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Maitre E, Cornet E, Debliquis A, Drenou B, Gravey F, Chollet D, Cheze S, Docquier M, Troussard X, Matthes T. Hairy cell leukemia: a specific 17-gene expression signature points to new targets for therapy. J Cancer Res Clin Oncol 2022; 148:2013-2022. [PMID: 35476232 PMCID: PMC9293816 DOI: 10.1007/s00432-022-04010-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
Background Hairy cell leukemia (HCL) is a rare chronic B cell malignancy, characterized by infiltration of bone marrow, blood and spleen by typical “hairy cells” that bear the BRAFV600E mutation. However, in addition to the intrinsic activation of the MAP kinase pathway as a consequence of the BRAFV600E mutation, the potential participation of other signaling pathways to the pathophysiology of the disease remains unclear as the precise origin of the malignant hairy B cells. Materials and methods Using mRNA gene expression profiling based on the Nanostring technology and the analysis of 290 genes with crucial roles in B cell lymphomas, we defined a 17 gene expression signature specific for HCL. Results Separate analysis of samples from classical and variant forms of hairy cell leukemia showed almost similar mRNA expression profiles apart from overexpression in vHCL of the immune checkpoints CD274 and PDCD1LG2 and underexpression of FAS. Our results point to a post-germinal memory B cell origin and in some samples to the activation of the non-canonical NF-κB pathway. Conclusions This study provides a better understanding of the pathogenesis of HCL and describes new and potential targets for treatment approaches and guidance for studies in the molecular mechanisms of HCL. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04010-4.
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Affiliation(s)
- Elsa Maitre
- Normandie University, UNIROUEN, UNICAEN, INSERM1245, MICAH, Avenue de la côte de Nacre, 14033, Caen, France.,Laboratory Hematology, University Hospital Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France
| | - Edouard Cornet
- Laboratory Hematology, University Hospital Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France
| | - Agathe Debliquis
- Department of Haematology, Groupe Hospitalier de la Région Mulhouse Sud Alsace, 20 avenue du docteur René laennec, 68100, Mulhouse, France
| | - Bernard Drenou
- Department of Haematology, Groupe Hospitalier de la Région Mulhouse Sud Alsace, 20 avenue du docteur René laennec, 68100, Mulhouse, France
| | - François Gravey
- Normandie University, UNIROUEN, UNICAEN, GRAM2.0, Avenue de la côte de Nacre, 14033, Caen, France
| | - Didier Chollet
- iGE3 Genomics Platform, University Medical Center, Geneva University, 1211, Geneva, Switzerland.,Department of Genetics and Evolution, Sciences III, Geneva University, 1205, Geneva, Switzerland
| | - Stephane Cheze
- Hematology Institute, University Hospital Caen, Avenue de la Côte de Nacre, 14033, Caen, France
| | - Mylène Docquier
- iGE3 Genomics Platform, University Medical Center, Geneva University, 1211, Geneva, Switzerland.,Department of Genetics and Evolution, Sciences III, Geneva University, 1205, Geneva, Switzerland
| | - Xavier Troussard
- Normandie University, UNIROUEN, UNICAEN, INSERM1245, MICAH, Avenue de la côte de Nacre, 14033, Caen, France.,Laboratory Hematology, University Hospital Caen, Avenue de la Côte de Nacre, 14033, Caen cedex, France.,Hematology Institute, University Hospital Caen, Avenue de la Côte de Nacre, 14033, Caen, France
| | - Thomas Matthes
- Hematology Service, Department of Oncology and Clinical Pathology Service, Department of Diagnostics, University Hospital Geneva, 1211, Geneva, Switzerland.
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Deciphering Genetic Alterations of Hairy Cell Leukemia and Hairy Cell Leukemia-like Disorders in 98 Patients. Cancers (Basel) 2022; 14:cancers14081904. [PMID: 35454811 PMCID: PMC9028144 DOI: 10.3390/cancers14081904] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary The diagnosis of hairy cell leukemia (cHCL) and HCL-like disorders, including the variant form of HCL (vHCL) and splenic diffuse red pulp lymphoma (SDRPL) can be challenging, particularly in complex situations. The integration of all data, including molecular data, is essential for distinguishing the different entities. The BRAFV600E mutation is identified in most cHCL cases, whereas it is absent in vHCL and SDRPL. MAP2K1 mutations are observed in half of vHCL cases and in cHCL BRAFWT and they are associated with a worse prognosis. The interest in deep sequencing for the diagnosis and prognosis of hairy cell leukemia and HCL-like disorders is essential. Some KLF2 genetic alterations have been localized on the AID consensus motif, suggesting an AID-induced mutation mechanism. KLF2 is the second most altered gene in HCL, and mutations must be investigated to confirm whether AID could be responsible for the genetic alterations in this gene. Clonal evolution can be observed in half of the cases. Abstract Hairy cell leukemia (cHCL) patients have, in most cases, a specific clinical and biological presentation with splenomegaly, anemia, leukopenia, neutropenia, monocytopenia and/or thrombocytopenia, identification of hairy cells that express CD103, CD123, CD25, CD11c and identification of the V600E mutation in the B-Raf proto-oncogene (BRAF) in 90% of cases. Monocytopenia is absent in vHCL and SDRPL patients and the abnormal cells do not express CD25 or CD123 and do not present the BRAFV600E mutation. Ten percent of cHCL patients are BRAFWT and the distinction between cHCL and HCL-like disorders including the variant form of HCL (vHCL) and splenic diffuse red pulp lymphoma (SDRPL) can be challenging. We performed deep sequencing in a large cohort of 84 cHCL and 16 HCL-like disorders to improve insights into the pathogenesis of the diseases. BRAF mutations were detected in 76/82 patients of cHCL (93%) and additional mutations were identified in Krüppel-like Factor 2 (KLF2) in 19 patients (23%) or CDKN1B in 6 patients (7.5%). Some KLF2 genetic alterations were localized on the cytidine deaminase (AID) consensus motif, suggesting AID-induced mutations. When analyzing sequential samples, a clonal evolution was identified in half of the cHCL patients (6/12 pts). Among the 16 patients with HCL-like disorders, we observed an enrichment of MAP2K1 mutations in vHCL/SDRPL (3/5 pts) and genes involved in the epigenetic regulation (KDM6A, EZH2, CREBBP, ARID1A) (3/5 pts). Furthermore, MAP2K1 mutations were associated with a bad prognosis and a shorter time to next treatment (TTNT) and progression-free survival (PFS), independently of the HCL classification.
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Splenic marginal zone B-cell lymphoma: a distinct clinicopathological and molecular entity. Recent advances in ontogeny and classification. Curr Opin Oncol 2013; 23:441-8. [PMID: 21760505 DOI: 10.1097/cco.0b013e328349ab8d] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Indolent B-cell lymphomas that are supposed to derive from marginal zone encompass three distinct entities: extranodal marginal zone lymphoma (MZL) or mucosa-associated lymphatic tissue (MALT), nodal MZL (NMZL) and splenic MZL (SMZL). Although MALT lymphoma is well characterized and extensively studied at the clinical and molecular levels, SMZL and NMZL remain incompletely characterized. However, during the last years, the clinical and molecular heterogeneity of SMZL has been clarified. The recent 2008 WHO classification has maintained the distinction between the three diseases according to the organ where it arises and introduced a new provisional category of unclassified splenic lymphoma for overlapping entities, splenic diffuse red pulp lymphoma (SDRPL) and hairy cell leukemia-variant (HCL-V). RECENT FINDINGS Recent findings in SMZL contributed to a better characterization, including the few cases associated with hepatitis C, the recurrence of 7q deletion and the possibility of CD5 expression. Furthermore, the peculiar pattern of immunoglobulin heavy chain genes mutations and the biased usage of immunoglobulin heavy chain variable region genes (IGHV)1-2 segment are suggestive of a T-independent antigen driven proliferation, at least at initial steps. This review will focus on recent findings and differential diagnosis with SDRPL and HCL-V. SUMMARY The conjunction of morphologic, cytogenetic and clinical data has increased diagnosis reproducibility.
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Wang X, Spielberger R, Huang Q. Hairy Cell Leukemia Variant, a New Entity of the WHO 2008. J Clin Oncol 2011; 29:e864-6. [DOI: 10.1200/jco.2011.37.8497] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Xiaoqiong Wang
- City of Hope National Medical Center, Duarte, CA; and Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Ricardo Spielberger
- City of Hope National Medical Center, Duarte, CA; and Southern California Kaiser Permanente Medical Group, Los Angeles, CA
| | - Qin Huang
- City of Hope National Medical Center, Duarte, CA
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Abstract
An increasing number of neoplasms are associated with variably specific genetic abnormalities. This is best exemplified by hematological malignancies, in which there is a growing list of entities that are defined by their genetic lesion(s); this is not (yet) the case in mature B-cell lymphomas. However, enhanced insights into the pathogenesis of this large and diverse group of lymphomas have emerged with the ongoing unraveling of a plethora of fascinating genetic abnormalities. The purpose of this review is to synthesize well-recognized data and nascent discoveries in our understanding of the genetic basis of a spectrum of mature B-cell lymphomas, and how this may be applied to contemporary clinical practice. Despite the explosion of new and exciting knowledge in this arena, with the potential for enhanced diagnostic and prognostic strategies, it is essential to remain cognizant of the limitations (and complexity) of genetic investigations, so that assays can be developed and used both judiciously and rationally.
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