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Ananthamurthy A. An immunohistochemical study of double-expressor lymphomas and its correlation with cell of origin. J Cancer Res Ther 2023; 19:S0. [PMID: 37147953 DOI: 10.4103/jcrt.jcrt_587_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Background Diffuse large B cell Lymphomas (DLBCL) that co express C MYC and BCL 2 are known as 'double expressor lymphomas' and are believed to have a worse prognosis than other diffuse large B cell lymphomas. This was a study to assess the frequency of double expressor lymphomas in our cohort of DLBCL. Aims and Objectives The aims of this study were to assess the frequency of double expression of C MYC and BCL 2 in cases of DLBCL and to correlate the same with clinicopathological parameters including cell of origin, namely germinal centre type versus non germinal centre type. Materials and Methods This was a retrospective observational study Immunostaining for MYC antibody and BCL2 were performed using the standard polymer/DAB technique. 40% for MYC and 50% for BCL2 were taken as cut off values.Chi square analysis was used to compare the variables, and a p value of less than 0.05 was taken as statistically significant. Results Of 40 cases studied, 11 (27.5%) were double expressors. There was no significant correlation of double expression with gender, site (nodal versus extra nodal), cell of origin namely germinal centre/non germinal centre types and Ki67 index when compared to the other group which did not show double expression. Conclusions Immunohistochemistry is a useful technique to detect double expressor lymphomas which are known to have an aggressive course. Cell of origin did not show significant correlation with double expression in our study.
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Rössler F, Sachs A, Bieri U, Kuzmanic B, Ballova V, Schneider U, Singer G, Nocito A. Extranodal Diffuse Large B-cell Lymphoma With Primary Clinical Presentation as Acute Cholecystitis: A Case Report. Cureus 2023; 15:e37552. [PMID: 37193435 PMCID: PMC10183092 DOI: 10.7759/cureus.37552] [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: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
This case describes a rare presentation of a diffuse large B-cell lymphoma not otherwise specified (DLBC NOS) in the gallbladder. We report the case of an 89-year-old male who initially presented with a two-week history of weakness and abdominal discomfort. We performed laparoscopic cholecystectomy for suspicion of acute cholecystitis. After the initial uneventful course, readmission occurred for persisting weakness a few weeks after surgery. Computed tomography revealed progressive retroperitoneal lymphadenopathy. With new emerging neurological symptoms, taking into account the histopathological findings of the gallbladder specimen, the diagnosis of DLBCL NOS was confirmed. Due to the rapid clinical deterioration and extranodal involvement, the patient opted against further therapy. When the suspicion of cholecystitis is inconclusive, rare differential diagnoses need to be considered. This analysis may improve the understanding of the presentation and course of DLBC NOS in abdominal organs and could form the basis for a systematic review to improve diagnosis and therapy.
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Affiliation(s)
- Fabian Rössler
- Department of Surgery and Transplantation, Universitätsspital Zürich, Zürich, CHE
| | - Alexandra Sachs
- Department of Internal Medicine, Spital Limmattal, Zürich, CHE
| | - Uwe Bieri
- Department of Urology, Kantonsspital Chur, Chur, CHE
| | - Boris Kuzmanic
- Department of Pathology, Kantonsspital Baden, Baden, CHE
| | | | - Ulrich Schneider
- Department of General, Visceral and Vascular Surgery, Kantonsspital Baden, Baden, CHE
| | - Gad Singer
- Department of Pathology, Kantonsspital Baden, Baden, CHE
| | - Antonio Nocito
- Department of General, Visceral and Vascular Surgery, Kantonsspital Baden, Baden, CHE
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Epstein-Barr Virus and the Pathogenesis of Diffuse Large B-Cell Lymphoma. Life (Basel) 2023; 13:life13020521. [PMID: 36836878 PMCID: PMC9967091 DOI: 10.3390/life13020521] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
Epstein-Barr virus (EBV), defined as a group I carcinogen by the World Health Organization (WHO), is present in the tumour cells of patients with different forms of B-cell lymphoma, including Burkitt lymphoma, Hodgkin lymphoma, post-transplant lymphoproliferative disorders, and, most recently, diffuse large B-cell lymphoma (DLBCL). Understanding how EBV contributes to the development of these different types of B-cell lymphoma has not only provided fundamental insights into the underlying mechanisms of viral oncogenesis, but has also highlighted potential new therapeutic opportunities. In this review, we describe the effects of EBV infection in normal B-cells and we address the germinal centre model of infection and how this can lead to lymphoma in some instances. We then explore the recent reclassification of EBV+ DLBCL as an established entity in the WHO fifth edition and ICC 2022 classifications, emphasising the unique nature of this entity. To that end, we also explore the unique genetic background of this entity and briefly discuss the potential role of the tumour microenvironment in lymphomagenesis and disease progression. Despite the recent progress in elucidating the mechanisms of this malignancy, much work remains to be done to improve patient stratification, treatment strategies, and outcomes.
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Choi JH, Lim I, Byun BH, Kim BI, Choi CW, Kang HJ, Shin DY, Lim SM. The role of 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma after radioimmunotherapy using 131I-rituximab as consolidation therapy. PLoS One 2022; 17:e0273839. [PMID: 36156599 PMCID: PMC9512194 DOI: 10.1371/journal.pone.0273839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the prognostic value of pretreatment 18F-FDG PET/CT after consolidation therapy of 131I-rituximab in patients with diffuse large B-cell lymphoma (DLBCL) who had acquired complete remission after receiving chemotherapy. Methods Patients who were diagnosed with DLBCL via histologic confirmation were retrospectively reviewed. All patients had achieved complete remission after 6 to 8 cycles of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone) chemotherapy after which they underwent consolidation treatment with 131I-rituximab. 18F-FDG PET/CT scans were performed before R-CHOP for initial staging. The largest diameter of tumor, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained from pretreatment 18F-FDG PET/CT scans. Receiver-operating characteristic curves analysis was introduced for assessing the optimal criteria. Kaplan-Meier curve survival analysis was performed to evaluate both relapse free survival (RFS) and overall survival (OS). Results A total of 15 patients (12 males and 3 females) with a mean age of 56 (range, 30–73) years were enrolled. The median follow-up period of these patients was 73 months (range, 11–108 months). Four (27%) patients relapsed. Of them, three died during follow-up. Median values of the largest tumor size, highest SUVmax, MTV, and TLG were 5.3 cm (range, 2.0–16.4 cm), 20.2 (range, 11.1–67.4), 231.51 (range, 15–38.34), and 1277.95 (range, 238.37–10341.04), respectively. Patients with SUVmax less than or equal to 16.9 showed significantly worse RFS than patients with SUVmax greater than 16.9 (5-year RFS rate: 60% vs. 100%, p = 0.008). Patients with SUVmax less than or equal to 16.9 showed significantly worse OS than patients with SUVmax greater than 16.9 (5-year OS rate: 80% vs. 100% p = 0.042). Conclusion Higher SUVmax at pretreatment 18F-FDG PET/CT was associated with better relapse free survival and overall survival in DLBCL patients after consolidation therapy with 131I-rituximab. However, because this study has a small number of patients, a phase 3 study with a larger number of patients is needed for clinical application in the future.
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Affiliation(s)
- Joon Ho Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
- Department of Radiological & Medico-Oncological Sciences, University of Science and Technology (UST), Seoul, Korea
- * E-mail: (IL); (HJK)
| | - Byung Hyun Byun
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Chang Woon Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Hye Jin Kang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
- * E-mail: (IL); (HJK)
| | - Dong-Yeop Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
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Duś-Szachniewicz K, Gdesz-Birula K, Rymkiewicz G. Development and Characterization of 3D Hybrid Spheroids for the Investigation of the Crosstalk Between B-Cell Non-Hodgkin Lymphomas and Mesenchymal Stromal Cells. Onco Targets Ther 2022; 15:683-697. [PMID: 35747403 PMCID: PMC9213039 DOI: 10.2147/ott.s363994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose B-cell non-Hodgkin lymphomas (B-NHLs) are the most common lymphoproliferative malignancy. Despite targeted therapies, the bone marrow involvement remains a challenge in treating aggressive B-NHLs, partly due to the protective interactions of lymphoma cells with mesenchymal stromal cells (MSCs). However, data elucidating the relationship between MSCs and B-NHLs are limited and inconclusive due to the lack of reproducible in vitro three-dimensional (3D) models. Here, we developed and described a size-controlled and stable 3D hybrid spheroids of Ri-1 (diffuse large B-cell lymphoma, DLBCL) and RAJI (Burkitt lymphoma, BL) cells with HS-5 fibroblasts to facilitate research on the crosstalk between B-NHL cells and MSCs. Materials and Methods We applied the commercially available agarose hydrogel microwells for a fast, low-cost, and reproducible hybrid lymphoma/stromal spheroids formation. Standard histological automated procedures were used for formalin fixation and paraffin embedding (FFPE) of 3D models to produce good quality slides for histopathology and immunohistochemical staining. Next, we tested the effect of the anti-cancer drugs: doxorubicin (DOX) and ibrutinib (IBR) on mono-cultured and co-cultured B-NHLs with the use of alamarBlue and live/dead cell fluorescence based assays to confirm their relevancy for drug testing studies. Results We optimized the conditions for B-NHLs spheroid formation in both: a cell line-specific and application-specific manner. Lymphoma cells aggregate into stable spheroids when co-cultured with stromal cells, of which internal architecture was driven by self-organization. Furthermore, we revealed that co-culturing of lymphoma cells with stromal cells significantly reduced IBR-induced apoptosis compared to the 3D mono-culture. Conclusion This article provides details for generating 3D B-NHL spheroids for the studies on the lymphoma- stromal cells. This approach makes it suitable to assess in a relevant in vitro model the activity of new therapeutic agents in B-NHLs.
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Affiliation(s)
- Kamila Duś-Szachniewicz
- Institute of General and Experimental Pathology, Department of Clinical and Experimental Pathology, Wrocław Medical University, Wrocław, Poland
| | - Katarzyna Gdesz-Birula
- Institute of General and Experimental Pathology, Department of Clinical and Experimental Pathology, Wrocław Medical University, Wrocław, Poland
| | - Grzegorz Rymkiewicz
- Flow Cytometry Laboratory, Department of Cancer Pathomorphology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Immunohistochemical expression of transcription factors PAX5, OCT2, BCL6 and transcription regulator P53 in Non-Hodgkin lymphomas: A diagnostic cross-sectional study. Ann Med Surg (Lond) 2022; 78:103786. [PMID: 35600178 PMCID: PMC9119824 DOI: 10.1016/j.amsu.2022.103786] [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: 04/06/2022] [Revised: 05/08/2022] [Accepted: 05/10/2022] [Indexed: 11/21/2022] Open
Abstract
Background Non-Hodgkin lymphoma represents a heterogeneous group of tumors that constitute the seventh most common malignancy. Immunohistochemistry plays a major role in the detection of specific cell receptors. Transcription factors are a heterogeneous group of genes that play a critical role in the commitment, differentiation, and proliferation of specific cell types. Methods Paraffin-embedded tissue sections of non-Hodgkin lymphoma cases were selected, classified, and evaluated before staining with immunohistochemical markers (PAX5, OCT2, BCL6, and P53). Expression of the aforementioned markers was compared with histological subtypes and grades of lymphoma cases. Means of expression were also compared among histological subtypes. Results A total of 55 cases of NHL including 26 cases of low-grade lymphomas and 29 cases of high-grade lymphomas were included in the study. DLBCL and FL were the most common subtypes of high-grade and low-grade lymphomas respectively. Both PAX5 and OCT2 were positive in 44 cases of NHL (80%) including all cases of B-cell lymphomas. BCL6 and P53 demonstrated positive expression in 29.1% and 67.3% respectively. Interestingly, we found a significant association between the histological subtypes and the aforementioned markers (P-value<0.05). Discussion Expression of PAX5, OCT2, BCL, and P53 played a major role in the diagnosis and grading of non-Hodgkin lymphomas in our study. Both PAX5 and OCT2 provided more accuracy and specificity in the diagnosis of B-cell neoplasms compared to the classical B-cell markers. BCL6 expression reflected its role in germinal center formation in normal and malignant lymphoid tissues, and expression of P53 mirrored the accumulation of gene mutations in more aggressive lymphoma subtypes. Conclusion In this manuscript, we aimed to present a unique study that highlights the immunohistochemical expression of all the aforementioned factors among various histological subtypes of non-Hodgkin lymphomas with disparities in histological aggressiveness, highlighting a promising diagnostic and prognostic panel for non-Hodgkin lymphomas. Transcription factors are essential for the differentiation of B-cells. PAX5 and OCT2 provide more accuracy in the diagnosis of lymphomas. BCL6 expression reflects its role in germinal center formation. P53 expression is higher in aggressive subtypes.
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Yano H, Fujiwara Y, Hasita H, Pan C, Kai K, Niino D, Ohsawa K, Higashi M, Nosaka K, Okuno Y, Tamaru JI, Mukasa A, Matsuoka M, Komohara Y. Blocking cholesterol efflux mechanism is a potential target for anti-lymphoma therapy. Cancer Sci 2022; 113:2129-2143. [PMID: 35343027 PMCID: PMC9207360 DOI: 10.1111/cas.15349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
Cholesterol is an essential plasma membrane lipid for the maintenance of cellular homeostasis and cancer cell proliferation. Free cholesterol is harmful to cells; therefore, excessive free cholesterol must be quickly esterified by acetyl-coenzyme A:cholesterol acetyltransferase (ACAT) and exported by scavenger receptor class B member I (SR-BI) or ATP-binding cassette protein A1 (ABCA1) from specific cells such as macrophage foam cells, which contain cholesteryl ester-derived vacuoles. Many vacuoles are present in the cytoplasm of Burkitt's lymphoma cells. In this study, we observed that these "vacuoles" are often seen in high-grade lymphomas. Cell culture study using lymphoma cell lines found that esterified cholesterol is the main component of these "vacuoles." and the expression of cholesterol metabolism-related molecules was significantly upregulated in lymphoma cell lines, with SR-BI and ACAT inhibitors (BLT-1 and CI-976, respectively) impeding lymphoma cell proliferation. Cytoplasmic free cholesterol was increased by ACAT and SR-BI inhibitors, and the accumulation of free cholesterol induced lymphoma cell apoptosis via inducing endoplasmic reticulum stress. Furthermore, synergistic effects of SR-BI and ACAT inhibitors were observed in a preclinical study. SR-BI inhibitor administration suppressed lymphoma progression in a tumor-bearing mouse model, whereas ACAT inhibitor did not. Therefore, SR-BI inhibitors are potential new antilymphoma therapeutics that target cholesterol metabolism.
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Affiliation(s)
- Hiromu Yano
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Yukio Fujiwara
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Horlad Hasita
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Chang Pan
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Keitaro Kai
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Daisuke Niino
- Department of Pathology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 101-0048, Japan
| | - Kumiko Ohsawa
- Department of Pathology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Morihiro Higashi
- Department of Pathology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Kisato Nosaka
- Department of Hematology, Rhaumatology, and Infectious Diseases, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Yutaka Okuno
- Department of Hematology, Rhaumatology, and Infectious Diseases, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Jun-Ichi Tamaru
- Department of Pathology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 350-8550, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Masao Matsuoka
- Department of Hematology, Rhaumatology, and Infectious Diseases, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
| | - Yoshihiro Komohara
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan.,Center for Metabolic Regulation of Healthy Aging, Kumamoto University, Honjo 1-1-1, Kumamoto, 860-8556, Japan
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Samiee F, Mohammadi R, Shirian S, Alijani MR, Aledavood A, Negahban S, Ghaemi A, Daneshbod K, Daneshbod Y. Spectrum of lymphoma subtypes based on the latest World Health Organization classification in southern Iran from 2000 to 2011. Future Oncol 2021; 17:4733-4744. [PMID: 34756105 DOI: 10.2217/fon-2020-0534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Lymphoma, both Hodgkin and non-Hodgkin, is one of the most common malignancies, with a distinct subtype distribution throughout the world. Methods: A total of 453 lymphoma cases, identified retrospectively from January 2000 to October 2011, were studied to identify the subtype distribution of lymphoma in our center, located in southern Iran, according to the latest WHO classification. Results: The most common sites of involvement of all lymphomas were extranodal (59.16%). The highest frequency of extranodal sites in all lymphoid neoplasms were associated with diffuse large B-cell lymphoma (22.95%) and classical Hodgkin lymphoma (10.15%). Of 453 cases, 23 (5.32%) were T and natural killer cell neoplasms, of which the most common subtypes were T-cell large granular lymphocytic leukemia and anaplastic large cell lymphoma. Conclusion: This study indicated that the subtype distribution of lymphoma (except for the higher prevalence of diffuse large B-cell lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma and lower rate of follicular lymphoma) in this part of Iran is similar to that in the Middle Eastern countries. Mature B-cell neoplasms are less frequent compared with both western and far east Asian countries.
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Affiliation(s)
- Fatemeh Samiee
- Department of Pathology, Qazvin Metabolic Disease Research Center, Qazvin University of Medical Sciences, Qazvin, Iran, Bahonar St, Qazvin, Iran
| | - Reza Mohammadi
- Department of Medical Genetics, Shiraz Infertility Treatment Center, Shiraz, Iran, Zand St, Shiraz 7134777108, Iran
| | - Sadegh Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran, Rahbar St, Shahrekord 8818634141, Iran.,Shiraz Molecular Pathology Research Center, Dr Daneshbod Pathology Laboratory, Shiraz, Iran, Eastern Ordibehesht, Zand St, Shiraz 7134777118, Iran.,Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Mohammad-Reza Alijani
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran, Rahbar St, Shahrekord 8818634141, Iran
| | - Azita Aledavood
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Pathology Laboratory, Shiraz, Iran, Eastern Ordibehesht, Zand St, Shiraz 7134777118, Iran
| | - Shahrzad Negahban
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Pathology Laboratory, Shiraz, Iran, Eastern Ordibehesht, Zand St, Shiraz 7134777118, Iran
| | - Amir Ghaemi
- Department of Virology, Pasteur Institute of Iran, Farvardin St, Tehran 1316943551, Iran
| | - Khosrow Daneshbod
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Pathology Laboratory, Shiraz, Iran, Eastern Ordibehesht, Zand St, Shiraz 7134777118, Iran
| | - Yahya Daneshbod
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Pathology Laboratory, Shiraz, Iran, Eastern Ordibehesht, Zand St, Shiraz 7134777118, Iran.,Department of Pathology & Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
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BAKKAL FK, GÜLHAN N, ERAVCI FC, KIZIL Y, AYDİL U. Head and neck lymphomas from otolaryngology perspective. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.948863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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10
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Kim H, Kim HJ, Kim SH. Diagnostic Approach for Double-Hit and Triple-Hit Lymphoma Based on Immunophenotypic and Cytogenetic Characteristics of Bone Marrow Specimens. Ann Lab Med 2021; 40:361-369. [PMID: 32311849 PMCID: PMC7169621 DOI: 10.3343/alm.2020.40.5.361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/16/2019] [Accepted: 03/13/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND High-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6 (BCL2/BCL6), also known as double-hit lymphoma (DHL) and/or triple-hit lymphoma (THL), is a new entity of B-cell lymphoma in the 2017 WHO Classification. We retrospectively investigated D/THL and their clinico-laboratory features among cases of large B-cell lymphoma involving the bone marrow (BM), including diffuse large B-cell lymphoma, Burkitt lymphoma, and B-cell lymphomas with medium to large lymphoid cells, by additional FISH analysis of BM aspirates. METHODS A total of 111 patients diagnosed with aggressive B-cell lymphomas or B-cell lymphoma involving the BM with medium to large-sized malignant lymphocytes were reviewed from January 2000 to January 2018. Patients with available BM aspirates were evaluated by immunophenotyping by flow cytometry, chromosome, and FISH analysis for MYC and/or BCL2/BCL6 rearrangements. RESULTS In total, 23/111 (20.7%) showed MYC rearrangement, and eight (7.2%) were reclassified as D/THL on BM after FISH analysis for MYC and BCL2/BCL6. The detection of CD5(-)/CD10(+) based on flow cytometry was strongly associated with D/THL. A complex karyotype with aberrations related to regions in MYC and BCL2/BCL6 was significantly associated with D/THL. When the MYC FISH results of 28 BM aspirates and formalin-fixed paraffin-embedded tissue specimens were compared, 14% were discrepant. CONCLUSIONS Immunophenotypic and cytogenetic characteristics facilitate the diagnosis of D/THL in the cases with BM-involving aggressive B-cell lymphomas.
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Affiliation(s)
- Heyjin Kim
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Hee-Jin Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun-Hee Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Vivarelli S, Falzone L, Ligresti G, Candido S, Garozzo A, Magro GG, Bonavida B, Libra M. Role of the Transcription Factor Yin Yang 1 and Its Selectively Identified Target Survivin in High-Grade B-Cells Non-Hodgkin Lymphomas: Potential Diagnostic and Therapeutic Targets. Int J Mol Sci 2020; 21:ijms21176446. [PMID: 32899428 PMCID: PMC7504013 DOI: 10.3390/ijms21176446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/21/2020] [Accepted: 09/02/2020] [Indexed: 12/19/2022] Open
Abstract
B-cell non-Hodgkin lymphomas (B-NHLs) are often characterized by the development of resistance to chemotherapeutic drugs and/or relapse. During drug-induced apoptosis, Yin Yang 1 (YY1) transcription factor might modulate the expression of apoptotic regulators genes. The present study was aimed to: (1) examine the potential oncogenic role of YY1 in reversing drug resistance in B-NHLs; and (2) identify YY1 transcriptional target(s) that regulate the apoptotic pathway in B-NHLs. Predictive analyses coupled with database-deposited data suggested that YY1 binds the promoter of the BIRC5/survivin anti-apoptotic gene. Gene Expression Omnibus (GEO) analyses of several B-NHL repositories revealed a conserved positive correlation between YY1 and survivin, both highly expressed, especially in aggressive B-NHLs. Further validation experiments performed in Raji Burkitt’s lymphomas cells, demonstrated that YY1 silencing was associated with survivin downregulation and sensitized the cells to apoptosis. Overall, our results revealed that: (1) YY1 and survivin are positively correlated and overexpressed in B-NHLs, especially in BLs; (2) YY1 strongly binds to the survivin promoter, hence survivin may be suggested as YY1 transcriptional target; (3) YY1 silencing sensitizes Raji cells to drug-induced apoptosis via downregulation of survivin; (4) both YY1 and survivin are potential diagnostic markers and therapeutic targets for the treatment of resistant/relapsed B-NHLs.
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Affiliation(s)
- Silvia Vivarelli
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (S.V.); (G.L.); (S.C.)
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori ‘Fondazione G. Pascale’, 80131 Naples, Italy;
| | - Giovanni Ligresti
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (S.V.); (G.L.); (S.C.)
| | - Saverio Candido
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (S.V.); (G.L.); (S.C.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy; (A.G.); (G.G.M.)
| | - Adriana Garozzo
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy; (A.G.); (G.G.M.)
- Laboratory of Virology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Gaetano Giuseppe Magro
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy; (A.G.); (G.G.M.)
- Department of Medical and Surgical Sciences and Advanced Technology “G.F. Ingrassia”, University of Catania, 95123 Catania, Sicily, Italy
| | - Benjamin Bonavida
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - Massimo Libra
- Laboratory of Translational Oncology, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (S.V.); (G.L.); (S.C.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy; (A.G.); (G.G.M.)
- Correspondence: ; Tel.: +39-095-478-1271
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12
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A Unique Presentation of Cutaneous Diffuse Large B-Cell Lymphoma. Case Rep Dermatol Med 2020; 2020:8310602. [PMID: 32318298 PMCID: PMC7166262 DOI: 10.1155/2020/8310602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/17/2020] [Indexed: 12/26/2022] Open
Abstract
Cutaneous B-cell lymphomas (CBCL) are rare heterogeneous neoplastic diseases composing about 22.5% of all cutaneous lymphomas. These diseases can be divided into primary and secondary cutaneous variants with primary cutaneous B-cell lymphoma (PCBCL) divided into three distinct entities including primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT). Secondary cutaneous diffuse large B-cell lymphoma (CDLBCL) and PCDLBCL, LT are more aggressive neoplasms compared to the aforementioned CBCL with survival rates of 37% and 50% after 5 years, respectively. CDLBCL can present as cutaneous or subcutaneous nodules, papular lesions, or indurated plaques. Here, we present a case of CDLBCL of an 88-year-old female that was mistaken for lower extremity cellulitis with phlegmon. Our patient failed two courses of antibiotic therapy as an outpatient and received a third as an inpatient before a cutaneous biopsy clinched the diagnosis.
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13
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Conte GA, Harmon JS, Le ML, Sun X, Schuler JW, Levitt MJ, Chinnici AA, Hossain MA. Hypercalcemia in T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: An Unusual Presentation of a Rare Disease and Literature Review. World J Oncol 2019; 10:231-236. [PMID: 31921379 PMCID: PMC6940034 DOI: 10.14740/wjon1246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 01/18/2023] Open
Abstract
T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is an extremely rare morphologic subtype of diffuse large B-cell lymphoma (DLBCL), accounting for only 1-3% of total cases. It is considered an aggressive lymphoma with a poor prognosis. Hypercalcemia has been described as an uncommon presenting symptom of patients with DLBCL in several case reports. Here, we report an unusual case of severe hypercalcemia in a patient who was ultimately diagnosed with T-cell/histiocyte-rich B-cell lymphoma. A 69-year-old male patient presented to our hospital with nausea, vomiting, weakness and unintentional weight loss. His initial blood tests showed a serum calcium level of 16.1 mg/dL and serum creatinine level of 3.25 mg/dL. He had high intact parathyroid hormone (PTH, 6.8 pg/mL), mildly elevated 25-hydroxyvitamin D and serum PTH-related peptide (PTHrP). To exclude malignancy, computed tomography (CT) scans of the chest, abdomen and pelvis were performed which were unremarkable. A bone marrow biopsy was performed to detect any hidden hematologic malignancy which showed large mononuclear cells with prominent nucleoli and occasional Reed-Sternberg cells, consistent with the diagnosis of THRLBCL. Subsequent positron emission tomography demonstrated diffuse fluorodeoxyglucose (FDG) uptake. This case reports a unique presentation of a rare subtype of non-Hodgkin's lymphoma. We highlight the importance of pursuing a thorough workup for causes of hypercalcemia as well as understanding the underlying mechanisms of severe hypercalcemia in malignancy.
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Affiliation(s)
- Gabriella A Conte
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, NJ, USA
| | - Jonathan S Harmon
- Department of Medicine, Jefferson Health New Jersey, Jefferson University Hospital, Stratford, NJ, USA
| | - Marjolein L Le
- Department of Medicine, Easton Hospital, Easton, PA, USA
| | - Xiu Sun
- Department of Pathology, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA
| | - Jake W Schuler
- Saint George's University School of Medicine, Grenada, West Indies
| | - Michael J Levitt
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, NJ, USA
| | - Angelo A Chinnici
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, NJ, USA
| | - Mohammad A Hossain
- Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, NJ, USA
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14
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Maes A, Maes K, De Raeve H, De Smedt E, Vlummens P, Szablewski V, Devin J, Faict S, De Veirman K, Menu E, Offner F, Spaargaren M, Moreaux J, Vanderkerken K, Van Valckenborgh E, De Bruyne E. The anaphase-promoting complex/cyclosome: a new promising target in diffuse large B-cell lymphoma and mantle cell lymphoma. Br J Cancer 2019; 120:1137-1146. [PMID: 31089208 PMCID: PMC6738099 DOI: 10.1038/s41416-019-0471-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 01/03/2023] Open
Abstract
Background The aggressive B-cell non-Hodgkin lymphomas diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL) are characterised by a high proliferation rate. The anaphase-promoting complex/cyclosome (APC/C) and its co-activators Cdc20 and Cdh1 represent an important checkpoint in mitosis. Here, the role of the APC/C and its co-activators is examined in DLBCL and MCL. Methods The expression and prognostic value of Cdc20 and Cdh1 was investigated using GEP data and immunohistochemistry. Moreover, the therapeutic potential of APC/C targeting was evaluated using the small-molecule inhibitor proTAME and the underlying mechanisms of action were investigated by western blot. Results We demonstrated that Cdc20 is highly expressed in DLBCL and aggressive MCL, correlating with a poor prognosis in DLBCL. ProTAME induced a prolonged metaphase, resulting in accumulation of the APC/C-Cdc20 substrate cyclin B1, inactivation/degradation of Bcl-2 and Bcl-xL and caspase-dependent apoptosis. In addition, proTAME strongly enhanced the anti-lymphoma effect of the clinically relevant agents doxorubicin and venetoclax. Conclusion We identified for the first time APC/C as a new, promising target in DLBCL and MCL. Moreover, we provide evidence that Cdc20 might be a novel, independent prognostic factor in DLBCL and MCL.
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Affiliation(s)
- Anke Maes
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ken Maes
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hendrik De Raeve
- Department of Pathology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva De Smedt
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Philip Vlummens
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium.,Hematology, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | | | - Julie Devin
- Laboratory for Monitoring Innovative Therapies, Institute of Human Genetics, CNRS, Montpellier, France
| | - Sylvia Faict
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kim De Veirman
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eline Menu
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fritz Offner
- Hematology, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marcel Spaargaren
- Department of Pathology, Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jérôme Moreaux
- Laboratory for Monitoring Innovative Therapies, Institute of Human Genetics, CNRS, Montpellier, France
| | - Karin Vanderkerken
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Els Van Valckenborgh
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke De Bruyne
- Department of Hematology and Immunology, Myeloma Center Brussels, Vrije Universiteit Brussel, Brussels, Belgium.
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15
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Puneeth HK, Kumar SRR, Ananthaneni A, Jakkula AN. Physical torment: A predisposition for diffuse B-cell lymphoma. J Oral Maxillofac Pathol 2019; 23:17-22. [PMID: 30967717 PMCID: PMC6421932 DOI: 10.4103/jomfp.jomfp_7_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Lymphomas of the oral cavity are rare and represent only 3%–5% of all lymphomas. Diffuse large B-cell lymphomas (DLBCLs) are a heterogeneous group of tumor and the most common type of all non-Hodgkin's lymphomas (NHLs). They mostly arise from soft tissue as asymptomatic swelling and involvement of jaw bones is infrequent. We present a case of a 23-year-old patient who developed DLBCL in oral cavity region 4 months after blunt trauma. The patient lacked other physical symptoms at the time of presentation. Histopathology, bone marrow and immunohistochemistry revealed DLBCL. After chemotherapy of eight cycles, swelling was totally reduced and no relapse observed in 10 months’ follow-up period. Thus, the present report represents an example of possible rapport between trauma and unresolved soft-tissue swelling which may be caused by NHLs.
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Affiliation(s)
- H K Puneeth
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - S Ravi Raja Kumar
- Department of Oral and Maxillofacial Surgery, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Anuradha Ananthaneni
- Department of Oral Pathology and Microbiology, Saint Joseph Dental College, Eluru, Andhra Pradesh, India
| | - Ananth Nag Jakkula
- Department of Oral and Maxillofacial Surgery, GSL Dental College, Rajahmundry, Andhra Pradesh, India
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16
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Ting CY, Chang KM, Kuan JW, Sathar J, Chew LP, Wong OLJ, Yusuf Y, Wong L, Samsudin AT, Pana MNBM, Lee SK, Gopal NSR, Puri R, Ong TC, Bahari SK, Goh AS, Teoh CS. Clinical Significance of BCL2, C- MYC, and BCL6 Genetic Abnormalities, Epstein-Barr Virus Infection, CD5 Protein Expression, Germinal Center B Cell/Non-Germinal Center B-Cell Subtypes, Co-expression of MYC/BCL2 Proteins and Co-expression of MYC/BCL2/BCL6 Proteins in Diffuse Large B-Cell Lymphoma: A Clinical and Pathological Correlation Study of 120 Patients. Int J Med Sci 2019; 16:556-566. [PMID: 31171907 PMCID: PMC6535654 DOI: 10.7150/ijms.27610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/29/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Clinical significance of germinal center B-cell (GCB) and non-GCB sub-categorization, expression of MYC, BCL2, BCL6, CD5 proteins and Epstein Barr virus encoded RNA (EBER) positivity in diffuse large B-cell lymphoma (DLBCL) remain controversial. Could these biomarkers accurately identify high risk DLBCL patients? Are MYC, BCL2 and BCL6 proteins expression feasible as baseline testing to predict c-Myc, BCL2 or BCL6 gene rearrangements? Aims: To investigate prognostic values of GCB/non-GCB sub-categorization, Double Protein Expression Lymphoma (DPL), Triple Protein Expression Lymphoma (TPL), positivity of CD5 protein and EBER in patients with DLBCL disease. To evaluate correlation between BCL2 , c-Myc and BCL6 gene rearrangements with BCL2, MYC and BCL6 proteins expression. Methods: Diagnostic tissue samples of 120 DLBCL patients between January 2012 to December 2013 from four major hospitals in Malaysia were selected. Samples were subjected to immunohistochemical staining, fluorescent in-situ hybridization (FISH) testing, and central pathological review. Pathological data were correlated with clinical characteristics and treatment outcome. Results: A total of 120 cases were analysed. Mean age of diagnosis was 54.1 years ± 14.6, 64 were males, 56 were females, mean follow up period was 25 months (ranged from 1 to 36 months). Of the 120 cases, 74.2% were non-GCB whereas 25.8% were GCB, 6.7% were EBER positive, 6.7% expressed CD5 protein, 13.3% were DPL and 40% were TPL. The prevalence of c-Myc, BCL2, BCL6 gene rearrangements were 5.8%, 5.8%, and 14.2%, respectively; and 1.6% were Double Hit Lymphoma (DHL). EBER positivity, DPL, TPL, c-Myc gene rearrangement, BCL2 gene rearrangement, extra copies of BCL2 gene and BCL6 gene rearrangement were associated with shorter median overall survival (P<0.05). IPI score was the significant determinants of median overall survival in DPL and TPL (P<0.05). CD5 protein expression and GCB/non-GCB sub-categorization did not affect treatment outcome (P>0.05). Overall, c-Myc, BCL2 and BCL6 gene rearrangements showed weak correlation with expression of MYC, BCL2 and BCL6 proteins (P>0.05). Fluorescent in situ hybridization is the preferred technique for prediction of treatment outcome in DLBCL patients. Conclusion: c-Myc, BCL2, and BCL6 gene rearrangements, EBER expression, DHL, TPL and IPI score are reliable risk stratification tools. MYC, BCL2 and BCL6 proteins expression are not applicable as baseline biomarkers to predict c-Myc, BCL2, and BCL6 gene rearrangements.
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Affiliation(s)
- Choo-Yuen Ting
- Department of Hematology, Hospital Ampang, Ministry of Health Malaysia
| | - Kian-Meng Chang
- Department of Hematology, Hospital Ampang, Ministry of Health Malaysia
| | - Jew-Win Kuan
- Department of Medicine, Faculty of Medicine and Health Sciences, University Malaysia Sarawak
| | - Jameela Sathar
- Department of Hematology, Hospital Ampang, Ministry of Health Malaysia.,Clinical Research Centre, National Institutes of Health, Ministry of Health Malaysia
| | - Lee-Ping Chew
- Clinical Research Centre, National Institutes of Health, Ministry of Health Malaysia.,Department of Medicine, Hospital Umum Sarawak, Ministry of Health Malaysia
| | | | - Yusri Yusuf
- Department of Pathology, Hospital Umum Sarawak, Ministry of Health Malaysia
| | - Lily Wong
- Department of Medicine, Queen Elizabeth Hospital, Ministry of Health Malaysia
| | - Ahmad Toha Samsudin
- Department of Pathology, Queen Elizabeth Hospital, Ministry of Health Malaysia
| | | | - Suk-Kam Lee
- Department of Pathology, Hospital Pulau Pinang, Ministry of Health Malaysia
| | | | - Rita Puri
- Department of Hematology, Hospital Ampang, Ministry of Health Malaysia
| | - Tee-Chuan Ong
- Department of Hematology, Hospital Ampang, Ministry of Health Malaysia
| | | | - Ai-Sim Goh
- Department of Medicine, Hospital Pulau Pinang, Ministry of Health Malaysia
| | - Ching-Soon Teoh
- Department of Medicine, Hospital Pulau Pinang, Ministry of Health Malaysia
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17
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Sioud M, Westby P, Vasovic V, Fløisand Y, Peng Q. Development of a new high-affinity human antibody with antitumor activity against solid and blood malignancies. FASEB J 2018; 32:5063-5077. [PMID: 29913558 DOI: 10.1096/fj.201701544r] [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: 12/12/2022]
Abstract
mAbs have emerged as a promising strategy for the treatment of cancer. However, in several malignancies, no effective antitumor mAbs are yet available. Identifying therapeutic mAbs that recognize common tumor antigens could render the treatment widely applicable. Here, a human single-chain variable fragment (scFv) antibody library was sequentially affinity selected against a panel of human cancer cell lines and an antibody fragment (named MS5) that bound to solid and blood cancer cells was identified. The MS5 scFv was fused to the human IgG1 Fc domain to generate an antibody (MS5-Fc fusion) that induced antibody-dependent cellular cytotoxicity and phagocytosis of cancer cells by macrophages. In addition, the MS5-Fc antibody bound to primary leukemia cells and induced antibody-dependent cellular cytotoxicity. In the majority of analyzed cancer cells, the MS5-Fc antibody induced cell surface redistribution of the receptor complexes, but not internalization, thus maximizing the accessibility of the IgG1 Fc domain to immune effector cells. In vitro stability studies showed that the MS5-Fc antibody was stable after 6 d of incubation in human serum, retaining ∼60% of its initial intact form. After intravenous injections, the antibody localized into tumor tissues and inhibited the growth of 3 different human tumor xenografts (breast, lymphoma, and leukemia). These antitumor effects were associated with tumor infiltration by macrophages and NK cells. In the Ramos B-cell lymphoma xenograft model, the MS5-Fc antibody exhibited a comparable antitumor effect as rituximab, a chimeric anti-CD20 IgG1 mAb. These results indicate that human antibodies with pan-cancer abilities can be generated from phage display libraries, and that the engineered MS5-Fc antibody could be an attractive agent for further clinical investigation.-Sioud, M., Westby, P., Vasovic, V., Fløisand, Y., Peng, Q. Development of a new high-affinity human antibody with antitumor activity against solid and blood malignancies.
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Affiliation(s)
- Mouldy Sioud
- Department of Cancer Immunology, Rikshospitalet-Radiumhospitalet, University Hospital, Oslo, Norway
| | - Phuong Westby
- Department of Cancer Immunology, Rikshospitalet-Radiumhospitalet, University Hospital, Oslo, Norway
| | - Vlada Vasovic
- Department of Pathology, Rikshospitalet-Radiumhospitalet, University Hospital, Oslo, Norway; and
| | - Yngvar Fløisand
- Department of Hematology, Rikshospitalet-Radiumhospitalet, University Hospital, Oslo, Norway
| | - Qian Peng
- Department of Pathology, Rikshospitalet-Radiumhospitalet, University Hospital, Oslo, Norway; and
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18
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Differential IgM expression distinguishes two types of pediatric Burkitt lymphoma in mouse and human. Oncotarget 2018; 7:63504-63513. [PMID: 27566574 PMCID: PMC5325380 DOI: 10.18632/oncotarget.11531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/13/2016] [Indexed: 11/25/2022] Open
Abstract
Endemic Burkitt lymphoma (eBL) is primarily a childhood cancer in parts of Africa and Brazil. Classic studies describe eBL as a homogeneous entity based on t(8;14) IgH-Myc translocation and clinical response to cytotoxic therapy. By contrast, sporadic BL (sBL) in Western countries is considered more heterogeneous, and affects both children and adults. It is overrepresented in AIDS patients. Unlike diffuse large B cell lymphoma (DLBCL), molecular subtypes within BL have not been well defined. We find that differential IgM positivity can be used to describe two subtypes of pediatric Burkitt lymphoma both in a high incidence region (Brazil), as well as in a sporadic region (US), suggesting the phenotype is not necessarily geographically isolated. Moreover, we find that IgM positivity also distinguishes between early and late onset BL in the standard Eμ-Myc mouse model of BL. This suggests that the t(8;14) translocation not only can take place before, but also after isotype switch recombination, and that IgM-negative, t(8;14) positive lymphomas in children should nevertheless be considered BL.
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19
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Singh N, Pasricha S, Agrawal N, Gandhi JS, Panaych A, Mehta A, Ahmed R, Bhurani D. Diagnostic Dilemmas in Aggressive Large B Cell Neoplasms with Enigmatic Immunohistochemical Profile: How Far Should We Investigate? Indian J Hematol Blood Transfus 2018; 34:194-196. [PMID: 29398833 DOI: 10.1007/s12288-017-0839-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 06/07/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Neha Singh
- Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Sunil Pasricha
- Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Narendra Agrawal
- Department of Hemato-Oncology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Jatin S Gandhi
- Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Ajit Panaych
- Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Anurag Mehta
- Department of Laboratory Medicine, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Rayaz Ahmed
- Department of Hemato-Oncology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
| | - Dinesh Bhurani
- Department of Hemato-Oncology, Rajiv Gandhi Cancer Institute and Research Center, Rohini, Delhi, India
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20
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Chen Z, Liang Q, Wang J, Huang QX, Chen JN, Weng ZJ, Shao CK, Gao X, Pang J. Collapsin response mediator protein 4 promotor methylation level as a potential predictor for diagnosing primary malignant lymphoma of the prostate. Cancer Cell Int 2018; 18:3. [PMID: 29308052 PMCID: PMC5753574 DOI: 10.1186/s12935-017-0484-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 11/23/2017] [Indexed: 01/03/2023] Open
Abstract
Background Primary malignant lymphoma of the prostate (PMLP) is prone to occur in the elderly, and it has no significant correlation with lactate dehydrogenase (LDH) and prostate specific antigen (PSA). Clinical symptoms and imaging data of PMLP remain unspecific, and its prognosis is poor. A previous result showed that collapsin response mediator protein 4 (CRMP4) promotor methylation can be used as a predictor for lymph node metastases in prostate biopsies. However, the relationship between CRMP4 promotor methylation and PMLP has not been studied. Methods We investigated the clinicopathological features of PMLP and the significance of CRMP4 methylation in PMLP. The clinical data and diagnosis information of 10 patients with PMLP were retrospectively analyzed. The CRMP4 promotor methylation level in paraffin-embedded tissues of the 10 patients with PMLP were determined and then compared to limited prostate cancer (LPCa) and its negative lymph node tissue [LPCa-LN (−) (10 cases)] and also to metastatic prostate adenocarcinoma (mPCa) and its positive lymph node tissue [mPCa-LN (+) (10 cases)]. Methylation of the CRMP4 promotor in each group was analyzed statistically. A receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of CRMP4 methylation in PMLP. Results The average methylation value of CRMP4 in 10 PMLP patients, 20 cases of prostate adenocarcinoma tissue, 10 cases LPCa-LN (−) and 10 cases mPCa-LN (+) were 42.3, 30.6, 6.7 and 20.3%, respectively. A Kruskal–Wallis test showed that the difference of CRMP4 methylation was significant (X2 = 38.0, P < 0.001). An ROC curve analysis found that CRMP4 methylation > 40.9% could diagnose PMLP. This method had 90% sensitivity and 95% specificity under conditions of CRMP4 methylation > 40.9%. The area under the curve (AUC) was 0.957. Conclusions Methylation of the CRMP4 gene was significantly increased in PMLP, and it is expected to become a new predictor for PMLP.
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Affiliation(s)
- Zheng Chen
- Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Tianhe Road 600, Guangzhou, 510630 China
| | - Qiong Liang
- Department of Pathology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jue Wang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qun-Xiong Huang
- Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Tianhe Road 600, Guangzhou, 510630 China
| | - Jian-Ning Chen
- Department of Pathology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zi-Jin Weng
- Department of Pathology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun-Kui Shao
- Department of Pathology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xin Gao
- Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Tianhe Road 600, Guangzhou, 510630 China
| | - Jun Pang
- Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Tianhe Road 600, Guangzhou, 510630 China
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21
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Beham-Schmid C. Aggressive lymphoma 2016: revision of the WHO classification. MEMO-MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY 2017; 10:248-254. [PMID: 29250206 PMCID: PMC5725508 DOI: 10.1007/s12254-017-0367-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/02/2017] [Indexed: 11/27/2022]
Abstract
Aggressive lymphomas are a heterogeneous group of malignancies reflecting clinical, biological and pathological diversity. Diffuse large B‑cell lymphoma is the most common histological subtype and therefore will constitute the key aspect in this article. This lymphoma affects patients of all age groups with wide range presentations concerning localization, morphology and molecular mechanisms. The median age at presentation is about 60 years with a slight male preponderance. Up to 50% of patients present with advanced disease. About 70% of these lymphomas occur nodal, about 30% extranodal, the most common sites of the latter being the gastrointestinal tract, Waldeyer’s ring, skin, cerebrum, mediastinum, testis, salivary gland, thyroid and bone. However, diffuse large B‑cell lymphoma can involve virtually any organ.Since the last WHO classification 2008 the adoption of new genomic technologies has provided new insights into the biology of these lymphomas and led to the identification of distinct separate molecular entities and novel pathogenic pathways. These findings induced an expanding number of entities in the new WHO classification of 2016, the knowledge of which is essential concerning treatment options and survival of the patients. Therefore, the clinicians request an accurate diagnosis from the investigating pathologist, which can be quite challenging. The diagnosis of lymphomas requires multiple immunohistochemical studies, and often additional tests, such as fluorescent in situ hybridization and/or polymerase chain reaction techniques and occasionally, in particular cases, next generation sequencing for identification of recurrent somatic mutations. This review summarizes relevant aspects of the new WHO classification in aggressive B‑cell lymphomas, especially from a haematopathologist’s point of view.
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Affiliation(s)
- Christine Beham-Schmid
- Institute of Pathology, Medical University Graz, Neue Stiftingtalstr. 6, 8010 Graz, Austria
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22
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Reddy NM, Thieblemont C. Maintenance therapy following induction chemoimmunotherapy in patients with diffuse large B-cell lymphoma: current perspective. Ann Oncol 2017; 28:2680-2690. [PMID: 29045503 DOI: 10.1093/annonc/mdx358] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Maintenance therapy has proven efficacy in indolent non-Hodgkin lymphoma (NHL), yet its role in diffuse large B-cell lymphoma (DLBCL) is an area of ongoing investigation. While DLBCL is potentially curable, >30% of patients relapse following front-line therapy and have a poor prognosis, especially those with refractory disease. Maintenance therapy holds promise to maintain response post-induction. PATIENTS AND METHODS Keyword searches were carried out in PubMed and congress abstracts of 'diffuse large B-cell lymphoma' and 'maintenance' and focused on phase II/III studies of maintenance following front-line induction. RESULTS Although used in indolent forms of NHL, studies of maintenance therapy with rituximab in patients with DLBCL responding to front-line R-CHOP (rituximab/cyclophosphamide/doxorubicin/vincristine/prednisone) have not improved efficacy and are not recommended. Targeted agents enzastaurin and everolimus reported results from the phase III studies PRELUDE and PILLAR-2, respectively, both of which showed no proven maintenance benefit following front-line chemoimmunotherapy induction. Overall, the reported efficacy results with these agents in the maintenance setting do not outweigh the risks. Lenalidomide for maintenance has been reported in three studies. Results from two phase II trials on lenalidomide maintenance revealed positive outcomes in higher-risk patients following induction, resulting in improved progression-free survival in relapsed DLBCL patients who were ineligible for transplantation. First analysis from the phase III REMARC trial showed a significant improvement in progression-free survival for lenalidomide versus placebo, with no difference in overall survival, following front-line R-CHOP induction in elderly patients. CONCLUSIONS Based on currently available studies of DLBCL maintenance therapies, initial results in front-line, as well as the relapsed setting, with immunomodulators such as lenalidomide show promise for further research to identify appropriate patients who would most benefit. Overall, this review of maintenance studies underscores the need for additional analyses of patient subtypes, clinical risk status, and molecular profiles, with careful consideration of study end points.
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Affiliation(s)
- N M Reddy
- Department of Hematology/Oncology, Vanderbilt-Ingram Cancer Center, Nashville, USA;.
| | - C Thieblemont
- Department of Hemato-Oncology, Hôpital Saint-Louis, Paris, France.
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An Aggressive Primary Cutaneous Follicle Center Lymphoma With c-MYC Translocation and CDKN2A (9p21) Deletion: A Case Report and Review of the Literature. Am J Dermatopathol 2017; 39:e44-e49. [DOI: 10.1097/dad.0000000000000738] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chettiankandy TJ, Tupkari JV, Kumar K, Ahire MS. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Burkitt's lymphoma: A case report and review. J Oral Maxillofac Pathol 2016; 20:333. [PMID: 27601842 PMCID: PMC4989580 DOI: 10.4103/0973-029x.185936] [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] [Indexed: 12/22/2022] Open
Abstract
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Burkitt's lymphoma (BL), is a diagnostic provisional category in the World Health Organization 2008 classification of lymphomas. This category was designed as a measure to accommodate borderline cases that cannot be reliably classified into a single distinct disease entity after all available morphological, immunophenotypical and molecular studies have been performed. Typically, these cases share features intermediate between DLBCL and classical BL or include characteristics of both lymphomas. The rarity of such cases poses a tremendous challenge to both pathologists and oncologists because its differential diagnosis has direct implications for management strategies. In this article, we present a “classical unclassifiable lymphoma with features intermediate between DLBCL and BL” in a young male patient and review of literature.
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Affiliation(s)
- Tabita Joy Chettiankandy
- Department of Oral Pathology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Jagdish Vishnu Tupkari
- Department of Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Keshav Kumar
- Department of Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Manisha Sandeep Ahire
- Department of Microbiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
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Primary Cutaneous Diffuse Large B-Cell Lymphoma With a MYC-IGH Rearrangement and Gain of BCL2: Expanding the Spectrum of MYC/BCL2 Double-Hit Lymphomas. Am J Dermatopathol 2016; 38:769-74. [PMID: 27391453 DOI: 10.1097/dad.0000000000000607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Aggressive extracutaneous B-cell lymphomas span the various stages of B-cell ontogeny and include B-cell lymphoblastic lymphoma, Burkitt lymphoma, mantle cell lymphoma, and diffuse large B-cell lymphoma. Diffuse large B-cell lymphomas represent the most common histologic subtype of non-Hodgkin lymphomas, comprising 30% of adult non-Hodgkin lymphomas in the United States. A distinctive form of diffuse large B-cell lymphoma is the double-hit lymphoma, with most cases exhibiting a combined MYC and BCL2 rearrangement, leading some hematopathologists to propose the term MYC/BCL2 lymphoma. More recently, MYC rearrangement with multiple copies/gain of BCL2 or multiple copies/gain of MYC with a BCL2 rearrangement have been described and exhibit a very similar clinical course to conventional double-hit lymphomas. We report the seventh case of diffuse large B-cell lymphoma exhibiting this distinct cytogenetic abnormality and the first reported case in the skin. The patient's clinical course was aggressive, succumbing to disease 18 months after his initial presentation.
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Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive disease with considerable heterogeneity reflected in the 2008 World Health Organization classification. In recent years, genome-wide assessment of genetic and epigenetic alterations has shed light upon distinct molecular subsets linked to dysregulation of specific genes or pathways. Besides fostering our knowledge regarding the molecular complexity of DLBCL types, these studies have unraveled previously unappreciated genetic lesions, which may be exploited for prognostic and therapeutic purposes. Following the last World Health Organization classification, we have witnessed the emergence of new variants of specific DLBCL entities, such as CD30 DLBCL, human immunodeficiency virus-related and age-related variants of plasmablastic lymphoma, and EBV DLBCL arising in young patients. In this review, we will present an update on the clinical, pathologic, and molecular features of DLBCL incorporating recently gained information with respect to their pathobiology and prognosis. We will emphasize the distinctive features of newly described or emerging variants and highlight advances in our understanding of entities presenting a diagnostic challenge, such as T-cell/histiocyte-rich large B-cell lmphoma and unclassifiable large B-cell lymphomas. Furthermore, we will discuss recent advances in the genomic characterization of DLBCL, as they may relate to prognostication and tailored therapeutic intervention. The information presented in this review derives from English language publications appearing in PubMed throughout December 2015. For a complete outline of this paper, please visit: http://links.lww.com/PAP/A12.
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Borsarelli Carvalho Brito A, Torresan Delamain M, de Oliveira C, Antonio de Souza C, Vassallo J, Silvia Passos Lima C. Polymorphisms in key regulator genes of the intrinsic apoptosis pathway in risk and clinical presentation of diffuse large B-cell lymphoma. Hematol Oncol 2016; 35:911-913. [PMID: 27139711 DOI: 10.1002/hon.2297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Cristiane de Oliveira
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Carmino Antonio de Souza
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.,Haematology and Haemotherapy Centre, University of Campinas, Campinas, São Paulo, Brazil
| | - José Vassallo
- Laboratory of Molecular and Investigative Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Carmen Silvia Passos Lima
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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B-cell-specific conditional expression of Myd88p.L252P leads to the development of diffuse large B-cell lymphoma in mice. Blood 2016; 127:2732-41. [PMID: 27048211 DOI: 10.1182/blood-2015-11-684183] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/30/2016] [Indexed: 12/20/2022] Open
Abstract
The adaptor protein MYD88 is critical for relaying activation of Toll-like receptor signaling to NF-κB activation. MYD88 mutations, particularly the p.L265P mutation, have been described in numerous distinct B-cell malignancies, including diffuse large B-cell lymphoma (DLBCL). Twenty-nine percent of activated B-cell-type DLBCL (ABC-DLBCL), which is characterized by constitutive activation of the NF-κB pathway, carry the p.L265P mutation. In addition, ABC-DLBCL frequently displays focal copy number gains affecting BCL2 Here, we generated a novel mouse model in which Cre-mediated recombination, specifically in B cells, leads to the conditional expression of Myd88(p.L252P) (the orthologous position of the human MYD88(p.L265P) mutation) from the endogenous locus. These mice develop a lymphoproliferative disease and occasional transformation into clonal lymphomas. The clonal disease displays the morphologic and immunophenotypical characteristics of ABC-DLBCL. Lymphomagenesis can be accelerated by crossing in a further novel allele, which mediates conditional overexpression of BCL2 Cross-validation experiments in human DLBCL samples revealed that both MYD88 and CD79B mutations are substantially enriched in ABC-DLBCL compared with germinal center B-cell DLBCL. Furthermore, analyses of human DLBCL genome sequencing data confirmed that BCL2 amplifications frequently co-occurred with MYD88 mutations, further validating our approach. Finally, in silico experiments revealed that MYD88-mutant ABC-DLBCL cells in particular display an actionable addiction to BCL2. Altogether, we generated a novel autochthonous mouse model of ABC-DLBCL that could be used as a preclinical platform for the development and validation of novel therapeutic approaches for the treatment of ABC-DLBCL.
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Jayapalan CS, Pynadath MK, Mangalath U, George A, Aslam S, Hafiz A. Clinical diagnostic dilemma in an uncharacteristic rapidly enlarging swelling of the anterior maxilla: extranodal diffuse large B cell lymphoma. BMJ Case Rep 2016; 2016:bcr-2015-213141. [PMID: 27030451 DOI: 10.1136/bcr-2015-213141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Extranodal non-Hodgkin lymphoma (NHL) is infrequent in the oral cavity and constitutes 3.5% of oral cancers, and less than 2.2% of maxillofacial lymphomas. Diffuse large B cell lymphoma (DLBCL) accounts for 40% of NHL and has a 5-year survival rate of less than 30%. Early detection of extranodal NHL by dental personnel is extremely important as a delay in diagnosis can result in the cancer being diagnosed at an advanced stage and a poor prognosis. A 60-year-old male presented with an uncharacteristic asymptomatic rapidly enlarging swelling of the anterior maxilla, which on histopathological and immunohistochemical analysis was diagnosed as DLBCL. Imaging studies showed bone invasion and lymph node metastasis with poor prognosis. The patient received radiotherapy and chemotherapy but died within 3 months of diagnosis. A literature search revealed one another case with anterior maxilla occurrence, as the few oral DLBCL so far reported have appeared on the posterior palate or other intraoral sites.
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Affiliation(s)
| | - Meera Kunjumon Pynadath
- Department of Oral Pathology and Microbiology, MES Dental College, Perinthalmanna, Kerala, India
| | - Ummar Mangalath
- Oral and Maxillofacial Surgery, MES Dental College, Perinthalmanna, Kerala, India
| | - Antony George
- Department of Oral Pathology and Microbiology, MES Dental College, Perinthalmanna, Kerala, India
| | - Sachin Aslam
- Department of Oral Pathology and Microbiology, MES Dental College, Perinthalmanna, Kerala, India
| | - Abdul Hafiz
- Department of Pedodontics, MES Dental College, Perinthalmanna, Kerala, India
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Tzankov A, Leu N, Muenst S, Juskevicius D, Klingbiel D, Mamot C, Dirnhofer S. Multiparameter analysis of homogeneously R-CHOP-treated diffuse large B cell lymphomas identifies CD5 and FOXP1 as relevant prognostic biomarkers: report of the prospective SAKK 38/07 study. J Hematol Oncol 2015; 8:70. [PMID: 26071053 PMCID: PMC4472251 DOI: 10.1186/s13045-015-0168-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/05/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prognostic role of tumor-related parameters in diffuse large B cell lymphoma (DLBCL) is a matter of controversy. METHODS We investigated the prognostic value of phenotypic and genotypic profiles in DLBCL in clinical trial (NCT00544219) patients homogenously treated with six cycles of rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, prednisone (R-CHOP), followed by two cycles of R (R-CHOP-14). The primary endpoint was event-free survival at 2 years (EFS). Secondary endpoints were progression-free (PFS) and overall survival (OS). Immunohistochemical (bcl2, bcl6, CD5, CD10, CD20, CD95, CD168, cyclin E, FOXP1, GCET, Ki-67, LMO2, MUM1p, pSTAT3) and in situ hybridization analyses (BCL2 break apart probe, C-MYC break apart probe and C-MYC/IGH double-fusion probe, and Epstein-Barr virus probe) were performed and correlated with the endpoints. RESULTS One hundred twenty-three patients (median age 58 years) were evaluable. Immunohistochemical assessment succeeded in all cases. Fluorescence in situ hybridization was successful in 82 instances. According to the Tally algorithm, 81 cases (66%) were classified as non-germinal center (GC) DLBCL, while 42 cases (34%) were GC DLBCL. BCL2 gene breaks were observed in 7/82 cases (9%) and C-MYC breaks in 6/82 cases (8%). "Double-hit" cases with BCL2 and C-MYC rearrangements were not observed. Within the median follow-up of 53 months, there were 51 events, including 16 lethal events and 12 relapses. Factors able to predict worse EFS in univariable models were failure to achieve response according to international criteria, failure to achieve positron emission tomography response (p < 0.005), expression of CD5 (p = 0.02), and higher stage (p = 0.021). Factors predicting inferior PFS were failure to achieve response according to international criteria (p < 0.005), higher stage (p = 0.005), higher International Prognostic Index (IPI; p = 0.006), and presence of either C-MYC or BCL2 gene rearrangements (p = 0.033). Factors predicting inferior OS were failure to achieve response according to international criteria and expression of FOXP1 (p < 0.005), cyclin E, CD5, bcl2, CD95, and pSTAT3 (p = 0.005, 0.007, 0.016, and 0.025, respectively). Multivariable analyses revealed that expression of CD5 (p = 0.044) and FOXP1 (p = 0.004) are independent prognostic factors for EFS and OS, respectively. CONCLUSION Phenotypic studies with carefully selected biomarkers like CD5 and FOXP1 are able to prognosticate DLBCL course at diagnosis, independent of stage and IPI and independent of response to R-CHOP.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- CD5 Antigens/metabolism
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/therapeutic use
- Doxorubicin/administration & dosage
- Doxorubicin/therapeutic use
- Female
- Forkhead Transcription Factors/metabolism
- Humans
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Male
- Middle Aged
- Phenotype
- Prednisone/administration & dosage
- Prednisone/therapeutic use
- Prognosis
- Prospective Studies
- Rituximab
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/therapeutic use
- Young Adult
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Affiliation(s)
- Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, Schoenbeinstrasse 40, CH-4031, Basel, Switzerland.
| | - Nora Leu
- Institute of Pathology, University Hospital Basel, Schoenbeinstrasse 40, CH-4031, Basel, Switzerland.
| | - Simone Muenst
- Institute of Pathology, University Hospital Basel, Schoenbeinstrasse 40, CH-4031, Basel, Switzerland.
| | - Darius Juskevicius
- Institute of Pathology, University Hospital Basel, Schoenbeinstrasse 40, CH-4031, Basel, Switzerland.
| | - Dirk Klingbiel
- Swiss Group for Clinical Cancer Research (SAKK), Effingerstrasse 40, CD-3008, Bern, Switzerland.
| | - Christoph Mamot
- Division of Hematology and Oncology, Cantonal Hospital Aarau, Tellstrasse house Nr. 40, CH-5001, Aarau, Switzerland.
| | - Stephan Dirnhofer
- Institute of Pathology, University Hospital Basel, Schoenbeinstrasse 40, CH-4031, Basel, Switzerland.
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Papoudou-Bai A, Goussia A, Batistatou A, Stefanou D, Malamou-Mitsi V, Kanavaros P. The expression levels of JunB, JunD and p-c-Jun are positively correlated with tumor cell proliferation in diffuse large B-cell lymphomas. Leuk Lymphoma 2015; 57:143-50. [PMID: 25813203 DOI: 10.3109/10428194.2015.1034704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We analyzed the expression of Jun family in relation to CD30 expression, cell proliferation and B-cell differentiation immunophenotypes [Germinal Center and non-Germinal Center] in diffuse large B-cell lymphomas (DLBCL). Expression and high expression of phosphorylated-c-Jun (p-c-Jun), JunB, JunD and CD30 (cut-off scores 20% and 50%, respectively) was found in 18/103, 49/103, 72/101 and 26/102 cases, respectively, and in 6/103, 27/103, 60/101 and 21/102 cases, respectively. The following significant positive correlations were observed: (a) JunB with cyclin A (p = 0.046), cyclin B1 (p = 0.033), cyclin E (p = 0.003), MUM-1 (p = 0.002) and CD30 (p < 0.001), (b) JunD with Ki67 (p = 0.002) and cyclin E (p = 0.014), (c) p-c-Jun with CD30 (p = 0.015), and (d) high p-c-Jun with cyclin A (p = 0.034). The positive correlation between expression of JunB, JunD and p-c-Jun and tumor cell proliferation in DLBCL, suggests that increased JunB, JunD and p-c-Jun expression may be involved in the pathogenesis of DLBCL by increasing tumor cell proliferation.
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Affiliation(s)
| | - Anna Goussia
- a Department of Pathology , Medical Faculty , University of Ioannina, Ioannina , Greece
| | - Anna Batistatou
- a Department of Pathology , Medical Faculty , University of Ioannina, Ioannina , Greece
| | - Dimitrios Stefanou
- a Department of Pathology , Medical Faculty , University of Ioannina, Ioannina , Greece
| | | | - Panagiotis Kanavaros
- b Department of Anatomy-Histology-Embryology , Medical Faculty , University of Ioannina, Ioannina , Greece
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Wang J, Xie Y, Feng Y, Zhang L, Huang X, Shen X, Luo X. (-)-Epigallocatechingallate induces apoptosis in B lymphoma cells via caspase-dependent pathway and Bcl-2 family protein modulation. Int J Oncol 2015; 46:1507-15. [PMID: 25647297 PMCID: PMC4356505 DOI: 10.3892/ijo.2015.2869] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/20/2015] [Indexed: 02/05/2023] Open
Abstract
(−)-Epigallocatechingallate (EGCG) as a representative polyphenol has attracted increasing attention due to its diversified effects, especially its potential as an agent for the prevention or treatment of certain cancers. However, the molecular mechanisms of EGCG-induced apoptosis in B lymphoma cells are unclear. The aim of this study was to investigate the effect of EGCG on proliferation and apoptosis in the B lymphoma cell lines Jeko-1 and Raji, and determine the underlying mechanisms. Cell proliferation and cytotoxicity were determined by the cell counting kit (CCK-8) assay; apoptosis was assessed by flow cytometry using the Annexin V-PE/7AAD double staining; Fas, Bcl-2 and Bax mRNA expression levels were determined by real-time PCR; caspase activity was measured by the caspase activity assay kit; the expression levels of apoptosis-associated proteins were determined by western blot analysis. We demonstrated that EGCG induced growth inhibition and apoptosis in a dose- and time-dependent manner. In agreement, EGCG upregulated the mRNA expression of Fas and Bax while downregulating Bcl-2. Protein expression levels of Bax, activated caspase-3, -7, -8, and -9, and PARP were increased, while Bcl-2 protein levels were reduced by EGCG treatment. Taken together, EGCG induces B lymphoma cell apoptosis by triggering caspase-dependent intrinsic (mitochondrial) and extrinsic (death receptor) pathways. These findings suggest that EGCG may be a potential agent for the treatment of B lymphoma.
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Affiliation(s)
- Jiangyan Wang
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Yu'an Xie
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Yan Feng
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Litu Zhang
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Xinping Huang
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Xiaoyun Shen
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
| | - Xiaoling Luo
- Research Department, Affiliated Tumour Hospital of Guangxi Medical University, Nanning 530021, P.R. China
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Abstract
The diagnosis of B-cell non-Hodgkin lymphomas has changed significantly over the past few decades as new immunophenotypic markers, molecular subtype classification schemes, and novel biomarkers have emerged. Meanwhile, there has been an increasing emphasis on individualizing treatment approaches in accordance with a biologic heterogeneity that has been uncovered within many of the individual B-cell lymphoma entities. The application of high-throughput genomic sequencing to B-cell lymphomas has yielded large amounts of valuable information. The data encompass discoveries essential to an understanding of pathogenesis, clonal or tumoral evolution, and identification of biomarkers that may be useful for prognostic or therapeutic considerations. The following review discusses several of the more common, primarily tissuebased B-cell lymphomas, with a focus on pathologic classification and certain phenotypic characteristics or genetic lesions that apply to refinement of diagnosis and therapy.
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MESH Headings
- Biomarkers, Tumor
- High-Throughput Nucleotide Sequencing
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Mantle-Cell/diagnosis
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/pathology
- Mutation
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Affiliation(s)
- Sarah L Ondrejka
- Cleveland Clinic-Robert J. Tomsich Pathology and Laboratory Medicine Institute, 9500 Euclid Ave, L3, Cleveland, OH, 44195, USA
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Drug–drug interactions in HIV positive cancer patients. Biomed Pharmacother 2014; 68:665-77. [DOI: 10.1016/j.biopha.2014.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 04/16/2014] [Indexed: 12/12/2022] Open
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Carbone A, Gloghini A, Kwong YL, Younes A. Diffuse large B cell lymphoma: using pathologic and molecular biomarkers to define subgroups for novel therapy. Ann Hematol 2014; 93:1263-77. [PMID: 24870942 PMCID: PMC4082139 DOI: 10.1007/s00277-014-2116-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 05/19/2014] [Indexed: 12/22/2022]
Abstract
Diffuse large B cell lymphoma (DLBCL) comprises specific subtypes, disease entities, and other not otherwise specified (NOS) lymphomas. This review will focus on DLBCL NOS because of their prevalence and their heterogeneity with respect to morphology, clinical presentation, biology, and response to treatment. Gene expression profiling of DLBCL NOS has identified molecular subgroups that correlate with prognosis and may have relevance for treatment based on signaling pathways. New technologies have revealed that the "activated B cell" subgroup is linked to activation of the nuclear factor kB (NF-kB) pathway, with mutations found in CD79A/B, CARD11, and MYD88, and loss of function mutations in TNFAIP3. The "germinal center B cell-like" subgroup is linked to mutational changes in EZH2 and CREBBP. Biomarkers that are related to pathways promoting tumor cell growth and survival in DLBCL have been recognized, although their predictive role requires clinical validation. Immunohistochemistry for detecting the expression of these biomarkers is a practical technique that could provide a rational for clinical trial design.
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Affiliation(s)
- Antonino Carbone
- Department of Pathology, Centro di Riferimento Oncologico (CRO) Aviano, Istituto Nazionale Tumori, IRCCS, Via F. Gallini 2, 33081, Aviano, Italy,
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Abstract
The gastrointestinal tract is the most common extranodal site of non-Hodgkin lymphoma. Certain lymphomas have a predilection for the gastrointestinal tract, including extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, mantle cell lymphoma, natural killer/T-cell lymphoma, and enteropathy-associated T-cell lymphoma. Follicular lymphoma may also be primary to the gastrointestinal tract. In addition to diagnosing neoplastic conditions, it is important to differentiate lymphomas from atypical reactive proliferations. Recent research relevant to non-Hodgkin lymphomas involving this location is reviewed with an emphasis on novel and evolving areas of classification.
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Campo E. Whole genome profiling and other high throughput technologies in lymphoid neoplasms--current contributions and future hopes. Mod Pathol 2013; 26 Suppl 1:S97-S110. [PMID: 23281439 DOI: 10.1038/modpathol.2012.179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of high throughput technologies based on the knowledge of the human genome has opened the possibility to search for global genomic alterations in tumors responsible for their development and progression that may have important clinical implications. One of the major applications of this genomic knowledge has been the design of different types of microarray platforms for the analysis of DNA alterations and gene expression profiling (GEP). The main contributions of the DNA studies in lymphoid neoplasms include the definition of relatively characteristic genomic profiles for specific disease entities, the demonstration of common chromosomal alterations across entities, the identification of genes and pathways targeted by the altered chromosomal regions, and the identification of chromosomal alterations with prognostic implications. RNA GEP studies in these tumors have enhanced the molecular characterization of known entities and facilitated the recognition of new subtypes and categories of lymphoid neoplasms, the identification of new biomarkers and prognostic models, and the detection of oncogenic pathways with potential implications for targeted therapies. The recent development of the next generation sequencing (NGS) technologies and its application in lymphoid neoplasms already have provided an initial view of the complex landscape of somatic mutations in these tumors and some findings with important functional and clinical implications. This review addresses the major contributions and limitations of the microarray technologies in the understanding of lymphoid neoplasms and discusses how this knowledge may be transferred into the clinics. The initial results of the NGS studies are also presented.
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Affiliation(s)
- Elías Campo
- Haematopathology Section, Department of Anatomic Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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