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Nguyen PC, Nguyen T, Wilson C, Tiong IS, Baldwin K, Nguyen V, Came N, Blombery P, Westerman DA. Evaluation of T-cell clonality by anti-TRBC1 antibody-based flow cytometry and correlation with T-cell receptor sequencing. Br J Haematol 2024; 204:910-920. [PMID: 38098188 DOI: 10.1111/bjh.19252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 03/14/2024]
Abstract
Flow cytometry (FC) incorporating the T-cell receptor β constant chain-1 (TRBC1) has been recently proposed as a new standard in T-cell clonality assessment. While early studies demonstrated high sensitivity in samples with conspicuous tumour burden, performance in real-world samples, including those with low tumour burden and correlation with molecular methods has been limited. We evaluated TRBC1-FC performance and correlated the results with high-throughput TRB sequencing and a targeted next-generation sequencing gene panel. Our cohort consisted of 90 evaluable samples from 57 patients. TRBC1-FC confirmed T-cell clonality in 37 out of 38 samples (97%) that were involved in a mature T-cell neoplasm (MTCN). T-cell clonality was also identified in nine samples from patients lacking a current or prior diagnosis of MTCN, consistent with the emerging entity T-cell clonality of uncertain significance. TRBC-FC was polyclonal in all samples and negative for disease involvement by standard pathology assessment. However, correlation with TRB sequencing in 17 of these samples identified two cases that harboured the known clonal sequence from index testing, indicating the presence of measurable residual disease not otherwise detected. Our study provides real-world correlative validation of TRBC1-FC, highlighting the strengths and limitations pertinent to its increasing implementation by general diagnostic laboratories.
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Affiliation(s)
- Phillip C Nguyen
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Tamia Nguyen
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Clarissa Wilson
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Ing Soo Tiong
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kylie Baldwin
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Vuong Nguyen
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Neil Came
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - David A Westerman
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
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2
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Bellairs JA, Yu SK, Dong ZM, Rizvi ZH. Benign Follicular Hyperplasia With Clonal B Cell Expansion: An Uncommon Differential to Unilateral Tonsillar Enlargement. EAR, NOSE & THROAT JOURNAL 2023:1455613231183538. [PMID: 37365834 DOI: 10.1177/01455613231183538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Affiliation(s)
- Joseph A Bellairs
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Shengyan K Yu
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Zhao Ming Dong
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
- US Department of Veterans Affairs, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Zain H Rizvi
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, WA, USA
- US Department of Veterans Affairs, VA Puget Sound Health Care System, Seattle, WA, USA
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3
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Xing MH, Shaari AL, Beute JE, Mundi N, Matloob A, Khorsandi AS, Wisdom G, Urken ML. Rare case of anaplastic plasmacytoma in the sinonasal tract. Head Neck 2021; 43:E46-E50. [PMID: 34272912 DOI: 10.1002/hed.26818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/10/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Extramedullary plasmacytomas are tumors that develop from plasma cells and rarely express anaplastic features. To our knowledge, there have only been three reported cases of anaplastic plasmacytomas of the sinonasal tract in the English literature. We detail the fourth case. METHODS A 70-year-old male was seen with a 4-month history of nasal congestion, bloody mucous, and left sided nasal obstruction. On positron emission tomography/computed tomography, the lesion was FDG-avid with an SUVmax of 25.1. A biopsy of the lesion and subsequent immunohistochemical staining confirmed the diagnosis of an anaplastic plasmacytoma. RESULTS The patient is undergoing a 5-week course of curative-intent radiation therapy. CONCLUSION Extramedullary plasmacytomas with anaplastic features are very rare. We highlight the value of thorough histopathological review and detailed immunostains to arrive at a diagnosis of anaplastic extramedullary plasmacytoma.
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Affiliation(s)
- Monica H Xing
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - Ariana L Shaari
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - John E Beute
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA
| | - Neil Mundi
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ammar Matloob
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Azita S Khorsandi
- Department of Radiology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Gregory Wisdom
- Department of Otolaryngology, Caremount Medical Katonah Office, Katonah, New York, USA
| | - Mark L Urken
- The Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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4
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Mendoza H, Tormey CA, Rinder HM, Howe JG, Siddon AJ. The utility and limitations of B- and T-cell gene rearrangement studies in evaluating lymphoproliferative disorders. Pathology 2020; 53:157-165. [PMID: 33358756 DOI: 10.1016/j.pathol.2020.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/05/2020] [Accepted: 09/10/2020] [Indexed: 12/16/2022]
Abstract
A hallmark of lymphoid malignancies is the presence of a monoclonal lymphocyte population. Monoclonality of B- and T-cell populations can be established through immunoglobulin (IG) or T-cell receptor (TCR) gene rearrangement analysis, respectively. The biological rationale of IG and TCR gene rearrangement analysis is that due to the extensive combinatorial repertoire made possible by V(D)J recombination in lymphocytes, it is unlikely that any substantive lymphocyte population would share the same IG or TCR gene rearrangement pattern unless there is an underlying neoplastic or reactive origin. Modern IG and TCR gene rearrangement analysis is typically performed by polymerase chain reaction (PCR) using commercially available primer sets followed by gel capillary electrophoresis. This process is highly sensitive in the detection of nearly all lymphoid malignancies. Several pitfalls and limitations, both biological and technical, apply to IG/TCR gene rearrangement analysis, but these can be minimised with high quality controls, performance of assays in duplicate, and adherence to strict criteria for interpreting and reporting results. Next generation sequencing (NGS) will likely replace PCR based methods of IG/TCR gene rearrangement analysis but is not yet widespread due to the absence of standardised protocols and multicentre validation.
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Affiliation(s)
- Hadrian Mendoza
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Henry M Rinder
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA; Hematology Section, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - John G Howe
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Alexa J Siddon
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA; Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
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5
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Nishimura N, Takeuchi K, Asaka R, Tuyama N, Inoue N, Kusano Y, Mishima Y, Yokoyama M, Terui Y. MYD88 L265P mutation detected by digital PCR as a prognostic factor in patients with diffuse large B-cell lymphoma in rituximab era. Leuk Res 2020; 97:106426. [PMID: 32781214 DOI: 10.1016/j.leukres.2020.106426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/03/2020] [Accepted: 07/19/2020] [Indexed: 01/02/2023]
Abstract
The central nervous system (CNS) relapse in patients with diffuse large B cell lymphoma (DLBCL) is fatal as there are no effective rescue treatments. To test if the presence of the MYD88 L265P mutation is a prognostic factor for secondary CNS relapse, we carried out the digital PCR analysis of 134 samples from patients with DLBCL at diagnosis. The MYD88 L265P mutations were detected in 22 (16.4%) patients, particularly in those with a non-GC subtype, CD5-positive, high absolute monocyte count, extra-nodal lymphoma, and B symptoms. Nine patients showed low signal in digital PCR but were deemed positive for the MYD88 L265P mutation by the nested allele-specific PCR. The remaining 103 patients were negative according to the results of both the PCR analyses. With a median follow-up period of 64 months, the carriers of MYD88 L265P mutation exhibited inferior CNS relapse-free survival at 5 years (53.2% versus 96% and 100%, respectively, P < 0.001) with a significant effect of the mutation demonstrated by the multivariate analysis (hazard ratio 5.1; 95% CI 1.2-22.9, P = 0.02). This suggests that the MYD88 L265P mutation plays a critical role in the progression of DLBCL to CNS.
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Affiliation(s)
- Noriko Nishimura
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Kengo Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Reimi Asaka
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoko Tuyama
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Norihito Inoue
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshiharu Kusano
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuko Mishima
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masahiro Yokoyama
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yasuhito Terui
- Division of Hematology/Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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6
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PKN1 kinase-negative knock-in mice develop splenomegaly and leukopenia at advanced age without obvious autoimmune-like phenotypes. Sci Rep 2019; 9:13977. [PMID: 31562379 PMCID: PMC6764976 DOI: 10.1038/s41598-019-50419-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/30/2019] [Indexed: 01/08/2023] Open
Abstract
Protein kinase N1 (PKN1) knockout (KO) mice spontaneously form germinal centers (GCs) and develop an autoimmune-like disease with age. Here, we investigated the function of PKN1 kinase activity in vivo using aged mice deficient in kinase activity resulting from the introduction of a point mutation (T778A) in the activation loop of the enzyme. PKN1[T778A] mice reached adulthood without external abnormalities; however, the average spleen size and weight of aged PKN1[T778A] mice increased significantly compared to aged wild type (WT) mice. Histologic examination and Southern blot analyses of spleens showed extramedullary hematopoiesis and/or lymphomagenesis in some cases, although without significantly different incidences between PKN1[T778A] and WT mice. Additionally, flow cytometry revealed increased numbers in B220+, CD3+, Gr1+ and CD193+ leukocytes in the spleen of aged PKN1[T778A] mice, whereas the number of lymphocytes, neutrophils, eosinophils, and monocytes was reduced in the peripheral blood, suggesting an advanced impairment of leukocyte trafficking with age. Moreover, aged PKN1[T778A] mice showed no obvious GC formation nor autoimmune-like phenotypes, such as glomerulonephritis or increased anti-dsDNA antibody titer, in peripheral blood. Our results showing phenotypic differences between aged Pkn1-KO and PKN1[T778A] mice may provide insight into the importance of PKN1-specific kinase-independent functions in vivo.
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7
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Nagai LAE, Park SJ, Nakai K. Analyzing the 3D chromatin organization coordinating with gene expression regulation in B-cell lymphoma. BMC Med Genomics 2019; 11:127. [PMID: 30894186 PMCID: PMC7402584 DOI: 10.1186/s12920-018-0437-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 11/21/2018] [Indexed: 01/11/2023] Open
Abstract
Background Eukaryotes compact chromosomes densely and non-randomly, forming three-dimensional structures. Alterations of the chromatin structures are often associated with diseases. In particular, aggressive cancer development from the disruption of the humoral immune system presents abnormal gene regulation which is accompanied by chromatin reorganizations. How the chromatin structures orchestrate the gene expression regulation is still poorly understood. Herein, we focus on chromatin dynamics in normal and abnormal B cell lymphocytes, and investigate its functional impact on the regulation of gene expression. Methods We conducted an integrative analysis using publicly available multi-omics data that include Hi-C, RNA-seq and ChIP-seq experiments with normal B cells, lymphoma and ES cells. We processed and re-analyzed the data exhaustively and combined different scales of genome structures with transcriptomic and epigenetic features. Results We found that the chromatin organizations are highly preserved among the cells. 5.2% of genes at the specific repressive compartment in normal pro-B cells were switched to the permissive compartment in lymphoma along with increased gene expression. The genes are involved in B-cell related biological processes. Remarkably, the boundaries of topologically associating domains were not enriched by CTCF motif, but significantly enriched with Prdm1 motif that is known to be the key factor of B-cell dysfunction in aggressive lymphoma. Conclusions This study shows evidence of a complex relationship between chromatin reorganization and gene regulation. However, an unknown mechanism may exist to restrict the structural and functional changes of genomic regions and cognate genes in a specific manner. Our findings suggest the presence of an intricate crosstalk between the higher-order chromatin structure and cancer development. Electronic supplementary material The online version of this article (10.1186/s12920-018-0437-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Luis Augusto Eijy Nagai
- Department of Computational Biology and Medical Science, the University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-shi, Chiba, 277-8562, Japan
| | - Sung-Joon Park
- Human Genome Center, the Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai Minato-ku, Tokyo, 108-8639, Japan
| | - Kenta Nakai
- Department of Computational Biology and Medical Science, the University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa-shi, Chiba, 277-8562, Japan. .,Human Genome Center, the Institute of Medical Science, the University of Tokyo, 4-6-1 Shirokanedai Minato-ku, Tokyo, 108-8639, Japan.
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8
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Villa A, Cairo G, Pozzi MR, Schiaffonati L, Bardella L, Lucchini R, Delia D, Besana C, Biunno I, Vezzoni P. Lack of TdT and Immunoglobulin and T-Cell Receptor Gene Rearrangements in Hodgkin's Disease. Int J Biol Markers 2018; 2:65-70. [PMID: 3132516 DOI: 10.1177/172460088700200202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To study the pathogenesis of Hodgkin's disease (HD), which today remains obscure, we have undertaken a combined experimental approach: determination of TdT and molecular analysis of rearrangements of immunoglobulin heavy chain (IgH), T-cell receptor (TCR) beta chain and the T-cell rearranging gamma (TRG) genes. TdT determination indicate would the presence of immature cells that are not detected in the normal lymphnode; molecular analysis of the rearrangements of these genes would reveal the presence of even a small monoclonal population of both T and B lineages in the lymphnodes. We believe that the combination of these two types of analysis can indicate whether an expanding lymphoid clone is responsible for this disease. TdT determination was negative in all 41 cases tested. Gene rearrangements were studied in 10 cases for IgH and TCR beta genes and in 5 cases for the TRG gene. No abnormal band beside the germ-line ones was detected in any of our cases, ruling out the presence of a minor neoplastic population. We can explain these results in at least three ways: first, the neoplastic population could represent less than 1% of the total, thus escaping detection by current techniques; second, the neoplastic population is not lymphoid in nature or is composed of mature cells that do not rearrange Ig and TCR genes and therefore belongs to a true non-B, non-T lineage; third, the pathogenesis of HD is completely different from that of non-Hodgkin's lymphomas (NHL) and does not involve the clonal expansion of a cell frozen at a particular maturative stage as is thought to happen in most NHL.
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Affiliation(s)
- A Villa
- Centro Studi di Fisiologia del Lavoro Muscolare, CNR, Milano, Italy
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9
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Alkan S, Diaz JI, Sandin RL. Techniques of Diagnostic Molecular Pathology. Cancer Control 2018. [DOI: 10.1177/107327489500200211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Serhan Alkan
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
| | - Jose I. Diaz
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
| | - Ramon L. Sandin
- Department of Pathology H. Lee Moffitt Cancer Center & Research Institute
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10
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Alaibac M, Paradiso A, Giannella C, Labriola A, Marzullo F, Lorusso V, De Lena M. Immunoglobulin Heavy Chain Gene Rearrangement in B-Cell Non-Hodgkin's Lymphomas Detected by the Polymerase Chain Reaction. TUMORI JOURNAL 2018; 81:128-31. [PMID: 7778215 DOI: 10.1177/030089169508100211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background Immunoglobulin heavy chain gene rearrangement serves as a marker of clonality and cell lineage in B-cell lymphoproliferative disorders. In this study we used the polymerase chain reaction (PCR) to detect clonal rearrangements of the immunoglobulin heavy chain gene in a group of patients with B-cell lymphomas. Methods DNA was extracted from frozen tissue of 40 B-cell non-Hodgkin's lymphomas and subjected to PCR amplification using primers that recognize conserved sequences of the variable and joining regions of the immunoglobulin heavy chain gene. Results Monoclonal rearrangements were detected in 23 of 40 malignant B-cell lymphomas. No clonal rearrangements were detected in the 10 control cases. Conclusions We conclude that this PCR-based technique may provide a simplified and rapid approach for the detection of clonal immunoglobulin heavy chain gene rearrangements in B-cell lymphomas without recourse to Southern blotting, which can be reserved for cases in which PCR is negative.
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Affiliation(s)
- M Alaibac
- Experimental and Clinical Oncology Laboratory, Oncology Institute, Bari, Italy
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11
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Palumbo AP, Pileri A, Battaglio S, Omedè P, Redoglia V, Massaia M, Dianzani U, Boccadoro M. Monoclonal Immunoglobulin Gene Rearrangement in Peripheral Lymphocytes of a Patient with Multiple Myeloma. TUMORI JOURNAL 2018; 75:1-3. [PMID: 2711468 DOI: 10.1177/030089168907500101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We analyzed the immunoglobulin (Ig) heavy chain gene rearrangement in the peripheral blood lymphocytes of a patient with multiple myeloma (MM). Although the morphological and immunological examination did not reveal the presence of circulating plasma cells, a monoclonal Ig gene rearrangement was detected. This observation indicates that a monoclonal expansion of circulating B cells was present in the peripheral lympocytes of this patient.
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Affiliation(s)
- A P Palumbo
- Department of Medicine and Experimental Oncology, University of Torino, Italy
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12
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Vogt SL, Patel M, Omar T, Pather S, Martinson N, Ambinder R. Molecular Diagnostics for AIDS Lymphoma Diagnosis in South Africa and the Potential for Other Low- and Middle-Income Countries. J Glob Oncol 2017; 4:1-6. [PMID: 30241211 PMCID: PMC6180762 DOI: 10.1200/jgo.17.00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Samantha L Vogt
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
| | - Moosa Patel
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
| | - Tanvier Omar
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
| | - Sugeshnee Pather
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
| | - Neil Martinson
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
| | - Richard Ambinder
- Samantha L. Vogt and Richard Ambinder, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Moosa Patel, Tanvier Omar, and Sugeshnee Pather, University of the Witwatersrand, Johannesburg; and Neil Martinson, Perinatal HIV Research Unit, Soweto, South Africa
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13
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The relative utilities of genome-wide, gene panel, and individual gene sequencing in clinical practice. Blood 2017; 130:433-439. [PMID: 28600338 DOI: 10.1182/blood-2017-03-734533] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/09/2017] [Indexed: 12/12/2022] Open
Abstract
Advances in technology that have transpired over the past 2 decades have enabled the analysis of cancer samples for genomic alterations to understand their biologic function and to translate that knowledge into clinical practice. With the power to analyze entire genomes in a clinically relevant time frame and with manageable costs comes the question of whether we ought to and when. This review focuses on the relative merits of 3 approaches to molecular diagnostics in hematologic malignancies: indication-specific single gene assays, gene panel assays that test for genes selected for their roles in cancer, and genome-wide assays that broadly analyze the tumor exomes or genomes. After addressing these in general terms, we review specific use cases in myeloid and lymphoid malignancies to highlight the utility of single gene testing and/or larger panels.
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14
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Yu L, Chen K, Xu Y, Wang S, Liu Q, Ye Q, Ye T, Sun Y. The value of EUS in combination with cytological, flow cytometry, and gene rearrangement in the diagnosis of gastrointestinal lymphoma. Hematol Oncol 2016; 35:303-309. [PMID: 27139890 DOI: 10.1002/hon.2298] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/14/2016] [Accepted: 03/17/2016] [Indexed: 12/26/2022]
Abstract
Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) have a great value in clinical practice of gastrointestinal lymphoma (GIL). Auxiliary methods such as flow cytometry (FCM) and gene rearrangement provide additional information for the diagnosis. Current study aims to explore the diagnostic value of EUS-FNA combined with FCM and gene rearrangement for GIL in our single institution. Suspected GIL cases, which were referred to EUS, FNA, FCM, or gene rearrangement examination, were retrospectively reviewed from January 2011 to May 2014. Definitive final diagnosis was included based on the pathological and immunostaining evidence. The gene scan analysis was applied for fragment detection in gene rearrangement. The sensitivity, specificity, and accuracy were considered and calculated. Fifty-three EUS cases were identified, including 38 GIL, 10 inflammations, 4 linitis plastica, and one multiple myeloma. EUS-FNA was successfully conducted in 39 out of 53 cases. After combined with FCM, the sensitivity, specificity, and accuracy were increased from 60.7% to 76.9%, 90.9% to 100%, and from 69.2% to 81.8% respectively. Among 33 cases for FCM, 11 of them gained positive B or T non-Hodgkin lymphoma diagnosis, and 28 out of 53 specimens were delivered for gene rearrangement. The sensitivity, specificity, and accuracy of gene rearrangement were 68.2%, 100%, and 75% respectively. EUS-FNA is a possible technique for the diagnosis of GIL, With additional FCM examination may further improve the diagnostic efficiency and facilitate subclassification. Moreover, gene rearrangement assay by gene scan is also a considerable method in the specimens from GIL. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Liu Yu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Infectious Disease, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ke Chen
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Changzheng Hospital, The Second Military Medical University, Shanghai, China
| | - Ying Xu
- Department of Gastroenterology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shubei Wang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianqian Liu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiao Ye
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingjun Ye
- Department of Cytological Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunwei Sun
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abbas F, Yazbek SN, Shammaa D, Hoteit R, Fermanian P, Mahfouz R. Invivoscribe BIOMED-2 primer mixes in B-cell immunoglobulin gene rearrangement studies: experience of a molecular diagnostics laboratory in a major tertiary care center. Genet Test Mol Biomarkers 2015; 18:787-90. [PMID: 25299065 DOI: 10.1089/gtmb.2014.0174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS To determine the frequency of positive reactions obtained using the Invivoscribe BIOMED-2 kit for B-cell gene rearrangement studies in leukemias and lymphomas. MATERIALS AND METHODS We reviewed the gel patterns for 192 samples tested, using the above-mentioned kit and matched the positive signal with the corresponding mix available in the assay kit. RESULTS 92.2% had immunoglobulin heavy-chain clonality, of which 74% were detected by the IgH VH-FR1+JH primer set, 75.5% by IgH VH-FR2+JH primer set, 65.1% by IgH VH-FR3+JH primer set, 26% by IgH DH+JH primer set, and 2.1% by IgH DH7+JH primer set. In addition, 55.7% had clonality in the kappa light chain, where 33.3% were positive by the IgK Vκ +Jκ primer set and 39.6% by IgK Vκ and INTR+Kde primer sets. Clonality in the lambda light chain of immunoglobulins was detected in 17.7% of specimens tested using the IgL Vλ +Jλ primer set. CONCLUSION All primer mixes provided by the assay were positive. Thus, the Invivoscribe BIOMED-2 B-cell gene rearrangement kit is very reliable in adequately covering all targets represented by the master mixes. This assay is an integral part of the differential diagnosis of clonal populations of cells. Our report is the first in the literature that describes the full range of coverage of the BIOMED-2 primer mixes provided in this assay.
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Affiliation(s)
- Fatmeh Abbas
- 1 Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center , Beirut, Lebanon
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16
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Parameswaran P, Liu Y, Roskin KM, Jackson KKL, Dixit VP, Lee JY, Artiles KL, Zompi S, Vargas MJ, Simen BB, Hanczaruk B, McGowan KR, Tariq MA, Pourmand N, Koller D, Balmaseda A, Boyd SD, Harris E, Fire AZ. Convergent antibody signatures in human dengue. Cell Host Microbe 2013; 13:691-700. [PMID: 23768493 DOI: 10.1016/j.chom.2013.05.008] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/03/2013] [Accepted: 04/30/2013] [Indexed: 01/05/2023]
Abstract
Dengue is the most prevalent mosquito-borne viral disease in humans, and the lack of early prognostics, vaccines, and therapeutics contributes to immense disease burden. To identify patterns that could be used for sequence-based monitoring of the antibody response to dengue, we examined antibody heavy-chain gene rearrangements in longitudinal peripheral blood samples from 60 dengue patients. Comparing signatures between acute dengue, postrecovery, and healthy samples, we found increased expansion of B cell clones in acute dengue patients, with higher overall clonality in secondary infection. Additionally, we observed consistent antibody sequence features in acute dengue in the highly variable major antigen-binding determinant, complementarity-determining region 3 (CDR3), with specific CDR3 sequences highly enriched in acute samples compared to postrecovery, healthy, or non-dengue samples. Dengue thus provides a striking example of a human viral infection where convergent immune signatures can be identified in multiple individuals. Such signatures could facilitate surveillance of immunological memory in communities.
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Affiliation(s)
- Poornima Parameswaran
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720-3370, USA
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17
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Wang H, Cao X, Liu EC, He D, Ma Y, Zhang T, Feng Y, Qin G. Prognostic significance of immunoglobulin M overexpression in laryngeal squamous cell carcinoma. Acta Otolaryngol 2013; 133:1080-7. [PMID: 23964818 DOI: 10.3109/00016489.2013.799776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
CONCLUSIONS Immunoglobulin (Ig) M is overexpressed in laryngeal squamous cell carcinoma (LSCC), and its expression has an independent protective impact on disease-free survival in LSCC. OBJECTIVE A number of studies have reported on the ectopic expression of Ig in cancer cells, yet there has been a lack of understanding of its clinical and prognostic significance. This study aimed to investigate the expression of IgM in resected specimens of LSCC and to evaluate its clinical significance and prognostic value. METHODS Immunohistochemistry (IHC) and Western blotting were used to detect the expression of IgM in LSCC and normal laryngeal tissues. The serum level of IgM was also analyzed by immunoturbidimetric assay. RESULTS IHC and Western blot studies demonstrated that IgM was overexpressed in LSCC specimens (p < 0.001), while the serum level of IgM in patients with LSCC was not different from healthy controls. Chi-squared analysis revealed that the expression level of IgM was negatively correlated with regional lymph node metastasis and tumor stage (p = 0.011 and 0.025, respectively). Univariate analysis showed that IgM expression was significantly correlated with enhanced disease-free survival (DFS) (p = 0.004). In multivariate analysis, IgM retained its independent prognostic value for DFS (p = 0.048, HR = 0.506, 95% CI = 0.257-0.995).
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Affiliation(s)
- Haiyang Wang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Hospital of Luzhou Medical College , Luzhou, P.R. China
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18
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Sykes PJ, Morley AA. Molecular Biology Techniques in Malignant Lymphoma. J Histotechnol 2013. [DOI: 10.1179/his.1992.15.3.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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19
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Schrijver I, Natkunam Y, Galli S, Boyd SD. Integration of genomic medicine into pathology residency training: the stanford open curriculum. J Mol Diagn 2013; 15:141-8. [PMID: 23313248 DOI: 10.1016/j.jmoldx.2012.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/10/2012] [Accepted: 11/28/2012] [Indexed: 10/27/2022] Open
Abstract
Next-generation sequencing methods provide an opportunity for molecular pathology laboratories to perform genomic testing that is far more comprehensive than single-gene analyses. Genome-based test results are expected to develop into an integral component of diagnostic clinical medicine and to provide the basis for individually tailored health care. To achieve these goals, rigorous interpretation of high-quality data must be informed by the medical history and the phenotype of the patient. The discipline of pathology is well positioned to implement genome-based testing and to interpret its results, but new knowledge and skills must be included in the training of pathologists to develop expertise in this area. Pathology residents should be trained in emerging technologies to integrate genomic test results appropriately with more traditional testing, to accelerate clinical studies using genomic data, and to help develop appropriate standards of data quality and evidence-based interpretation of these test results. We have created a genomic pathology curriculum as a first step in helping pathology residents build a foundation for the understanding of genomic medicine and its implications for clinical practice. This curriculum is freely accessible online.
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Affiliation(s)
- Iris Schrijver
- Department of Pathology, Stanford University School of Medicine, Stanford, California 94305, USA.
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20
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EuroClonality/BIOMED-2 guidelines for interpretation and reporting of Ig/TCR clonality testing in suspected lymphoproliferations. Leukemia 2012; 26:2159-71. [PMID: 22918122 PMCID: PMC3469789 DOI: 10.1038/leu.2012.246] [Citation(s) in RCA: 340] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PCR-based immunoglobulin (Ig)/T-cell receptor (TCR) clonality testing in suspected lymphoproliferations has largely been standardized and has consequently become technically feasible in a routine diagnostic setting. Standardization of the pre-analytical and post-analytical phases is now essential to prevent misinterpretation and incorrect conclusions derived from clonality data. As clonality testing is not a quantitative assay, but rather concerns recognition of molecular patterns, guidelines for reliable interpretation and reporting are mandatory. Here, the EuroClonality (BIOMED-2) consortium summarizes important pre- and post-analytical aspects of clonality testing, provides guidelines for interpretation of clonality testing results, and presents a uniform way to report the results of the Ig/TCR assays. Starting from an immunobiological concept, two levels to report Ig/TCR profiles are discerned: the technical description of individual (multiplex) PCR reactions and the overall molecular conclusion for B and T cells. Collectively, the EuroClonality (BIOMED-2) guidelines and consensus reporting system should help to improve the general performance level of clonality assessment and interpretation, which will directly impact on routine clinical management (standardized best-practice) in patients with suspected lymphoproliferations.
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21
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Yoshida M, Ichikawa A, Miyoshi H, Takeuchi M, Kimura Y, Nino D, Ohshima K. High frequency of t(14;18) in Hodgkin's lymphoma associated with follicular lymphoma. Pathol Int 2012; 62:518-24. [PMID: 22827759 DOI: 10.1111/j.1440-1827.2012.02835.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
t(14;18) is a common cytogenetic abnormality in B-cell lymphoma, especially in follicular lymphoma (FL), but is rarely seen in Hodgkin's lymphoma (HL). However, due to the small number of cases, the incidence of t(14;18) in HL associated with FL remains unclear. In this study, we applied chromogenic in situ hybridization and fluorescence in situ hybridization for t(14;18) on paraffin-embedded tissue from four HL associated with FL cases and 11 HL cases without a history of FL for comparison. t(14;18) was present in all of the three successfully-tested HL associated with FL cases and one case without a history of FL. The frequency of t(14;18) was significantly high in HL associated with FL (p = 0.013). All Hodgkin's and Reed-Sternberg (HRS) cells having t(14;18) showed immunoreactivity for BCL2 and were negatively stained for nuclear factor-κB (NF-κB), even in Epstein-Barr virus (EBV)-infected cases. However, HRS cells without t(14;18) showed BCL2 and NF-κB immunoreactivity in 33% and 57% of cases, respectively. There was an inverse correlation between t(14;18) and NF-κB. In conclusion, we assume the incidence of t(14;18) in HL associated with FL is higher than previously believed and BCL2 expression derived from t(14;18) may play a role in the pathogenesis of HL associated with FL.
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Affiliation(s)
- Maki Yoshida
- Department of Pathology, School of Medicine, Kurume University, Kurume city, Fukuoka, Japan.
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22
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Orita Y, Sato Y, Kondo E, Ishihara H, Hirai H, Hanakawa H, Onoda T, Igawa T, Saito R, Nishizaki K, Yoshino T. Minimally Invasive Procedure for Accurate Diagnosis of Mucosa-associated Lymphoid Tissue Lymphoma of the Head and Neck. Jpn J Clin Oncol 2012; 42:325-30. [DOI: 10.1093/jjco/hys011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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23
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Diss TC, Molina TJ, Cabeçadas J, Langerak AW. Molecular diagnostics in lymphoma: why, when and how to apply. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.mpdhp.2011.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Payne K, Wright P, Grant JW, Huang Y, Hamoudi R, Bacon CM, Du MQ, Liu H. BIOMED-2 PCR assays for IGK gene rearrangements are essential for B-cell clonality analysis in follicular lymphoma. Br J Haematol 2011; 155:84-92. [DOI: 10.1111/j.1365-2141.2011.08803.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Ferrero S, Drandi D, Mantoan B, Ghione P, Omedè P, Ladetto M. Minimal residual disease detection in lymphoma and multiple myeloma: impact on therapeutic paradigms. Hematol Oncol 2011; 29:167-76. [PMID: 22678691 DOI: 10.1002/hon.989] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Early identification of patients at high risk of relapse is a major goal of current translational research in oncohematology. Minimal residual disease (MRD) detection by polymerase chain reaction-based methods is currently part of the routine clinical management of patients with acute lymphoblastic leukemia. However, the current knowledge indicates that it is also a useful prognostic tool in several mature lymphoproliferative disorders. Its utility is currently well established in follicular lymphoma, mantle cell lymphoma, and multiple myeloma. In some of these entities, clinical trials employing MRD as a decision-making tool are currently ongoing. In the present review, we will discuss the 'state of the art' of MRD evaluation in these three neoplasms with the ultimate aim of providing critical take-home messages for clinicians working in the field. Moreover, we will outline the role of MRD detection in the design of future clinical trials.
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Affiliation(s)
- Simone Ferrero
- Division of Hematology, Department of Experimental Medicine and Oncology, University of Torino, Turin, Italy
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26
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27
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Ke X, Wang J, Gao Z, Zhao L, Li M, Jing H, Wang J, Zhao W, Gilbert H, Yang XF. Clinical characteristics and prognostic analysis of Chinese patients with diffuse large B-cell lymphoma. Blood Cells Mol Dis 2009; 44:55-61. [PMID: 19819170 DOI: 10.1016/j.bcmd.2009.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Indexed: 12/27/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma in adults. As it is a highly heterogenous disease, many studies have focused on finding useful prognostic factors to help guide therapy. In this report, we examine several biological markers in 83 patients with DLBCL enrolled in our hospital, including cell origin, serum lactate dehydrogenase (LDH) levels, and international prognostic index (IPI), in order to find the best combination of prognostic factors. We also examined whether DLBCL has a significant geographic difference, since several studies have suggested that the prevalence and potential etiological factors of lymphomas in China may be different from those in other countries. Our results demonstrate that: (1) patients in China have higher extranodal tissue involvement and different extranodal organ distribution than patients reported from other countries; (2) Chinese patients have higher rates of germinal center (GC) cell origin; and (3) among nine prognostic variables, lower IPI scores, GC cell origin determined by immunohistochemical staining, and no more than 1.5 times of normal levels of LDH are statistically significant good prognostic factors in Chinese patients with DLBCL, whereas age at the time of diagnosis, clinical stage, beta(2)-microglobulin levels, extranodal tissue involvement, and expression levels of Bcl-6 protein were not useful in determining prognosis.
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Affiliation(s)
- Xiaoyan Ke
- Department of Hematology and Lymphoma Research Center, Peking University Third Hospital, Beijing 100191, PR China.
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28
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Knauf WU, Ho AD, Heger G, Hoelzer D, Hunstein W, Thiel E. Detection of Minimal Residual Disease in Adult Acute Lymphoblastic Leukemia by Analysis of Gene Rearrangements and Correlation with Early Relapses. Leuk Lymphoma 2009; 5:57-63. [DOI: 10.3109/10428199109068105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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Affiliation(s)
- Lode J. Swinnen
- Section Hematology/Oncology, Loyola University of Chicago, Maywood, IL and Hines VA Hospital, Hines, Illinois, USA
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30
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Sze DMY, Brown RD, Yuen E, Gibson J, Ho J, Raitakari M, Basten A, Joshua DE, Fazekas de St Groth B. Clonal Cytotoxic T Cells in Myeloma. Leuk Lymphoma 2009; 44:1667-74. [PMID: 14692517 DOI: 10.1080/1042819031000097438] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Multiple myeloma (MM) is a malignant disease characterized by accumulation of morphologically recognizable plasma cells producing immunoglobulin (Ig) in the bone marrow. The occurrence of clonal T cells in MM, as defined by the presence of rearrangements in the T-cell receptor (TCR)-beta chains detected on Southern blotting, is associated with an improved prognosis. This review aims to describe the various ways in which we have demonstrated the presence of such T cell clones, and to describe the phenotype of these cells. Finally, the specificities of these clinically important CD8+ T cell populations will be discussed in the context of immunotherapy.
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Affiliation(s)
- Daniel M Y Sze
- Institute of Haematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
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31
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Montillo M, Schinkoethe T, Elter T. Eradication of Minimal Residual Disease with Alemtuzumab in B-Cell Chronic Lymphocytic Leukemia (B-CLL) Patients: The Need for a Standard Method of Detection and the Potential Impact of Bone Marrow Clearance on Disease Outcome. Cancer Invest 2009; 23:488-96. [PMID: 16203656 DOI: 10.1080/07357900500201418] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The introduction of new therapeutic agents, such as fludarabine phosphate (Fludara) and alemtuzumab (MabCampath, Campath), has made it possible to treat B-cell chronic lymphocytic leukemia (B-CLL) more effectively, compared with alkylating agents. However, although an increasing number of patients are able to achieve complete remission (CR), relapse is almost inevitable, because of the re-emergence of the malignant clone from small numbers of residual malignant cells. This phenomenon has introduced a need for a more sensitive assessment of low-level disease which, in turn, has encouraged the development of therapies aimed at the eradication of all residual disease in CR patients. The eradication of residual disease is associated with improved remission durability and has great potential in offering the possibility of cure. Alemtuzumab is the foundation of many eradication-based treatment approaches because of its ability to achieve clinical remissions and to successfully purge minimal residual disease (MRD) from both blood and bone marrow in B-CLL patients. This article describes and compares polymerase chain reaction (PCR) and flow cytometric methodologies for the assessment of MRD, and presents data demonstrating that alemtuzumab can eliminate residual malignant cells from blood and bone marrow (whether assessed by PCR or flow cytometry) at the highest levels of sensitivity currently available. The ability to clear MRD from bone marrow in patients achieving clinical CR using alemtuzumab is a significant step forward in the treatment of B-CLL, and supports treatment strategies in which alemtuzumab is used in combination with other agents. Purging of MRD from both blood and bone marrow also enables patients to proceed to autologous hematopoietic stem cell transplantation, a strategy that is able to achieve long-term remission.
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MESH Headings
- Alemtuzumab
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/therapeutic use
- Antineoplastic Agents/therapeutic use
- Clinical Trials as Topic
- Flow Cytometry
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/drug therapy
- Polymerase Chain Reaction
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Affiliation(s)
- Marco Montillo
- Division of Haematology, Department of Oncology-Haematology, Niguarda Ca'Granda Hospital, Milan, Italy.
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32
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Zheng J, Huang J, Mao Y, Liu S, Sun X, Zhu X, Ma T, Zhang L, Ji J, Zhang Y, Yin CC, Qiu X. Immunoglobulin gene transcripts have distinct VHDJH recombination characteristics in human epithelial cancer cells. J Biol Chem 2009; 284:13610-13619. [PMID: 19293154 DOI: 10.1074/jbc.m809524200] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
It was well accepted that only B-lymphocytes and plasma cells expressed immunoglobulin (Ig) gene. However, our group and others have confirmed that non-B-cells, such as epithelial cancer cells, can also express Ig. The aim of this work is to elucidate the role of non-B-cell-derived Ig by investigating the characteristics of the Ig heavy chain (IgH) gene repertoire in epithelial cancer cells. We cloned and sequenced 89 V(H)DJ(H) (V-D-J recombination of the IgH variable region) transcripts by microdissecting cells from eight different types of epithelial cancers and two cancer cell lines (HT-29 and HeLa S3). The cancer-derived Ig gene repertoire showed specific restricted patterns of V(H)DJ(H) recombination with seven sets of predominant V(H)DJ(H) sequences. Surprisingly, within a set of V(H)DJ(H) recombination, the variable (V) sequences derived from different cancer types had not only identical heavy chain variable (VH), diversity (D), and joining (JH) segments usage, but also identical junctions and mutation targets in the V(H) region. The V(Hgamma)DJ(Hgamma) (but not V(Hmicro)DJ(Hmicro)) in the cancer-derived sequences had a high mutation rate; however, it was shown that the mechanism of hypermutation was different from antigen selection in B-cell-derived V(Hgamma)DJ(Hgamma)sequences. In contrast to V(Hmicro)DJ(Hmicro), the V(Hgamma)DJ(Hgamma) sequences did not appear to originate from classical class switching. These results suggest that cancer-derived Ig genes have a distinct repertoire that may have implications for their role in carcinogenesis.
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Affiliation(s)
- Jie Zheng
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Jing Huang
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Yuntao Mao
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Shiqing Liu
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Xin Sun
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Xiaohui Zhu
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Teng Ma
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Li Zhang
- Peking University Center for Human Disease Genomics, Beijing, 100191, China
| | - Jiafu Ji
- Department of Surgery, Peking University School of Oncology, Beijing, 100142, China
| | - Youhui Zhang
- Department of Immunology, Cancer Institute, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100021, China
| | - C Cameron Yin
- Department of Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030
| | - Xiaoyan Qiu
- Peking University Center for Human Disease Genomics, Beijing, 100191, China.
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Ishikawa CC, Ab'Saber AM, Parra ER, Lin CJ, Barbas CSV, Capelozzi VL. [Immunophenotyping and gene rearrangement analysis in lymphoid/lymphoproliferative disorders of the lungs]. J Bras Pneumol 2008; 33:625-34. [PMID: 18200361 DOI: 10.1590/s1806-37132007000600004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Accepted: 04/11/2007] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the usefulness, in routine practice, of using polymerase chain reaction to analyze B and T lymphocyte clonality in pulmonary tissue as a tool for the diagnosis of pulmonary lymphoproliferative disorders. METHODS Immunohistochemistry and molecular gene rearrangement analysis were performed in order to assess 8 cases of lymphoid interstitial pneumonia (LIP) and 7 cases of pulmonary lymphoproliferative disorders. RESULTS All 8 cases of LIP presented moderate to strong immunostaining for CD3, compared with only 2 cases of lymphoma and 1 case of pseudolymphoma (p = 0.02). Gene rearrangement was detected in 4 of the 8 cases, which changed the diagnosis from LIP to lymphoma, showing the importance of gene rearrangement detection in cases of LIP. In this situation, gene rearrangement using the VH/JH and Vgamma11/Jgamma12 primer pairs was detected in 3 cases and 1 case, respectively, and no gene abnormalities were found using the Dbeta1/Jbeta2 and Vgamma101/Jgamma12 primer pairs in any of the cases. A significant positive association was found between the intensity of CD20 and CD68 expression and gene rearrangement using the VH/JH primer pair. Prior to the gene rearrangement, 4 patients with LIP died quickly, whereas only one patient with LIP died after the gene rearrangement. CONCLUSIONS Detection of monoclonal B and T cells by immunophenotyping and polymerase chain reaction had an impact on the diagnosis of pulmonary lymphomas in patients previously diagnosed with LIP. Therefore, immunophenotyping and polymerase chain reaction should be used as 'gold standard' techniques in routine practice.
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Longtine J, Fox E, Reynolds C, Sklar J. Molecular analysis of DNA rearrangements in leukemias and non-Hodgkin's lymphomas. CURRENT PROTOCOLS IN HUMAN GENETICS 2008; Chapter 10:Unit 10.4. [PMID: 18428241 DOI: 10.1002/0471142905.hg1004s02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Genetic markers for leukemias and lymphomas include chromosomal translocations and antigen-receptor gene rearrangements. Clonal rearrangements of immunoglobulin or T cell receptor (TCR) genes reflect clonal proliferations of lymphocytes, a characteristic feature of lymphoid neoplasia. These rearrangements can be detected as described in this unit by Southern blot hybridization or, in many instances, the polymerase chain reaction (PCR). Specific chromosomal translocations can also serve as markers for clonality, for malignant transformation, and for various defined subtypes of hematopoietic cancers. PCR protocols are described for detection of the two most commonly assayed translocations, t(9;22) of chronic myelogenous leukemia or acute lymphoblastic leukemia, and t(14;18) of follicular lymphomas.
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Affiliation(s)
- J Longtine
- Brigham and Women's Hospital, Boston, Massachusetts, USA
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35
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Takiyama A, Nishihara H, Tateishi U, Kimura T, Wang L, Lei W, Marukawa K, Itoh T, Hashino S, Nagashima K, Tanaka S. CNS lymphomatoid granulomatosis with lymph node and bone marrow involvements. Neuropathology 2008; 28:640-4. [PMID: 18410281 DOI: 10.1111/j.1440-1789.2008.00903.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphomatoid granulomatosis (LYG) in the CNS is an uncommon lymphoproliferative disease with characteristic angiocentric lymphoreticular proliferative and granulomatous lesions exhibiting low-grade malignant potential. Here we report a rare case of CNS-LYG, which disseminated to the lymph node and bone marrow. A 50-year-old man was diagnosed with CNS-LYG based on brain biopsy showing perivascular infiltration of CD3-positive small T-lymphocytes without overt nuclear atypism. Eight months after the initial neurological symptoms, inguinal lymph node swelling was found and histopathologically diagnosed as peripheral T-cell lymphoma. TCRgamma-gene rearrangement study using both paraffin-embedded specimens of brain and inguinal lymph node demonstrated an identical clonal band. Considering the clinical course, we concluded lymph node involvement of CNS-LYG, suggesting the malignant potential of CNS-LYG.
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Affiliation(s)
- Akihiro Takiyama
- Laboratory of Molecular and Cellular Pathology, Hokkaido University School of Medicine, Kita-Ku, Sapporo, Japan
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Setyadi HG, Nash JW, Duvic M. The solitary lymphomatous papule, nodule, or tumor. J Am Acad Dermatol 2007; 57:1072-83. [PMID: 17706321 DOI: 10.1016/j.jaad.2007.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 06/30/2007] [Accepted: 07/07/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lymphoma and reactive lymphoid infiltrates presenting as solitary lesion pose a diagnostic and prognostic dilemma for the clinician. OBJECTIVE We sought to review prognosis and treatment of suggestive solitary lymphoma lesions. METHODS A retrospective chart review was conducted in 27 patients who presented with a single solitary lesion suggestive of lymphoma at a cancer center. RESULTS Eighteen of 27 patients' (66.7%) lesions were diagnosed as lymphoma by histology and the remainder was classified as reactive lymphoid infiltrates. Only one patient's lymphoma was systemic at presentation and one progressed later. In all, 23 patients (85.2%) subsequently experienced prolonged, complete remissions. The treatments used varied from none or conservative to chemotherapy, with the more aggressive treatments directed especially against lymphomas or recurrent diseases. LIMITATIONS This study is limited by the number of patients and follow-up duration (average 36.8 months, range 3-133 months). CONCLUSION Patients presenting with a solitary lesion suggestive of lymphoma and negative staging work-up results generally have a good prognosis. Excellent prognosis is usually expected for benign lesions.
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Baehring JM, Landry ML, Cooper D, Hui P, Bannykh S. CSF IgH gene rearrangement analysis in isolated post-transplant lymphoproliferative disorder of the central nervous system. J Neurooncol 2007; 86:57-60. [PMID: 17909942 DOI: 10.1007/s11060-007-9429-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2007] [Accepted: 05/31/2007] [Indexed: 11/30/2022]
Abstract
Isolated post-transplant lymphoproliferative disorder (PTLD) of the central nervous system is rare and its diagnosis can be challenging. A biopsy is usually required in order to distinguish the disease from opportunistic infections. We present a case in whom immunoglobulin heavy chain gene rearrangement analysis of cerebrospinal fluid (CSF) was instrumental in establishing the diagnosis.
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Affiliation(s)
- Joachim M Baehring
- Department of Neurology and Neurosurgery, Yale University School of Medicine, 333 Cedar Street, TMP412, New Haven, CT 06510, USA.
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Kriangkum J, Taylor BJ, Treon SP, Mant MJ, Reiman T, Belch AR, Pilarski LM. Molecular Characterization of Waldenstrom's Macroglobulinemia Reveals Frequent Occurrence of Two B-Cell Clones Having Distinct IgH VDJ Sequences. Clin Cancer Res 2007; 13:2005-13. [PMID: 17404080 DOI: 10.1158/1078-0432.ccr-06-2788] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Malignant B lineage cells in Waldenstrom's macroglobulinemia (WM) express a unique clonotypic IgM VDJ. The occurrence of biclonal B cells and their clonal relationships were characterized. EXPERIMENTAL DESIGN Bone marrow and blood from 20 WM patients were analyzed for clonotypic VDJ sequences, clonal B-cell frequencies, and the complementary determining region 3 profile. RESULTS Two different clonotypic VDJ sequences were identified in 4 of 20 WM. In two cases, partner clones had different VDJ rearrangements, with one clonotypic signature in bone marrow and a second in blood. For both cases, the bone marrow clone was hypermutated, whereas the blood clone was germ line or minimally mutated. In two other cases, partner clones shared a common VDJ rearrangement but had different patterns of somatic mutations. They lacked intraclonal diversity and were more abundant in bone marrow than in blood. VDJ mutation profiles suggested they arose from a common IgM progenitor. Single-cell analysis in one case indicated the partner clones were reciprocally expressed, following rules of allelic exclusion. CONCLUSIONS The existence of two B-cell clones having distinct VDJ sequences is common in WM, suggesting that frequent transformation events may occur. In two cases, the partner clones had distinct tissue distributions in either blood or bone marrow, were of different immunoglobulin isotypes, and in one case exhibited differential response to therapy. The contributions of each clone are unknown. Their presence suggests that WM may involve a background of molecular and cellular events leading to emergence of one or more malignant clones.
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Affiliation(s)
- Jitra Kriangkum
- Departments of Oncology, Cross Cancer Institute and Medicine, University of Alberta, Edmonton, Canada
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Baehring JM, Hochberg FH, Betensky RA, Longtine J, Sklar J. Immunoglobulin gene rearrangement analysis in cerebrospinal fluid of patients with lymphoproliferative processes. J Neurol Sci 2006; 247:208-16. [PMID: 16764890 DOI: 10.1016/j.jns.2006.05.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 03/24/2006] [Accepted: 05/02/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the sensitivity and specificity of clonal immunoglobulin heavy chain gene rearrangement (IGHR) analysis in the distinction of benign and malignant lymphoproliferative diseases. METHODS A retrospective analysis was conducted of patients in whom a malignant lymphoproliferative process was suspected. Cells of CSF samples were collected by centrifugation, resuspended in 100 microl of the supernatant and boiled. A 10 microl aliquot of this lysate served as template for semi-nested polymerase chain reaction using variable and joining region consensus primers. PCR products were analyzed by polyacrylamide gel electrophoresis. Cytopathological diagnosis and flow cytometry results were recorded. Sensitivity and specificity of IGHR analysis, cytopathology and flow cytometry were calculated. RESULTS Eleven patients (12 specimens) had involvement of leptomeninges at the time of lumbar puncture. Another 25 cases (27 specimens) had normal CSF findings or were diagnosed with benign lymphoproliferative conditions. Sensitivity of CSF cytopathology, flow cytometry and IGHR analysis were 0.27 [95% confidence interval 0.06, 0.61], 0.1 [0.003, 0.45] and 0.58 [0.28, 0.85]. Specificity was 1 [0.86, 1], 0.95 [0.77, 1.0] and 0.85 [0.66, 0.96]. INTERPRETATION IGHR analysis appears to be a useful addition to morphological and flow cytometry analysis of cerebrospinal fluid in the evaluation of CNS lymphoproliferative processes.
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Affiliation(s)
- Joachim M Baehring
- Pappas Center for Neuro-Oncology, Yawkey 9E, Massachusetts General Hospital, Boston, MA 02114, USA.
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40
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Hara S, Yokote T, Oka S, Akioka T, Kobayashi K, Tsuji M, Hanafusa T. Bronchial infiltration with diffuse large B-cell lymphoma. Leuk Res 2006; 30:1319-22. [PMID: 16533528 DOI: 10.1016/j.leukres.2006.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2005] [Revised: 12/17/2005] [Accepted: 02/07/2006] [Indexed: 11/28/2022]
Abstract
Non-Hodgkin's lymphoma (NHL) refers to a heterogeneous group of lymphoproliferative diseases with a diversity of clinical courses, including involvement in another organs. NHL frequently involves the thoracic structures, and particularly the mediastinum and lung parenchyma. Several clinical reports have described bronchial-associated lymphoid tissue (BALT) lymphoma as an endobronchial lesion, but endobronchial infiltration with diffuse large B-cell lymphoma is extremely rare. Here, we provide the first report of this condition confirmed by a histopathological study and the presence of an immunoglobulin heavy chain (IgH) gene rearrangement detected by a polymerase chain reaction (PCR).
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Affiliation(s)
- Satoshi Hara
- First Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka, Japan.
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41
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Baehring JM, Androudi S, Longtine JJ, Betensky RA, Sklar J, Foster CS, Hochberg FH. Analysis of clonal immunoglobulin heavy chain rearrangements in ocular lymphoma. Cancer 2005; 104:591-7. [PMID: 15973665 DOI: 10.1002/cncr.21191] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The morphologic diagnosis of primary and metastatic intraocular lymphoma (IOL) was made difficult by the paucicellular specimens with fragile populations of lymphocytes retrieved through pars plana vitrectomy (PPV). The analysis of immunoglobulin heavy chain (IgH) gene rearrangements (AIGHR) was used as an adjunct to cytopathology and flow cytometry in systemic lymphoma. In IOL, the sensitivity and specificity of AIGHR are unknown. METHODS The authors reviewed the clinical records of patients who underwent PPV for suspicion of IOL at the Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary (Boston, MA) between 2000 and 2002. AIGHR was performed as a routine diagnostic test on cell lysates isolated from < 0.5 mL of vitreous fluid. The authors used seminested polymerase chain reaction (PCR) with consensus primers for the VDJ-region of the IgH gene. PCR products were analyzed by polyacrylamide gel electrophoresis. RESULTS Thirty patients (37 specimens) with chronic vitritis and 17 patients (23 specimens) with IOL were included. The specificity of vitreous fluid cytopathology, flow cytometry, and AIGHR was 1.0, and the sensitivity values were 0.24, 0.36, and 0.64, respectively. AIGHR was negative in two patients for whom cytopathology or flow cytometry revealed the diagnosis of lymphoma. Clonal IGHR was found in four specimens classified as negative for lymphoma based on cytopathology and flow cytometry. CONCLUSIONS AIGHR supplemented cytopathology and flow cytometry to increase the diagnostic yield in IOL.
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Affiliation(s)
- Joachim M Baehring
- Brain Tumor Center, Department of Neurology, Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA
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Takano T, Miyauchi A, Matsuzuka F, Yoshida H, Notomi T, Kuma K, Amino N. Detection of monoclonality of the immunoglobulin heavy chain gene in thyroid malignant lymphoma by vectorette polymerase chain reaction. J Clin Endocrinol Metab 2005; 90:720-3. [PMID: 15536159 DOI: 10.1210/jc.2004-0951] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Distinguishing between thyroid malignant lymphoma and lymphocytic thyroiditis (Hashimoto's thyroiditis) is quite difficult and problematic. B cell lymphomas display clonal Ig heavy-chain (IgH) gene rearrangement, and Southern blot hybridization (SBH) is often used for detection of the monoclonality of the IgH gene. However, SBH is often problematic because it requires a large volume of samples. We examined the efficiency in detecting the monoclonality of IgH gene in thyroid malignant lymphomas by vectorette PCR, which we started with only 200 ng of genomic DNA. Monoclonality was detected in 36 of 47 (76.6%) malignant lymphomas, whereas it was not detected in 10 samples of tissue of Hashimoto's thyroiditis. The sensitivity was almost the same as that with SBH in which monoclonality was detected in 33 of 45 (73.3%) malignant lymphomas. These results suggest that vectorette PCR may be a substitute for SBH, and because it requires only a small volume of samples, it may be used in the analysis of aspiration biopsies.
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Affiliation(s)
- Toru Takano
- Department of Laboratory Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
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Spagnolo DV, Ellis DW, Juneja S, Leong ASY, Miliauskas J, Norris DL, Turner J. The role of molecular studies in lymphoma diagnosis: a review. Pathology 2004; 36:19-44. [PMID: 14757555 DOI: 10.1080/00313020310001648404] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Lymphoma classification is based on a multiparametric approach to diagnosis, in which clinical features, morphology, immunophenotype, karyotype and molecular characteristics are important to varying degrees. While in most cases, a diagnosis can be confidently established on the basis of morphology and immunophenotype alone, a small proportion of diagnostically difficult cases will rely on molecular studies to enable a definitive diagnosis. This review discusses the various molecular techniques available including Southern blotting (SB), polymerase chain reaction (PCR), fluorescence in situ hybridisation (FISH)--including multicolour-FISH/spectral karyotyping and comparative genomic hybridisation--and also gene expression profiling using cDNA microarray technology. Emphasis is given to the analysis of antigen receptor gene rearrangements and chromosomal translocations as they relate to lymphoma diagnosis and also in the setting of minimal residual disease (MRD) detection and monitoring. Laboratories performing these tests need to have expertise in these areas of testing, and there is a need for greater standardisation of molecular tests. It is important to know the sensitivity and specificity of each test as well as its limitations and the pitfalls in the interpretation of results. Above all, results of molecular testing should never be considered in isolation, and must always be interpreted in the context of clinical and other laboratory data.
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Affiliation(s)
- Dominic V Spagnolo
- Division of Tissue Pathology, The Western Australian Centre for Pathology and Medical Research (PathCentre), Nedlands, WA, Australia.
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Honda K, Kusama H, Takagi S, Sekine S, Noguchi M, Chiba H. Diagnosis of intra-oral MALT lymphoma using seminested polymerase chain reaction. Br J Oral Maxillofac Surg 2004; 42:28-32. [PMID: 14706295 DOI: 10.1016/s0266-4356(03)00233-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma based on histological examination alone is difficult. We report three patients with histologically suspected MALT lymphoma who developed lymphoproliferative lesions of the sublingual gland. Seminested polymerase chain reaction (PCR) analysis applied to formalin-fixed and paraffin-embedded specimens showed clonal rearrangement of immunoglobulin heavy chain genes in two patients and a polyclonal characteristic in one. The clinical findings and Southern blot analysis confirmed the accuracy of the diagnosis. The molecular method described can be applied routinely to processed specimens to obtain helpful information for the diagnosis of low-grade malignancies of lymphoproliferative disorders, such as MALT lymphoma.
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Affiliation(s)
- Kazufumi Honda
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo Ami-machi, Inashiki-gun, Ibaraki 300-0395, Japan.
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45
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Zompi S, Couderc LJ, Cadranel J, Antoine M, Epardeau B, Fleury-Feith J, Popa N, Santoli F, Farcet JP, Delfau-Larue MH. Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma. Blood 2004; 103:3208-15. [PMID: 15070704 DOI: 10.1182/blood-2003-07-2335] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The diagnostic procedure of chronic pulmonary opacities may envisage the search for non-Hodgkin lymphoma (NHL). Previous retrospective studies have shown that clonality analysis of bronchoalveolar B lymphocytes could reflect the clonality of pulmonary lymphocytes. Our objective was to define the diagnostic usefulness of bronchoalveolar lavage (BAL) B-lymphocyte clonality analysis in the setting of a clinical suspicion of both primary and secondary pulmonary lymphoma. A prospective BAL fluid B-cell clonality analysis was performed by polymerase chain reaction (PCR) in 106 consecutive patients presenting with a clinical suspicion of pulmonary NHL. Diagnosis was pulmonary B-cell lymphoma for 22 patients (13 primary and 9 secondary). When compared, pulmonary biopsy and BAL fluid have clonal identity. The detection of a strong B-cell clonal population in BAL fluid was associated with the diagnosis of pulmonary NHL (P <.0001), with a 97% specificity and a 95% negative predictive value. Thus, the absence of a dominant B-cell clone detection in BAL fluid could help to dismiss invasive investigations of pulmonary lesions. The detection of a dominant B-cell clone would lead to the performance of a pulmonary biopsy to get histologic diagnosis in primary pulmonary lymphoma and, by contrast, would avoid the need for biopsy in the setting of a secondary pulmonary lymphoma.
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Affiliation(s)
- Simona Zompi
- Service de Pneumologie, Hôpital Foch, Suresnes, France
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46
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Demierre MF, Kerl H, Willemze R. Primary cutaneous B-cell lymphomas: a practical approach. Hematol Oncol Clin North Am 2003; 17:1333-50. [PMID: 14710888 DOI: 10.1016/s0889-8588(03)00118-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PCBCL are a heterogeneous group of B-cell lymphomas that originate in the skin, with the absence of extracutaneous disease at diagnosis. Overall, these cutaneous lymphomas have an excellent prognosis. Recurrences are common but dissemination is rare. The EORTC classification allows a more uniform diagnosis and treatment of patients with PCBCL. Careful clinical and pathologic correlation is critical in confirming a diagnosis of PCBCL, before deciding on therapy. Several therapeutic options that are aimed at cure, are available. In most instances, chemotherapy should not be the first line of treatment.
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Affiliation(s)
- Marie-France Demierre
- Department of Dermatology, Boston University School of Medicine, 609 Albany Street, Boston, MA 02118, USA.
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Abstract
A wide array of diagnostic tests are available to evaluate molecular abnormalities in pediatric cancer. Classic cytogenetics, FISH, flow cytometry, PCR, and Southern blot analysis are in widespread use throughout pediatric hospitals. Examples of the application of these methods in pediatric cancer diagnosis are reviewed. Newer methods such as CGH, SKY, gene expression microarrays and proteomic methods are under active investigation andwill almost certainly lead to significant advances in our ability to diagnose and treat pediatric cancer.
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Affiliation(s)
- Jon M Rowland
- Department of Pathology, Children's Hospital and Research Center at Oakland, 747 52nd Street, Oakland, CA 94609, USA.
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48
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Gribben JG. Monitoring disease in lymphoma and CLL patients using molecular techniques. Best Pract Res Clin Haematol 2002; 15:179-95. [PMID: 11987923 DOI: 10.1053/beha.2002.0191] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Over the past decade considerable advances have been made in the sensitivity of detection of residual lymphoma and leukaemia cells. Assays based on the polymerase chain reaction (PCR) can detect one tumour cell in up to 10(5) to 10(6) normal cells. The identification and cloning of breakpoints associated with specific chromosomal translocations has made possible the application of these techniques to a variety of lymphoid malignancies. In parallel, B cell malignancies exhibit rearrangements of their immunoglobulin genes that are also suitable targets for PCR amplification to identify residual cells. Although these techniques provide a useful adjunct to standard methods of detection and diagnosis, their role in determining disease outcome remains investigational. There is confusion as to whether it is necessary to eradicate PCR-detectable lymphoma cells for cure, so it is not yet possible to determine whether the detection of residual lymphoma cells by PCR is an indication to continue therapy.
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MESH Headings
- Gene Rearrangement
- Genes, Immunoglobulin
- Genes, T-Cell Receptor
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/therapy
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Neoplasm, Residual/therapy
- Polymerase Chain Reaction
- Stem Cell Transplantation
- Translocation, Genetic
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Affiliation(s)
- John G Gribben
- Department of Medicine, Harvard Medical School, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA 02115, USA
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Pham LV, Tamayo AT, Yoshimura LC, Lo P, Terry N, Reid PS, Ford RJ. A CD40 Signalosome anchored in lipid rafts leads to constitutive activation of NF-kappaB and autonomous cell growth in B cell lymphomas. Immunity 2002; 16:37-50. [PMID: 11825564 DOI: 10.1016/s1074-7613(01)00258-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
B cell lineage non-Hodgkin's lymphomas (NHL-B) are neoplastic B cells that show dysregulated B lymphocyte growth characteristics. Unlike normal B cells, aggressive NHL-B cells show constitutive expression of nuclear NF-kappaB by maintaining an assembled, scaffold-like signaling platform, called a Signalosome within the lipid raft microdomain, extending from the cell membrane. The CD40 Signalosome appears to be initiated through autochthonous production and cognate binding of CD154 (CD40L, gp39) to CD40 by the lymphoma cell. Constitutive expression of NF-kappaB in NHL-B can be downregulated by treatment with antibodies to CD40 or CD154 that disrupt Signalosomes, inhibit lymphoma cell growth, and induce cell death. CD40 Signalosomes may provide a potentially vulnerable target for therapeutic intervention in NHL-B cells.
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Affiliation(s)
- Lan V Pham
- Department of Hematopathology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
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50
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Alpen B, Thiede C, Wündisch T, Bayerdörffer E, Stolte M, Neubauer A. Molecular diagnostics in low-grade gastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type after Helicobacter pylori eradication therapy. CLINICAL LYMPHOMA 2001; 2:103-8. [PMID: 11707850 DOI: 10.3816/clm.2001.n.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The primary gastric lymphomas are extranodal non-Hodgkin's lymphomas that likely originate from the mucosa-associated lymphoid tissue (MALT). Data suggest that chronic infection with Helicobacter pylori (H pylori) is significantly associated with the pathogenesis of low-grade gastric MALT lymphomas. This is in keeping with the observation that many patients with early low-grade MALT lymphomas have complete remissions after H pylori eradication therapy. However, the stability of these remissions remains unclear and relapses have been reported. It can be difficult to distinguish between early malignant and benign disorders of the gastric mucosa. A polymerase chain reaction (PCR) assay can detect rearrangements of the variable region of immunoglobulin heavy chains. This assay can be used to distinguish the clonality of B lymphocytes and has been investigated as a test for differential diagnosis of MALT lymphomas. Monoclonality is observed in the majority of MALT-lymphoma samples at diagnosis but has been found in gastritis samples as well. Whether the presence of monoclonal B cells is associated with the risk of lymphoma progression remains unclear. As many as 50% of patients who have complete histologic remissions of MALT lymphoma after H pylori eradication therapy have persisting monoclonal bands in follow-up PCR monitoring. Although it is unclear as to whether monoclonality indicates the presence of minimal residual disease, patients who have persistent monoclonal bands during follow-up should be considered at risk for relapse. The PCR assay for rearrangements of the variable region of the immunoglobulin heavy-chain gene appears to be of low value in the diagnosis of B-cell malignancies but could provide a useful tool in the follow-up of patients who achieve remissions after H pylori eradication.
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Affiliation(s)
- B Alpen
- Abteilung Hämatologie/Onkologie/Immunologie, Philipps-Universität, Marburg, Germany
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