1
|
Ivanova VS, Davies J, Menter T, Wild D, Müller A, Krasniqi F, Stenner F, Papachristofilou A, Dirnhofer S, Tzankov A. Primary bone diffuse large B-cell lymphoma (PB-DLBCL): a distinct extranodal lymphoma of germinal centre origin, with a common EZB-like mutational profile and good prognosis. Histopathology 2024; 84:525-538. [PMID: 37965677 DOI: 10.1111/his.15096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/03/2023] [Accepted: 10/28/2023] [Indexed: 11/16/2023]
Abstract
AIMS Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is not recognized as a separate entity by the current classification systems. Here we define and highlight its distinctive clinical presentation, morphology, phenotype, gene expression profile (GEP), and molecular genetics. METHODS We collected 27 respective cases and investigated their phenotype, performed gDNA panel sequencing covering 172 genes, and carried out fluorescence in situ hybridization to evaluate MYC, BCL2, and BCL6 translocations. We attempted to genetically subclassify cases using the Two-step classifier and performed GEP for cell-of-origin subtyping and in silico comparison to uncover up- and downregulated genes as opposed to other DLBCL. RESULTS Most cases (n = 22) were germinal centre B-cell-like (GCB) by immunohistochemistry and all by GEP. Additionally, PB-DLBCL had a mutational profile similar to follicular lymphoma and nodal GCB-DLBCL, with the exception of more frequent TP53 and B2M mutations. The GEP of PB-DLBCL was unique, and the frequency of BCL2 rearrangements was lower compared to nodal GCB-DLBCL. The Two-step classifier categorized eight of the cases as EZB, three as ST2, and one as MCD. CONCLUSION This study comprehensively characterizes PB-DLBCL as a separate entity with distinct clinical and morpho-molecular features. These insights may aid in developing tailored therapeutic strategies and shed light on its pathogenesis.
Collapse
Affiliation(s)
- Vanesa-Sindi Ivanova
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - John Davies
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Thomas Menter
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Damian Wild
- Divison of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Anne Müller
- Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Fatime Krasniqi
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Frank Stenner
- Division of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | | | - Stefan Dirnhofer
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| |
Collapse
|
2
|
Nagy Á, Bátai B, Kiss L, Gróf S, Király PA, Jóna Á, Demeter J, Sánta H, Bátai Á, Pettendi P, Szendrei T, Plander M, Körösmezey G, Alizadeh H, Kajtár B, Méhes G, Krenács L, Timár B, Csomor J, Tóth E, Schneider T, Mikala G, Matolcsy A, Alpár D, Masszi A, Bödör C. Parallel testing of liquid biopsy (ctDNA) and tissue biopsy samples reveals a higher frequency of EZH2 mutations in follicular lymphoma. J Intern Med 2023; 294:295-313. [PMID: 37259686 DOI: 10.1111/joim.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Recent genomic studies revealed enhancer of zeste homolog 2 (EZH2) gain-of-function mutations, representing novel therapeutic targets in follicular lymphoma (FL) in around one quarter of patients. However, these analyses relied on single-site tissue biopsies and did not investigate the spatial heterogeneity and temporal dynamics of these alterations. OBJECTIVES We aimed to perform a systematic analysis of EZH2 mutations using paired tissue (tumor biopsies [TB]) and liquid biopsies (LB) collected prior to treatment within the framework of a nationwide multicentric study. METHODS Pretreatment LB and TB samples were collected from 123 patients. Among these, 114 had paired TB and LB, with 39 patients characterized with paired diagnostic and relapse samples available. The EZH2 mutation status and allele burden were assessed using an in-house-designed, highly sensitive multiplex droplet digital PCR assay. RESULTS EZH2 mutation frequency was found to be 41.5% in the entire cohort. In patients with paired TB and LB samples, EZH2 mutations were identified in 37.8% of the patients with mutations exclusively found in 5.3% and 7.9% of TB and LB samples, respectively. EZH2 mutation status switch was documented in 35.9% of the patients with paired diagnostic and relapse samples. We also found that EZH2 wild-type clones may infiltrate the bone marrow more frequently compared to the EZH2 mutant ones. CONCLUSION The in-depth spatio-temporal analysis identified EZH2 mutations in a considerably higher proportion of patients than previously reported. This expands the subset of FL patients who most likely would benefit from EZH2 inhibitor therapy.
Collapse
Affiliation(s)
- Ákos Nagy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Bence Bátai
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Laura Kiss
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Stefánia Gróf
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Péter Attila Király
- Hematology and Lymphoma Unit, National Institute of Oncology, Budapest, Hungary
| | - Ádám Jóna
- Department of Hematology, Faculty of Medicine, Medical School of Clinical Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Demeter
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Hermina Sánta
- Szent György Hospital of County Fejér, Székesfehérvár, Hungary
| | - Árpád Bátai
- Szent György Hospital of County Fejér, Székesfehérvár, Hungary
| | - Piroska Pettendi
- Hetényi Géza Hospital, Clinic of County Jász-Nagykun-Szolnok, Szolnok, Hungary
| | - Tamás Szendrei
- Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - Márk Plander
- Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - Gábor Körösmezey
- Department of Medicine, Military Hospital - Medical Centre, Hungarian Defence Forces, Budapest, Hungary
| | - Hussain Alizadeh
- 1st Department of Internal Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Béla Kajtár
- Department of Pathology, Medical School, Clinical Centre, University of Pécs, Pécs, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Krenács
- Laboratory of Tumor Pathology and Molecular Diagnostics, Szeged, Hungary
| | - Botond Timár
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Judit Csomor
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Erika Tóth
- Department of Surgical and Molecular Pathology, National Institute of Oncology, Budapest, Hungary
| | - Tamás Schneider
- Hematology and Lymphoma Unit, National Institute of Oncology, Budapest, Hungary
| | - Gábor Mikala
- Department of Hematology and Stem Cell Transplantation, National Institute for Hematology and Infectious Diseases, South Pest Central Hospital, Budapest, Hungary
| | - András Matolcsy
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Karolinska Institutet, Solna, Sweden
| | - Donát Alpár
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - András Masszi
- Hematology and Lymphoma Unit, National Institute of Oncology, Budapest, Hungary
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| |
Collapse
|
3
|
Zhao F, Cheng LL, Zheng Z, Zhang MC, Cheng S, Xu PP, Wang L, Zhao WL. [Analysis of clinical factors of bendamustine combined with rituximab in the treatment of recurrent follicular lymphoma]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:513-7. [PMID: 35968596 DOI: 10.3760/cma.j.issn.0253-2727.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
4
|
Raychaudhuri R, Ujjani C. Targeted Therapy for Relapsed/Refractory Follicular Lymphoma: Focus on Clinical Utility of Tazemetostat. Onco Targets Ther 2022; 15:193-199. [PMID: 35250278 PMCID: PMC8893153 DOI: 10.2147/ott.s267011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022] Open
Abstract
The management of follicular lymphoma (FL) in the relapsed and refractory setting is challenging and an area of ongoing investigation. Epigenetic dysregulation has recently been shown to be a hallmark of FL. Mutations in histone-modifying genes are likely early, driver events in FL pathogenesis, and so are attractive targets to drug. Gain-of-function mutations in the histone methyltransferase EZH2 are common in FL and maintained through disease evolution. With mounting data supporting a critical role for EZH2 as an oncogenic driver for FL, the small molecule inhibitor, tazemetostat, was developed. Tazemetostat has shown promising activity in preclinical models and early phase trials. Importantly, responses were seen in patients with high-risk features. Based on these data, tazemetostat was approved in the US in 2020 for EZH2mut patients with FL who had received at least two prior lines of systemic therapy, or for EZH2wt patients without alternative treatment options. Here, we will review the biology of FL as it pertains to tazemetostat, the available clinical trial data, and future directions for this new therapy.
Collapse
Affiliation(s)
- Ruben Raychaudhuri
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Chaitra Ujjani
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
- Correspondence: Chaitra Ujjani, Tel +1 206-606-1955, Email
| |
Collapse
|
5
|
Abstract
Follicular lymphoma (FL) is a B-cell non-Hodgkin lymphoma of germinal center (GC) origin with a distinctive tumor microenvironment (TME) and a unique spectrum of mutations. Despite the important therapeutic advances, FL is still incurable. During B-cell development, the GC reaction is a complex multistep process in which epigenetic regulators dynamically induce or suppress transcriptional programs. In FL, epigenetic gene mutations perturb the regulation of these programs, changing GC B-cell function and skewing differentiation towards tumor cells and altering the microenvironment interactions. FL pathogenesis and malignant transformation are promoted by epigenetic reprogramming of GC B cells that alters the immunological synapse and niche. Despite the extensive characterization of FL epigenetic signature and TME, the functional consequences of epigenetic dysregulation on TME and niche plasticity need to be better characterized. In this review, first we describe the most frequent epigenomic alterations in FL (KMT2D, CREBBP and EZH2) that affect the immunological niche, and their potential consequences on the informational transfer between tumor B cells and their microenvironment. Then, we discuss the latest progress to harness epigenetic targets for inhibiting the FL microenvironment. Finally, we highlight unexplored research areas and outstanding questions that should be considered for a successful long-term treatment of FL.
Collapse
Affiliation(s)
- Rada Amin
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE, USA.
| | - Mounia S Braza
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
6
|
Zhong M, Tan J, Pan G, Jiang Y, Zhou H, Lai Q, Chen Q, Fan L, Deng M, Xu B, Zha J. Preclinical Evaluation of the HDAC Inhibitor Chidamide in Transformed Follicular Lymphoma. Front Oncol 2021; 11:780118. [PMID: 34926293 PMCID: PMC8677934 DOI: 10.3389/fonc.2021.780118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/09/2021] [Indexed: 01/02/2023] Open
Abstract
The key factors leading to transformed follicular lymphoma (t-FL) include the aberrations of epigenetic modifiers as early and driving events, especially mutations in the gene encoding for histone acetyltransferase. Therefore, reversal of this phenomenon by histone deacetylase (HDAC) inhibitors is essential for the development of new treatment strategies in t-FL. Several t-FL cell lines were treated with various doses of chidamide and subjected to cell proliferation, apoptosis and cell cycle analyses with CCK-8 assay, Annexin V/PI assay and flow cytometry, respectively. Chidamide dose-dependently inhibited cell proliferation, caused G0/G1 cycle arrest and triggered apoptosis in t-FL cells. In addition, the effects of chidamide on tumor growth were evaluated in vivo in xenograft models. RNA-seq analysis revealed gene expression alterations involving the PI3K-AKT signaling pathway might account for the mechanism underlying the antitumor activity of chidamide as a single agent in t-FL. These findings provide a basis for further clinical exploration of chidamide as a promising treatment for FL.
Collapse
Affiliation(s)
- Mengya Zhong
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Jinshui Tan
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Guangchao Pan
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Yuelong Jiang
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Hui Zhou
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Qian Lai
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Qinwei Chen
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Liyuan Fan
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Manman Deng
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Bing Xu
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| | - Jie Zha
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.,Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China
| |
Collapse
|
7
|
Bastos-Oreiro M, Suárez-González J, Andrés-Zayas C, Carrión NC, Moreno S, Carbonell D, Chicano M, Muñiz P, Sanz L, Diaz-Crespo FJ, Menarguez J, Diez-Martín JL, Buño I, Martínez-Laperche C. Incorporation of next-generation sequencing in clinical practice using solid and liquid biopsy for patients with non-Hodgkin's lymphoma. Sci Rep 2021; 11:22815. [PMID: 34819573 PMCID: PMC8613247 DOI: 10.1038/s41598-021-02362-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022] Open
Abstract
Although next-generation sequencing (NGS) data on lymphomas require further validation before being implemented in daily practice, the clinical application of NGS can be considered right around the corner. The aim of our study was to validate an NGS lymphoid panel for tissue and liquid biopsy with the most common types of non-Hodgkin’s lymphoma [follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL)]. In this series, 372 somatic alterations were detected in 93.6% (44/47) of the patients through tissue biopsy. In FL, we identified 93 somatic alterations, with a median of 7.4 mutations per sample. In DLBCL, we detected 279 somatic variants with a median of 8.6 mutations (range 0–35). In 92% (24/26) of the cases, we were able to detect some variant in the circulating tumor DNA. We detected a total of 386 variants; 63.7% were detected in both types of samples, 13.2% were detected only in the circulating tumor DNA, and 23% were detected only in the tissue biopsy. We found a correlation between the number of circulating tumor DNA mutations, advanced stage, and bulky disease. The genetic alterations detected in this panel were consistent with those previously described at diagnosis. The liquid biopsy sample is therefore a complementary tool that can provide new genetic information, even in cases where a solid biopsy cannot be performed or an insufficient sample was obtained. In summary, we describe and analyze in this study the findings and difficulties encountered when incorporating liquid biopsy into clinical practice in non-Hodgkin’s lymphoma at diagnosis.
Collapse
Affiliation(s)
- Mariana Bastos-Oreiro
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain. .,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.
| | - Julia Suárez-González
- Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Cristina Andrés-Zayas
- Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Natalia Carolina Carrión
- Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Solsiré Moreno
- Deparment of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Diego Carbonell
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - María Chicano
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Paula Muñiz
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | - Laura Sanz
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| | | | - Javier Menarguez
- Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Deparment of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - José Luis Diez-Martín
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Department of Medicine, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Ismael Buño
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.,Department of Cell Biology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Carolina Martínez-Laperche
- Department of Hematology, Gregorio Marañón General University Hospital, C/ Doctor Esquerdo 46, 28007, Madrid, Spain.,Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain
| |
Collapse
|
8
|
Valle-Argos B, Chiodin G, Bryant DJ, Taylor J, Lemm E, Duriez PJ, Rock PJ, Strefford JC, Forconi F, Burack RW, Packham G, Stevenson FK. DC-SIGN binding to mannosylated B-cell receptors in follicular lymphoma down-modulates receptor signaling capacity. Sci Rep 2021; 11:11676. [PMID: 34083646 PMCID: PMC8175722 DOI: 10.1038/s41598-021-91112-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/20/2021] [Indexed: 12/13/2022] Open
Abstract
In follicular lymphoma (FL), surface immunoglobulin (sIg) carries mandatory N-glycosylation sites in the variable regions, inserted during somatic hypermutation. These glycosylation sites are tumor-specific, indicating a critical function in FL. Added glycan unexpectedly terminates at high mannose (Mann) and confers capability for sIg-mediated interaction with local macrophage-expressed DC-SIGN lectin resulting in low-level activation of upstream B-cell receptor signaling responses. Here we show that despite being of low-level, DC-SIGN induces a similar downstream transcriptional response to anti-IgM in primary FL cells, characterized by activation of pathways associated with B-cell survival, proliferation and cell-cell communication. Lectin binding was also able to engage post-transcriptional receptor cross-talk pathways since, like anti-IgM, DC-SIGN down-modulated cell surface expression of CXCR4. Importantly, pre-exposure of a FL-derived cell line expressing sIgM-Mann or primary FL cells to DC-SIGN, which does not block anti-IgM binding, reversibly paralyzed the subsequent Ca2+ response to anti-IgM. These novel findings indicate that modulation of sIg function occurs in FL via lectin binding to acquired mannoses. The B-cell receptor alternative engagement described here provides two advantages to lymphoma cells: (i) activation of signaling, which, albeit of low-level, is sufficient to trigger canonical lymphoma-promoting responses, and (ii) protection from exogenous antigen by paralyzing anti-IgM-induced signaling. Blockade of this alternative engagement could offer a new therapeutic strategy.
Collapse
MESH Headings
- Calcium/metabolism
- Calcium Signaling
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/metabolism
- Cell Line, Tumor
- Gene Expression Regulation, Neoplastic
- Glycosylation
- Humans
- Immunoglobulin M/immunology
- Lectins, C-Type/genetics
- Lectins, C-Type/metabolism
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/metabolism
- Protein Binding
- Receptors, Antigen, B-Cell/metabolism
- Receptors, CXCR4/metabolism
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/metabolism
- Signal Transduction
Collapse
Affiliation(s)
- Beatriz Valle-Argos
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Giorgia Chiodin
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Dean J Bryant
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Joe Taylor
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Elizabeth Lemm
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Patrick J Duriez
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Philip J Rock
- Pathology Department, University of Rochester Medical Center, NY, USA
| | - Jonathan C Strefford
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Francesco Forconi
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Richard W Burack
- Pathology Department, University of Rochester Medical Center, NY, USA
| | - Graham Packham
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK.
| | - Freda K Stevenson
- Cancer Research UK Centre, Cancer Sciences Unit, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK.
| |
Collapse
|
9
|
Julia E, Salles G. EZH2 inhibition by tazemetostat: mechanisms of action, safety and efficacy in relapsed/refractory follicular lymphoma. Future Oncol 2021; 17:2127-2140. [PMID: 33709777 PMCID: PMC9892962 DOI: 10.2217/fon-2020-1244] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Epigenetic alterations are major drivers of follicular lymphomagenesis, and these alterations are frequently caused by mutations in or upregulation of EZH2, a histone methyltransferase responsible for PRC2-mediated gene repression. EZH2 hyperactivation increases proliferation of B cells and prevents them from exiting the germinal center, favoring lymphomagenesis. The first FDA-approved EZH2 inhibitor is tazemetostat, which is orally available and targets both mutant and wild-type forms of the protein to induce cell cycle arrest and apoptosis of lymphoma cells in preclinical models. Phase II trials have shown objective response rates of 69% for patients with lymphoma-carrying EZH2 mutations and 35% for those with wild-type EZH2 without major toxicity, leading to tazemetostat approval for this cancer by the US FDA in June 2020.
Collapse
Affiliation(s)
- Edith Julia
- Department of Hematology, Hospices Civils de Lyon, Hôpital Lyon-Sud, Pierre-Bénite, 69310, France,Faculté de Médecine Lyon-Sud, Université de Lyon, Université Claude Bernard, 165, Chemin du Grand Revoyet, Cedex, Oullins, 69495, France
| | - Gilles Salles
- Faculté de Médecine Lyon-Sud, Université de Lyon, Université Claude Bernard, 165, Chemin du Grand Revoyet, Cedex, Oullins, 69495, France,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA,Author for correspondence:
| |
Collapse
|
10
|
Cheng F, Yu F, Wang X, Huang K, Lu H, Wang Z. A Pedigree Analysis and Clonal Correlations of the Coexistence of B-Cell Lymphoma and Histiocytic/Dendritic Cell Tumor. Int J Surg Pathol 2021; 29:906-914. [PMID: 33939500 DOI: 10.1177/10668969211013402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Histiocytic/dendritic cell tumors are rare in clinical practice. It is postulated that they originate from bone marrow stem cells. Accumulating evidence has established the existence of immunoglobulin gene and T-cell receptor gene rearrangements in these tumors. Cases of transdifferentiation across lineages from follicular lymphoma to histiocytic/dendritic cell tumors have also been reported. Herein, we report 2 adult males with histiocytic neoplasms coexisting with B-cell lymphoma. Laser capture microdissection and capillary electrophoresis polymerase chain reaction analysis revealed comparable immunoglobulin gene rearrangement in both patients. In one case, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), Langerhans cell sarcoma, and histiocytic sarcoma coexisted in the lymph nodes. 11q22 deletion often present in CLL/SLL and expression of the BRAF V600E gene was detected in all the 3 components. In the other case, there diffuse large B-cell lymphoma and histiocytic sarcoma coexisted in the spleen. Forty-seven mutated genes commonly found in B-cell lymphoma were detected by next-generation sequencing. In the same line, DTX1, IRF8, KMT2D, MAP2K1, and TET2 genes were found to have similar mutation sites. The results of this study will contribute in providing new ideas for targeted treatment of these diseases.
Collapse
Affiliation(s)
- Fei Cheng
- 71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fang Yu
- 71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoxi Wang
- 71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ke Huang
- 71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongsheng Lu
- 56709Taizhou Central Hospital, Taizhou, Zhejiang, China
| | - Zhaoming Wang
- 71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
11
|
Hamamoto Y, Kukita Y, Kitamura M, Kurashige M, Masaie H, Fuji S, Ishikawa J, Honma K, Wakasa T, Hanamoto H, Hirokawa M, Suzuki A, Morii E, Nakatsuka SI. Bcl-2-negative IGH-BCL2 translocation-negative follicular lymphoma of the thyroid differs genetically and epigenetically from Bcl-2-positive IGH-BCL2 translocation-positive follicular lymphoma. Histopathology 2021; 79:521-532. [PMID: 33829512 DOI: 10.1111/his.14378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/11/2021] [Accepted: 04/04/2021] [Indexed: 11/30/2022]
Abstract
AIMS Follicular lymphoma (FL), comprising a minor subset of primary thyroid lymphomas, is divided into two groups based on Bcl-2 expression and IGH-BCL2 translocation. The clinicopathological features exhibited by Bcl-2-negative IGH-BCL2 translocation-negative FL of the thyroid (Bcl-2- /IGH-BCL2- tFL) are different from those of conventional FL; however, its lymphomagenesis remains unclear. Here, we collected samples from seven patients with Bcl-2- /IGH-BCL2- tFL to investigate their epigenetic and genetic aberrations. METHODS AND RESULTS The immunohistochemical profiles of epigenetic modifiers and the methylation status of histones were examined, including EZH2, MLL2/KMT2D, CBP/CREBBP, EP300, H3K27me3 and H3K4me3, in Bcl-2- /IGH-BCL2- tFL and Bcl-2-positive IGH-BCL2 translocation-positive FL of the thyroid (Bcl-2+ /IGH-BCL2+ tFL). Most Bcl-2- /IGH-BCL2- tFLs retained the positivity of epigenetic modifiers and lower expression of H3K27me3, although Bcl-2+ /IGH-BCL2+ tFLs exhibited aberrant immunohistochemical patterns of EZH2 and CBP/CREBBP and overexpression of H3K27me3. Samples from seven cases were further analysed using targeted sequencing, focusing on the exons of 409 key tumour suppressor genes and oncogenes. Bcl-2- /IGH-BCL2- tFLs do not have pathogenic mutations of epigenetic modifiers, such as EZH2, MLL2/KMT2D, MLL3/KMT2C, EP300 and ARID1A, which have been reported in FLs in the literature, whereas Bcl-2+ /IGH-BCL2+ tFLs are probably pathogenic/pathogenic missense mutations or frameshift mutations of these genes. Additionally, novel mutations in TET2 and EP400 were detected in Bcl-2- /IGH-BCL2- tFLs. CONCLUSIONS Different genetic and epigenetic abnormalities might be involved in the oncogenesis of Bcl-2- /IGH-BCL2- tFLs from Bcl-2+ /IGH-BCL2+ tFLs and other FLs.
Collapse
Affiliation(s)
- Yuichiro Hamamoto
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan.,Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoji Kukita
- Laboratory of Genomic Pathology, Osaka International Cancer Institute, Osaka, Japan
| | - Masanori Kitamura
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Masako Kurashige
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroaki Masaie
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoko Wakasa
- Diagnostic Pathology and Laboratory Medicine, Kindai University Nara Hospital, Nara, Japan
| | - Hitoshi Hanamoto
- Department of Hematology, Kindai University Nara Hospital, Nara, Japan
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Hyogo, Japan
| | - Ayana Suzuki
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Hyogo, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | | |
Collapse
|
12
|
Venturutti L, Melnick AM. The dangers of déjà vu: memory B cells as the cells of origin of ABC-DLBCLs. Blood 2020; 136:2263-74. [PMID: 32932517 DOI: 10.1182/blood.2020005857] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023] Open
Abstract
Activated B-cell (ABC)-diffuse large B-cell lymphomas (DLBCLs) are clinically aggressive and phenotypically complex malignancies, whose transformation mechanisms remain unclear. Partially differentiated antigen-secreting cells (plasmablasts) have long been regarded as cells-of-origin for these tumors, despite lack of definitive experimental evidence. Recent DLBCL reclassification based on mutational landscapes identified MCD/C5 tumors as specific ABC-DLBCLs with unfavorable clinical outcome, activating mutations in the signaling adaptors MYD88 and CD79B, and immune evasion through mutation of antigen-presenting genes. MCD/C5s manifest prominent extranodal dissemination and similarities with primary extranodal lymphomas (PENLs). In this regard, recent studies on TBL1XR1, a gene recurrently mutated in MCD/C5s and PENLs, suggest that aberrant memory B cells (MBs), and not plasmablasts, are the true cells-of-origin for these tumors. Moreover, transcriptional and phenotypic profiling suggests that MCD/C5s, as a class, represent bona fide MB tumors. Based on emerging findings we propose herein a generalized stepwise model for MCD/C5 and PENLs pathogenesis, whereby acquisition of founder mutations in activated B cells favors the development of aberrant MBs prone to avoid plasmacytic differentiation on recall and undergo systemic dissemination. Cyclic reactivation of these MBs through persistent antigen exposure favors their clonal expansion and accumulation of mutations, which further facilitate their activation. As a result, MB-like clonal precursors become trapped in an oscillatory state of semipermanent activation and phenotypic sway that facilitates ulterior transformation and accounts for the extranodal clinical presentation and biology of these tumors. In addition, we discuss diagnostic and therapeutic implications of a MB cell-of-origin for these lymphomas.
Collapse
|
13
|
Dobaño-López C, Araujo-Ayala F, Serrat N, Valero JG, Pérez-Galán P. Follicular Lymphoma Microenvironment: An Intricate Network Ready for Therapeutic Intervention. Cancers (Basel) 2021; 13:641. [PMID: 33562694 DOI: 10.3390/cancers13040641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 02/07/2023] Open
Abstract
Follicular Lymphoma (FL), the most common indolent non-Hodgkin's B cell lymphoma, is a paradigm of the immune microenvironment's contribution to disease onset, progression, and heterogeneity. Over the last few years, state-of-the-art technologies, including whole-exome sequencing, single-cell RNA sequencing, and mass cytometry, have precisely dissected the specific cellular phenotypes present in the FL microenvironment network and their role in the disease. In this already complex picture, the presence of recurring mutations, including KMT2D, CREBBP, EZH2, and TNFRSF14, have a prominent contributory role, with some of them finely tuning this exquisite dependence of FL on its microenvironment. This precise characterization of the enemy (FL) and its allies (microenvironment) has paved the way for the development of novel therapies aimed at dismantling this contact network, weakening tumor cell support, and reactivating the host's immune response against the tumor. In this review, we will describe the main microenvironment actors, together with the current and future therapeutic approaches targeting them.
Collapse
|
14
|
Munguía-Fuentes R, Maqueda-Alfaro RA, Chacón-Salinas R, Flores-Romo L, Yam-Puc JC. Germinal Center Cells Turning to the Dark Side: Neoplasms of B Cells, Follicular Helper T Cells, and Follicular Dendritic Cells. Front Oncol 2021; 10:587809. [PMID: 33520702 PMCID: PMC7843373 DOI: 10.3389/fonc.2020.587809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022] Open
Abstract
Gaining knowledge of the neoplastic side of the three main cells—B cells, Follicular Helper T (Tfh) cells, and follicular dendritic cells (FDCs) —involved in the germinal center (GC) reaction can shed light toward further understanding the microuniverse that is the GC, opening the possibility of better treatments. This paper gives a review of the more complex underlying mechanisms involved in the malignant transformations that take place in the GC. Whilst our understanding of the biology of the GC-related B cell lymphomas has increased—this is not reviewed in detail here—the dark side involving neoplasms of Tfh cells and FDCs are poorly studied, in great part, due to their low incidence. The aggressive behavior of Tfh lymphomas and the metastatic potential of FDCs sarcomas make them clinically relevant, merit further attention and are the main focus of this review. Tfh cells and FDCs malignancies can often be misdiagnosed. The better understanding of these entities linked to their molecular and genetic characterization will lead to prediction of high-risk patients, better diagnosis, prognosis, and treatments based on molecular profiles.
Collapse
Affiliation(s)
- Rosario Munguía-Fuentes
- Departmento de Ciencias Básicas, Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas, Instituto Politécnico Nacional, UPIITA-IPN, Mexico City, Mexico
| | - Raúl Antonio Maqueda-Alfaro
- Department of Cell Biology, Center for Advanced Research, National Polytechnic Institute, Cinvestav-IPN, Mexico City, Mexico
| | - Rommel Chacón-Salinas
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, ENCB-IPN, Mexico City, Mexico
| | - Leopoldo Flores-Romo
- Department of Cell Biology, Center for Advanced Research, National Polytechnic Institute, Cinvestav-IPN, Mexico City, Mexico
| | - Juan Carlos Yam-Puc
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
15
|
García-Álvarez M, Alonso-Álvarez S, Prieto-Conde I, Jiménez C, Sarasquete ME, Chillón MC, Medina A, Balanzategui A, Maldonado R, Antón A, Rodríguez M, Blanco O, Díaz LG, Tamayo P, Blanco P, Esteban C, González-Calle V, Puig N, Gutiérrez N, Martín A, García-Sanz R, González M, Caballero MD, Alcoceba M. Genetic complexity impacts the clinical outcome of follicular lymphoma patients. Blood Cancer J 2021; 11:11. [PMID: 33431798 DOI: 10.1038/s41408-020-00395-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
|
16
|
Abstract
Despite considerable progress in the treatment of patients with lymphoid malignancies in recent decades, the prognosis of patients with relapsed or refractory lymphomas often remains disappointing. Increasing evidence has established the relevance of epigenetic alterations in the pathogenesis of lymphoid malignancies, and a succession of agents has been evaluated in clinical studies with varying efficacy. In the present review, we outline the importance of epigenetic modifications in lymphoma biology and discuss the published experience with epigenetic modifying agents by lymphoma subtype before considering ongoing clinical studies in this area.
Collapse
Affiliation(s)
- Stephen Booth
- Early Phase Clinical Trials Unit, Department of Oncology, University of Oxford, Oxford, UK
| | - Graham Collins
- Oxford Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
17
|
Ferry JA. Scientific Advances and the Evolution of Diagnosis, Subclassification and Treatment of Lymphoma. Arch Med Res 2020; 51:749-64. [PMID: 32553461 DOI: 10.1016/j.arcmed.2020.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022]
Abstract
The diagnosis of lymphoma has evolved tremendously over time. Initially, diagnosis of lymphoma was largely based on morphology alone. Over time, immunophenotyping using flow cytometry and immunohistochemistry, and then in situ hybridization, have contributed dramatically to the pathologist's ability to recognize, diagnose and subclassify lymphomas more precisely. In recent years, cytogenetic and molecular genetic techniques have developed that allow evaluation of abnormalities in lymphomas, leading to an understanding of their pathogenesis and opening the door to targeted therapies that will lead to better outcomes for lymphoma patients.
Collapse
|
18
|
Chen M, Jiang G, Liu Y, Li D, Li T, Peng J, Jiang Q, You H, Ba R, Pan J, Li M, Long W, Yan J, Zhu Y, Wang Y, Xi X, Mao J, Shi X. Establishment and characterization of a novel 'double-hit' follicular lymphoma cell line, FL-SJC. J Cell Mol Med 2020; 24:7928-7938. [PMID: 32459397 PMCID: PMC7348184 DOI: 10.1111/jcmm.15425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 01/28/2023] Open
Abstract
About 5 per cent of follicular lymphoma (FL) cases are double-hit (DH) lymphomas. Double-hit follicular lymphoma (DHFL) cell lines can improve our understanding and drug development on FL. But there are only few DHFL cell lines. Here, we established a new MYC/BCL2 DHFL cell line, FL-SJC. The cells were obtained from the hydrothorax of a patient with MYC/BCL2 DHFL and cultured for 140 passages in vitro. FL-SJC cells demonstrated CD19++ , CD20+ , CD22++ , HLA-DR+ , CD10+ , CD38+ , Lambda+ CD23- , CD5- and Kappa- . The chromosome karyotypic analysis confirmed the co-existence of t(8;22)(q24;q11) and t(14;18)(q32;q21), as well as additional abnormalities involving chromosomes 2 and 3. Fluorescence in situ hybridization analysis (FISH) showed IGH/BCL2 fusion gene and the MYC rearrangement. In addition, the FL-SJC cells displayed KMT2D/MLL2 and CREBBP gene mutations. After subcutaneous inoculation of FL-SJC cells, the SCID mice developed solid tumour masses within 6-8 weeks. FL-SJC cells were proven to be free of Epstein-Barr (EB) virus infection and be multidrug-resistant. In a conclusion, the FL-SJC cell line has been identified as a novel MYC/BCL2 double-hit follicular lymphoma that can be used as a potentially available tool for the clinical and basic research, together with the drug development for MYC/BCL2 DHFL.
Collapse
Affiliation(s)
- Min Chen
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Guoxiong Jiang
- Affiliated Hospital of Jiangsu University, Zhenjiang, China.,Jiangdu People's Hospital, Yangzhou, China
| | - Yichen Liu
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Dongya Li
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Tiantian Li
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jie Peng
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qian Jiang
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Haiyan You
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Rong Ba
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jinlan Pan
- Affiliated Hospital of Suzhou University, Suzhou, China
| | - Mei Li
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Weiguo Long
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jinsong Yan
- The Second Hospital of Dalian Medical University, Dalian, China
| | - Yan Zhu
- Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yun Wang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaodong Xi
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianhua Mao
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaofeng Shi
- Affiliated Hospital of Jiangsu University, Zhenjiang, China.,The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
19
|
Belman JP, Meng W, Wang HY, Li J, Strauser HT, Rosenfeld AM, Zhang Q, Prak ETL, Wasik M. Dramatic increase in gene mutational burden after transformation of follicular lymphoma into TdT + B-lymphoblastic leukemia/lymphoma. Cold Spring Harb Mol Case Stud 2019; 6:mcs.a004614. [PMID: 31776129 PMCID: PMC6996523 DOI: 10.1101/mcs.a004614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/16/2019] [Indexed: 12/17/2022] Open
Abstract
Transformation of follicular lymphoma (FL) into B-lymphoblastic leukemia/lymphoma (B-ALL/LBL) is rare and results in greatly increased aggressiveness of clinical course. Here we present extensive molecular analysis of this unusual transformation, including immunoglobulin (Ig) gene rearrangement studies, cytogenetic analysis, and whole-exome sequencing (WES) of the patient's FL, B-ALL/LBL, and normal cells. Although FL showed marked somatic hypermutation (SHM) of the Ig genes, SHM appeared to be even more extensive in B-ALL/LBL. Cytogenetically, at least three translocations were identified in the B-ALL/LBL involving the BCL2, BCL6, and MYC genes; two of these, the BCL6 and BCL2 gene rearrangements, were already seen at the FL stage. WES identified 751 single-nucleotide variants with high allelic burden in the patient's cells, with the vast majority (575) present exclusively at the B-ALL/LBL stage. Of note, a TAF3 gene mutation was shared by normal, FL, and B-ALL/LBL tissue. A KMT2D nonsense mutation was identified in both FL and B-ALL/LBL and therefore may have contributed directly to lymphomagenesis. Mutations in KDM6A, SMARCA4, CBX1, and JMY were specific to the B-ALL/LBL stage, possibly contributing to the B-ALL/LBL transformation. Functionally, these identified mutations may lead to dysregulation of DNA repair, transcription, and cell differentiation. Thus, these genetic changes, together with the identified chromosomal translocations, may have contributed to lymphoma development and progression. Our findings may improve the mechanistic understanding of the FL-B-ALL/LBL transformation and may have therapeutic implications for this aggressive disease.
Collapse
Affiliation(s)
- Jonathan P Belman
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Wenzhao Meng
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Hong Yi Wang
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Jie Li
- Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
| | - Honore T Strauser
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Aaron M Rosenfeld
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Qian Zhang
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Eline T Luning Prak
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Mariusz Wasik
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| |
Collapse
|
20
|
Dada R. Diagnosis and management of follicular lymphoma: A comprehensive review. Eur J Haematol 2019; 103:152-163. [PMID: 31270855 DOI: 10.1111/ejh.13271] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 12/18/2022]
Abstract
Follicular Lymphoma (FL) is an indolent lymphoma and may have various clinical courses. Worldwide, FL is the second most common non-Hodgkin lymphoma (NHL) type after diffuse large B-cell lymphoma. In this review article, the author is discussing relevant diagnostic tools, prognostic factors, and updated study results on the management of patients with newly diagnosed and relapsed/refractory FL. Controversies in the treatment, maintenance therapy, stem cell transplantation, and novel treatment approaches will be comprehensively discussed.
Collapse
Affiliation(s)
- Reyad Dada
- King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.,College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
| |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW The treatment of the germinal center lymphomas, diffuse large B cell (DLBCL) and follicular lymphoma, has changed little beyond the introduction of immunochemotherapies. However, there exists a substantial group of patients within both diseases for which improvements in care will involve appropriate tailoring of treatment. RECENT FINDINGS DLBCL consists of two major subtypes with striking differences in their clinical outcomes paralleling their underlying genetic heterogeneity. Recent studies have seen advances in the stratification of germinal center lymphomas, through comprehensive profiling of 1001 DLBCLs alongside refinements in the identification of high-risk follicular lymphoma patients using m7-FLIPI and 23G models. A new wave of novel therapeutic agents is now undergoing clinical trials for germinal center lymphomas, with BCR and EZH2 inhibitors demonstrating preferential benefit in subgroups of patients. The emergence of cell-free DNA has raised the possibility of dynamic disease monitoring to potentially mitigate the complexity of spatial and temporal heterogeneity, whilst predicting tumor evolution in real time. SUMMARY Altogether knowledge of the genomic landscape of germinal center lymphomas is offering welcome opportunities in patient risk stratification and therapeutics. The challenge ahead is to establish how best to combine upfront or dynamic prognostication with precision therapies, while retaining practicality in clinical trials and the real-world setting.
Collapse
|
22
|
Sutamtewagul G, Link BK. Novel treatment approaches and future perspectives in follicular lymphoma. Ther Adv Hematol 2019; 10:2040620718820510. [PMID: 30719267 PMCID: PMC6348550 DOI: 10.1177/2040620718820510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022] Open
Abstract
Follicular lymphoma (FL) is a common B-cell malignancy characterized by relatively indolent growth and incurability with an expected lifetime course of serial intermittent treatment courses. Many patients with FL have lives shortened by the disease and despite a relatively favorable prognosis relative to other incurable systemic malignancies, optimal management of FL has not been achieved. This review focuses on identifying both patients for whom novel therapies might be most beneficial as well as systematically reviewing novel strategies at various levels of investigation. Prognostic markers incorporating clinical measurements and tumor genetics are discussed, yet at the time of diagnosis do not yet powerfully discriminate patients for whom specific strategies are beneficial. Reassessment of prognosis after evaluating the response to initial therapy is the most powerful identifier of those in need of novel management strategies. For initial therapy of high burden systemic disease, anti-CD20 antibody along with chemotherapy or immunomodulators all offer relatively similar effects on overall survival with subtly different effects on progression-free survival and quality of life. Several new agents currently under investigation in the upfront setting are discussed. Perhaps the best testing ground for novel therapies is in patients with early relapse following initial immunochemotherapy. Ongoing research in multiple therapy classes including, novel monoclonal antibodies, antibody drug conjugates, immunomodulatory agents, intracellular pathway inhibitors, immune checkpoint inhibitors, and epigenetic regulators are discussed herein.
Collapse
Affiliation(s)
| | - Brian K. Link
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| |
Collapse
|
23
|
Choi SM, Andea AA, Wang M, Behdad A, Shao L, Zhang Y, Lu X, Dittmann D, Castro J, Chen YH, Gao J. KRAS mutation in secondary malignant histiocytosis arising from low grade follicular lymphoma. Diagn Pathol 2018; 13:78. [PMID: 30322385 PMCID: PMC6190545 DOI: 10.1186/s13000-018-0758-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 10/02/2018] [Indexed: 12/16/2022] Open
Abstract
Background Transformation of follicular lymphoma most typically occurs as diffuse large B-cell lymphoma, however other forms of transformation such as classic Hodgkin lymphoma and lymphoblastic transformation can occur. Secondary malignant histiocytosis also represents a rare form of transformation, which is thought to occur due to a process of transdifferentiation whereby the lymphoma cells exhibit lineage plasticity and lose all evidence of B-cell phenotype and instead acquire the phenotype of a histiocytic neoplasm. Little is known about the underlying genetic alterations that occur during this unusual process. Comparative genetic analysis of pre- and post-transformation/transdifferentiation would be one tool by which we could better understand how this phenomenon occurs. Case presentation Here we report the clinical, immunophenotypic and genetic features of a rare case of secondary malignant histiocytosis, Langerhans cell-type (Langerhans cell sarcoma) arising from a previous low grade follicular lymphoma. FISH analysis confirmed the presence of IgH/BCL2 rearrangement in both the low grade follicular lymphoma (FL) and transformed Langerhans cells sarcoma (LCS) samples, demonstrating a clonal relationship. Comparative whole exome sequencing was then performed, which identified a KRAS p.G13D mutation in the LCS that was not present in the FL. Conclusions This report highlights genetic alterations, in particular an acquired somatic KRAS mutation, that may occur during transdifferentiation, with additional significance of KRAS mutation as a possible therapeutic target in cases which otherwise would have limited treatment options. Electronic supplementary material The online version of this article (10.1186/s13000-018-0758-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sarah M Choi
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA.,Current address: Department of Pathology, University of Michigan, 5242 Medical Science Building 1, 1301 Catherine Street, Ann Arbor, MI, 48109, USA
| | - Aleodor A Andea
- Current address: Department of Pathology, University of Michigan, 5242 Medical Science Building 1, 1301 Catherine Street, Ann Arbor, MI, 48109, USA
| | - Min Wang
- Current address: Department of Pathology, University of Michigan, 5242 Medical Science Building 1, 1301 Catherine Street, Ann Arbor, MI, 48109, USA
| | - Amir Behdad
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Lina Shao
- Current address: Department of Pathology, University of Michigan, 5242 Medical Science Building 1, 1301 Catherine Street, Ann Arbor, MI, 48109, USA
| | - Yanming Zhang
- Current address: Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Xinyan Lu
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - David Dittmann
- Diagnostic Molecular Biology Laboratory, Northwestern Memorial Hospital, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Juan Castro
- Diagnostic Molecular Biology Laboratory, Northwestern Memorial Hospital, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Yi-Hua Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA.
| |
Collapse
|
24
|
Affiliation(s)
- Manel Esteller
- a Cancer Epigenetics and Biology Program (PEBC) , Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Catalonia , Spain.,b Physiological Sciences Department , School of Medicine and Health Sciences, University of Barcelona (UB) , Barcelona , Catalonia , Spain.,c Institucio Catalana de Recerca i Estudis Avançats (ICREA) , Barcelona , Catalonia , Spain
| |
Collapse
|
25
|
Abstract
OPINION STATEMENT Even in the modern era, follicular lymphoma (FL) remains largely an incurable but treatable disease with both standard and novel treatment modalities. Despite the abundance of efficacious treatment modalities currently available, there is no universally agreed upon standard approach to treatment for patients with FL, particularly in the relapsed/refractory (R/R) setting. There is an increasing need for better tools to risk-stratify patients and to identify those likely to experience relapse early. Additionally, the use of gene expression profiling and next-generation sequencing techniques in recent years has led to a wealth of knowledge regarding the molecular drivers of lymphomagenesis; however, much of this knowledge is not currently applicable on a day to day basis in the clinic setting. Further studies are needed to determine a validated, clinically relevant predictive model that incorporates patient factors and molecular factors that will guide clinicians on the most effective treatment strategy. With many questions left unanswered, it is our opinion that the treatment of FL and sequencing of therapy in the R/R setting should be a personalized approach that balances patient-specific factors such as preferences and comorbidities with treatment-related factors such as known response rates and toxicity profiles.
Collapse
|
26
|
Abstract
Follicular lymphoma (FL) is the most frequent indolent B cell lymphoma and is still considered to be incurable. In recent years, whole-exome sequencing studies of large cohorts of patients have greatly improved our knowledge of the FL mutational landscape. Moreover, the prolonged evolution of this disease has enabled some insights regarding the early pre-lymphoma lesions as well as the clonal evolution after treatment, allowing an evolutionary perspective on lymphomagenesis. Deciphering the earliest initiating lesions and identifying the molecular alterations leading to disease progression currently represent important goals; accomplishing these could help identify the most relevant targets for precision therapy.
Collapse
Affiliation(s)
- Sarah Huet
- Cancer Research Center of Lyon, INSERM 1052 CNRS5286, 'Clinical and experimental models of lymphomagenesis' Team, Equipe labellisée Ligue Contre le Cancer Oullins, France
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, 165 chemin du Grand Revoyet, Pierre Bénite 69495, France
- Université Lyon-1, ISPB-Faculté de Pharmacie de Lyon, Lyon, France
| | - Pierre Sujobert
- Cancer Research Center of Lyon, INSERM 1052 CNRS5286, 'Clinical and experimental models of lymphomagenesis' Team, Equipe labellisée Ligue Contre le Cancer Oullins, France
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, 165 chemin du Grand Revoyet, Pierre Bénite 69495, France
- Université Lyon-1, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Oullins, France
| | - Gilles Salles
- Cancer Research Center of Lyon, INSERM 1052 CNRS5286, 'Clinical and experimental models of lymphomagenesis' Team, Equipe labellisée Ligue Contre le Cancer Oullins, France
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, 165 chemin du Grand Revoyet, Pierre Bénite 69495, France
- Université Lyon-1, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Oullins, France
| |
Collapse
|