 219 patients of these had HL and were included for analysis. The median age at presentation (32 years) was similar in the HIV+ and HIV- populations. While males predominated in the HIV- group, females predominated in the HIV+ group (male:female ratio of 1.5:1 vs 0.7:1, respectively). The majority of patients (71%) were HIV negative (HIV-) and 29% were HIV positive (HIV+). The diagnosis of HL was made on BMB in 17% of cases. BMI was seen in 37% (82/219) overall, and was found in more HIV+ patients (61%; 39/64) than HIV- patients (28%; 43/155; p = 0.03). The histological subtype varied according to HIV status with nodular sclerosis classical Hodgkin lymphoma (NSCHL) being most frequent in the HIV- group and classical Hodgkin lymphoma (CHL)-unclassifiable the most frequent in the HIV+ group. HIV+ patients had a median CD4 count of 149 × 106/L and 39% were anti-retroviral therapy (cART) naive at HL diagnosis. HIV+ patients had received anti-TB therapy more frequently than HIV- patients (72% vs 17%; p = 0.007). More HIV+ patients did not receive chemotherapy than HIV- patients (31% vs 3%; p = 0.001). The 5-year OS was 56%. HIV+ patients with BMI had a 5-year OS of 18%. BMI, HIV status, low CD4 count, histological subtype and TB therapy had a statistical significant impact on 5-year OS (p < 0.01). The 5-year OS was 56%, with both BMI and HIV+ status being associated with poor survival. BMB provided the diagnosis of HL in 17% of cases, confirming its diagnostic utility in our setting. Our cohort showed similar survival outcomes to other countries in Africa, Asia and Central America with comparable socio-economic constraints to SA.
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Pernot B, Gyan E, Maillot F, Hodges P, Ertault M, Ferreira-Maldent N. Lymphomas diagnosed in an internal medicine department compared to lymphomas diagnosed in other departments: Clinical and outcome differences. Medicine (Baltimore) 2018; 97:e13228. [PMID: 30461623 PMCID: PMC6392786 DOI: 10.1097/md.0000000000013228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lymphomas are common malignancies with highly variable clinical presentations and prognosis. Prognostic value of clinical presentation at onset is still questioned. The objective of this study was to compare the disease presentation and the outcome of lymphomas diagnosed in an Internal Medicine Department of a University Hospital to disease presentation and outcome of patients who were referred to the Hematology Department of the same institution by other departments or healthcare facilities.This retrospective monocentric observational study included 37 patients. They were matched to 73 patients, who were referred to the Hematology Department, according to age, histology, and Ann Arbor stage. The demographics, clinical and biological presentations, overall survival, and progression-free survival were compared.Patients diagnosed with lymphoma in the Internal Medicine Department were more likely to be febrile (67.5% vs 21.9%; P < .001) and have higher inflammatory markers (mean C-reactive protein 86.6 vs 56.3 mg/L; P = .02). The median overall survival of these patients was poorer (P < .001), even in the subset of patients treated with standard treatment, and remained shorter in multivariable analysis (P = .002). The specific treatment started earlier (20.2 vs 37.5 days; P = .006), but was more frequently palliative (37.8% vs 19.2%; P = .04). There was no significant difference in median progression-free survival.Lymphomas diagnosed in an Internal Medicine Department had aggressive clinical presentations and a poorer outcome, despite an early start of conventional treatment.
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Affiliation(s)
- Benoit Pernot
- Geriatrics Department, Hospital Center André Gibotteau, Boulevard Kennedy, Vendôme
| | - Emmanuel Gyan
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - François Maillot
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Penelope Hodges
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
| | - Marjan Ertault
- Hematology Department, University Hospital Center of Tours, Boulevard Tonnelé, Tours
| | - Nicole Ferreira-Maldent
- Internal Medicine Department, University Hospital Center of Tours, Université François Rabelais, France
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Wang X, Ludwig EA, Passarell J, Bello A, Roy A, Hruska MW. Population Pharmacokinetics and Exposure - Safety Analyses of Nivolumab in Patients With Relapsed or Refractory Classical Hodgkin Lymphoma. J Clin Pharmacol 2018; 59:364-373. [DOI: 10.1002/jcph.1324] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/19/2018] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | | | - Amit Roy
- Bristol-Myers Squibb; Princeton NJ USA
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36
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Huang R, Zhang X, Min Z, Shadia AS, Yang S, Liu X. MGCD0103 induces apoptosis and simultaneously increases the expression of NF-κB and PD-L1 in classical Hodgkin's lymphoma. Exp Ther Med 2018; 16:3827-3834. [PMID: 30344659 PMCID: PMC6176203 DOI: 10.3892/etm.2018.6677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 07/26/2018] [Indexed: 12/22/2022] Open
Abstract
At present there is no consensus on the treatment of classical Hodgkin's lymphoma (CHL) following relapse. The aim of the present study was to access the class I-selective histone deacetylase (HDAC) inhibitor (HDACI) MGCD0103 on the expression levels of Bcl-2, nuclear factor (NF)-κB and programmed death-ligand 1 (PD-L1) in CHL, to explore the possible therapeutic value of MGCD0103 in combined relative target drugs for patients with CHL. In L1236 and L428 cell lines, apoptosis and cell cycle stage were identified using flow cytometry, and the effects of HDACI on CHL were assessed in terms of Bcl-2, NF-κB and PD-L1 expression levels, which were detected by western blotting and co-focusing experiments. The results demonstrated that MGCD0103 could induce cell apoptosis and cell cycle arrest, down-regulate Bcl-2 and increase NF-κB and PD-L1 expression levels in L1236 and L428 cell lines. MGCD0103 decreases Bcl-2 levels and upregulates PD-L1, which indicates that the combined use of HDACIs and a PD-L1 inhibitor in theory may improve treatment outcomes in patients with CHL. MGCD0103 may also up-regulate NF-κB, which seems to induce resistance towards anti-apoptotic drugs. Clinical trials combining HDACIs with NF-κB and/or PD-L1 inhibitors should be designed to further improve treatment outcomes for patients with CHL.
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Affiliation(s)
- Renhong Huang
- Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, P.R. China
| | - Xiaowei Zhang
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai 200031, P.R. China
| | - Zhijun Min
- Department of Gastrointestinal Surgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, P.R. China
| | - Abdelbari Sophia Shadia
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai 200031, P.R. China
| | - Shun'e Yang
- Department of Lymphoma, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, P.R. China
| | - Xiaojian Liu
- Department of Medical Oncology, Shanghai Cancer Center, Fudan University, Shanghai 200031, P.R. China
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37
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Nagaharu K, Masuya M, Kageyama Y, Yamaguchi T, Ito R, Kawakami K, Ito M, Katayama N. Successful treatment of primary bone marrow Hodgkin lymphoma with brentuximab vedotin: a case report and review of the literature. J Med Case Rep 2018; 12:151. [PMID: 29843820 PMCID: PMC5975584 DOI: 10.1186/s13256-018-1693-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/17/2018] [Indexed: 12/27/2022] Open
Abstract
Background Hodgkin lymphoma usually presents with sequential enlargement of peripheral lymph nodes, and bone marrow invasion rarely occurs (approximately 3–5%). However, several cases have been reported as “primary” bone marrow Hodgkin lymphoma, especially among patients with human immunodeficiency virus and the elderly. This type of Hodgkin lymphoma is characterized by no peripheral lymphadenopathies and has been reported to have poorer prognosis. Case presentation A 38-year-old Japanese man was admitted to our hospital because of fever of unknown origin and pancytopenia without lymphadenopathies. Bone marrow examination revealed Hodgkin cells mimicking abnormal cells. These were positive for CD30, EBER-1, CD15, PAX-5, and Bob-1 and negative for Oct-2, CD3, CD20, surface immunoglobulin, CD56. On the basis of systemic evaluation and bone marrow examination, he was diagnosed with primary bone marrow Hodgkin lymphoma. We initiated therapy with DeVIC (dexamethasone, etoposide, ifosfamide, and carboplatin) therapy, but remission was not achieved. Then, the patient was treated with brentuximab vedotin combined with systemic chemotherapy (Adriamycin, vinblastine and dacarbazine), which was effective. Conclusions There is no established treatment strategy for Hodgkin lymphoma, and therapeutic outcomes using ABVD (Adriamycin, bleomycin, vinblastine and dacarbazine)-like or CHOP (cyclophosphamide, Adriamycin, vincristine, and prednisone)-like regimens are reportedly poor. Only a few patients have been reported to achieve long-term remission. Through this case report, we suggest an alternative therapeutic option for primary bone marrow Hodgkin lymphoma.
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Affiliation(s)
- Keiki Nagaharu
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan. .,Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
| | - Masahiro Masuya
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan
| | - Yuki Kageyama
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan
| | - Takanori Yamaguchi
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Ryugo Ito
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Keiki Kawakami
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Masafumi Ito
- Department of Pathology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Naoyuki Katayama
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
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Shah S, Smith M, Butler R. A Case of Hodgkin Lymphoma Mimicking Lymphomatoid Granulomatosis Diagnosed at Autopsy. Lab Med 2018; 49:80-86. [PMID: 29165611 DOI: 10.1093/labmed/lmx065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hodgkin lymphoma and lymphomatoid granulomatosis (LYG) are entities that contain a small number of large, variably Epstein-Barr virus (EBV)-positive neoplastic cells scattered within background non-neoplastic mixed inflammatory infiltrate. The 2 entities can typically be distinguished histologically by the angiocentric and angiodestructive pattern of lymphomatoid granulomatosis (LYG); also, they differ in overall prognosis. Herein, we report a case of Hodgkin lymphoma in a 64-year-old Caucasian woman, diagnosed at autopsy with unusual histologic features and aggressive clinical course that mimicked LYG.
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Affiliation(s)
- Sujal Shah
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center, Cinncinati, OH
| | - Megan Smith
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center, Cinncinati, OH
| | - Randall Butler
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center, Cinncinati, OH
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Lee SJ, Rho JY, Kim GI, Park J. Anterior mediastinal Hodgkin lymphoma presenting as an extremely hypervascular tumor on computed tomography: A case report. Medicine (Baltimore) 2018; 97:e0607. [PMID: 29742695 PMCID: PMC5959439 DOI: 10.1097/md.0000000000010607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE In the thorax, Hodgkin lymphoma (HL) most frequently involves the anterior mediastinal and paratracheal regions and tends to spread to contiguous nodal groups. Enlarged lymph nodes typically have homogeneous soft tissue attenuation similar to that of muscle tissue on computed tomography (CT). PATIENT CONCERNS A contrast-enhanced CT examination of a 19-year-old man with right-sided chest pain showed an intense, heterogeneously enhancing mass with organization of serpentine and dilated blood vessels in the right anterior mediastinum that had invaded the upper lobe of the right lung. DIAGNOSES Following a wedge resection, histopathological examination showed Reed-Sternberg cells that were positive for CD-15 and CD-30, which is typical of HL. INTERVENTIONS The patient was started treatment with 6 cycles of doxorubicin, bleomycin, vincristine, and dacarbazine (ABVD) regimen. OUTCOMES After chemotherapy, the patient had shown a partial response to the treatment. LESSONS This presentation of HL as an extremely hypervascular anterior mediastinal mass on CT imaging has not been previously reported in the literature. This case suggests that HL should be included in the differential diagnosis of a hypervascular anterior mediastinal mass, especially if the patient is a young adult.
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Affiliation(s)
| | | | | | - Joonsuk Park
- Department of Thoracic Surgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Republic of Korea
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40
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Hjort MA, Hov H, Abdollahi P, Vandsemb EN, Fagerli UM, Lund B, Slørdahl TS, Børset M, Rø TB. Phosphatase of regenerating liver-3 (PRL-3) is overexpressed in classical Hodgkin lymphoma and promotes survival and migration. Exp Hematol Oncol 2018; 7:8. [PMID: 29651360 PMCID: PMC5894150 DOI: 10.1186/s40164-018-0100-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/31/2018] [Indexed: 11/25/2022] Open
Abstract
Background Phosphatase of regenerating liver-3 (PRL-3) is implicated in oncogenesis of hematological and solid cancers. PRL-3 expression increases metastatic potential, invasiveness and is associated with poor prognosis. With this study, we aimed to show a possible oncogenic role of PRL-3 in classical Hodgkin lymphoma (cHL). Methods PRL-3 expression was measured in 25 cHL patients by immunohistochemistry and gene expression was analyzed from microdissected malignant cells. We knocked down PRL-3 in the cHL cell lines L1236 and HDLM2 and used small molecular inhibitors against PRL-3 to investigate proliferation, migration and cytokine production. Results PRL-3 protein was expressed in 16% of patient samples. In three different gene expression datasets, PRL-3 was significantly overexpressed compared to normal controls. PRL-3 knockdown reduced proliferation, viability and Mcl-1 expression in L1236, but not in HDLM2 cells. Thienopyridone, a small molecule inhibitor of PRL-3, reduced proliferation of both L1236 and HDLM2. PRL-3 affected IL-13 secretion and enhanced STAT6 signaling. IL-13 stimulation partially rescued proliferation in L1236 cells after knockdown of PRL-3. PRL-3 knockdown reduced migration in both L1236 and HDLM2 cells. Conclusion PRL-3 was overexpressed in a subset of cHL patients. Inhibition of PRL-3 increased IL-13 cytokine production and reduced migration, proliferation and viability. The effects could be mediated through regulation of the anti-apoptotic molecule Mcl-1 and a feedback loop of IL-13 mediated activation of STAT6. This point to a role for PRL-3 in the pathogenesis of Hodgkin lymphoma, and PRL-3 could be a possible new drug target. Electronic supplementary material The online version of this article (10.1186/s40164-018-0100-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Magnus Aassved Hjort
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,2Children's Clinic, Trondheim University Hospital, Trondheim, Norway
| | - Håkon Hov
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,3Department of Pathology, Trondheim University Hospital, Trondheim, Norway
| | - Pegah Abdollahi
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,2Children's Clinic, Trondheim University Hospital, Trondheim, Norway
| | - Esten Nymoen Vandsemb
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,2Children's Clinic, Trondheim University Hospital, Trondheim, Norway
| | - Unn-Merete Fagerli
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,4Cancer Clinic, Trondheim University Hospital, Trondheim, Norway
| | - Bendik Lund
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,2Children's Clinic, Trondheim University Hospital, Trondheim, Norway
| | - Tobias Schmidt Slørdahl
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,5Department of Hematology, Trondheim University Hospital, Trondheim, Norway
| | - Magne Børset
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,6Department of Immunology and Transfusion Medicine St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torstein Baade Rø
- 1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, (NTNU), P.O. Box 8905, 7491 Trondheim, Norway.,2Children's Clinic, Trondheim University Hospital, Trondheim, Norway
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Chiu J, Ernst DM, Keating A. Acquired Natural Killer Cell Dysfunction in the Tumor Microenvironment of Classic Hodgkin Lymphoma. Front Immunol 2018; 9:267. [PMID: 29491867 PMCID: PMC5817071 DOI: 10.3389/fimmu.2018.00267] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/30/2018] [Indexed: 12/21/2022] Open
Abstract
An understanding of interactions within the tumor microenvironment (TME) of classic Hodgkin lymphoma (cHL) has helped pave the way to novel immunotherapies that have enabled dormant and tumor-tolerant immune cells to be reactivated. The immunosuppressive nature of the TME in cHL specifically inhibits the proliferation and activity of natural killer (NK) cells, which contributes to tumor immune-escape mechanisms. This deficiency of NK cells begins at the tumor site and progresses systemically in patients with advanced disease or adverse prognostic factors. Several facets of cHL account for this effect on NK cells. Locally, malignant Reed-Sternberg cells and cells from the TME express ligands for inhibitory receptors on NK cells, including HLA-E, HLA-G, and programmed death-ligand 1. The secretion of chemokines and cytokines, including soluble IL-2 receptor (sCD25), Transforming Growth Factor-β, IL-10, CXCL9, and CXCL10, mediates the systemic immunosuppression. This review also discusses the potential reversibility of quantitative and functional NK cell deficiencies in cHL that are likely to lead to novel treatments.
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Affiliation(s)
- Jodi Chiu
- Cell Therapy Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Daniel M Ernst
- Cell Therapy Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Armand Keating
- Cell Therapy Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
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42
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Santos MAO, Lima MDM. CD20 role in pathophysiology of Hodgkin's disease. ACTA ACUST UNITED AC 2018; 63:810-813. [PMID: 29239464 DOI: 10.1590/1806-9282.63.09.810] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/02/2017] [Indexed: 11/21/2022]
Abstract
Hodgkin's lymphoma (HL) is a tumor comprising non-malignant and malignant B-cells. Classical HL expresses CD15+ and CD30+ antigens, and 20 to 40% of patients are CD20+. This antigen is a ligand free protein present in B lymphocyte cells and its function is not well known. Some studies suggest that expression of CD20 may play a major role in Hodgkin's disease pathophysiology and may affect the patients' treatment prognosis, as well as relapse and refractory response. In the past few years, development of monoclonal anti-CD20 antibodies changed drastically the treatment for non-Hodgkin lymphomas in which CD20 is expressed. HL treatment is essentially composed of radiotherapy and chemotherapy; however, monoclonal anti-CD20 antibodies applicability is not well delimitated due to lack of information about clinical outcomes with anti-CD20 monotherapy or combined drug therapy using a classic regimen, as well as about CD20 pathophysiology mechanisms in B-cells tumors. The objective of our review is to discuss CD20 function in Hodgkin's lymphoma development, its influence on disease evolution and outcomes, as well as its effects on therapeutics and patients' prognostic.
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Affiliation(s)
- Marcelo Antônio Oliveira Santos
- Epidemiology and Cardiology Research Group, Centro Universitário Maurício de Nassau, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Marinus de Moraes Lima
- Hospital do Câncer de Pernambuco, Centro Universitário Maurício de Nassau, Recife, CE, Brazil
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Agarwal M, Nabavizadeh SA, Mohan S. Chapter 6 Non-Squamous Cell Causes of Cervical Lymphadenopathy. Semin Ultrasound CT MR 2017; 38:516-530. [PMID: 29031368 DOI: 10.1053/j.sult.2017.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cervical lymphadenopathy is a common indication for imaging evaluation of the neck. Besides metastatic squamous cell carcinoma of the head and neck, cervical lymphadenopathy can be due to many causes, with simple reactive lymphadenopathy on one end of the spectrum and malignant lymphadenopathy due to a distant infraclavicular primary, on the other end. A systematic approach to the cause of cervical lymphadenopathy, which includes pattern of lymph node enlargement, lymph node characteristics, systemic symptoms, and extranodal abnormalities, can be very useful in arriving at the correct diagnosis. In this article, various patterns of cervical lymphadenopathy due to non-squamous cell causes are discussed.
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Affiliation(s)
- Mohit Agarwal
- Department of Radiology, Section of Neuroradiology, Medical College of Wisconsin, Milwaukee, WI
| | - Seyed Ali Nabavizadeh
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Suyash Mohan
- Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
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Szabo SM, Hirji I, Johnston KM, Juarez-Garcia A, Connors JM. Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study. PLoS One 2017; 12:e0180261. [PMID: 28991893 PMCID: PMC5633181 DOI: 10.1371/journal.pone.0180261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/13/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Although brentuximab vedotin (BV) has changed the management of patients with relapsed or refractory Hodgkin lymphoma (RRHL), little information is available on routine clinical practice. We identified treatment patterns and costs of care among RRHL patients in the United States (US) treated with BV. METHODS A retrospective observational study of adults initiating BV for RRHL from 2011-2015, with ≥6 months of data prior to and following BV initiation, was conducted. Treatments were classified based on dispensations and chemotherapy administration. Median total and monthly costs were estimated based on all-cause healthcare resource use in 2015 US dollars (USD). RESULTS The cohort comprised 289 patients (59% male; mean age at diagnosis, 42 years) with a mean follow-up of 250 weeks. Eleven percent had BV salvage therapy prior to ASCT, and 32% had BV for a relapse post-ASCT. 43% received treatment post-BV, most commonly allogeneic stem cell transplant (SCT) and bendamustine (both 10.2%). Median (IQR) total costs from BV initiation to censoring were 294,790 (142,110-483,360) USD; and were highest among those treated with BV prior to ASCT (up to 421,900 [300,940-778,970] USD). Median monthly costs were almost 20,000 USD per month, and up to 25,000 USD per month among those with BV and ASCT. Medications were the greatest driver of median monthly costs. CONCLUSIONS Median total all-cause costs were almost 300,000 USD, and median monthly costs approximately 20,000 USD, per patient treated. Patients requiring treatment following BV continue to incur high costs, highlighting the economic burden associated with managing patients in the RRHL setting.
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Affiliation(s)
| | - Ishan Hirji
- Bristol-Myers Squibb, Princeton, New Jersey, United States of America
| | | | | | - Joseph M. Connors
- BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
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Massoud M, Kerbage F, Nehme J, Sakr R, Rached L, Zeghondy J, Nasr F, Chahine G. Survival Pattern of Hodgkin Lymphoma Patients in the Last 25 Years in Lebanon. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17S:S88-S91. [PMID: 28760307 DOI: 10.1016/j.clml.2017.03.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
CONTEXT After the emergence of combination chemotherapy in 1960s, survival of patients with Hodgkin lymphoma (HL) has dramatically improved worldwide. We lack studies that document the favorable evolution of survival regarding this disease in Lebanon. OBJECTIVE To compare the overall survival in HL over 3 different decades in Lebanon. METHODS We retrospectively reviewed the charts of 196 patients diagnosed with HL, treated and followed from 1990 to 2015 in our center. Patients were divided into 3 groups according to period of analysis: group A (1990-1999), group B (2000-2009), and group C (2010-2015). We studied the characteristics and survival patterns of patients in each group. RESULTS The male-to-female sex ratio was 1.06. The median age at diagnosis was 33 years in group A, 30.4 in group B, and 33.12 in group C (P = .6). Results showed variations in the subtypes of the disease according to the following: nodular-sclerosis HL 59.5% in group A, 76.2% in group B, and 85.4% in group C. Mixed cellularity HL 21.6% in group A, 2.4% in group B, and 73.7% in group C (P = .0001). Patients presented with localized disease in 58.6%, 73.7%, and 56.4% in groups A, B, and C, respectively (P = .173). Complete remission was achieved in 76.5% in group A, 85.3% in group B, and 69.5% in group C (P = .007). The survival rate at 5 years in group A was 91%, 94% in group B, and 100% in group C. CONCLUSION The survival of patients with HL has dramatically improved over the past 25 years in Lebanon. These results resemble those achieved in Western countries due to the fast adoption of new molecular imaging technologies at diagnosis and follow-up and the rapid approval of new drugs for relapse in the Lebanese market.
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Affiliation(s)
- Marcel Massoud
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon
| | - Fouad Kerbage
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon.
| | - Joseph Nehme
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon
| | - Riwa Sakr
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon
| | - Layale Rached
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon
| | - Jean Zeghondy
- Holy Spirit University of Kaslik, Medical School, Jouneih, Lebanon, and CHU-Notre Dame Des Secours, Jbeil, Lebanon
| | - Fady Nasr
- Saint Joseph University, Medical School, Beirut, Lebanon
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Kirova Y, Horn S, Chen JY. Évolution des techniques d’irradiation pour la prise en charge de la maladie de Hodgkin : histoire et avenir. Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ye X, Mahmud S, Skrabek P, Lix L, Johnston JB. Long-term time trends in incidence, survival and mortality of lymphomas by subtype among adults in Manitoba, Canada: a population-based study using cancer registry data. BMJ Open 2017; 7:e015106. [PMID: 28716788 PMCID: PMC5734550 DOI: 10.1136/bmjopen-2016-015106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To examine 30-year time trends in incidence, survival and mortality of lymphomas by subtype in Manitoba, Canada. METHODS Lymphoma cases diagnosed between 1984 and 2013 were classified according to the 2008 WHO classification system for lymphoid neoplasms. Death data (1984-2014) were obtained from the Manitoba Vital Statistics Agency. To examine time trends in incidence and mortality, we used joinpoint regression to estimate annual percentage change and average annual percentage change. Age-period-cohort modelling was conducted to measure the effects of age, period and cohort on incidence and mortality time trends. We estimated age-specific and standardised 5-year relative survival and used Poisson regression model to test time trends in relative survival. RESULTS Total Hodgkin lymphoma (HL) incidence in men and women was stable during the study period. Age-standardised total non-Hodgkin lymphoma (NHL) incidence increased by 4% annually until around 2000, and the trend varied by sex and NHL subtype. Total HL mortality continuously declined (by 2.5% annually in men and by 2.7% annually in women), while total NHL mortality increased (by 4.4% annually in men until 1998 and by 3.2% annually in women until 2001) and then declined (by 3.6% annually in men and by 2.5% annually in women). Age-standardised 5-year relative survival for HL improved from 72.6% in 1984-1993 to 85.8% in 2004-2013, and for NHL from 57.0% in 1984-1993 to 67.5% in 2004-2013. Survival improvement was also noted for NHL subtypes, although the extent varied, with the greatest improvement for follicular lymphoma (from 65.3% in 1984-1993 to 87.6% in 2004-2013). CONCLUSIONS Time trends were generally consistent with those reported in other jurisdictions in total HL and NHL incidence, but were unique in incidence for HL and for NHL subtypes chronic/small lymphocytic leukaemia/lymphoma, diffuse large B cell lymphoma and follicular lymphoma. Survival improvements and mortality reductions were seen for HL and NHL in both sexes.
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Affiliation(s)
- Xibiao Ye
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin Mahmud
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Pamela Skrabek
- Department of Medical Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James B Johnston
- Department of Medical Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Abstract
The programmed death-1 (PD-1) pathway of immune evasion is exploited by many malignancies to limit host T-cell-mediated immune responses. Nivolumab is a PD-1-blocking monoclonal antibody that disrupts this pathway and is FDA approved for the treatment of metastatic melanoma, renal cell carcinoma, and squamous non-small cell lung cancer. In this case report, we describe the first published pediatric experience of nivolumab in refractory classic Hodgkin lymphoma. In this patient with primary refractory disease and high disease burden, cytokine release syndrome requiring inotropic support developed following the first infusion of nivolumab. The patient subsequently demonstrated a dramatic clinical response with resolution of fevers, transfusion independence, improvement in functional status, and very good partial response on PET/CT following a single dose. Nivolumab was continued with corticosteroid and antihistamine premedication without further adverse events and clinical benefit was sustained at 11 months after therapy initiation, despite evidence of slow radiographic disease progression.
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Swerev TM, Wirth T, Ushmorov A. Activation of oncogenic pathways in classical Hodgkin lymphoma by decitabine: A rationale for combination with small molecular weight inhibitors. Int J Oncol 2016; 50:555-566. [DOI: 10.3892/ijo.2016.3827] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/12/2016] [Indexed: 11/06/2022] Open
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England CG, Rui L, Cai W. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies. Eur J Nucl Med Mol Imaging 2016; 44:517-532. [PMID: 27844106 DOI: 10.1007/s00259-016-3560-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
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