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Turbatu A, Dobrea C, Stoian M, Barta CT, Halcu G, Birceanu A, Bordea AM, Ghimici CG, Oprea MM, Neacșu LD, Lupu AR, Coliță A. Tumor microenvironment in Hodgkin lymphoma: novel prognostic factors for assessing disease evolution. J Med Life 2023; 16:1201-1210. [PMID: 38024830 PMCID: PMC10652678 DOI: 10.25122/jml-2023-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/28/2023] [Indexed: 12/01/2023] Open
Abstract
Hodgkin lymphoma (HL) has become one of the most curable hematological neoplasia. Clinical and biological factors remain the main pillars guiding therapeutic strategies in HL. Recent studies have improved our understanding of the phenotype, the characteristics of histogenesis, and other possible mechanisms of lymphomagenesis, including the role of Epstein-Barr virus (EBV) infection. Tumor cells manipulate the microenvironment, allowing them to develop their malignant phenotype and evade the attack of the host's immune response so that the interaction between tumor cells and the reactive microenvironment determines not only the histological features but also the clinical-pathological characteristics and prognosis of these patients - essential for the development of future therapies targeting various other cellular components of the tumor microenvironment. This article aimed to evaluate the characteristics of the tumor microenvironment and malignant cells using histopathology and immunohistochemistry (IHC) techniques to highlight the association of EBV and to study the expression of characteristic antigens in malignant and non-malignant cells within the tumor mass (overexpression of BCL2 (B-cell lymphoma 2) in malignant cells, presence of PD1 (Programmed cell death Protein 1) on T lymphocytes, CD68+ macrophages in the tumor microenvironment, and presence of EGFR (epidermal growth factor receptor). The analysis of the data collected in this paper highlights several key parameters with prognostic value and statistical significance: the EBV infection at diagnosis, its association with low-intensity BCL2(+), the presence of CD68 with rosette formation, and the identification of specific vascularization patterns. The development of prognostic systems that take into account the integration of biological prognostic markers seems essential for a better risk stratification.
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Affiliation(s)
- Andrei Turbatu
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Hematology, Colțea Clinical Hospital, Bucharest, Romania
| | - Camelia Dobrea
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- OncoTeam Diagnostic Laboratory, Royal Hospital Clinic, Bucharest, Romania
| | - Marilena Stoian
- Clinic of Internal Medicine, Dr. I. Cantacuzino Clinical Hospital, Bucharest, Romania
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cristian Tudor Barta
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Georgian Halcu
- Clinic of Pathology, Colțea Clinical Hospital, Bucharest, Romania
- PathoTeam Diagnostic Laboratory, Bucharest, Romania
| | | | - Ana-Maria Bordea
- Clinic of Hematology, Colțea Clinical Hospital, Bucharest, Romania
| | | | | | - Livia Doria Neacșu
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Hematology, Colțea Clinical Hospital, Bucharest, Romania
| | - Anca-Roxana Lupu
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Hematology, Colțea Clinical Hospital, Bucharest, Romania
| | - Andrei Coliță
- Department of Hematology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinic of Hematology, Colțea Clinical Hospital, Bucharest, Romania
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2
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Ribatti D, Tamma R, Annese T, d'Amati A, Ingravallo G, Specchia G. Vascular Growth in Lymphomas: Angiogenesis and Alternative Ways. Cancers (Basel) 2023; 15:3262. [PMID: 37370872 DOI: 10.3390/cancers15123262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
The formation of new blood vessels is a critical process for tumor growth and may be achieved through different mechanisms. Angiogenesis represents the first described and most studied mode of vessel formation, but tumors may also use alternative ways to secure blood supply and eventually acquire resistance to anti-angiogenic treatments. These non-angiogenic mechanisms have been described more recently, including intussusceptive microvascular growth (IMG), vascular co-option, and vasculogenic mimicry. Like solid tumors, angiogenic and non-angiogenic pathways in lymphomas play a fundamental role in tumor growth and progression. In view of the relevant prognostic and therapeutic implications, a comprehensive understanding of these mechanisms is of paramount importance for improving the efficacy of treatment in patients with lymphoma. In this review, we summarize the current knowledge on angiogenic and non-angiogenic mechanisms involved in the formation of new blood vessels in Hodgkin's and non-Hodgkin's lymphomas.
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Affiliation(s)
- Domenico Ribatti
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberto Tamma
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Tiziana Annese
- Department of Medicine and Surgery, Libera Università del Mediterraneo (LUM) "Giuseppe Degennaro", 70124 Bari, Italy
| | - Antonio d'Amati
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
- Section of Anatomical and Molecular Pathology, Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Anatomical and Molecular Pathology, Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giorgina Specchia
- School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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3
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Ethiraj P, Sasi B, Holder KN, Lin AP, Qiu Z, Jaafar C, Elkhalili A, Desai P, Saksena A, Ritter JP, Aguiar RCT. Cyclic-AMP signalling, MYC and hypoxia-inducible factor 1α intersect to regulate angiogenesis in B-cell lymphoma. Br J Haematol 2022; 198:349-359. [PMID: 35411936 DOI: 10.1111/bjh.18196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023]
Abstract
Angiogenesis and MYC expression associate with poor outcome in diffuse large B-cell lymphoma (DLBCL). MYC promotes neo-vasculature development but whether its deregulation in DLBCL contributes to angiogenesis is unclear. Examination of this relationship may uncover novel pathogenic regulatory circuitry as well as anti-angiogenic strategies in DLBCL. Here, we show that MYC expression positively correlates with vascular endothelial growth factor (VEGF) expression and angiogenesis in primary DLBCL biopsies, independently of dual expressor status or cell-of-origin classification. We found that MYC promotes VEGFA expression, a correlation that was validated in large datasets of mature B-cell tumours. Using DLBCL cell lines and patient-derived xenograft models, we identified the second messenger cyclic-AMP (cAMP) as a potent suppressor of MYC expression, VEGFA secretion and angiogenesis in DLBCL in normoxia. In hypoxia, cAMP switched targets and suppressed hypoxia-inducible factor 1α, a master regulator of VEGFA/angiogenesis in low oxygen environments. Lastly, we used the phosphodiesterase 4b (Pde4b) knockout mouse to demonstrate that the cAMP/PDE4 axis exercises additional anti-angiogenesis by directly targeting the lymphoma microenvironment. In conclusion, MYC could play a direct role in DLBCL angiogenesis, and modulation of cAMP levels, which can be achieved with clinical grade PDE4 inhibitors, has cell and non-cell autonomous anti-angiogenic activity in DLBCL.
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Affiliation(s)
- Purushoth Ethiraj
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Binu Sasi
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Kenneth N Holder
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - An-Ping Lin
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Zhijun Qiu
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Carine Jaafar
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Alia Elkhalili
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Parth Desai
- Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Annapurna Saksena
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Jacob P Ritter
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Ricardo C T Aguiar
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
- South Texas Veterans Health Care System, Audie Murphy VA Hospital, San Antonio, Texas, USA
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4
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Oriaifo IA, Gerard JM, Thomas SM. Diagnostic Value of Lactate Dehydrogenase and Uric Acid as Screening Tools for Malignancies in Children. Pediatr Emerg Care 2022; 38:e1327-e1331. [PMID: 35477707 DOI: 10.1097/pec.0000000000002733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the diagnostic value of lactate dehydrogenase (LDH) and uric acid (UA) in children undergoing evaluation for possible malignancies. METHODS This was a retrospective chart review of patients aged 0 to 18 years presenting to an urban, tertiary care, pediatric hospital between July 1, 2011, and July 1, 2016. Patients were included if they had an LDH and/or UA level drawn, and they were excluded if they had a known cancer diagnosis. Sensitivity, specificity, and receiver operating characteristic curves were calculated for each biomarker. RESULTS Six hundred five subjects were included in this study; 579 and 384 subjects had LDH and UA levels drawn, respectively; 15.7% had a final diagnosis of malignancy (49 leukemia, 46 nonleukemia). CONCLUSION The specificities of both biomarkers for all types of malignancies were lower than their respective sensitivities. Comparing leukemic versus nonleukemic malignancies, the areas under the curve were 0.848 and 0.719, respectively, for LDH and 0.681 and 0.555, respectively, for UA.
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Affiliation(s)
- Irene A Oriaifo
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics, Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St Louis, MO
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Tong Y, Yang D, Mi X, Song Y, Xin W, Zhong L, Shi Z, Xu G, Ding H, Fang L. Modified microvessel density based on perfusion distance: a preferable NSCLC prognostic factor. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:43. [PMID: 35282046 PMCID: PMC8848420 DOI: 10.21037/atm-21-6566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/05/2022] [Indexed: 11/06/2022]
Abstract
Background Despite the vital role of blood perfusion in tumor progression, the prognostic value of typical blood perfusion markers, such as microvessel density (MVD) or microvessel area (MVA), in patients with non-small cell lung cancer (NSCLC) is still unclear. This study established a modified MVD (mMVD) measurement based on perfusion distance and determined its prognostic value in patients with NSCLC. Methods A total of 100 patients with NSCLC were enrolled in this retrospective study. The intratumor microvessels of NSCLC patients were visualized using immunohistochemical staining for CD31. The blood perfusion distance was evaluated as the distance from each vessel to its nearest cancer cell (Dmvcc), and the cutoff value for prognosis was determined. Apart from the total MVD (tMVD), microvessels near cancer cells within the cutoff-Dmvcc were counted as mMVD. Predictive values for mortality and recurrence were evaluated and compared. Results The Dmvcc ranged from 1.6 to 269.8 µm (median, 13.1 µm). The mMVD (range: 2-70; median 23) was counted from tMVD according to the cutoff-Dmvcc (~20 µm). Compared with tMVD, a larger fraction of mMVD (80% vs. 2.9%) played a significant role in overall survival, with an improved area under the receiver operating characteristic (ROC) curve (AUC) (0.74 vs. 0.56). A high mMVD was an independent positive indicator of overall survival (OS) and progression-free survival (PFS). In contrast, tMVD was only related to PFS at the optimal cutoff. Conclusions Perfusion-distance-based mMVD is a promising prognostic factor for NSCLC patients with superior sensitivity, specificity, and clinical applicability compared to tMVD. This study provides novel insights into the prognostic role of tumor vessel perfusion in patients with NSCLC.
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Affiliation(s)
- Yinghui Tong
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Dihong Yang
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Xiufang Mi
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Yu Song
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Wenxiu Xin
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Like Zhong
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Zheng Shi
- The Department of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Gaoqi Xu
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Haiying Ding
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Luo Fang
- The Department of Pharmacy, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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6
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Menzel L, Höpken UE, Rehm A. Angiogenesis in Lymph Nodes Is a Critical Regulator of Immune Response and Lymphoma Growth. Front Immunol 2020; 11:591741. [PMID: 33343570 PMCID: PMC7744479 DOI: 10.3389/fimmu.2020.591741] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023] Open
Abstract
Tumor-induced remodeling of the microenvironment in lymph nodes (LNs) includes the formation of blood vessels, which goes beyond the regulation of metabolism, and shaping a survival niche for tumor cells. In contrast to solid tumors, which primarily rely on neo-angiogenesis, hematopoietic malignancies usually grow within pre-vascularized autochthonous niches in secondary lymphatic organs or the bone marrow. The mechanisms of vascular remodeling in expanding LNs during infection-induced responses have been studied in more detail; in contrast, insights into the conditions of lymphoma growth and lodging remain enigmatic. Based on previous murine studies and clinical trials in human, we conclude that there is not a universal LN-specific angiogenic program applicable. Instead, signaling pathways that are tightly connected to autochthonous and infiltrating cell types contribute variably to LN vascular expansion. Inflammation related angiogenesis within LNs relies on dendritic cell derived pro-inflammatory cytokines stimulating vascular endothelial growth factor-A (VEGF-A) expression in fibroblastic reticular cells, which in turn triggers vessel growth. In high-grade B cell lymphoma, angiogenesis correlates with poor prognosis. Lymphoma cells immigrate and grow in LNs and provide pro-angiogenic growth factors themselves. In contrast to infectious stimuli that impact on LN vasculature, they do not trigger the typical inflammatory and hypoxia-related stroma-remodeling cascade. Blood vessels in LNs are unique in selective recruitment of lymphocytes via high endothelial venules (HEVs). The dissemination routes of neoplastic lymphocytes are usually disease stage dependent. Early seeding via the blood stream requires the expression of the homeostatic chemokine receptor CCR7 and of L-selectin, both cooperate to facilitate transmigration of tumor and also of protective tumor-reactive lymphocytes via HEV structures. In this view, the HEV route is not only relevant for lymphoma cell homing, but also for a continuous immunosurveillance. We envision that HEV functional and structural alterations during lymphomagenesis are not only key to vascular remodeling, but also impact on tumor cell accessibility when targeted by T cell-mediated immunotherapies.
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Affiliation(s)
- Lutz Menzel
- Translational Tumor Immunology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Uta E. Höpken
- Microenvironmental Regulation in Autoimmunity and Cancer, Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - Armin Rehm
- Translational Tumor Immunology, Max Delbrück Center for Molecular Medicine, Berlin, Germany
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Liu Y, Xue K, Xia Z, Jin J, Wang J, Sun H, Lv F, Liu X, Cao J, Hong X, Guo Y, Ma X, Zhang Q. Radiotherapy followed by DICEP regimen in treatment of newly diagnosed, stage IE/IIE, extranodal NK/T-cell lymphoma patients. Cancer Med 2020; 9:5400-5405. [PMID: 32519518 PMCID: PMC7402823 DOI: 10.1002/cam4.3207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/07/2020] [Accepted: 05/14/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The optimal treatment strategies for extranodal natural killer/ T-cell lymphoma (ENKTL) have not been defined. We conducted this prospective, open-label, phase II, single-center study aimed to explore the efficacy and safety of radiotherapy followed by DICEP (Dexamethasone, ifosfamide, cisplatin, etoposide, and pegaspargase) regimen in the treatment of patients with untreated, stage IE/IIE, extranodal NK/T-cell lymphoma. METHODS Thirty eligible patients were enrolled in this study, receiving radiotherapy of 50Gy/25fx, and followed by chemotherapy with DICEP regimen for 3 cycles if tolerated. Median follow-up time of this study was 70.8 months. We constructed Kaplan-Meier survival curves for survival analyses. RESULTS The most common manifestations at the onset of disease were nasal obstruction (80%), with or without fever, and pharyngalgia (20%). The overall response rate (ORR) was 96.7% (29/30). Four patients (13.3%) had progression of the disease (PD), the estimated 5-year progression-free survival (PFS) rate was 86%. Four patients (13.3%) died of disease, and the estimated 5-year cumulative overall survival (OS) was 87%. The most common hematological toxicity was grade 3 or grade 4 neutropenia, which could be successfully managed via using growth-stimulating factors or dose modifications. Hypoalbuminemia and decreased fibrinogen are the top two nonhematologic toxicities. No treatment-related death occurred in this study. CONCLUSIONS Our present study showed that radiotherapy followed by DICEP chemotherapy could be an effective and tolerable treatment modality for newly diagnosed, stage IE/IIE ENKTL patients. Adverse events were predictable and manageable. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01667302. Registered: 1 July 2012.
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Affiliation(s)
- Yizhen Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kai Xue
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zuguang Xia
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jia Jin
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiachen Wang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui Sun
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangfang Lv
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaojian Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Junning Cao
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaonan Hong
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ye Guo
- Department of Medical Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuejun Ma
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qunling Zhang
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Matolay O, Méhes G. Sustain, Adapt, and Overcome-Hypoxia Associated Changes in the Progression of Lymphatic Neoplasia. Front Oncol 2019; 9:1277. [PMID: 31824854 PMCID: PMC6881299 DOI: 10.3389/fonc.2019.01277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/04/2019] [Indexed: 12/15/2022] Open
Abstract
Irregular perfusion and related tissue hypoxia is a common feature of solid tumors the role of which in the survival and progression cancer has been gradually recognized. Adaptation and selection mechanisms in hypoxic areas in solid tumors are regulated by Hypoxia Inducible transcriptional factor 1 (HIF1) and other hypoxia mediators and are associated with aggressive clinical behavior in a large spectrum of malignancies. Aggressive forms of lymphatic neoplasias present with solid tumor-like features, also including rapid cell growth, necrosis and angiogenesis, the clinical potential of which is still underestimated. While the role of regional hypoxia in normal B-cell maturation and malignant transformation is becoming evident, the impact of tissue hypoxia on their behavior is not well-understood. Compared to some of the common solid cancer types data for some of the key regulators, such as HIF1 and HIF2, and for their downstream effectors are available in a limited fashion. In the current review we aim to overview the physiological aspects of major hypoxia pathways during B-cell maturation and adaptation-related changes reported in lymphatic neoplasia covering important targets, such as carbonic anhydrases IX and XII (CAIX, CAXII), glucose transporter 1 (GLUT-1) and vascular endothelial growth factor (VEGF). In conclusion, experimental and clinical results direct to important but currently unexploited role of hypoxia-driven resistance mechanisms especially in aggressive forms of B-cell neoplasia.
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Affiliation(s)
- Orsolya Matolay
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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9
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Liu Y, Huang R, Liu L, Meng Y, Liu X. Epigenetic abnormalities of classical Hodgkin lymphoma and its effect on immune escape. Cell Biochem Funct 2019; 38:242-248. [PMID: 31709594 DOI: 10.1002/cbf.3463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/30/2019] [Accepted: 10/30/2019] [Indexed: 01/23/2023]
Abstract
Classical Hodgkin lymphoma (cHL) is a particular kind of malignant tumour that originates from the B cells. The malignant phenotype of cHL is, at least in part, maintained by epigenetic aberrations, which primarily consist of abnormal histone methylation and acetylation. Progress has been made in clinical trials concerning the histone deacetylases inhibitors (HDACis) in cHL. Also, some demethylation regimens could serve the purpose of preventing and treating tumours. Programmed death-ligand receptor 1 (PD-L1, CD274) inhibitors or apoptosis receptor 1 (PD-1, CD279) inhibitors are used in treating patients with relapsed cHL in recent years. Academic researches indicated that PD-1/PD-L1 inhibitors, including nivolumab and pembrolizumab, demonstrate remarkable activity in relapsed cHL. In addition, in recent years, a close association between epigenetic aberrations and immune escape has been explored in cHL. DNA methyltransferase (DNMT) inhibitors, HDACis, and immune checkpoint blockade exhibit synergistic effects. Thus, this review aims to provide an overview on the epigenetic abnormalities of cHL and its effect on immune escape, in order to explore the optimal combination approach to treat the disease. SIGNIFICANCE OF THE STUDY: Cancer Statistics 2018 reported that more than 8000 new cases of Hodgkin lymphoma were diagnosed. In recent years, PD-1/PD-L1 inhibitors for cHL have been utilized, and the therapeutic strategies of HDACis combined with PD-1/PD-L1 inhibitors have been raised. It is critical for improving the efficacy and decreasing the toxicity in treating the patients with cHL.
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Affiliation(s)
- Yizhen Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Renhong Huang
- Department of General Surgery of Changzheng Hospital, Naval Military Medical University, Shanghai, China
| | - Lianfang Liu
- Department of Medical Oncology, Zhangjiagang TCM Hospital, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yanchun Meng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiaojian Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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10
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Murbach BDA, Delamain MT, Daniel V, de Souza CA, Lima CSP, Lourenço GJ. Association between polymorphisms in angiogenesis-related genes and the prognosis of classical Hodgkin lymphoma. Br J Haematol 2018; 185:366-370. [PMID: 30079959 DOI: 10.1111/bjh.15512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Bruna de A Murbach
- Laboratory of Cancer Genetics, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Marcia T Delamain
- Hematology and Hemotherapy Centre, University of Campinas, Campinas, SP, Brazil
| | - Vanessa Daniel
- Laboratory of Cancer Genetics, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Carmino A de Souza
- Hematology and Hemotherapy Centre, University of Campinas, Campinas, SP, Brazil
| | - Carmen S P Lima
- Laboratory of Cancer Genetics, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Gustavo J Lourenço
- Laboratory of Cancer Genetics, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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11
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Kumar D, Xu ML. Microenvironment Cell Contribution to Lymphoma Immunity. Front Oncol 2018; 8:288. [PMID: 30101129 PMCID: PMC6073855 DOI: 10.3389/fonc.2018.00288] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/09/2018] [Indexed: 12/11/2022] Open
Abstract
Lymphoma microenvironment is a complex system composed of stromal cells, blood vessels, immune cells as well as extracellular matrix, cytokines, exosomes, and chemokines. In this review, we describe the function, localization, and interactions between various cellular components. We also summarize their contribution to lymphoma immunity in the era of immunotherapy. Publications were identified from searching Pubmed. Primary literature was carefully evaluated for replicability before incorporating into the review. We describe the roles of mesenchymal stem/stromal cells (MSCs), lymphoma-associated macrophages (LAMs), dendritic cells, cytotoxic T cells, PD-1 expressing CD4+ tumor infiltrating lymphocytes (TILs), T-cells expressing markers of exhaustion such as TIM-3 and LAG-3, regulatory T cells, and natural killer cells. While it is not in itself a cell, we also include a brief overview of the lymphoma exosome and how it contributes to anti-tumor effect as well as immune dysfunction. Understanding the cellular players that comprise the lymphoma microenvironment is critical to developing novel therapeutics that can help block the signals for immune escape and promote tumor surveillance. It may also be the key to understanding mechanisms of resistance to immune checkpoint blockade and immune-related adverse events due to certain types of immunotherapy.
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Affiliation(s)
- Deepika Kumar
- Departments of Pathology & Laboratory Medicine, Yale University School of Medicine, New Haven, CT, United States
| | - Mina L Xu
- Departments of Pathology & Laboratory Medicine, Yale University School of Medicine, New Haven, CT, United States
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Flattened microvessel independently predicts poor prognosis of patients with non-small cell lung cancer. Oncotarget 2018; 8:30092-30099. [PMID: 28404911 PMCID: PMC5444728 DOI: 10.18632/oncotarget.15617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/27/2017] [Indexed: 12/21/2022] Open
Abstract
Angiogenesis plays an essential role in improving tumor progression, whereas, its value in prognosis predicting remains controversial, especially in non-small cell lung cancer (NSCLC). Most recently, microvessel pattern has been raised as a novel prognosis factor. In this study, flattened microvessel, evaluated by tumor microvessel aspect ratio (TMAR), was conducted as a prognostic factor in NSCLC patients. A total of 100 patients with NSCLC were retrospectively reviewed. Microvessel in tumor was visualized by immunochemistry staining and then TMAR was determined. The prognostic role of TMAR was evaluated by univariate and multivariate analysis. Most of intratumor microvessels were flattened with a median TMAR of 3.65 (range, 2.43 - 6.28). Patients were stratified into high TMAR group (TMAR ≥ 3.6) and low TMAR group (TMAR < 3.6). Compared with subpopulation with low TMAR, high TMAR had significantly high risk of cancer-related death (univariate analysis: HR = 5.06, 95% CI: 2.44-10.47, p<0.001; multivariate analysis: HR = 4.53, 95% CI: 1.70-12.06, p=0.002). In conclusion, the results of our study demonstrate that flattened microvessel in tumor tissue is a promising prognosis predictor of NSCLC patients.
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Koh YW, Han JH, Yoon DH, Suh C, Huh J. PD-L1 expression correlates with VEGF and microvessel density in patients with uniformly treated classical Hodgkin lymphoma. Ann Hematol 2017; 96:1883-1890. [PMID: 28842748 DOI: 10.1007/s00277-017-3115-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/16/2017] [Indexed: 12/26/2022]
Abstract
Recent studies have reported the associations between programmed death-ligand 1 (PD-L1) or PD-L2/PD-1 pathways and pro-angiogenic genes including hypoxia-inducible factors (HIFs) and vascular endothelial growth factor (VEGF) in several malignancies. However, no study has examined the relationship or prognostic implication of PD-L1, PD-L2, PD-1, VEGF expression, and microvessel density (MVD) in classical Hodgkin lymphoma (cHL) patients. Diagnostic tissues from 109 patients with doxorubicin, bleomycin, vinblastine, and dacarbazine-treated cHL were evaluated retrospectively by immunohistochemical analysis for PD-L1, PD-L2, PD-1, VEGF expression, and for CD31 expression as a measure of MVD. There was a positive correlation between PD-L1 and VEGF expression (P = 0.008) and additionally between PD-L2 and VEGF expression (P = 0.001). The mean MVD in tumors positive for both PD-L1 and VEGF was significantly (P = 0.022) higher than the mean MVD in tumors negative for both markers. High PD-1 expression group had lower (P = 0.019) 5-year overall survival rate than low PD-1 expression group. Multivariate analysis revealed that PD-1 was an independent prognostic factor for cHL with significance (P = 0.026). However, PD-L1, PD-L2, and VEGF expression had no prognostic impact. Our data confirmed the positive correlations between PD-L1, VEGF, or MVD. Our findings provided evidence supporting new therapeutic approaches including combinations of anti-PD-L1/PD-1 and anti-VEGF therapy in addition to the current standard regimen for cHL.
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Affiliation(s)
- Young Wha Koh
- Department of Pathology, Ajou University School of Medicine, Suwon, South Korea
| | - Jae-Ho Han
- Department of Pathology, Ajou University School of Medicine, Suwon, South Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, 138736, South Korea.
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Koh YW, Han JH, Yoon DH, Suh C, Huh J. Epstein-Barr virus positivity is associated with angiogenesis in, and poorer survival of, patients receiving standard treatment for classical Hodgkin's lymphoma. Hematol Oncol 2017; 36:182-188. [DOI: 10.1002/hon.2468] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Young Wha Koh
- Department of Pathology; Ajou University School of Medicine; Suwon Korea
| | - Jae-Ho Han
- Department of Pathology; Ajou University School of Medicine; Suwon Korea
| | - Dok Hyun Yoon
- Departments of Oncology; University of Ulsan College of Medicine; Seoul Korea
| | - Cheolwon Suh
- Departments of Oncology; University of Ulsan College of Medicine; Seoul Korea
| | - Jooryung Huh
- Pathology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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P Vassilakopoulos T, Levidou G, Milionis V, Hartmann S, Lakiotaki E, Sepsa A, Thymara I, Ntailiani P, Spanou K, K Angelopoulou M, P Siakantaris M, Moschogiannis M, A Pangalis G, Panayiotidis P, Konstantopoulos K, Patsouris E, Hansmann ML, Korkolopoulou P. Thioredoxin-1, chemokine (C-X-C motif) ligand-9 and interferon-γ expression in the neoplastic cells and macrophages of Hodgkin lymphoma: clinicopathologic correlations and potential prognostic implications. Leuk Lymphoma 2017; 58:1-13. [PMID: 28571489 DOI: 10.1080/10428194.2017.1289520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Expression of thioredoxin-1 (TXN) and CXCL9 is not restricted to THRLBCL macrophages, but may be observed in histiocytes and neoplastic (HRS) cells of EBV + mixed cellularity (MC) classical Hodgkin lymphoma (cHL) and nodular lymphocyte predominant HL. We aimed to validate and extend the above observations in 174 cHL patients evaluating the immunohistochemical expression of TXN, CXCL9 and IFN-γ. HRS-cell CXCL9 expression was higher in latent membrane protein-1 (LMP1)+, MC and Stage IV. TXN and CXCL9 expression by cHL histiocytes was more frequent in LMP1+, MC and older patients (only for CXCL9). TXN expression by HRS cells (≥80%) was independently associated with better failure-free survival. In conclusion, markers of TCHRLBCL histiocytes (TXN, CXCL9), as well as IFN-γ are also expressed by histiocyte subsets and neoplastic cells of cHL. The expression of some of them is more prominent in EBV + MC, but not restricted to this subtype. The prognostic implication of TXN needs further evaluation.
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Affiliation(s)
- Theodoros P Vassilakopoulos
- a Department of Haematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Levidou
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Vassilis Milionis
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Sylvia Hartmann
- c Dr Senckenberg Institute of Pathology, Goethe University Hospital Frankfurt , Frankfurt , Germany
| | - Eleftheria Lakiotaki
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Athanasia Sepsa
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Irene Thymara
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Panagiota Ntailiani
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Kallirroi Spanou
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Maria K Angelopoulou
- a Department of Haematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marina P Siakantaris
- a Department of Haematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Moschogiannis
- d Department of Haematology , Athens Medical Center , Psychikon , Athens , Greece
| | | | - Panayiotis Panayiotidis
- c Dr Senckenberg Institute of Pathology, Goethe University Hospital Frankfurt , Frankfurt , Germany
| | - Kostas Konstantopoulos
- c Dr Senckenberg Institute of Pathology, Goethe University Hospital Frankfurt , Frankfurt , Germany
| | - Efstratios Patsouris
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Martin-Leo Hansmann
- c Dr Senckenberg Institute of Pathology, Goethe University Hospital Frankfurt , Frankfurt , Germany
| | - Penelope Korkolopoulou
- b Department of Pathology , Laikon General Hospital, National and Kapodistrian University of Athens , Athens , Greece
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Unusual Histology in Hodgkin's Lymphoma: Report of an Interesting Case. Indian J Surg Oncol 2017; 8:181-184. [PMID: 28546715 DOI: 10.1007/s13193-016-0602-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022] Open
Abstract
Hodgkin's lymphoma has a significant presence in the Indian subcontinent. Microscopically, the hallmark of Hodgkin's lymphoma (HL) is the Hodgkin and Reed-Sternberg (HRS) cell, which is usually surrounded by a cellular infiltrate of non-malignant inflammatory cells that constitute the majority of the tumor tissue. Cells which are known to be histologic mimics of HRS cells include immunoblasts, plasmablasts and rarely dendritic cells. We report a case of a 70-year-old male who presented with fever and lymphadenopathy. In the present case, the large cells with prominent nucleoli stained positively for both CD15 and CD30 and hence the possibility of angioimmunoblastic lymphadenopathy which was considered on the H&E-stained sections was excluded. In addition, noteworthy microscopic features in this case were angiogenesis and the presence of mast cells, both associated with a poor prognosis. The clinical impression was that of disseminated tuberculosis, but on histopathology, the final opinion was 'Hodgkin's lymphoma not classifiable with an unusual histology'. The aim of reporting this case is to highlight the unusual presentation in the form of prominent angiogenesis and mast cell infiltration in a case of HL, which is indicative of a poor prognosis.
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Benharroch D, Prinsloo I, Gopas J, Lazarev I. Lymphangiogenesis in Classical Hodgkin Lymphoma - Preliminary Study with Clinicopathological Correlations. J Cancer 2016; 7:2117-2123. [PMID: 27877228 PMCID: PMC5118676 DOI: 10.7150/jca.16389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/14/2016] [Indexed: 11/25/2022] Open
Abstract
A role for lymphangiogenesis in metastatic breast and prostate cancers has been suggested recently. The relevance of lymphangiogenesis in cancer as a rule, and more specifically in classical Hodgkin lymphoma, is poorly understood in comparison with that of angiogenesis. In a preliminary (pilot) study we have investigated the role of lymphatic vessels growth in 19 cases of classical Hodgkin lymphoma stained with the D2-40 (podoplanin) antibody. In each case, three lymphatic vessels hot spots were scrutinized twice. Of the 57 hot spots thus identified, we chose 15 at random for photography, microvessel counting and image analysis. We determined the mean perimeter, surface area, major axis length and complexity factor for each hot spot and correlated them with clinical and biological features of classical Hodgkin lymphoma. No correlations were found with clinical features. No associations were noted with the standard immuno-markers of classical Hodgkin lymphoma. However, significant inverse correlations were shown with pRb, BAX and IκB-α expression. The mean lymphatic major axis length was inversely correlated with the complexity factor. Last, we carried out an additional clinicopathological correlation of the expression of pRb, BAX and IκB-α in a cohort of classical Hodgkin lymphoma patients previously published.
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Affiliation(s)
- Daniel Benharroch
- Departments of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
| | - Isebrand Prinsloo
- Departments of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
| | - Jacob Gopas
- Departments of Oncology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva;; Department of Immunology, Microbiology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Irena Lazarev
- Departments of Oncology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva
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Atypical variants of nodular lymphocyte-predominant Hodgkin lymphoma show low microvessel density and vessels of distention type. Hum Pathol 2016; 60:129-136. [PMID: 27816718 DOI: 10.1016/j.humpath.2016.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/28/2016] [Accepted: 10/04/2016] [Indexed: 01/25/2023]
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) presents different histopathologic growth patterns, including atypical forms showing overlapping histopathologic and clinical features with T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL). Because growth patterns are associated with vessel distribution, the aim of the present study was to compare angiogenesis in different NLPHL patterns with THRLBCL as well as other lymphomas. Atypical variants of NLPHL and THRLBCL (n=10 per group) both showed a low microvessel density (MVD; 1.16-1.31/μm2) with a diffuse vessel distribution. In contrast, in typical NLPHL (n=10), follicular areas with low MVD were retained, whereas an increase in vessels in the interfollicular areas was observed (MVD 1.35/μm2). THRLBCL and typical NLPHL could additionally be distinguished by differences in their molecular angiogenesis signature. Furthermore, the number of intravascular T cells was significantly reduced in THRLBCL (0.0028 T cells/mm2 vessel area) when compared with typical NLPHL (0.0059 T cells/mm2 vessel area), potentially reflecting the different composition of the microenvironment in these 2 lymphoma entities. The results of our study reveal a similar vascular pattern and angiogenesis behavior in atypical NLPHL variants and THRLBCL in contrast to the retained follicular pattern in typical NLPHL.
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20
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Insights into the molecular roles of heparan sulfate proteoglycans (HSPGs—syndecans) in autocrine and paracrine growth factor signaling in the pathogenesis of Hodgkin’s lymphoma. Tumour Biol 2016; 37:11573-11588. [DOI: 10.1007/s13277-016-5118-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 06/09/2016] [Indexed: 12/25/2022] Open
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Jurisic V, Radenkovic S, Konjevic G. The Actual Role of LDH as Tumor Marker, Biochemical and Clinical Aspects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 867:115-24. [PMID: 26530363 DOI: 10.1007/978-94-017-7215-0_8] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Lactate dehydrogenase (LDH) among many biochemical parameters represents a very valuable enzyme in patients with cancer with possibility for easy routine measurement in many clinical laboratories. Previous studies where mostly based on investigated LDH in serum of patients with cancer with aims to estimate their clinical significance. The new directions in investigation of LDH where based on the principle that tumor cells release intracellular enzymes trough damaged cell membrane, that is mostly consequence in intracellular mitochondrial machinery alteration, and apoptosis deregulation. This consideration can be used not only in-vitro assays, but also in respect to clinical characteristics of tumor patients. Based on new techniques of molecular biology it is shown that intracellular characteristics of LDH enzyme are very sensitive indicators of the cellular metabolic state, aerobic or anaerobic direction of glycolysis, activation status and malignant transformation. Using different molecular analyses it is very useful to analyzed intracellular LDH activity in different cell line and tumor tissues obtained from patients, not only to understanding complexity in cancer biochemistry but also in early clinical diagnosis. Based on understandings of the LDH altered metabolism, new therapy option is created with aims to blocking certain metabolic pathways and stop tumors growth.
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Affiliation(s)
- Vladimir Jurisic
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
| | | | - Gordana Konjevic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Yeung TL, Leung CS, Li F, Wong SST, Mok SC. Targeting Stromal-Cancer Cell Crosstalk Networks in Ovarian Cancer Treatment. Biomolecules 2016; 6:3. [PMID: 26751490 PMCID: PMC4808797 DOI: 10.3390/biom6010003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/20/2015] [Accepted: 12/09/2015] [Indexed: 12/13/2022] Open
Abstract
Ovarian cancer is a histologically, clinically, and molecularly diverse disease with a five-year survival rate of less than 30%. It has been estimated that approximately 21,980 new cases of epithelial ovarian cancer will be diagnosed and 14,270 deaths will occur in the United States in 2015, making it the most lethal gynecologic malignancy. Ovarian tumor tissue is composed of cancer cells and a collection of different stromal cells. There is increasing evidence that demonstrates that stromal involvement is important in ovarian cancer pathogenesis. Therefore, stroma-specific signaling pathways, stroma-derived factors, and genetic changes in the tumor stroma present unique opportunities for improving the diagnosis and treatment of ovarian cancer. Cancer-associated fibroblasts (CAFs) are one of the major components of the tumor stroma that have demonstrated supportive roles in tumor progression. In this review, we highlight various types of signaling crosstalk between ovarian cancer cells and stromal cells, particularly with CAFs. In addition to evaluating the importance of signaling crosstalk in ovarian cancer progression, we discuss approaches that can be used to target tumor-promoting signaling crosstalk and how these approaches can be translated into potential ovarian cancer treatment.
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Affiliation(s)
- Tsz-Lun Yeung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Cecilia S Leung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Fuhai Li
- Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medical College, Houston, TX 77030, USA.
| | - Stephen S T Wong
- Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medical College, Houston, TX 77030, USA.
- National Cancer Institute Center for Modeling Cancer Development, Houston Methodist Research Institute, Houston, TX 77030, USA.
| | - Samuel C Mok
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Yeung TL, Leung CS, Yip KP, Au Yeung CL, Wong STC, Mok SC. Cellular and molecular processes in ovarian cancer metastasis. A Review in the Theme: Cell and Molecular Processes in Cancer Metastasis. Am J Physiol Cell Physiol 2015. [PMID: 26224579 DOI: 10.1152/ajpcell.00188.2015] [Citation(s) in RCA: 233] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ovarian cancer is the most lethal gynecological malignancy. It is usually diagnosed at a late stage, with a 5-yr survival rate of <30%. The majority of ovarian cancer cases are diagnosed after tumors have widely spread within the peritoneal cavity, limiting the effectiveness of debulking surgery and chemotherapy. Owing to a substantially lower survival rate at late stages of disease than at earlier stages, the major cause of ovarian cancer deaths is believed to be therapy-resistant metastasis. Although metastasis plays a crucial role in promoting ovarian tumor progression and decreasing patient survival rates, the underlying mechanisms of ovarian cancer spread have yet to be thoroughly explored. For many years, researchers have believed that ovarian cancer metastasizes via a passive mechanism by which ovarian cancer cells are shed from the primary tumor and carried by the physiological movement of peritoneal fluid to the peritoneum and omentum. However, the recent discovery of hematogenous metastasis of ovarian cancer to the omentum via circulating tumor cells instigated rethinking of the mode of ovarian cancer metastasis and the importance of the "seed-and-soil" hypothesis for ovarian cancer metastasis. In this review we discuss the possible mechanisms by which ovarian cancer cells metastasize from the primary tumor to the omentum, the cross-talk signaling events between ovarian cancer cells and various stromal cells that play crucial roles in ovarian cancer metastasis, and the possible clinical implications of these findings in the management of this deadly, highly metastatic disease.
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Affiliation(s)
- Tsz-Lun Yeung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Cecilia S Leung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas
| | - Kay-Pong Yip
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Chi Lam Au Yeung
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen T C Wong
- Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute, Weill Cornell Medical College, Houston, Texas; NCI Center for Modeling Cancer Development, Houston Methodist Research Institute, Houston, Texas
| | - Samuel C Mok
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas; The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas;
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SOX11 promotes tumor angiogenesis through transcriptional regulation of PDGFA in mantle cell lymphoma. Blood 2014; 124:2235-47. [DOI: 10.1182/blood-2014-04-569566] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Key Points
SOX11 mediates regulation of angiogenesis via the PDGFA signaling pathway in MCL. SOX11-dependent increased angiogenesis contributes to a more aggressive MCL phenotype.
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Marinaccio C, Nico B, Maiorano E, Specchia G, Ribatti D. Insights in Hodgkin Lymphoma angiogenesis. Leuk Res 2014; 38:857-61. [DOI: 10.1016/j.leukres.2014.05.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/20/2014] [Accepted: 05/27/2014] [Indexed: 12/11/2022]
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Functional integration of acute myeloid leukemia into the vascular niche. Leukemia 2014; 28:1978-1987. [PMID: 24637335 PMCID: PMC4167983 DOI: 10.1038/leu.2014.109] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 02/06/2014] [Accepted: 03/13/2014] [Indexed: 12/15/2022]
Abstract
Vascular endothelial cells are a critical component of the hematopoietic microenvironment that regulates blood cell production. Recent studies suggest the existence of functional cross-talk between hematologic malignancies and vascular endothelium. Here, we show that human acute myeloid leukemia (AML) localizes to the vasculature in both patients and in a xenograft model. A significant number of vascular tissue-associated AML cells (V-AML) integrate into vasculature in vivo and can fuse with endothelial cells. V-AML cells acquire several endothelial cell-like characteristics, including the up-regulation of CD105, a receptor associated with activated endothelium. Remarkably, endothelial-integrated V-AML shows an almost 4-fold reduction in proliferative activity compared to non-vascular associated AML. Primary AML cells can be induced to down regulate the expression of their hematopoietic markers in vitro and differentiate into phenotypically and functionally-defined endothelial-like cells. After transplantation, these leukemia-derived endothelial cells are capable of giving rise to AML. Taken together, these novel functional interactions between AML cells and normal endothelium along with the reversible endothelial cell potential of AML suggest that vascular endothelium may serve as a previously unrecognized reservoir for acute myeloid leukemia.
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Koh YW, Park CS, Yoon DH, Suh C, Huh J. CD163 expression was associated with angiogenesis and shortened survival in patients with uniformly treated classical Hodgkin lymphoma. PLoS One 2014; 9:e87066. [PMID: 24489836 PMCID: PMC3906082 DOI: 10.1371/journal.pone.0087066] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 12/22/2013] [Indexed: 12/12/2022] Open
Abstract
Background Recent studies have reported the prognostic value of tissue-associated magrophages (TAMs) in classical Hodgkin lymphoma (cHL). In addition, TAMs are implicated in the tumor angiogenesis. In this study, we examined the prognostic relevance of TAMs in relation to vascular endothelial growth factor (VEGF) expression and angiogenesis in uniformly treated cases of cHL. Methods Diagnostic tissue from 116 patients with ABVD-treated cHL was evaluated retrospectively by immunohistochemical analysis for CD68, CD163 and VEGF expression and for CD31 expression as a measure of microvessel density (MVD). Results High CD163 expression (≥35% of cellularity) correlated with VEGF expression (Pearson’s Chi-square test, P = 0.008) and MVD (Spearman correlation coefficient 0.310, P<0.001). High CD163 expression was associated with inferior event-free survival (EFS, P = 0.005) and overall survival (OS, P<0.001) in univariate analysis. In multivariate analysis, high CD163 expression was strongly associated with inferior EFS (P = 0.043) and OS (P = 0.008). Patients with high MVD had a lower OS than those with low MVD, but the difference was not significant (P = 0.071, respectively). While high expression of CD68 was also associated with inferior EFS (P = 0.007), it showed no correlation with VEGF or MVD. Conclusions Our data confirms that CD163 expression provides independent prognostic information in cHL. The correlation of CD163 with VEGF expression and MVD suggests the role of CD163-positive cells in tumor angiogenesis of cHL.
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Affiliation(s)
- Young Wha Koh
- Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Chan-Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Dok Hyun Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jooryung Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- * E-mail:
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Mikalsen LTG, Dhakal HP, Bruland ØS, Naume B, Borgen E, Nesland JM, Olsen DR. The clinical impact of mean vessel size and solidity in breast carcinoma patients. PLoS One 2013; 8:e75954. [PMID: 24146798 PMCID: PMC3795733 DOI: 10.1371/journal.pone.0075954] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/17/2013] [Indexed: 12/31/2022] Open
Abstract
Angiogenesis quantification, through vessel counting or area estimation in the most vascular part of the tumour, has been found to be of prognostic value across a range of carcinomas, breast cancer included. We have applied computer image analysis to quantify vascular properties pertaining to size, shape and spatial distributions in photographed fields of CD34 stained sections. Aided by a pilot (98 cases), seven parameters were selected and validated on a separate set from 293 breast cancer patients. Two new prognostic markers were identified through continuous cox regression with endpoints breast cancer specific survival and distant disease free survival: The average size of the vessels as measured by their perimeter (p = 0.003 and 0.004, respectively), and the average complexity of the vessel shapes measured by their solidity (p = 0.004 and 0.004). The Hazard ratios for the corresponding median-dichotomized markers were 2.28 (p = 0.005) and 1.89 (p = 0.016) for the mean perimeter and 1.80 (p = 0.041) and 1.55 (p = 0.095) for the shape complexity. The markers were associated with poor histologic type, high grade, necrosis, HR negativity, inflammation, and p53 expression (vessel size only). Both markers were found to strongly influence the prognostic properties of vascular invasion (VI) and disseminated tumour cells in the bone marrow. The latter being prognostic only in cases with large vessels (p = 0.004 and 0.043) or low complexity (p = 0.018 and 0.024), but not in the small or complex vessel groups (p>0.47). VI was significant in all groups, but showed greater hazard ratios for small and low complexity vessels (6.54-11.2) versus large and high complexity vessels (2.64-3.06). We find that not only the overall amount of produced vasculature in angiogenic hot-spots is of prognostic significance, but also the morphological appearance of the generated vessels, i.e. the size and shape of vessels in the studied hot spots.
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Affiliation(s)
| | - Hari Prasad Dhakal
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital HF, Oslo, Norway
| | - Øyvind S. Bruland
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bjørn Naume
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elin Borgen
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital HF, Oslo, Norway
| | - Jahn M. Nesland
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital HF, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Dag Rune Olsen
- Faculty of Mathematics and Natural Sciences, University of Bergen, Bergen, Norway
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Minoia C, Quero C, Asselti M, Galise I, Marzano AL, Iacobazzi A, Rana A, Merchionne F, Serratì S, De Tullio G, Quintana G, Casiello M, Maiorano E, Simone G, Zito FA, Iacopino P, Guarini A. Changes in angiogenesis and hypoxia-inducible factor-1α protein expression in relapsed/refractory indolent non-Hodgkin lymphomas. Br J Haematol 2013; 163:640-5. [DOI: 10.1111/bjh.12560] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 07/19/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Carla Minoia
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Carmela Quero
- Department of Pathology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Mariaconsilia Asselti
- Department of Pathology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Ida Galise
- Registro Tumori Puglia; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Alessia L. Marzano
- Department of Pathology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Angela Iacobazzi
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Antonio Rana
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Francesca Merchionne
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Simona Serratì
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Giacoma De Tullio
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Giovanni Quintana
- Haematology Division and BMT Unit; Antonio Perrino Hospital; Brindisi Italy
| | - Michela Casiello
- Human Anatomy and Histology Unit; Antonio Perrino Hospital; Brindisi Italy
| | - Eugenio Maiorano
- Department of Human Anatomy and Histology; University of Bari Medical School; Bari Italy
| | - Giovanni Simone
- Department of Pathology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | | | - Pasquale Iacopino
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
| | - Attilio Guarini
- Haematology Unit; Department of Medical and Experimetal Oncology; IRCCS National Cancer Research Centre “Giovanni Paolo II”; Bari Italy
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Prognostic Significance of COX-2 Expression and Correlation With Bcl-2 and VEGF Expression, Microvessel Density, and Clinical Variables in Classical Hodgkin Lymphoma. Am J Surg Pathol 2013; 37:1242-51. [DOI: 10.1097/pas.0b013e31828b6ad3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wilms' tumor gene 1: a possible new proangiogenic factor in Hodgkin lymphoma. Appl Immunohistochem Mol Morphol 2013; 21:177-80. [PMID: 22688351 DOI: 10.1097/pai.0b013e318259852a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Wilms' tumor gene 1 (WT1) was recently found to play a role in solid and hematologic malignancies and serves as a marker of prognosis and minimal residual disease in acute leukemia. WT1 was also found to be involved in tumor angiogenesis. There are no data concerning the involvement of WT1 in angiogenesis in lymphoproliferative tumors. The aim of this study was to explore the involvement of WT1 in Hodgkin lymphoma. METHODS The expression of WT1, neuropilin 1, and VEGF was tested by immunohistochemistry in lymph nodes biopsies of 20 Hodgkin patients and 7 reactive lymph nodes. RESULTS WT1 was expressed in endothelial cells, in 95% of the malignant lymph nodes. The average of WT1 expression scale was higher in the malignant lymph nodes than in reactive lymph nodes. We found a positive correlation between WT1 expression scale and the angiogenesis scale (0.53) that was statistically significant (P<0.05). As the number of vessels increases, the expression of WT1 is more intense. CONCLUSIONS We found, for the first time, that WT1 is expressed in endothelial cells in Hodgkin lymphoma. The clinical implications of these findings should be tested in a future study.
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Dimtsas GS, Georgiadi EC, Karakitsos P, Vassilakopoulos TP, Thymara I, Korkolopoulou P, Patsouris E, Kittas C, Doussis-Anagnostopoulou IA. Prognostic significance of immunohistochemical expression of the angiogenic molecules vascular endothelial growth factor-A, vascular endothelial growth factor receptor-1 and vascular endothelial growth factor receptor-2 in patients with classical Hodgkin lymphoma. Leuk Lymphoma 2013; 55:558-64. [PMID: 23772669 DOI: 10.3109/10428194.2013.813629] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Angiogenesis leads to new blood vessel formation and is implicated in both physiological and pathological situations. The vascular endothelial growth factor (VEGF) family is the major mediator of this process. The aim of our study was to evaluate the expression of VEGF-A, vascular endothelial growth factor receptor-1 (VEGFR-1) and VEGFR-2 and their correlation with clinicopathological parameters and prognosis in patients with classical Hodgkin lymphoma (cHL), since the role of angiogenesis in this tumor still remains unclear. The immunohistochemical expression of VEGF-A, VEGFR-1 and VEGFR-2 was examined in 194 patients with cHL. The neoplastic Hodgkin Reed-Sternberg (HRS) cells expressed VEGF-A, VEGFR-1 and VEGFR-2 in 90.3%, 97.2% and 94.1% of cases, respectively. Only the expression of VEGFR-2 was positively correlated with serum albumin levels ≥ 4 g/dL. No correlation with patient outcome was observed. All three molecules were statistically correlated with ramifications of blood vessels. Summarizing, our results are not sufficient to consider VEGF-A and/or VEGF receptors as prognosticators in cHL.
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Panico L, Ronconi F, Lepore M, Tenneriello V, Cantore N, Dell'Angelo AC, Ferbo U, Ferrara F. Prognostic role of tumor-associated macrophages and angiogenesis in classical Hodgkin lymphoma. Leuk Lymphoma 2013; 54:2418-25. [PMID: 23432688 DOI: 10.3109/10428194.2013.778405] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We studied by immunohistochemistry CD68 + tumor-associated macrophages (TAMs) and angiogenesis in 121 consecutive cases of uniformly treated classical Hodgkin lymphoma (cHL). High TAM count showed a significant correlation with age ≥ 45, mixed cellularity subtype and high β₂-microglobulin level. Vessel density (VD) was unrelated to clinicopathological features, while a significant correlation was found between TAM count and VD. Patients with high TAMs showed a trend toward reduced progression-free survival and significantly shorter overall survival (OS). No correlation was found between VD and survival. At multivariate analysis, bulky disease was an independent predictor of reduced progression-free survival, while independent adverse prognostic factors for OS were male sex, age ≥ 45, advanced stage and bulky disease. High TAM count results in an adverse overall outcome in cHL and is significantly correlated to VD. Since VD has no prognostic relevance, the adverse effect of TAMs is presumably unrelated to angiogenesis.
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Affiliation(s)
- Luigi Panico
- Unit of Pathology, Hospital S. G. Moscati , Avellino , Italy
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Okur FV, Karadeniz C, Buyukpamukcu M, Oguz A, Yucel A, Cinaz P, Emir S, Varan A. Clinical significance of serum vascular endothelial growth factor, endostatin, and leptin levels in children with lymphoma. Pediatr Blood Cancer 2010; 55:1272-7. [PMID: 20734403 DOI: 10.1002/pbc.22722] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 05/27/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND A number of clinical studies conducted in adults have demonstrated the prognostic significance of angiogenic factors in malignancies, however, only a limited number of studies have been conducted in children. The aim of this study was to determine serum vascular endothelial growth factor (VEGF), endostatin, and leptin levels in children with lymphoma and to investigate whether these factors provide prognostic information. PROCEDURE Serum samples from 36 children with lymphoma (non-Hodgkin lymphoma (NHL) N = 21, Hodgkin lymphoma (HL) N = 15) were collected at diagnosis and during remission. Serum samples were also collected from 18 healthy children as the control group. Serum VEGF and endostatin levels were quantified by using enzyme-linked immunosorbent assay (ELISA) and serum leptin by immunoradiometric assay. RESULTS The serum VEGF levels were found elevated in patients compared to controls (P = 0.033), while endostatin and leptin levels were lower in patients than in controls (endostatin, 43.9 ± 5.8 ng/ml vs. 123.6 ± 13.5 ng/ml, P < 0.001; leptin, 5 ± 1.5 ng/ml vs. 6.7 ± 1.2 ng/ml, P = 0.013). VEGF levels declined (pre, 151.6 ± 55.9 pg/ml vs. post, 16.2 ± 7.9 pg/ml, P = 0.041), while endostatin and leptin levels increased in patients who achieved remission (33 of 36 patients) when compared to pre-treatment levels (endostatin pre, 43.1 ± 5.9 ng/ml vs. post, 65.9 ± 6.8 ng/ml, P = 0.047; leptin, pre, 5.3 ± 1.6 ng/ml vs. post, 9.8 ± 2.7 ng/ml, P = 0.012). Serum VEGF, endostatin, and leptin levels were not predictive of survival. CONCLUSION Serial measurement of serum VEGF, endostatin, and leptin levels could potentially be used to predict response to treatment or progressive disease in children with lymphoma.
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Affiliation(s)
- Fatma Visal Okur
- Faculty of Medicine, Department of Pediatric Oncology, Gazi University, Ankara, Turkey.
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35
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Dincaslan HU, Yavuz G, Unal E, Tacyildiz N, Ikinciogullari A, Dogu F, Guloglu D, Yuksek N, Ertem U. Does serum soluble vascular endothelial growth factor levels have different importance in pediatric acute leukemia and malignant lymphoma patients? Pediatr Hematol Oncol 2010; 27:503-16. [PMID: 20677920 DOI: 10.3109/08880018.2010.493574] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Vascular endothelial growth factor (VEGF) seems to play a central role in angiogenesis-lymphangiogenesis in hematological malignancies. There are limited data related to childhood hematologic malignancies. The aim of the study was to evaluate soluble VEGF (sVEGF) levels in children with acute leukemia and malignant lymphoma (ML) at diagnosis and in remission. The levels of serum sVEGF were measured by enzyme-linked immunosorbent assay (ELISA) in 20 children with acute leukemia, 33 children with different histopathological subtypes of ML, and 20 healthy controls. The levels of sVEGF at diagnosis (range 2 -1040 pg/mL; median 52 pg/mL) was significantly lower than in remission (range 136 -1960 pg/mL; median 630 pg/mL) in acute myeloid leukemia (AML) group (P = .018). The sVEGF levels at diagnosis (range: 2 -640 pg/mL; median 89 pg/mL) was significantly lower compared to remission values (range: 116 -1960 pg/mL; median 136 pg/mL) in patients with acute lymphoblastic leukemia (ALL) (P = .002). In ML group, including Burkitt's lymphoma (BL), T-cell non-Hodgkin's lymphoma (NHL), and Hodgkin's lymphoma (HL), sVEGF levels at diagnosis were higher than remission levels, but there was no statistically significant difference (P >.05). On the other hand, there were significant difference between levels in active disease and control group, ie, BL versus control, T-cell NHL versus control, and HL versus control (P = .008, P = .043, P = .007, respectively). The authors noticed that sVEGF levels showed distinct behavioral pattern in different childhood malignancies at diagnosis and in remission. In acute leukemia and ML patients, VEGF acts through different pathophysiological mechanisms, in both bone marrow (BM) angiogenesis and lymphoid tissue lymphangiogenesis.
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Affiliation(s)
- Handan Ugur Dincaslan
- Department of Pediatric Oncology, Ankara University School of Medicine, Ankara, Turkey.
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Paydas S, Ergin M, Seydaoglu G, Erdogan S, Yavuz S. Pronostic significance of angiogenic/lymphangiogenic, anti-apoptotic, inflammatory and viral factors in 88 cases with diffuse large B cell lymphoma and review of the literature. Leuk Res 2009; 33:1627-35. [DOI: 10.1016/j.leukres.2009.02.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 02/11/2009] [Accepted: 02/14/2009] [Indexed: 11/16/2022]
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Mucci LA, Powolny A, Giovannucci E, Liao Z, Kenfield SA, Shen R, Stampfer MJ, Clinton SK. Prospective study of prostate tumor angiogenesis and cancer-specific mortality in the health professionals follow-up study. J Clin Oncol 2009; 27:5627-33. [PMID: 19858401 DOI: 10.1200/jco.2008.20.8876] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Tumor growth requires the development of independent vascular networks that are often primitive in morphology and function. We examined whether microvessel morphology contributes to the considerable biologic heterogeneity of prostate cancer. METHODS We evaluated microvessel morphology as a predictor of prostate cancer mortality among 572 men in the Health Professionals Follow-Up Study diagnosed with cancer during 1986 to 2000. We immunostained prostatectomy tumor block sections for endothelial marker CD34 and assessed microvessel density, vessel size (area and diameter), and irregularity of vessel lumen using image analysis. Proportional hazards models were used to assess microvessel density and morphology in relation to lethal prostate cancer. RESULTS Poorly differentiated tumors exhibited greater microvessel density, greater irregularity of the vessel lumen, and smaller vessels. During 20 years of follow-up, 44 men developed bone metastases or died of cancer. Men with tumors exhibiting the smallest vessel diameter, based on quartiles, were 6.0 times more likely (95% CI, 1.8 to 20.0) to develop lethal prostate cancer. Men with the most irregularly shaped vessels were 17.1 times more likely (95% CI, 2.3 to 128) to develop lethal disease. Adjusting for Gleason grade and prostate-specific antigen levels did not qualitatively change the results. Microvessel density was not linked to cancer-specific mortality after adjusting for clinical factors. CONCLUSION Aggressive tumors form vessels that are primitive in morphology and function, with consequences for metastases. Vascular size and irregularity reflect the angiogenic potential of prostate cancer and may serve as biomarkers to predict prostate cancer mortality several years after diagnosis.
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Affiliation(s)
- Lorelei A Mucci
- Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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Mainou-Fowler T, Angus B, Miller S, Proctor SJ, Taylor PRA, Wood KM. Micro-vessel density and the expression of vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor (PdEGF) in classical Hodgkin lymphoma (HL). Leuk Lymphoma 2009; 47:223-30. [PMID: 16321851 DOI: 10.1080/01674820500305838] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There is little information to date regarding the role of angiogenesis in Hodgkin lymphoma (HL). The present study examines micro-vessel density and the expression of vascular endothelial growth factor (VEGF) and platelet-derived endothelial growth factor (PdEGF) in lymph node biopsies of patients with HL at presentation and relapse. Using immunohistochemistry, the degree of new blood vessel formation and the expression of VEGF and PdEGF was assessed in Hodgkin-rich tissue. The micro-vessel density (MVD) increased with disease progression in seven out of 11 cases. Expression of VEGF was observed in endothelial cells (EC) of some micro-vessels and also in follicular dendritic cells. The Hodgkin/Reed-Sternberg (H-RS) cells as well as the inflammatory lymphocytes were negative for VEGF. Cytoplasmic or cytoplasmic and nuclear expression of PdEGF by the H-RS cells was observed in five of the 11 presentation cases. The expression of PdEGF increased with disease progression in seven cases. In conclusion, Hodgkin tissue shows prominent vascularization. The increased MVD and PdEGF expression with disease progression merits further investigation.
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Affiliation(s)
- Tryfonia Mainou-Fowler
- Academic Haematology, School of Clinical and Laboratory Sciences, Newcastle upon Tyne, UK.
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Histological expression of angiogenic factors: VEGF, PDGFRα, and HIF-1α in Hodgkin lymphoma. Pathol Res Pract 2009; 205:11-20. [DOI: 10.1016/j.prp.2008.07.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2008] [Revised: 07/16/2008] [Accepted: 07/21/2008] [Indexed: 11/21/2022]
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Paydas S, Ergin M, Erdogan S, Seydaoglu G. Prognostic significance of EBV-LMP1 and VEGF-A expressions in non-Hodgkin's lymphomas. Leuk Res 2008; 32:1424-30. [PMID: 18282597 DOI: 10.1016/j.leukres.2008.01.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Revised: 01/09/2008] [Accepted: 01/12/2008] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIM EBV is an important virus in the pathogenesis of NHL. VEGF-A is the essential factor in tumor angiogenesis. There is evidence of cross talk between angiogenesis and viral carcinogenesis. The viral latent protein LMP1, may play a role by inducing expression of angiogenic factors In this study EBV-LMP1 and VEGF-A expressions have been studied in cases with NHL and prognostic significance of these has been evaluated. PATIENTS AND METHODS One hundred seventy-seven cases (60 had low grade lymphoma (LGL), 117 had aggressive lymphoma (AL)) with NHL have been included in this analysis. Immunohistochemistry has been used for the detection of EBV and VEGF-A. RESULTS EBV was found in 25 cases (14%); 5 of 60 cases with LGL while 20 of 117 cases with AL had EBV positivity; (OR: 2.3, 95% CI: 0.8-6.3, p=0.113). VEGF-A expression was found in 108 cases (61%); 30 of 60 cases with LGL and 78 of 117 cases with AL showed VEGF-A expression. There was an association between VEGF-A and aggressive histology (OR: 2.0, 95% CI: 1.1-3.8, p=0.031). EBV positivity was associated with VEGF-A expression in diffuse large B cell lymphoma (DLBCL) (0.045). Mean Survival rates were shorter in EBV (+) and/or VEGF-A (+) cases. COMMENT Highly significant association between VEGF-A and EBV expression and survival rate, suggests an association between angiogenesis and viral lymphomagenesis. Targeting both the angiogenesis and EBV may be important in the therapy of cases with NHL expressing EBV and/or VEGF-A.
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Affiliation(s)
- Semra Paydas
- Department of Oncology, Cukurova University, Faculty of Medicine, Adana, Turkey.
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Enblad G, Molin D, Glimelius I, Fischer M, Nilsson G. The Potential Role of Innate Immunity in the Pathogenesis of Hodgkin's Lymphoma. Hematol Oncol Clin North Am 2007; 21:805-23. [PMID: 17908621 DOI: 10.1016/j.hoc.2007.07.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The innate immune system is our first line of defense against danger signals but in Hodgkin's lymphoma the role seems opposite, favoring malignant development. In this article we describe interactions between Hodgkin's and Reed-Sternberg cells and the cells of the innate immune system: eosinophils, mast cells, neutrophils, and macrophages. These cells clearly contribute to the pathogenesis of this disease and to the prognosis. Cytokines and chemokines released from the activated immune cells probably promote tumor cell growth and survival along with angiogenesis. Mast cells and eosinophils seem also to contribute to the fibrosis that is so characteristic for nodular sclerosis.
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Affiliation(s)
- Gunilla Enblad
- Department of Oncology, Radiology, and Clinical Immunology, Section of Oncology, Uppsala University Hospital, Rudbeck Laboratory C11, S-75185 Uppsala, Sweden.
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Birrer MJ, Johnson ME, Hao K, Wong KK, Park DC, Bell A, Welch WR, Berkowitz RS, Mok SC. Whole genome oligonucleotide-based array comparative genomic hybridization analysis identified fibroblast growth factor 1 as a prognostic marker for advanced-stage serous ovarian adenocarcinomas. J Clin Oncol 2007; 25:2281-7. [PMID: 17538174 DOI: 10.1200/jco.2006.09.0795] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To identify markers that can predict overall survival in patients with high-grade advanced stage serous adenocarcinomas. PATIENTS AND METHODS Oligonucleotide array comparative genomic hybridization (aCGH) was performed on 42 microdissected high-grade serous ovarian tumor samples. aCGH segments were obtained and a prediction Cox model was built and validated by the standard leave one out analysis. Both DNA and mRNA copy numbers of selected genes located on the candidate aCGH segments were determined by quantitative polymerase chain reaction (qPCR) and quantitative reverse transcriptase PCR (qRT-PCR) analyses. The gene that showed the highest correlation was further validated on an independent set of specimens and was selected for further functional studies. RESULTS Two chromosomal regions, 4p16.3 and 5q31-5q35.3, exhibited the strongest correlation with overall survival (P < .01). From the 5q31 region, fibroblast growth factor 1 (FGF-1) was selected for further validation study. FGF-1 mRNA copy number was significantly correlated with DNA copy number and protein expression levels (P = .021 and < .001), and both FGF-1 mRNA and protein levels were significantly associated with overall survival (P = .018 and .042). This association was validated for protein expression on an independent set of 81 samples, significant to P = .006. Further studies showed significant correlation between FGF-1 protein expression and CD31+ staining in the tumor stroma (P = .024). Finally, both cancer cells and endothelial cells treated with exogenous FGF-1 showed a significant increase in cell motility and survival. CONCLUSION Amplification of FGF-1 at 5q31 in ovarian cancer tissues leads to increased angiogenesis, and autocrine stimulation of cancer cells, which may result in poorer overall survival in patents with high-grade advanced stage serous ovarian cancer.
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Affiliation(s)
- Michael J Birrer
- Cell and Cancer Biology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Visco C, Nadali G, Vassilakopoulos TP, Bonfante V, Viviani S, Gianni AM, Federico M, Luminari S, Peethambaram P, Witzig TE, Pangalis G, Cabanillas F, Medeiros LJ, Sarris AH, Pizzolo G. Very high levels of soluble CD30 recognize the patients with classical Hodgkin's lymphoma retaining a very poor prognosis. Eur J Haematol 2006; 77:387-94. [PMID: 16879607 DOI: 10.1111/j.1600-0609.2006.00725.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the prognostic role of pretreatment serum levels of soluble CD30 (sCD30) in patients with advanced stage classical Hodgkin's lymphoma (cHL) treated with adriamycin, bleomycin, vinblastine, and dacarbazine or equivalent regimens. METHODS We identified 321 previously untreated patients with cHL who presented to the participating centers between 1985 and 2002, and had serum samples available for the determination of sCD30 levels. RESULTS With a median follow-up of 72 months, the actuarial 5-year overall survival was 82%, and failure-free survival (FFS) was 71%. The median serum level of sCD30 was 65 U/mL (range: 1-2230), and was significantly higher (P < 0.0001) when compared with a group of 113 healthy controls (4 U/mL, range: 0-20). Increasing level of sCD30 was associated with a continuous worsening of FFS and OS, and patients with sCD30 >or=200 U/mL had a 5-year FFS of 39%. With multivariate analysis, sCD30, Ann Arbor stage, and lactic acid dehydrogenase were significant independent factors in terms of FFS. The association of the above-mentioned three independent prognostic variables could discriminate 22% of patients with 5-year FFS of 40%. CONCLUSIONS Our data confirm the independent prognostic role of sCD30 in identifying the patients with high risk of treatment failure, and show that its association with other variables can recognize patients with FFS considerably lower than 50%.
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Affiliation(s)
- Carlo Visco
- Department of Hematology, Ospedale S. Bortolo, Vicenza, Italy
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Current Awareness in Hematological Oncology. Hematol Oncol 2005. [DOI: 10.1002/hon.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kadowaki I, Ichinohasama R, Harigae H, Ishizawa K, Okitsu Y, Kameoka J, Sasaki T. Accelerated lymphangiogenesis in malignant lymphoma: possible role of VEGF-A and VEGF-C. Br J Haematol 2005; 130:869-77. [PMID: 16156857 DOI: 10.1111/j.1365-2141.2005.05695.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
There is little information regarding the lymphangiogenesis of malignant lymphoma. In this study, we evaluated the lymphangiogenesis and angiogenesis in 44 lymph nodes of 39 malignant lymphomas and five non-reactive normal lymph nodes, based on the lymphatic vessel density (LVD) and microvessel density (MVD) calculated by the computer-assisted assessment of vessel density. The LVD of malignant lymphomas was significantly higher than that of non-reactive normal lymph nodes, irrespective of subtypes (P = 0.00077). On the contrary, there was no difference in MVD between malignant lymphomas and non-reactive normal lymph nodes, except for diffuse large B cell lymphomas, which had a significantly low value of MVD, in comparison with non-reactive normal lymph nodes (P = 0.009). We further examined the expression of vascular endothelial growth factor (VEGF)-C and VEGF-A, which function on lymphangiogenesis in lymph node samples. VEGF-C was expressed in 36 of 39 malignant lymphomas. All 39 of the malignant lymphoma samples expressed VEGF-A. Furthermore, the level of LVD and VEGF-A or VEGF-C was positively correlated. These findings suggest that lymphangiogenesis is actively developed in lymph nodes of malignant lymphomas and it may be induced by both VEGF-A and VEGF-C secreted from lymphoma cells.
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Affiliation(s)
- Ikuko Kadowaki
- Department of Rheumatology and Haematology, Tohoku University School of Medicine, Aoba-ku, Sendai, Japan.
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Glimelius I, Edström A, Fischer M, Nilsson G, Sundström C, Molin D, Amini RM, Enblad G. Angiogenesis and mast cells in Hodgkin lymphoma. Leukemia 2005; 19:2360-2. [PMID: 16224482 DOI: 10.1038/sj.leu.2403992] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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