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Celant E, Marconato L, Stefanello D, Moretti P, Aresu L, Comazzi S, Martini V. Clinical and Clinical Pathological Presentation of 310 Dogs Affected by Lymphoma with Aberrant Antigen Expression Identified via Flow Cytometry. Vet Sci 2022; 9:vetsci9040184. [PMID: 35448684 PMCID: PMC9032799 DOI: 10.3390/vetsci9040184] [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: 02/21/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/02/2022] Open
Abstract
Phenotypic aberrancies have been reported occasionally in canine lymphomas. Here, we retrospectively collected 310 canine lymphomas with an aberrant phenotype detected via flow cytometry and describe their clinical and clinical pathological features at diagnosis. There were 152 T-cell lymphomas not otherwise specified (T-NOS), 101 T-zone lymphomas (TZL), 54 B-cell lymphomas, and 3 cases with two suspected concurrent neoplastic populations. The most represented aberrancies were: CD5-, CD4-CD8-, and CD3- in T-NOS lymphomas, CD21+, CD4-CD8-, and CD3- in TZLs, and CD34+, CD44-, and CD5+ in B-cell lymphomas. Among T-cell lymphomas, the aberrant expression of CD21 was significantly more frequent in TZL and the loss of CD5 and CD44 in T-NOS. More than 75% of dogs were purebred; males outnumbered females; the mean age at diagnosis was 8–10 years, depending on lymphoma subtype. A few dogs were symptomatic at the time of diagnosis, and 30% had peripheral blood abnormalities, in line with what is already reported for the general population of dogs with lymphoma. Further studies are needed to assess the pathogenetic mechanisms underlying each specific antigen aberrancy, as well as the diagnostic and prognostic role.
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Affiliation(s)
- Elena Celant
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy; (E.C.); (D.S.); (P.M.); (S.C.)
| | - Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolara di Sopra 50, Ozzano dell’Emilia, 40064 Bologna, Italy;
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy; (E.C.); (D.S.); (P.M.); (S.C.)
| | - Pierangelo Moretti
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy; (E.C.); (D.S.); (P.M.); (S.C.)
| | - Luca Aresu
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco, 10095 Turin, Italy;
| | - Stefano Comazzi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy; (E.C.); (D.S.); (P.M.); (S.C.)
| | - Valeria Martini
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy; (E.C.); (D.S.); (P.M.); (S.C.)
- Correspondence: ; Tel.: +39-0250334585
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Minezaki T, Usui Y, Asakage M, Takanashi M, Shimizu H, Nezu N, Narimatsu A, Tsubota K, Umazume K, Yamakawa N, Kuroda M, Goto H. High-Throughput MicroRNA Profiling of Vitreoretinal Lymphoma: Vitreous and Serum MicroRNA Profiles Distinct from Uveitis. J Clin Med 2020; 9:jcm9061844. [PMID: 32545709 PMCID: PMC7356511 DOI: 10.3390/jcm9061844] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 01/01/2023] Open
Abstract
Purpose: Vitreoretinal lymphoma (VRL) is a non-Hodgkin lymphoma of the diffuse large B cell type (DLBCL), which is an aggressive cancer causing central nervous system related mortality. The pathogenesis of VRL is largely unknown. The role of microRNAs (miRNAs) has recently acquired remarkable importance in the pathogenesis of many diseases including cancers. Furthermore, miRNAs have shown promise as diagnostic and prognostic markers of cancers. In this study, we aimed to identify differentially expressed miRNAs and pathways in the vitreous and serum of patients with VRL and to investigate the pathogenesis of the disease. Materials and Methods: Vitreous and serum samples were obtained from 14 patients with VRL and from controls comprising 40 patients with uveitis, 12 with macular hole, 14 with epiretinal membrane, 12 healthy individuals. The expression levels of 2565 miRNAs in serum and vitreous samples were analyzed. Results: Expression of the miRNAs correlated significantly with the extracellular matrix (ECM) ‒receptor interaction pathway in VRL. Analyses showed that miR-326 was a key driver of B-cell proliferation, and miR-6513-3p could discriminate VRL from uveitis. MiR-1236-3p correlated with vitreous interleukin (IL)-10 concentrations. Machine learning analysis identified miR-361-3p expression as a discriminator between VRL and uveitis. Conclusions: Our findings demonstrate that aberrant microRNA expression in VRL may affect the expression of genes in a variety of cancer-related pathways. The altered serum miRNAs may discriminate VRL from uveitis, and serum miR-6513-3p has the potential to serve as an auxiliary tool for the diagnosis of VRL.
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Affiliation(s)
- Teruumi Minezaki
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
- Correspondence:
| | - Masaki Asakage
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Masakatsu Takanashi
- Department of Molecular Pathology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (M.T.); (M.K.)
| | - Hiroyuki Shimizu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Naoya Nezu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Akitomo Narimatsu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Kazuhiko Umazume
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Naoyuki Yamakawa
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (M.T.); (M.K.)
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (T.M.); (M.A.); (H.S.); (N.N.); (A.N.); (K.T.); (K.U.); (N.Y.); (H.G.)
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Tzankov A, Went P, Dirnhofer S. Prognostic Significance of in situ Phenotypic Marker Expression in Diffuse Large B-cell Lymphomas. Biomark Insights 2017. [DOI: 10.1177/117727190700200009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Diffuse large B-cell lymphomas (DLBCL) are the most common lymphoid malignancies, and encompass all malignant lymphomas characterized by large neoplastic cells and B-cell derivation. In the last decade, DLBCL has been subjected to intense clinical, phenotypic and molecular studies, and were found to represent a heterogeneous group of tumors. These studies suggested new disease subtypes and variants with distinct clinical characteristics, morphologies, immunophenotypes, genotypes or gene expression profiles, associated with distinct prognoses or unique sensitivities to particular therapy regimens. Unfortunately, the reliability and reproducibility of the molecular results remains unclear due to contradictory reports in the literature resulting from small sample sizes, referral and selection biases, and variable methodologies and cut-off levels used to determine positivity. Here, we review phenotypic studies on the prognostic significance of protein expression profiles in DLBCL and reconsider our own retrospective data on 301 primary DLBCL cases obtained on a previously validated tissue microarray in light of powerful statistical methods of determining optimal cut-off values of phenotypic factors for prediction of outcome.
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Affiliation(s)
| | - Philip Went
- Department of Pathology, University Hospital Basel, Switzerland
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Chao C, Silverberg MJ, Chen LH, Xu L, Martínez-Maza O, Abrams DI, Zha HD, Haque R, Said J. Novel tumor markers provide improved prediction of survival after diagnosis of human immunodeficiency virus (HIV)-related diffuse large B-cell lymphoma. Leuk Lymphoma 2017; 59:321-329. [PMID: 28610450 DOI: 10.1080/10428194.2017.1334121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Existing prognostic tools for HIV + diffuse large B-cell lymphoma (DLBCL) fail to accurately predict patient outcomes. To develop a novel prognostic algorithm incorporating molecular tumor characteristics and HIV disease factors, we included 80 patients with HIV-related DLBCL diagnosed between 1996 and 2007. Immunohistochemistry staining was used to analyze the expression of 26 tumor markers. Clinical data were collected from medical records. Logistic regression and bootstrapping were used to select and assess stability of the prognostic model, respectively. Of the tumor markers examined, expression of cMYC, Ki 67, CD44, EBV, SKP2, BCL6, p53, CD20 and IgM were associated with two-year mortality. The final prognostic model, confirmed in bootstrapped samples, included IPI, circulating CD4 cell count, history of clinical AIDS, and expression of CD44, p53, IgM and EBV. This model incorporating HIV disease history and tumor markers, achieved better prediction for two-year mortality [AUC = 0.87, 95% CI: 0.78-0.96] compared with IPI alone [AUC = 0.63 (0.51-0.75)].
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Affiliation(s)
- Chun Chao
- a Department of Research and Evaluation , Kaiser Permanente Southern California , Pasadena , CA , USA
| | - Michael J Silverberg
- b Division of Research , Kaiser Permanente Northern California , Oakland , CA , USA
| | - Lie-Hong Chen
- a Department of Research and Evaluation , Kaiser Permanente Southern California , Pasadena , CA , USA
| | - Lanfang Xu
- a Department of Research and Evaluation , Kaiser Permanente Southern California , Pasadena , CA , USA
| | - Otoniel Martínez-Maza
- c Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA.,d Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine at UCLA.,e Department of Epidemiology , UCLA Fielding School of Public Health , Los Angeles , CA , USA
| | - Donald I Abrams
- f San Francisco General Hospital , University of California , San Francisco , CA , USA.,g Department of Medicine , University of California , San Francisco , CA , USA
| | - Hongbin D Zha
- h Los Angeles Medical Center , Kaiser Permanente Southern California , Los Angeles , CA , USA
| | - Reina Haque
- a Department of Research and Evaluation , Kaiser Permanente Southern California , Pasadena , CA , USA
| | - Jonathan Said
- i Department of Pathology and Laboratory Medicine, School of Medicine , University of California , Los Angeles , CA , USA
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Zamani-Ahmadmahmudi M, Najafi A, Nassiri SM. Detection of Critical Genes Associated with Overall Survival (OS) and Progression-Free Survival (PFS) in Reconstructed Canine B-Cell Lymphoma Gene Regulatory Network (GRN). Cancer Invest 2016; 34:70-9. [PMID: 26818715 DOI: 10.3109/07357907.2015.1114120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Canine B-cell lymphoma GRN was reconstructed from gene expression data in the STRING and MiMI databases. Critical genes of networks were identified and correlations of critical genes with overall survival (OS) and progression-free survival (PFS) were evaluated. Significant changes were detected in the expressions of GLUL, CD44, CD79A, ARF3, FOS, BLOC1S1, FYN, GZMB, GALNT3, IFI44, CD3G, GNG2, ESRP1, and CCND1 in the STRING network and of PECAM1, GLUL, CD44, GDI1, E2F4, TLE1, CD79A, UCP2, CCND1, FYN, RHOQ, BIN1, and A2M in the MiMI network. Final survival analysis highlighted CCND1 and FOS as genes with significant correlations with OS and PFS.
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Affiliation(s)
- Mohamad Zamani-Ahmadmahmudi
- a Faculty of Veterinary Medicine, Department of Clinical Science, Shahid Bahonar University of Kerman , Kerman , Iran
| | - Ali Najafi
- b Molecular Biology Research Center, Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Seyed Mahdi Nassiri
- c Faculty of Veterinary Medicine, Department of Clinical Pathology, University of Tehran , Tehran , Iran
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Wei X, Xu M, Wei Y, Huang F, Zhao T, Li X, Feng R, Ye BH. The addition of rituximab to CHOP therapy alters the prognostic significance of CD44 expression. J Hematol Oncol 2014; 7:34. [PMID: 24739401 PMCID: PMC4022142 DOI: 10.1186/1756-8722-7-34] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/24/2014] [Indexed: 01/29/2023] Open
Abstract
Expression of CD44 splice isoforms has been previously reported to correlate with inferior outcomes in DLBCL patients treated with CHOP therapy. However, it is unclear whether this observation remains valid in the R-CHOP era. In this study, we correlated CD44H and CD44v6 status with survival outcomes among DLBCL patients with an emphasis on the comparison between CHOP- and R-CHOP-treated subgroups. Our results suggest that rituximab has significantly decreased the prognostic value of CD44H. We also observed that the therapeutic benefit of rituximab is largely restricted to CD44H-positive cases in this cohort.
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Affiliation(s)
| | | | | | | | | | | | - Ru Feng
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Yoshida T, Matsuda Y, Naito Z, Ishiwata T. CD44 in human glioma correlates with histopathological grade and cell migration. Pathol Int 2012; 62:463-70. [DOI: 10.1111/j.1440-1827.2012.02823.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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8
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Abstract
The CD44 protein family spans a large group of transmembrane glycoproteins acquired by alternative splicing and post-translational modifications. The great heterogeneity in molecular structure is reflected in its various important functions: CD44 mediates (1) interaction between cell and extracellular matrix, (2) signal submission, e.g., by acting as co-receptor for membrane-spanning receptor tyrosine kinases or by association with intracellular molecules initiating several signaling pathways, and (3) anchor function connecting to the cytoskeleton via the ezrin-radixin-moesin protein family. The expression pattern of the different CD44 isoforms display strong variations dependent on cell type, state of activation, and differentiation stage. In hematopoietic cells, CD44 mediates interaction of progenitor cells and bone marrow stroma during hematopoiesis, regulates maturation, and activation-induced cell death in T cells, influences neutrophil and macrophage migration as well as cytokine production, and participates in lymphocyte extravasation and migration. CD44 is involved in development and progress of hematological neoplasias by enhancement of apoptotic resistance, invasiveness, as well as regulation of bone marrow homing, and mobilization of leukemia-initiating cells into the peripheral blood. Thereby altered CD44 expression functions as marker for worse prognosis in most hematological malignancies. Additionally, CD44 expression levels can be used to distinguish between different hematological neoplasias and subtypes. Concerning new treatment strategies, CD44 displays promising potential either by direct targeting of CD44 expressed on the malignant cells or reversing an acquired resistance to primary treatment mediated through altered CD44 expression. The former can be achieved by antibody or hyaluronan-based immunotherapy.
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9
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Min KW, Oh YH, Park CK, Lim SD, Kim WS. CD44s and CD44v6 Are Predominantly Expressed in the Non-germinal Center B-Cell-like Type of Diffuse Large B-Cell Lymphomas. KOREAN JOURNAL OF PATHOLOGY 2011. [DOI: 10.4132/koreanjpathol.2011.45.6.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kyueng-Whan Min
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Young-Ha Oh
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Chan-Kum Park
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - So-Dug Lim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
| | - Wan-Seop Kim
- Department of Pathology, Konkuk University School of Medicine, Seoul, Korea
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Nagel S, Hirschmann P, Dirnhofer S, Günthert U, Tzankov A. Coexpression of CD44 variant isoforms and receptor for hyaluronic acid−mediated motility (RHAMM, CD168) is an International Prognostic Index and C-MYC gene status−independent predictor of poor outcome in diffuse large B-cell lymphomas. Exp Hematol 2010; 38:38-45. [DOI: 10.1016/j.exphem.2009.10.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 10/19/2009] [Accepted: 10/20/2009] [Indexed: 12/23/2022]
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Abstract
Diffuse Large B cell lymphoma (DLBCL) is characterized by a markedly heterogeneous clinical course and response to therapy that is not appreciated with standard histopathologic and immunophenotypic evaluations. Analysis of global gene expression using DNA microarrays has the potential to improve the classification of lymphomas. Molecular profiling may allow the description of specific disease subtypes with similar clinical behavior and outcome. In addition, gene expression profiling has led to the discovery of new putative genes and a better understanding of aberrant signaling pathways. These insights may lead to the discovery of new targeted therapies. This review describes the progress that has been made in our understanding of DLBCL as a result of gene expression profiling.
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Affiliation(s)
- Daniel Morgensztern
- Division of Hematology/Oncology, Department of Medicine, Washington University in St Louis, St Louis, MO, USA
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Arias-Mendoza F, Smith MR, Brown TR. Predicting treatment response in non-Hodgkin’s lymphoma from the pretreatment tumor content of phosphoethanolamine plus phosphocholine1. Acad Radiol 2004; 11:368-76. [PMID: 15109009 DOI: 10.1016/s1076-6332(03)00721-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
RATIONALE AND OBJECTIVES Phosphoethanolamine and phosphocholine, shown to be elevated in tumors and possibly related to apoptotic signaling, have the potential to be prognostic variables of cancer treatment. MATERIALS AND METHODS The sum of phosphoethanolamine and phosphocholine normalized by nucleotide-triphosphates was determined in tumors of non-Hodgkin's lymphoma (NHL) patients via in vivo 31P MR spectroscopy. RESULTS The normalized sum of phosphoethanolamine and phosphocholine showed significant differences in tumors of patients who had a complete response to treatment against those who did not (t-test: 1.45 +/- 0.15, mean +/- standard error, n = 10 vs. 2.28 +/- 0.15, n = 17, P < .001; Fisher test: P < .04; sensitivity and specificity approximately equal to 70%). This parameter also showed significant differences among treatment responses in the previously untreated and aggressive subgroups and in the low and low-intermediate-risk subgroups determined by the international prognostic index (IPI). Further, distinctly different treatment response cutoffs for the parameter were found in different risk groups. When these risk-dependent cutoffs were used, the Fisher test of the whole group improved (P < .0002, sensitivity 80%, specificity 94%). The normalized sum of phosphoethanolamine and phosphocholine and the IPI were better predictor covariates for time to treatment failure when fitted interactively in a Cox regression (P < .0003) than when fitted independently. When time to treatment failure was used as a surrogate of survival in Kaplan-Meier analysis, the interaction of both covariates segregated the cases significantly (P < .008). There was no significance with each covariate independently. CONCLUSION The normalized sum of phosphoethanolamine and phosphocholine measured before treatment successfully predicts long-term response to treatment and time to treatment failure in non-Hodgkin's lymphoma, particularly when combined with the IPI.
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Martínez A, Aymerich M, Castillo M, Colomer D, Bellosillo B, Campo E, Villamor N. Routine use of immunophenotype by flow cytometry in tissues with suspected hematological malignancies. CYTOMETRY PART B-CLINICAL CYTOMETRY 2004; 56:8-15. [PMID: 14582132 DOI: 10.1002/cyto.b.10044] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Immunophenotype is an essential parameter in the diagnosis of hematological malignancies. Flow cytometry (FCM) is used in the analysis of bone marrow or peripheral blood samples but is less frequently used in the evaluation of tissue biopsies with suspected hematological malignancies. The aim of this study was to analyze the role of FCM in the diagnosis of biopsies from patients with a suspected hematological disorder. METHODS A total of 422 consecutive biopsies were studied using standard morphology, immunohistochemistry (IHC), and FCM. Results of FCM were obtained in less than 3 h and were interpreted independently from morphology and IHC. RESULTS A strong correlation between malignant disease and abnormal pattern of FCM was observed (218 of 250) with the exception of Hodgkin disease (P < 0.001). Overall, negative predictive value was 0.52 and positive predictive value was 1. Light chain restriction was observed in 182 of 201 B-cell lymphoma and in 0 of 142 non-B-cell disorders by FCM. In contrast, light chain pattern could only be evaluated in 38 of 91 cases by IHC. FCM allowed a rapid diagnosis of infrequent or high-grade malignancies such as histiocytic sarcoma or T-lymphoblastic lymphoma. The addition of FCM in the routine study of tissue biopsies facilitates the diagnosis of double pathology in five (1%) patients. CONCLUSIONS FCM is a fast and reliable methodology for phenotyping tissue samples, which easily detects infrequent hematological malignancies, disease-specific phenotypes and clonality in B-cell lymphomas. Moreover, the simultaneous recognition of different cell populations allows the diagnosis of composite cell lymphomas, or double pathologies.
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Affiliation(s)
- Antoni Martínez
- Hematopathology Unit, Department of Pathology, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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de Leval L, Harris NL. Variability in immunophenotype in diffuse large B-cell lymphoma and its clinical relevance. Histopathology 2003; 43:509-28. [PMID: 14636252 DOI: 10.1111/j.1365-2559.2003.01758.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL), the single largest category of lymphoma, is a clinically and biologically heterogeneous disease entity. Clinically, patients differ in their mode of presentation and respond variably to therapy. A combination of clinical parameters can be used to predict the patient's response to therapy and survival. The pathological variability of DLBCL is expressed in morphology, immunophenotype, cytogenetic and molecular genetic features. Numerous markers detectable by immunohistochemistry and linked to different aspects of tumour biology have been studied in DLBCL, including lineage-associated and immune markers, proliferation and apoptosis markers, cell adhesion molecules, and more recently stage-specific markers of B-cell differentiation. This review summarizes these studies in regard to their clinical significance and in the light of recent advances in our understanding of the molecular pathology and histogenesis of DLBCL.
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Affiliation(s)
- L de Leval
- Department of Pathology, C.H.U. of Liège, Belgium.
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15
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Tzankov A, Pehrs AC, Zimpfer A, Ascani S, Lugli A, Pileri S, Dirnhofer S. Prognostic significance of CD44 expression in diffuse large B cell lymphoma of activated and germinal centre B cell-like types: a tissue microarray analysis of 90 cases. J Clin Pathol 2003; 56:747-52. [PMID: 14514777 PMCID: PMC1770073 DOI: 10.1136/jcp.56.10.747] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Gene expression profiling of diffuse large B cell lymphoma (DLBCL) revealed three disease types: germinal centre B cell-like (GC), activated B cell-like (ABC), and a "third" type. Expression of CD44 variant isoforms (CD44v) is associated with an unfavourable clinical outcome in DLBCL, but previous studies did not consider the clinicopathological heterogeneity of this disease. AIMS To analyse the expression and prognostic significance of CD44 in DLBCL types. METHODS A tissue microarray (TMA) comprising 90 DLBCLs was constructed. CD10, CD20, bcl-2, bcl-6, CD44 standard isoform (CD44s), and CD44v4, CD44v6, and CD44v9 were analysed immunohistochemically and correlated with clinical follow up. RESULTS TMA expression of CD10, CD20, bcl-2, and bcl-6 showed 100% concordance with results from conventional sections in 60 cases. Samples were segregated into 22 GC (bcl-6+/CD10+/bcl-2-), 25 ABC (bcl-6-/CD10-/bcl-2+), and 35 unclassifiable DLBCLs. Overall survival (OS) at 30 months was 89%, 44%, and 58% in GC, ABC, and unclassified types, respectively. CD44v6 was coexpressed with bcl-2, appeared predominantly on bcl-6 negative cases, and correlated with disease stage. Cases negative for CD44s could be separated into CD44v6 negative (OS, 82% at 70 months) and CD44v6 positive (OS, 58%). CONCLUSIONS TMA technology is useful for immunophenotyping and clinicopathological analysis of large lymphoma populations. The GC phenotype of DLBCL is of independent prognostic significance for OS. Expression of CD44v6 correlates with disease stage, and might contribute to lymphoma dissemination. CD44v6 is expressed predominantly in ABC DLBCL, and in CD44 negative cases is associated with worse OS.
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Affiliation(s)
- A Tzankov
- Institute of Pathology, University of Innsbruck, A-6020 Innsbruck, Austria
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Krol ADG, le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noordijk EM. Non-Hodgkin's lymphoma in the Netherlands: results from a population-based registry. Leuk Lymphoma 2003; 44:451-8. [PMID: 12688314 DOI: 10.1080/1042819021000038010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Comprehensive Cancer Centre West (CCCW) population based non-Hodgkin's lymphoma (NHL) registry contains information on all newly diagnosed NHL patients living in the region covered by the CCCW. Patients were entered from June 1st 1981 to December 31st 1989. Follow-up is still ongoing, median follow-up is 113 months (1-191 months) for patients alive. In this study, patient and tumor characteristics, data on patterns of care, response and (relative) survival are described. As follicular lymphomas and diffuse large B-cell lymphomas are the most frequently occurring NHL subtypes in the database, a separate analysis is performed to characterize the clinical picture of these disease entities in the CCCW population. Our data illustrate that NHL patients in the general population are substantially older than patients included in trials and hospital based series. Due to older age, treatment is withheld or adapted for a substantial number of patients. The resulting survival and relative survival rates are a reflection of these choices.
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Affiliation(s)
- A D G Krol
- Department of Clinical Oncology, KI-P, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
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Barrans SL, Carter I, Owen RG, Davies FE, Patmore RD, Haynes AP, Morgan GJ, Jack AS. Germinal center phenotype and bcl-2 expression combined with the International Prognostic Index improves patient risk stratification in diffuse large B-cell lymphoma. Blood 2002; 99:1136-43. [PMID: 11830458 DOI: 10.1182/blood.v99.4.1136] [Citation(s) in RCA: 200] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The International Prognostic Index (IPI) identifies poor- and good-risk patients with diffuse large B cell lymphoma (DLBCL); however, the majority of patients have an intermediate IPI, with an uncertain prognosis. To determine whether cellular factors can be combined with the IPI to more accurately predict outcome, we have analyzed 177 presentation nodal DLBCLs for the expression of bcl-2 and a germinal center (GC) phenotype (defined by expression of bcl-6 and CD10). P53 gene band shifts were detected using single-stranded conformational polymorphism polymerase chain reaction analysis of exons 5-9 and were correlated with protein expression. In a Cox regression analysis, IPI (R = 0.22, P <.0001) and bcl-2 (R = 0.14, P =.0001) were independent poor prognostic factors and a GC phenotype predicted a favorable outcome (R = -0.025, P =.02). Neither p53 expression nor band shifts had a significant effect on survival. Using the IPI alone, 8% of patients were identified as high risk. Expression of bcl-2 in the intermediate IPI group identified a further 28% of patients with an overall survival comparable to the high IPI group. In the intermediate IPI, bcl-2(-) group, the presence of a GC phenotype improved overall survival to levels approaching the IPI low group. Following this analysis only 15% of patients failed to be assigned to a favorable- or poor-risk group. Sequential addition of bcl-2 expression and GC phenotype into the IPI significantly improves risk stratification in DLBCL. For the 36% of high-risk patients with a 2-year overall survival of 19%, alternative treatment strategies should be considered in future trials.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Female
- Follow-Up Studies
- Germinal Center/metabolism
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/metabolism
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Mutation
- Phenotype
- Polymorphism, Single-Stranded Conformational
- Prognosis
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Risk Assessment
- Survival Analysis
- Treatment Outcome
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Sharon L Barrans
- Hematological Malignancy Diagnostic Service, Academic Unit of Hematology and Oncology, Leeds General Infirmary, Leeds, United Kingdom
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Molica S, Vitelli G, Levato D, Giannarelli D, Gandolfo GM. Elevated serum levels of soluble CD44 can identify a subgroup of patients with early B-cell chronic lymphocytic leukemia who are at high risk of disease progression. Cancer 2001; 92:713-9. [PMID: 11550139 DOI: 10.1002/1097-0142(20010815)92:4<713::aid-cncr1374>3.0.co;2-o] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although soluble CD44 (sCD44) is considered a reliable marker of both tumor burden and disease activity, to the authors' knowledge, its predictive and prognostic value in B-cell chronic lymphocytic leukemia (CLL) has not been addressed to date. METHODS The authors studied 94 previously untreated CD5-positive B-cell CLL patients whose sera was taken at the time of diagnosis, stored at - 70 degrees C, and analyzed for the presence of standard sCD44 (sCD44(std)) using a commercial enzyme-linked-immunoadsorbent-assay. The impact of the sCD44 level on the clinical outcome of the disease was assessed in 74 patients with early CLL (61 Binet Stage A patients and 13 asymptomatic Stage B patients). Because the time to disease progression appears to predict the survival time of patients with CLL, it was used as a surrogate endpoint in the current study. RESULTS Patients with higher than median sCD44 levels (i.e., 642 ng/mL) had a more advanced clinical disease stage (P = 0.04), higher peripheral blood lymphocytosis (P = 0.006), and increased circulating levels of either lactate dehydrogenase (P = 0.01) or beta(2)-microglobulin (P < 0.0001). In univariate analysis, seven of the nine parameters investigated predicted progression-free survival (PFS). In a stepwise multiple regression analysis, only 2 parameters provided independent prognostic information regarding PFS: Rai substages (0 vs. I-II) (P = 0.002) and serum sCD44 levels > 642 ng/mL (P = 0.01). When added to the classification of smoldering CLL versus nonsmoldering CLL, the sCD44 level distinguished two groups within the group of nonsmoldering Stage A patients; patients with a sCD44 level > 642 ng/mL had a median PFS of 36 months, whereas patients with a sCD44 level < 642 ng/mL experienced a longer PFS (median had not been reached at 8 years of follow-up). Furthermore, serum levels of sCD44 defined two different patterns of PFS within the group of patients with Rai disease Stages I-II (P = 0.01). CONCLUSIONS An increased serum level of sCD44 can be considered to be a promising parameter for predicting the risk of disease progression in patients with early CLL. Furthermore, sCD44 helps to refine the prognostic stratification of patients with either nonsmoldering CLL or Rai Stage I-II disease, thus enabling the identification of different prognostic subgroups in patients with early CLL.
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Affiliation(s)
- S Molica
- Divisione Ematologia e Oncologia Clinica, Azienda Ospedaliera Pugliese-Ciaccio, via Pio X, 88100 Catanzaro, Italy.
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Abstract
CD44 is a broadly distributed family of cell surface glycoproteins. The expression of CD44H has been documented in both Hodgkin lymphoma and non-Hodgkin lymphoma. CD44V6 has been associated with more aggressive behavior in non-Hodgkin lymphoma, but such a correlation has not been established in Hodgkin lymphoma. In addition, the utility of CD44 and CD44V6 in the subclassification of Hodgkin lymphoma in paraffin-embedded tissues has not previously been evaluated. The current study included formalin- or methacarn-fixed, paraffin-embedded tissue specimens from 42 patients with Hodgkin lymphoma (25 nodular sclerosis, three interfollicular, four lymphocyte-rich classic Hodgkin, six lymphocyte predominant, and four mixed cellularity). The clinical stage of the study population at initial presentation ranged from stage IA to IVB. Evaluation of CD44H and CD44V6 (Novocastra) was performed by ABC immunoperoxidase technique after heat-induced epitope retrieval. In the six cases of lymphocyte predominant Hodgkin, the neoplastic cells lacked reactivity with CD44H reminiscent of their normal germinal center counterparts. On the other hand, classic Hodgkin lymphoma showed variable membranous and Golgi reactivity in the neoplastic cells in all cases irrespective of disease stage at presentation. In all cases, the neoplastic cells lacked reactivity with CD44V6 except for three one lymphocyte-predominant, one interfollicular, and one nodular sclerosis), all of which represented recurrent cases. In conclusion, CD44 evaluation is useful in the distinction between lymphocyte predominant and classic Hodgkin lymphoma. The presence of CD44H expression has no relation to the clinical stage of the disease at presentation or recurrence. CD44V6 is detected in a minority of cases irrespective of the histologic subtype and its presence may be associated with recurrence. There was no correlation between disease stage at presentation and the expression of CD44V6.
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Affiliation(s)
- F Anwar
- Department of Laboratory Medicine, University of Washington, Seattle 98105, USA
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Abstract
AbstractRegulated lymphocyte trafficking is essential for the control and integration of systemic immune responses. This homing process disperses the immunologic repertoire, guides lymphocyte subsets to the specialized microenvironments that control their differentiation and survival, and targets immune effector cells to sites of antigenic insult. This review discusses data indicating that the adhesion receptors regulating the trafficking of normal lymphocytes are also expressed and functionally active in their malignant counterparts, the non-Hodgkin lymphomas. These “homing receptors” appear to mediate the highly tissue-specific dissemination of specific lymphoma subtypes, such as lymphomas of the mucosa-associated lymphoid tissues and lymphomas of the skin. Furthermore, as a result of their capability to enhance lymphoma dissemination and to transduce signals into the cell, promoting cell growth and survival, adhesion receptors may contribute to lymphoma aggressiveness. Taken together, the data offer a framework for understanding the dissemination routes of non-Hodgkin lymphomas and suggest that adhesion receptors, specifically those of the CD44 family, may present useful tools to predict prognosis in patients with lymphomas.
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