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Poullot E, Milowich D, Lemonnier F, Bisig B, Robe C, Pelletier L, Letourneau A, Dupuy A, Sako N, Ketterer N, Carde P, Dartigues P, Delfau-Larue MH, de Leval L, Gaulard P. Angioimmunoblastic T-cell lymphoma and Kaposi sarcoma: A fortuitous collision? Histopathology 2024; 84:556-564. [PMID: 37988271 DOI: 10.1111/his.15083] [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: 08/26/2023] [Revised: 08/26/2023] [Accepted: 10/14/2023] [Indexed: 11/23/2023]
Abstract
AIMS Follicular helper T-cell (TFH) lymphoma of the angioimmunoblastic-type (AITL), one of the most prevalent T-cell lymphomas, typically encompasses proliferation of high endothelial venules and Epstein-Barr virus-positive immunoblasts, but neither infection with HHV8 nor association with Kaposi's sarcoma (KS) have been described. The aims of this study are to characterise the association between AITL and HHV8 infection or KS. METHODS AND RESULTS Three male patients aged 49-76 years, HIV-negative, with concurrent nodal involvement by AITL and KS, were identified from our files and carefully studied. Two patients originated from countries where endemic KS occurs, including one with cutaneous KS. The lymphomas featured abundant vessels, expanded follicular dendritic cells and neoplastic TFH cells [PD1+ (three of three), ICOS+ (three of three), CXCL13+ (three of three), CD10+ (two of three), BCL6 (two of three)] but lacked EBV+ immunoblasts. The foci of KS consisted of subcapsular proliferations of ERG+, CD31+ and/or CD34+ , HHV8+ spindle cells. High-throughput sequencing showed AITL-associated mutations in TET2 (three of three), RHOA (G17V) (three of three) and IDH2 (R172) (two of three), which were absent in the microdissected KS component in two cases. Relapses in two patients consisted of AITL, without evidence of KS. No evidence of HHV8 infection was found in a control group of 23 AITL cases. CONCLUSION Concurrent nodal involvement by AITL and KS is rare and identification of both neoplastic components may pose diagnostic challenges. The question of whether the association between AITL and KS may be fortuitous or could reflect the underlying immune dysfunction in AITL remains open.
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Affiliation(s)
- Elsa Poullot
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Dina Milowich
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - François Lemonnier
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
- Unité Hémopathies Lymphoïdes, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Bettina Bisig
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Cyrielle Robe
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Laura Pelletier
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Audrey Letourneau
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Aurélie Dupuy
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Nouhoum Sako
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
| | | | - Patrice Carde
- Onco-Hématologie, American Hospital of Paris, Neuilly-sur-Seine, France
| | - Peggy Dartigues
- Département de Pathologie, Institut Gustave Roussy, Villejuif, France
| | - Marie-Hélène Delfau-Larue
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
- Département d'Hématologie et Immunologie Biologique, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
| | - Laurence de Leval
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Philippe Gaulard
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
- Université Paris Est Créteil, Créteil, France
- INSERMU955, Institut Mondor de Recherche Biomédicale, Créteil, France
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2
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Drieux F, Lemonnier F, Gaulard P. How molecular advances may improve the diagnosis and management of PTCL patients. Front Oncol 2023; 13:1202964. [PMID: 37427095 PMCID: PMC10328093 DOI: 10.3389/fonc.2023.1202964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Peripheral T-cell lymphomas (PTCL) comprised more than 30 rare heterogeneous entities, representing 10 to 15% of adult non-Hodgkin lymphomas. Although their diagnosis is still mainly based on clinical, pathological, and phenotypic features, molecular studies have allowed for a better understanding of the oncogenic mechanisms involved and the refinement of many PTCL entities in the recently updated classifications. The prognosis remains poor for most entities (5-year overall survival < 30%), with current conventional therapies based on anthracyclin-based polychemotherapy regimen, despite many years of clinical trials. The recent use of new targeted therapies appears to be promising for relapsed/refractory patients, such as demethylating agents in T-follicular helper (TFH) PTCL. However further studies are needed to evaluate the proper combination of these drugs in the setting of front-line therapy. In this review, we will summarize the oncogenic events for the main PTCL entities and report the molecular targets that have led to the development of new therapies. We will also discuss the development of innovative high throughput technologies that aid the routine workflow for the histopathological diagnosis and management of PTCL patients.
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Affiliation(s)
- Fanny Drieux
- Service d’Anatomie et de Cytologie Pathologiques, INSERM U1245, Centre Henri Becquerel, Rouen, France
| | - François Lemonnier
- Unité hémopathies Lymphoïdes, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
- Institut Mondor de Recherche Biomédicale, INSERM U955, Université Paris Est Créteil, Créteil, France
| | - Philippe Gaulard
- Institut Mondor de Recherche Biomédicale, INSERM U955, Université Paris Est Créteil, Créteil, France
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
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3
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Marques-Piubelli ML, Amador C, Vega F. Pathologic and molecular insights in nodal T-follicular helper cell lymphomas. Front Oncol 2023; 13:1105651. [PMID: 36793612 PMCID: PMC9923156 DOI: 10.3389/fonc.2023.1105651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023] Open
Abstract
T-follicular helper (TFH) cells are one of the T-cell subsets with a critical role in the regulation of germinal center (GC) reactions. TFH cells contribute to the positive selection of GC B-cells and promote plasma cell differentiation and antibody production. TFH cells express a unique phenotype characterized by PD-1hi, ICOShi, CD40Lhi, CD95hi, CTLAhi, CCR7lo, and CXCR5hi . Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS). The diagnosis of these neoplasms can be challenging, and it is rendered based on a combination of clinical, laboratory, histopathologic, immunophenotypic, and molecular findings. The markers most frequently used to identify a TFH immunophenotype in paraffin-embedded tissue sections include PD-1, CXCL13, CXCR5, ICOS, BCL6, and CD10. These neoplasms feature a characteristic and similar, but not identical, mutational landscape with mutations in epigenetic modifiers (TET2, DNMT3A, IDH2), RHOA, and T-cell receptor signaling genes. Here, we briefly review the biology of TFH cells and present a summary of the current pathologic, molecular, and genetic features of nodal lymphomas. We want to highlight the importance of performing a consistent panel of TFH immunostains and mutational studies in TCLs to identify TFH lymphomas.
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Affiliation(s)
- Mario L Marques-Piubelli
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Catalina Amador
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL, United States
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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4
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Riva M, Tisi MC, Bertorelle R, Famengo B, D'Amore ESG, Pizzi M, Parisi A, Boscato E, Mazzucco M, Semenzato G, Krampera M, Gherlinzoni F, Trentin L, Ruggeri M, Visco C, Stefani PM, Piazza F. IDH2 R172 mutation in angioimmunoblastic T-cell lymphoma: A retrospective multicenter case series. Eur J Haematol 2023; 110:217-220. [PMID: 36264618 DOI: 10.1111/ejh.13885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Marcello Riva
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | | | - Roberta Bertorelle
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Istituto Oncologico Veneto, Padova, Italy
| | | | | | - Marco Pizzi
- General Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Alice Parisi
- Unit of Pathology, Department of Diagnostics and Public Health, G.B. Rossi University Hospital, Verona, Italy
| | - Elena Boscato
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy
| | - Maddalena Mazzucco
- Hematology Unit, Ospedale dell'Angelo and Ospedale S. Giovanni e Paolo, Mestre Venezia, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Filippo Gherlinzoni
- Hematology Unit, Department of Medicine, Treviso General Hospital, Treviso, Italy
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Unit, Padova, Italy
| | - Marco Ruggeri
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Piero Maria Stefani
- Hematology Unit, Department of Medicine, Treviso General Hospital, Treviso, Italy
| | - Francesco Piazza
- Department of Medicine, Hematology and Clinical Immunology Unit, Padova, Italy
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5
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Wang L, Rocas D, Dalle S, Sako N, Pelletier L, Martin N, Dupuy A, Tazi N, Balme B, Vergier B, Beylot-Barry M, Carlotti A, Bagot M, Battistella M, Chaby G, Ingen-Housz-Oro S, Gaulard P, Ortonne N. Primary cutaneous peripheral T-cell lymphomas with a T-follicular helper phenotype: an integrative clinical, pathological and molecular case series study. Br J Dermatol 2022; 187:970-980. [PMID: 35895386 PMCID: PMC10087773 DOI: 10.1111/bjd.21791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Primary cutaneous peripheral T-cell lymphomas with a T-follicular helper phenotype (pcTFH-PTCL) are poorly characterized, and often compared to, but not corresponding with, mycosis fungoides (MF), Sézary syndrome, primary cutaneous CD4+ lymphoproliferative disorder, and skin manifestations of angioimmunoblastic T-cell lymphomas (AITL). OBJECTIVES We describe the clinicopathological features of pcTFH-PTCL in this original series of 23 patients, and also characterize these cases molecularly. METHODS Clinical and histopathological data of the selected patients were reviewed. Patient biopsy samples were also analysed by targeted next-generation sequencing. RESULTS All patients (15 men, eight women; median age 66 years) presented with skin lesions, without systemic disease. Most were stage T3b, with nodular (n = 16), papular (n = 6) or plaque (atypical for MF, n = 1) lesions. Three (13%) developed systemic disease and died of lymphoma. Nine (39%) patients received more than one line of chemotherapy. Histologically, the lymphomas were CD4+ T-cell proliferations, usually dense and located in the deep dermis (n = 14, 61%), with the expression of at least two TFH markers (CD10, CXCL13, PD1, ICOS, BCL6), including three markers in 16 cases (70%). They were associated with a variable proportion of B cells. Eight patients were diagnosed with an associated B-cell lymphoproliferative disorder (LPD) on biopsy, including Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (n = 3), EBV+ LPD (n = 1) and monotypic plasma cell LPD (n = 4). Targeted sequencing showed four patients to have a mutated TET2-RHOAG17V association (as frequently seen in AITL) and another a TET2/DNMT3A/PLCG1/SETD2 mutational profile. The latter patient, one with a TET2-RHOA association, and one with no detected mutations, developed systemic disease and died. Five other patients showed isolated mutations in TET2 (n = 1), PLCG1 (n = 2), SETD2 (n = 1) or STAT5B (n = 1). CONCLUSIONS Patients with pcTFH-PTCL have pathological and genetic features that overlap with those of systemic lymphoma of TFH derivation. Clinically, most remained confined to the skin, with only three patients showing systemic spread and death. Whether pcTFH-PTCL should be integrated as a new subgroup of TFH lymphomas in future classifications is still a matter of debate. What is already known about this topic? There is a group of cutaneous lymphomas that express T-follicular helper (TFH) markers that do not appear to correspond to existing World Health Organization diagnostic entities. These include mycosis fungoides, Sézary syndrome, or primary cutaneous CD4+ small/medium-sized T-cell lymphoproliferative disorder or cutaneous extensions of systemic peripheral T-cell lymphomas (PTCL) with TFH phenotype. What does this study add? This is the first large original series of patients with a diagnosis of primary cutaneous PTCL with a TFH phenotype (pcTFH-PTCL) to be molecularly characterized. pcTFH-PTCL may be a standalone group of cutaneous lymphomas with clinicopathological and molecular characteristics that overlap with those of systemic TFH lymphomas, such as angioimmunoblastic T-cell lymphoma, and does not belong to known diagnostic groups of cutaneous lymphoma. This has an impact on the treatment and follow-up of patients; the clinical behaviour needs to be better clarified in further studies to tailor patient management.
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Affiliation(s)
- Luojun Wang
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Delphine Rocas
- Department of Pathology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Stéphane Dalle
- Department of Dermatology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Nouhoum Sako
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Laura Pelletier
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nadine Martin
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Aurélie Dupuy
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nadia Tazi
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France
| | - Brigitte Balme
- Department of Pathology, Lyon Sud, Pierre-Bénite Hospital, 69495, Lyon, France
| | - Béatrice Vergier
- Department of Pathology, CHU de Bordeaux, Haut-Lévêque Hospital, 33600, Pessac, France.,INSERM, U1312, Université de Bordeaux, 33000, Bordeaux, France
| | - Marie Beylot-Barry
- INSERM, U1312, Université de Bordeaux, 33000, Bordeaux, France.,Department of Dermatology, CHU de Bordeaux, Saint-André Hospital, 33000, Bordeaux, France
| | - Agnès Carlotti
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Cochin Hospital, 75014, Paris, France
| | - Martine Bagot
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Saint-Louis Hospital, 75010, Université Paris Cité, Paris, France
| | - Maxime Battistella
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Saint-Louis Hospital, 75010, Université Paris Cité, Paris, France
| | - Guillaume Chaby
- Department of Dermatology, CHU d'Amiens-Picardie, Hôpital Sud, 80054, Amiens, France
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France
| | - Philippe Gaulard
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
| | - Nicolas Ortonne
- Department of Pathology, Assistance Publique - Hôpitaux de Paris, Henri-Mondor Hospital, 94010, Créteil, France.,INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Paris Est Créteil University, 94010, Créteil, France
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6
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Favre L, Sako N, Tarfi S, Quang VT, Joy C, Dupuy A, Guillerm E, Gaulard P, Wagner‐Ballon O, Pujals A, Sloma I. Evaluation of two new highly multiplexed PCR assays as an alternative to next-generation sequencing for IDH1/2 mutation detection. Mol Oncol 2022; 16:3916-3926. [PMID: 36062346 PMCID: PMC9718115 DOI: 10.1002/1878-0261.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/20/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
IDH1 and IDH2 somatic mutations have been identified in solid tumors and blood malignancies. The development of inhibitors of mutant IDH1 and IDH2 in the past few years has prompted the development of a fast and sensitive assay to detect IDH1R132 , IDH2R140 and IDH2R172 mutations to identify patients eligible for these targeted therapies. This study aimed to compare two new multiplexed PCR assays - an automated quantitative PCR (qPCR) on the PGX platform and a droplet digital PCR (ddPCR) with next-generation sequencing (NGS) for IDH1/2 mutation detection. These assays were evaluated on 102 DNA extracted from patient peripheral blood, bone marrow and formalin-fixed paraffin-embedded tissue samples with mutation allelic frequency ranging from 0.6% to 45.6%. The ddPCR assay had better analytical performances than the PGX assay with 100% specificity, 100% sensitivity and a detection limit down to 0.5% on IDH1R132 , IDH2R140 and IDH2R172 codons, and a high correlation with NGS results. Therefore, the new highly multiplexed ddPCR is a fast and cost-effective assay that meets most clinical needs to identify and follow cancer patients in the era of anti-IDH1/2-targeted therapies.
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Affiliation(s)
- Loetitia Favre
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Nouhoum Sako
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Sihem Tarfi
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Violaine Tran Quang
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Corine Joy
- Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | | | - Erell Guillerm
- Genetic DepartmentAP‐HP, University Hospital Pitié SalpêtrièreParisFrance
| | - Philippe Gaulard
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Orianne Wagner‐Ballon
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Anaïs Pujals
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Ivan Sloma
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
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7
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Gong Y, Wei S, Wei Y, Chen Y, Cui J, Yu Y, Lin X, Yan H, Qin H, Yi L. IDH2: A novel biomarker for environmental exposure in blood circulatory system disorders (Review). Oncol Lett 2022; 24:278. [PMID: 35814829 PMCID: PMC9260733 DOI: 10.3892/ol.2022.13398] [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] [Received: 04/08/2022] [Accepted: 05/24/2022] [Indexed: 11/11/2022] Open
Abstract
As the risk of harmful environmental exposure is increasing, it is important to find suitable targets for the diagnosis and treatment of the diseases caused. Isocitrate dehydrogenase 2 (IDH2) is an enzyme located in the mitochondria; it plays an important role in numerous cell processes, including maintaining redox homeostasis, participating in the tricarboxylic acid cycle and indirectly taking part in the transmission of the oxidative respiratory chain. IDH2 mutations promote progression in acute myeloid leukemia, glioma and other diseases. The present review mainly summarizes the role and mechanism of IDH2 with regard to the biological effects, such as the mitophagy and apoptosis of animal or human cells, caused by environmental pollution such as radiation, heavy metals and other environmental exposure factors. The possible mechanisms of these biological effects are described in terms of IDH2 expression, reduced nicotine adenine dinucleotide phosphate content and reactive oxygen species level, among other variables. The impact of environmental pollution on human health is increasingly attracting attention. IDH2 may therefore become useful as a potential diagnostic and therapeutic target for environmental exposure-induced diseases.
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Affiliation(s)
- Ya Gong
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Shuang Wei
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yuan Wei
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yong Chen
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jian Cui
- Institute of Cardiovascular Disease, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yue Yu
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Xiang Lin
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Hong Yan
- Pediatric Intensive Care Unit, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Hui Qin
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Lan Yi
- Institute of Cytology and Genetics, The Hengyang Key Laboratory of Cellular Stress Biology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, P.R. China
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8
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Genetic profiling and biomarkers in peripheral T-cell lymphomas: current role in the diagnostic work-up. Mod Pathol 2022; 35:306-318. [PMID: 34584212 DOI: 10.1038/s41379-021-00937-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/08/2022]
Abstract
Peripheral T-cell lymphomas are a heterogeneous, and usually aggressive, group of mature T-cell neoplasms with overlapping clinical, morphologic and immunologic features. A large subset of these neoplasms remains unclassifiable with current diagnostic methods ("not otherwise specified"). Genetic profiling and other molecular tools have emerged as widely applied and transformative technologies for discerning the biology of lymphomas and other hematopoietic neoplasms. Although the application of these technologies to peripheral T-cell lymphomas has lagged behind B-cell lymphomas and other cancers, molecular profiling has provided novel prognostic and diagnostic markers as well as an opportunity to understand the biologic mechanisms involved in the pathogenesis of these neoplasms. Some biomarkers are more prevalent in specific T-cell lymphoma subsets and are being used currently in the diagnosis and/or risk stratification of patients with peripheral T-cell lymphomas. Other biomarkers, while promising, need to be validated in larger clinical studies. In this review, we present a summary of our current understanding of the molecular profiles of the major types of peripheral T-cell lymphoma. We particularly focus on the use of biomarkers, including those that can be detected by conventional immunohistochemical studies and those that contribute to the diagnosis, classification, or risk stratification of these neoplasms.
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9
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Holst JM, Enemark MB, Pedersen MB, Lauridsen KL, Hybel TE, Clausen MR, Frederiksen H, Møller MB, Nørgaard P, Plesner TL, Hamilton-Dutoit SJ, d’Amore F, Honoré B, Ludvigsen M. Proteomic Profiling Differentiates Lymphoma Patients with and without Concurrent Myeloproliferative Neoplasia. Cancers (Basel) 2021; 13:cancers13215526. [PMID: 34771688 PMCID: PMC8583469 DOI: 10.3390/cancers13215526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/29/2021] [Accepted: 10/30/2021] [Indexed: 01/07/2023] Open
Abstract
Simple Summary Patients are diagnosed with myeloproliferative neoplasia (MPN) and lymphoma more frequently in the population than expected, which has led to the hypothesis that the two malignancies may, in some cases, be pathogenetically related. In this study, lymphoma patients with and without MPN show subtle but important differences in the protein expression that enables the clustering of the lymphomas, thus indicating the differences at the molecular level between the lymphoma malignancies with and without MPN, and strengthening the hypothesis that the lymphoma and MPN may be biologically related. Abstract Myeloproliferative neoplasia (MPN) and lymphoma are regarded as distinct diseases with different pathogeneses. However, patients that are diagnosed with both malignancies occur more frequently in the population than expected. This has led to the hypothesis that the two malignancies may, in some cases, be pathogenetically related. Using a mass spectrometry-based proteomic approach, we show that pre-treatment lymphoma samples from patients with both MPN and lymphoma, either angioimmunoblastic T-cell lymphoma (MPN-AITL) or diffuse large B-cell lymphoma (MPN-DLBCL), show differences in protein expression compared with reference AITL or DLBCL samples from patients without MPN. A distinct clustering of samples from patients with and without MPN was evident for both AITL and DLBCL. Regarding MPN-AITL, a pathway analysis revealed disturbances of cellular respiration as well as oxidative metabolism, and an immunohistochemical evaluation further demonstrated the differential expression of citrate synthase and DNAJA2 protein (p = 0.007 and p = 0.015). Interestingly, IDH2 protein also showed differential expression in the MPN-AITL patients, which contributes to the growing evidence of this protein’s role in both myeloid neoplasia and AITL. In MPN-DLBCL, the disturbed pathways included a significant downregulation of protein synthesis as well as a perturbation of signal transduction. These results imply an underlying disturbance of tumor molecular biology, and in turn an alternative pathogenesis for tumors in these patients with both myeloid and lymphoid malignancies.
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Affiliation(s)
- Johanne Marie Holst
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
| | - Marie Beck Enemark
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
| | - Martin Bjerregaard Pedersen
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
| | | | - Trine Engelbrecht Hybel
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
| | | | - Henrik Frederiksen
- Department of Hematology, Odense University Hospital, 5000 Odense, Denmark;
| | - Michael Boe Møller
- Department of Pathology, Odense University Hospital, 5000 Odense, Denmark;
| | - Peter Nørgaard
- Department of Pathology, Herlev Hospital, 2730 Herlev, Denmark;
| | | | - Stephen Jacques Hamilton-Dutoit
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
- Department of Pathology, Aarhus University Hospital, 8200 Aarhus, Denmark;
| | - Francesco d’Amore
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
| | - Bent Honoré
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark;
| | - Maja Ludvigsen
- Department of Hematology, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.M.H.); (M.B.E.); (M.B.P.); (T.E.H.); (F.d.)
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark;
- Correspondence: ; Tel.: +45-22859523
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10
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Huang F, Tian T, Wu Y, Che J, Yang H, Dong X. Isocitrate Dehydrogenase 2 Inhibitors for the Treatment of Hematologic Malignancies: Advances and Future Opportunities. Mini Rev Med Chem 2021; 21:1113-1122. [PMID: 33256576 DOI: 10.2174/1389557520666201130102724] [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: 07/03/2020] [Revised: 09/17/2020] [Accepted: 10/08/2020] [Indexed: 11/22/2022]
Abstract
Tumor cells frequently reprogram cellular metabolism from oxidative phosphorylation to glycolysis. Isocitrate dehydrogenase 2 (IDH2) has been intensively studied due to its involvement in the metabolic activity of cancer cells. Mutations in IDH2 promote neomorphic activity through the generation of oncometabolite 2-hydroxyglutarate (2-HG). The overproduced 2-HG can competitively inhibit α-KG-dependent dioxygenases to trigger cell differentiation disorders, a major cause of blood tumors. This review outlines recent progress in the identification of IDH2 inhibitors in blood cancer to provide a reference for ongoing and future clinical studies.
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Affiliation(s)
- Feng Huang
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Tian Tian
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Yizhe Wu
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Jinxin Che
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Haiyan Yang
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310011, China
| | - Xiaowu Dong
- Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
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11
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Angioimmunoblastic T-Cell Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: A Novel Form of Composite Lymphoma Potentially Mimicking Richter Syndrome. Am J Surg Pathol 2021; 45:773-786. [PMID: 33739791 DOI: 10.1097/pas.0000000000001646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is an indolent small B-cell neoplasm that may transform into a clinically aggressive disease, namely Richter syndrome, usually as diffuse large B-cell lymphoma. Besides, CLL/SLL encompasses an increased risk of developing other secondary cancers, including a variety of T-cell lymphomas, often of the anaplastic large-cell type or with a cytotoxic phenotype. Here, we report a small series of patients with composite lymphomas consisting of CLL/SLL and angioimmunoblastic T-cell lymphoma (AITL), a hitherto unrecognized association. The 3 patients (1 male/2 females, 68 to 83 y) presented with high-grade-type symptoms. One patient was clinically suspicious for Richter syndrome, in the others CLL/SLL and AITL were concomitant de novo diagnoses. CLL/SLL and AITL were admixed in the same lymph nodes (3/3 cases) and in the bone marrow (1/2 cases). In all cases, the AITL comprised prominent clear cells with a strong T follicular helper immunophenotype and similar mutations consisting of TET2 or DNMT3A alterations, IDH2 R172K/M, and RHOA G17V. The 3 patients received chemotherapy. One died of early AITL relapse. The other 2 remained in complete remission of AITL, 1 died with recurrent CLL, and 1 of acute myeloid leukemia. These observations expand the spectrum of T-cell lymphoma entities that occur in association with CLL/SLL, adding AITL to the rare variants of aggressive neoplasms manifesting as Richter syndrome. Given that disturbances of T-cell homeostasis in CLL/SLL affect not only cytotoxic but also helper T-cell subsets, these may contribute to the emergence of neoplasms of T follicular helper derivation.
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12
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Molecular epidemiology of IDH2 hotspot mutations in cancer and immunohistochemical detection of R172K, R172G, and R172M variants. Hum Pathol 2020; 106:45-53. [PMID: 33017591 DOI: 10.1016/j.humpath.2020.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/27/2020] [Indexed: 11/23/2022]
Abstract
IDH1/2 hotspot mutations occur in glioma, cholangiocarcinoma, chondrosarcoma, sinonasal carcinoma, and T-cell lymphoma and have diagnostic, prognostic, and/or therapeutic value. Availability of immunohistochemistry (IHC) protocols for specific IDH2 mutation detection is limited. A targeted exome sequencing assay MSK-IMPACT cohort comprising >38,000 cancer cases was explored for the presence of IDH1/2 mutations in solid malignancies and select T-cell lymphomas. Seventy-four formalin-fixed paraffin-embedded IDH1/2-mutated (n = 62) and wild-type (n = 12) samples were used for testing and optimization of anti-IDH2 monoclonal antibodies (mAbs) 14H7, 3C11, and MMab1 targeting R172K, R172G, and R172M mutant proteins, respectively. IDH1/2 mutations were common in glioma (26.8% and 1.6%), intrahepatic cholangiocarcinoma (23.1% and 5.7%), chondrosarcoma (19.4% and 10.7%), sinonasal undifferentiated/large-cell neuroendocrine carcinoma (0% and 84.2%), angioimmunoblastic T-cell lymphoma (0% and 22%), and peripheral T-cell lymphoma (0 and 5.1%). In other cancers, IDH2 mutations were rare. IDH2 R172 variants included R172K (39%), R172S (29%), R172W (12%), R172G (10%), R172M (5%), and R172T (4%). 14H7, 3C11, and MMab1 detected all IDH2 R172K, R172G, and R172M, respectively, and produced a crisp, granular cytoplasmic staining pattern. 3C11 was also positive in 5 of 6 IDH1 R132G mutants showing a homogeneous, smooth cytoplasmic staining. All 3 mAbs were negative in other IDH1/2 mutant or wild-type cases. IHC using mAbs 14H7, 3C11, and MMab1 can facilitate molecular diagnosis as a reliable, fast, and inexpensive alternative for specific IDH2 variant detection. Given the distinct distribution of IDH2 R172 mutations in cancers, these mAbs could also serve as useful pathologic diagnostic markers.
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13
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Che J, Huang F, Zhang M, Xu G, Qu B, Gao J, Chen B, Zhang J, Ying H, Hu Y, Hu X, Zhou Y, Gao A, Li J, Dong X. Structure-based design, synthesis and bioactivity evaluation of macrocyclic inhibitors of mutant isocitrate dehydrogenase 2 (IDH2) displaying activity in acute myeloid leukemia cells. Eur J Med Chem 2020; 203:112491. [PMID: 32679449 DOI: 10.1016/j.ejmech.2020.112491] [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: 02/10/2020] [Revised: 05/04/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022]
Abstract
The enzymes involved in the metabolic pathways in cancer cells have been demonstrated as important therapeutic targets such as the isocitrate dehydrogenase 2 (IDH2). A series of macrocyclic derivatives was designed based on the marketed IDH2 inhibitor AG-221 by using the conformational restriction strategy. The resulted compounds showed moderate to good inhibitory potential against different IDH2-mutant enzymes. Amongst, compound C6 exhibited better IDH2R140Q inhibitory potency than AG-221, and showed excellent activity of 2-hydroxyglutarate (2-HG) suppression in vitro and its mesylate displayed good pharmacokinetic profiles. Moreover, C6 performed strong binding mode to IDH2R140Q after computational docking and dynamic simulation, which may serve as a good starting point for further development.
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Affiliation(s)
- Jinxin Che
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Feng Huang
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Mengmeng Zhang
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China
| | - Gaoya Xu
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China
| | - Bingxue Qu
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Jian Gao
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Binhui Chen
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Jianjun Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, 310058, PR China
| | - Huazhou Ying
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Yongzhou Hu
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China
| | - Xiaobei Hu
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China
| | - Yubo Zhou
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China
| | - Anhui Gao
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China.
| | - Jia Li
- National Center for Drug Screening, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, PR China; Open Studio for Druggability Research of Marine Natural Products, Pilot National Laboratory for Marine Science and Technology (Qingdao), 1 Wenhai Road, Aoshanwei, Jimo, Qingdao, 266237, PR China.
| | - Xiaowu Dong
- ZJU-ENS Joint Laboratory of Medicinal Chemistry, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, Hangzhou Institute of Innovative Medicine, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, PR China.
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14
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Attygalle AD, Zamò A, Fend F, Johnston P, Arber DA, Laurent C. Challenges and limitations in the primary diagnosis of T-cell and natural killer cell/T-cell lymphoma in bone marrow biopsy. Histopathology 2020; 77:2-17. [PMID: 32064659 DOI: 10.1111/his.14093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | - Alberto Zamò
- Department of Oncology, University of Turin, Turin, Italy.,Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Falko Fend
- Institute of Pathology and Comprehensive Cancer Centre, Tübingen University Hospital, Tübingen, Germany
| | - Peter Johnston
- Department of Pathology, NHS Grampian, University of Aberdeen, NHS Education for Scotland, Aberdeen, UK
| | - Daniel A Arber
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Camille Laurent
- Pathology and Cytology Department, Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre de Recherche en Cancerologie de Toulouse, Inserm, UMR1037 laboratoire d'excellence TOUCAN, Paul Sabatier University Toulouse III, Toulouse, France
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15
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Hayashida M, Maekawa F, Chagi Y, Iioka F, Kobashi Y, Watanabe M, Ohno H. Combination of multicolor flow cytometry for circulating lymphoma cells and tests for the RHOAG17V and IDH2R172 hot-spot mutations in plasma cell-free DNA as liquid biopsy for the diagnosis of angioimmunoblastic T-cell lymphoma. Leuk Lymphoma 2020; 61:2389-2398. [PMID: 32476550 DOI: 10.1080/10428194.2020.1768382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We applied two-step multicolor flow cytometry (FCM) for circulating lymphoma cells in the blood of 20 patients with angioimmunoblastic T-cell lymphoma (AITL) and confirmed neoplastic T-cells in all. Eleven exhibited dim expression of CD3 and 7 lost its expression. The proportion of CD10+ lymphoma cells ranged widely from 0 to 100%, with a median of 15.7%. Ten patients demonstrated expansion of a single T-cell receptor β-chain repertoire. Lymphoma cells comprised 0.01 to 18.22% (median, 0.26%) of white cells and the absolute numbers ranged from 0.5 to 1491.6 cells (median, 29.3 cells) per microliter of blood. We next found that 14 (70%) and 3 (15%) patients carried RHOAG17V and IDH2R172 mutations, respectively, in cell-free DNA (cfDNA) in the plasma. The combination of multicolor FCM of the blood, and tests for RHOAG17V and IDH2R172 hot-spot mutations in plasma cfDNA provides a blood-based 'liquid biopsy' for the diagnosis of AITL.
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Affiliation(s)
- Masahiko Hayashida
- Tenri Institute of Medical Research, Tenri, Japan.,Department of Clinical Laboratory and Biomedical Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | | | | | - Futoshi Iioka
- Department of Hematology, Tenri Hospital, Tenri, Japan
| | - Yoichiro Kobashi
- Department of Diagnostic Surgical Pathology, Tenri Hospital, Tenri, Japan
| | - Mikio Watanabe
- Department of Clinical Laboratory and Biomedical Sciences, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hitoshi Ohno
- Tenri Institute of Medical Research, Tenri, Japan.,Department of Hematology, Tenri Hospital, Tenri, Japan
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16
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Piris MA, Rodriguez-Pinilla SM, Santonja C, Betancor I, Alonso-Alonso R, Gru AA, Rodriguez M. Update on peripheral T-cell lymphomas with T-helper phenotype: Are there too many subtypes? Semin Diagn Pathol 2019; 37:24-31. [PMID: 31870687 DOI: 10.1053/j.semdp.2019.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Follicular helper T (TFH) cells are the providers of T-cell help to B-cells in the development of germinal centers and for the generation of most class-switched antibodies. The markers most commonly associated with TFH activity are IL21, IL4, CD40L, BCL6, SAP, CXCR5/CXCL13, and ICOS. T-cell lymphoma genomic studies have shown that different T-cell lymphoma types express signatures typical for TFH cells, this including angioimmunoblastic T-cell lymphoma (AITL), a related condition termed peripheral T-cell lymphoma with TFH phenotype and primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. Angioimmunoblastic T-cell lymphoma is a well-established entity, a clinically aggressive disease with a survival of 30% OS after 5 years. Molecular and clinical studies have confirmed this as a well-established clinicopathological entity with relatively specific gene mutations, including mutations found in hematopoietic precursor cells and others. Peripheral T-cell lymphoma with TFH phenotype is an associated disorder with histology of PTCL but a TFH phenotype, as defined by the expression of 2-3 immunohistochemical markers. Molecular studies on this entity are showing a partial overlap with AITL. Primary cutaneous CD4+ small/medium lymphoproliferative disorder is an entirely different process that takes place in the skin, showing frank cytologic atypia, monoclonal TCR rearrangement and TFH phenotype in the context of a clinically benign lesion. Here we review the main clinical, molecular and diagnostic features of these three lymphoproliferative processes.
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Affiliation(s)
- Miguel A Piris
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain.
| | | | - Carlos Santonja
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
| | - Isabel Betancor
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
| | - Ruth Alonso-Alonso
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
| | - Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, VA, United States
| | - Marta Rodriguez
- Servicio de Anatomía Patológica, Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
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17
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Abstract
Peripheral T-cell lymphomas (PTCLs) represent a heterogeneous group of uncommon malignancies derived from mature T cells and usually characterised by an aggressive clinical course. Their clinical presentation, localisation and pattern of dissemination are highly variable, but the majority of cases present as nodal diseases. The recently revised classification of lymphomas has incorporated many new molecular genetic data derived from gene expression profiling and next generation sequencing studies, which refine the definition and diagnostic criteria of several entities. Nevertheless, the distinction of PTCL from various reactive conditions, and the diagnosis of PTCL subtypes remains notably challenging. Here, an updated summary of the clinicopathological and molecular features of the most common nodal-based PTCLs (angioimmunoblastic T-cell lymphoma and other nodal lymphomas derived from follicular T helper cells, anaplastic large cell lymphomas and peripheral T-cell lymphoma, not otherwise specified) is presented. Practical recommendations in the diagnostic approach to nodal T-cell lymphoproliferations are presented, including indications for the appropriate use and interpretation of ancillary studies. Finally, we discuss commonly encountered diagnostic problems, including pitfalls and mimics in the differential diagnosis with various reactive conditions, and the criteria that allow proper identification of distinct PTCL entities.
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Affiliation(s)
- Laurence de Leval
- Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.
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18
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Drieux F, Ruminy P, Abdel-Sater A, Lemonnier F, Viailly PJ, Fataccioli V, Marchand V, Bisig B, Letourneau A, Parrens M, Bossard C, Bruneau J, Dobay P, Veresezan L, Dupuy A, Pujals A, Robe C, Sako N, Copie-Bergman C, Delfau-Larue MH, Picquenot JM, Tilly H, Delarue R, Jardin F, de Leval L, Gaulard P. Defining signatures of peripheral T-cell lymphoma with a targeted 20-marker gene expression profiling assay. Haematologica 2019; 105:1582-1592. [PMID: 31488561 PMCID: PMC7271600 DOI: 10.3324/haematol.2019.226647] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/02/2019] [Indexed: 12/20/2022] Open
Abstract
Peripheral T-cell lymphoma comprises a heterogeneous group of mature non-Hodgkin lymphomas. Their diagnosis is challenging, with up to 30% of cases remaining unclassifiable and referred to as “not otherwise specified”. We developed a reverse transcriptase-multiplex ligation-dependent probe amplification gene expression profiling assay to differentiate the main T-cell lymphoma entities and to study the heterogeneity of the “not specified” category. The test evaluates the expression of 20 genes, including 17 markers relevant to T-cell immunology and lymphoma biopathology, one Epstein-Barr virus-related transcript, and variants of RHOA (G17V) and IDH2 (R172K/T). By unsupervised hierarchical clustering, our assay accurately identified 21 of 21 ALK-positive anaplastic large cell lymphomas, 16 of 16 extranodal natural killer (NK)/T-cell lymphomas, 6 of 6 hepatosplenic T-cell lymphomas, and 13 of 13 adult T-cell leukemia/lymphomas. ALK-negative anaplastic lymphomas (n=34) segregated into one cytotoxic cluster (n=10) and one non-cytotoxic cluster expressing Th2 markers (n=24) and enriched in DUSP22-rearranged cases. The 63 TFH-derived lymphomas divided into two subgroups according to a predominant TFH (n=50) or an enrichment in Th2 (n=13) signatures. We next developed a support vector machine predictor which attributed a molecular class to 27 of 77 not specified T-cell lymphomas: 17 TFH, five cytotoxic ALK-negative anaplastic and five NK/T-cell lymphomas. Among the remaining cases, we identified two cell-of-origin subgroups corresponding to cytotoxic/Th1 (n=19) and Th2 (n=24) signatures. A reproducibility test on 40 cases yielded a 90% concordance between three independent laboratories. This study demonstrates the applicability of a simple gene expression assay for the classification of peripheral T-cell lymphomas. Its applicability to routinely-fixed samples makes it an attractive adjunct in diagnostic practice.
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Affiliation(s)
- Fanny Drieux
- INSERM U1245, Centre Henri Becquerel, Rouen, France.,Service d'Anatomie et Cytologie Pathologiques, Centre Henri Becquerel, Rouen, France.,INSERM U955 and Université Paris-Est, Créteil, France
| | | | | | - François Lemonnier
- INSERM U955 and Université Paris-Est, Créteil, France.,Unité Hémopathies Lymphoïdes, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | | | | | | | - Bettina Bisig
- Institut de Pathologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Audrey Letourneau
- Institut de Pathologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Marie Parrens
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Haut-Lévêque, CHU de Bordeaux, France
| | - Céline Bossard
- Service d'Anatomie et Cytologie Pathologiques, CHU de Nantes, France
| | - Julie Bruneau
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France
| | - Pamela Dobay
- Institut de Pathologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Liana Veresezan
- INSERM U1245, Centre Henri Becquerel, Rouen, France.,Service d'Anatomie et Cytologie Pathologiques, Centre Henri Becquerel, Rouen, France
| | - Aurélie Dupuy
- INSERM U955 and Université Paris-Est, Créteil, France
| | - Anaïs Pujals
- INSERM U955 and Université Paris-Est, Créteil, France.,Département de Pathologie, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | - Cyrielle Robe
- INSERM U955 and Université Paris-Est, Créteil, France
| | - Nouhoum Sako
- INSERM U955 and Université Paris-Est, Créteil, France
| | - Christiane Copie-Bergman
- INSERM U955 and Université Paris-Est, Créteil, France.,Département de Pathologie, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | - Marie-Hélène Delfau-Larue
- INSERM U955 and Université Paris-Est, Créteil, France.,Département d'Hématologie et Immunologie Biologique, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
| | - Jean-Michel Picquenot
- INSERM U1245, Centre Henri Becquerel, Rouen, France.,Service d'Anatomie et Cytologie Pathologiques, Centre Henri Becquerel, Rouen, France
| | - Hervé Tilly
- INSERM U1245, Centre Henri Becquerel, Rouen, France
| | - Richard Delarue
- Service Hématologie Adultes, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France
| | | | - Laurence de Leval
- Institut de Pathologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Philippe Gaulard
- INSERM U955 and Université Paris-Est, Créteil, France .,Département de Pathologie, Groupe Hospitalier Henri Mondor, AP-HP, Créteil, France
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The pathological features of angioimmunoblastic T-cell lymphomas with IDH2 R172 mutations. Mod Pathol 2019; 32:1123-1134. [PMID: 30952970 DOI: 10.1038/s41379-019-0254-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/08/2022]
Abstract
Angioimmunoblastic T-cell lymphoma is a peripheral T-cell lymphoma derived from follicular T-helper cells. High-throughput genomic sequencing studies have shown that angioimmunoblastic T-cell lymphoma carries frequent mutations in RHOAG17V and IDH2R172 genes. The clinico-pathological features of angioimmunoblastic T-cell lymphoma cases with RHOAG17V mutations have been addressed; however, similar studies for IDH2 mutated cases are lacking. Therefore, the aim of the present study was to evaluate the pathological features of angioimmunoblastic T-cell lymphoma with IDH2 mutations. In order to identify cases with IDH2 mutations, 50 cases previously diagnosed as angioimmunoblastic T-cell lymphoma were subjected to next-generation sequencing analysis using a custom panel covering four genes frequently mutated in angioimmunoblastic T-cell lymphoma including DNMT3A, TET2, IDH2 and RHOA. All cases were analyzed for PD1, ICOS, CXCL13, CD10, BCL6, CD21, CD23 and EBER in situ hybridization. Mutational analysis recognized three groups. Group 1: IDH2R172 mutations were identified in 20 cases (40%). All cases carried RHOAG17V mutations. Group 2: RHOAG17V mutations without IDH2R172 mutation were identified in 16 cases (32%), and Group 3: 14 cases (28%) without RHOAG17V or IDH2R172 mutations. Morphologically, angioimmunoblastic T-cell lymphoma cases with IDH2R172 mutations were characterized by the presence of medium to large clear cells (p = 0.00001), and a follicular T-helper phenotype with the particular feature of strong CD10 (p = 0.0268) and CXCL13 expression (p = 0.0346). Interestingly, TET2 mutations were identified in 32 of 33 (97%) cases with IDH2R172 and/or RHOAG17V mutations whereas only 55% of angioimmunoblastic T-cell lymphoma cases wild-type for these two genes carried TET2 mutations (p = 0.0022). In contrast, DNMT3A mutations were found in 48% of the cases and were equally distributed in the three groups. In conclusion, our results support the results of gene expression profiling studies suggesting that IDH2R172 mutations define a unique subgroup within angioimmunoblastic T-cell lymphoma with strong follicular T-helper-like phenotype and characteristic morphological features.
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