1
|
Sonego B, Ibatici A, Rivoli G, Angelucci E, Sola S, Massone C. Histopathological Markers for Target Therapies in Primary Cutaneous Lymphomas. Cells 2023; 12:2656. [PMID: 37998391 PMCID: PMC10670482 DOI: 10.3390/cells12222656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
In recent years, targeted (biological) therapies have become available also for primary cutaneous T-cell lymphomas (PCTCLs) including anti-CD30 (brentuximab vedotin) in mycosis fungoides, primary cutaneous anaplastic large T-cell lymphoma, lymphomatoid papulosis; anti-CCR4 (mogamulizumab) in Sezary syndrome; anti-CD123 (tagraxofusp) in blastic plasmocytoid cell neoplasm. Moreover, anti-PD1 (nivolumab), anti-PDL1 (pembrolizumab, atezolizumab), anti-CD52 (alemtuzumab), anti-KIR3DL2-CD158k (lacutamab), and anti-CD70 (cusatuzumab) have been tested or are under investigations in phase II trials. The expression of these epitopes on neoplastic cells in skin biopsies or blood samples plays a central role in the management of PCTCL patients. This narrative review aims to provide readers with an update on the latest advances in the newest therapeutic options for PCTCLs.
Collapse
Affiliation(s)
- Benedetta Sonego
- Dermatology Clinic, University of Trieste, 35125 Trieste, Italy;
| | - Adalberto Ibatici
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Giulia Rivoli
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Emanuele Angelucci
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Simona Sola
- Surgical Pathology, Galliera Hospital, 16128 Genoa, Italy;
| | - Cesare Massone
- Dermatology Unit & Scientific Directorate, Galliera Hospital, 16128 Genoa, Italy
| |
Collapse
|
2
|
Sakamoto K, Baba S, Okumura Y, Momose S, Ono S, Tonooka A, Ichinohasama R, Takakuwa E, Nakasone H, Ohshima K, Takeuchi K. Comparison and Development of Immunohistochemical Diagnostic Criteria for Blastic Plasmacytoid Dendritic Cell Neoplasm. Mod Pathol 2023; 36:100253. [PMID: 37380058 DOI: 10.1016/j.modpat.2023.100253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy derived from the precursors of plasmacytoid dendritic cells. Diagnostic criteria for BPDCN have not been fully established. BPDCN is often diagnosed without other BPDCN markers than the 3 conventional markers (CD4, CD56, and CD123) in practice and case reports, although acute myeloid leukemia/myeloid sarcoma (AML/MS), which is always considered in the differential diagnosis of BPDCN, can express them. We reviewed published case reports on BPDCN and found that the diagnosis was made without any other BPDCN markers than the conventional markers in two-thirds of the cases. Next, 4 representative existing diagnostic criteria were applied to 284 cases of our cohort of BPDCN and mimics. The results differed in 20% (56/284) of the cases. The criterion based on the 3 conventional markers alone had a low concordance rate (80%-82%) with the other 3 criteria, which were almost concordant with each other. However, newly found minor limitations in these criteria prompted us to devise new diagnostic criterion for BPDCN composed of TCF4, CD123, TCL1, and lysozyme. We also revealed that CD123-positive AML/MS patients had a significantly poorer outcome than those with BPDCN and that 12% (24/205) of the cases were non-BPDCN even if all 3 conventional markers were positive, thus clarifying the risk of diagnosing BPDCN without more specific markers. In addition, histopathological features, such as the reticular pattern, which is not seen in BPDCN and suggests AML/MS, were also identified.
Collapse
Affiliation(s)
- Kana Sakamoto
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuka Okumura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Shuji Momose
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sawako Ono
- Department of Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Akiko Tonooka
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Komagome Hospital, Tokyo, Japan
| | - Ryo Ichinohasama
- Division of Hematopathology, Tohoku University Hospital, Sendai, Japan
| | - Emi Takakuwa
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Nakasone
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Clinical Pathology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
| |
Collapse
|
3
|
Cheng W, Yu TT, Tang AP, He Young K, Yu L. Blastic Plasmacytoid Dendritic Cell Neoplasm: Progress in Cell Origin, Molecular Biology, Diagnostic Criteria and Therapeutic Approaches. Curr Med Sci 2021; 41:405-419. [PMID: 34218354 DOI: 10.1007/s11596-021-2393-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy characterized by recurrent skin nodules, an aggressive clinical course with rapid involvement of hematological organs, and a poor prognosis with poor overall survival. BPDCN is derived from plasmacytoid dendritic cells (pDCs) and its pathogenesis is unclear. The tumor cells show aberrant expression of CD4, CD56, interleukin-3 receptor alpha chain (CD123), blood dendritic cell antigen 2 (BDCA 2/CD303), blood dendritic cell antigen 4 (BDCA4) and transcription factor (E protein) E2-2 (TCF4). The best treatment drugs are based on experience by adopting those used for either leukemia or lymphoma. Relapse with drug resistance generally occurs quickly. Stem cell transplantation after the first complete remission is recommended and tagraxofusp is the first targeted therapy. In this review, we summarize the differentiation of BPDCN from its cell origin, its connection with normal pDCs, clinical characteristics, genetic mutations and advances in treatment of BPDCN. This review provides insights into the mechanisms of and new therapeutic approaches for BPDCN.
Collapse
Affiliation(s)
- Wei Cheng
- Department of Hematology, the Second Affiliate Hospital of Nanchang University, Nanchang, 330006, China
| | - Tian-Tian Yu
- Department of Hematology, the Second Affiliate Hospital of Nanchang University, Nanchang, 330006, China
| | - Ai-Ping Tang
- Department of Hematology, the Second Affiliate Hospital of Nanchang University, Nanchang, 330006, China
| | - Ken He Young
- Division of Hematopathology and Department of Pathology, Duke University Medical Center, Durham, 27710, USA
| | - Li Yu
- Department of Hematology, the Second Affiliate Hospital of Nanchang University, Nanchang, 330006, China.
| |
Collapse
|
4
|
Deconinck E, Petrella T, Garnache Ottou F. Blastic Plasmacytoid Dendritic Cell Neoplasm: Clinical Presentation and Diagnosis. Hematol Oncol Clin North Am 2020; 34:491-500. [PMID: 32336414 DOI: 10.1016/j.hoc.2020.01.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Clinical and biological presentation of patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) is depicted to highlight criteria that might alert physicians. Diagnosis of BPDCN is still challenging and requires (1) immunophenotyping of blood or bone marrow aspiration using several markers (CD4, CD56, HLA-DR, myeloid and lymphoid lineage markers) and should include pDC markers such as CD123, cTCL1, CD303, and CD304, and/or (2) pathologic analysis of cutaneous lesions, also with immunohistochemistry using markers specific to BPDCN.
Collapse
Affiliation(s)
- Eric Deconinck
- Service Hématologie, Université de Bourgogne Franche-Comté, INSERM Unite Mixte de Recherche (UMR) 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Centre Hospitalier Universitaire de Besançon, 3 Boulevard Alexandre Fleming, Besançon Cedex 25030, France
| | - Tony Petrella
- Department of Pathology, University of Montréal, Hôpital Maisonneuve-Rosemont, 2900 Boulevard Edouard-Montpetit, Montréal QC H3T 1J4, Quebec, Canada
| | - Francine Garnache Ottou
- Université de Bourgogne Franche-Comté, INSERM Unite Mixte de Recherche (UMR) 1098, RIGHT Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, Etablissement Français du sang Bourgogne Franche-Comté, 8 rue du Dr JFX Girod, Besançon 25000, France.
| |
Collapse
|
5
|
Sakamoto K, Takeuchi K. Cytogenetics of Blastic Plasmacytoid Dendritic Cell Neoplasm: Chromosomal Rearrangements and DNA Copy-Number Alterations. Hematol Oncol Clin North Am 2020; 34:523-538. [PMID: 32336417 DOI: 10.1016/j.hoc.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a skin-tropic hematopoietic malignancy. Approximately 60% of cases with analyzable karyotyping results show complex karyotypes. Losses are more frequently found than copy-number gains. Recurrently deleted regions include tumor suppressor genes. No specific chromosomal abnormalities have been demonstrated in BPDCN, but genomic rearrangements involving the MYB family genes and MYC were identified. One-third of cases of BPDCN harbor the 8q24 rearrangement, most frequently with 6p21 harboring RUNX2, which is associated with immunoblastoid cytomorphology and MYC expression. MYB rearrangement is detected in 20% of patients with BPDCN. We review copy-number alterations and chromosomal rearrangements.
Collapse
Affiliation(s)
- Kana Sakamoto
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo 135-8550, Japan; Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo 135-8550, Japan; Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Clinical Pathology Center, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
| |
Collapse
|
6
|
Abstract
When looking for diseases of the skin, this is usually done in a holistic way, automatically and unconsciously, by recognizing localization, distribution, and appearance of the primary or secondary skin lesions. When Robert Willan (1757-1812) introduced the concept of morphology of skin lesions, it became the basis for the classification of dermatoses. Apart from ethnic factors, the various dermatoses comprise a rainbow of colors ranging from the most common red color to yellow, blue, brown, silver, green, black, and white.
Collapse
Affiliation(s)
- Günter Burg
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
| |
Collapse
|
7
|
Sapienza MR, Pileri A, Derenzini E, Melle F, Motta G, Fiori S, Calleri A, Pimpinelli N, Tabanelli V, Pileri S. Blastic Plasmacytoid Dendritic Cell Neoplasm: State of the Art and Prospects. Cancers (Basel) 2019; 11:cancers11050595. [PMID: 31035408 PMCID: PMC6562663 DOI: 10.3390/cancers11050595] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/16/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an extremely rare tumour, which usually affects elderly males and presents in the skin with frequent involvement of the bone-marrow, peripheral blood and lymph nodes. It has a dismal prognosis, with most patients dying within one year when treated by conventional chemotherapies. The diagnosis is challenging, since neoplastic cells can resemble lymphoblasts or small immunoblasts, and require the use of a large panel of antibodies, including those against CD4, CD56, CD123, CD303, TCL1, and TCF4. The morphologic and in part phenotypic ambiguity explains the uncertainties as to the histogenesis of the neoplasm that led to the use of various denominations. Recently, a series of molecular studies based on karyotyping, gene expression profiling, and next generation sequencing, have largely unveiled the pathobiology of the tumour and proposed the potentially beneficial use of new drugs. The latter include SL-401, anti-CD123 immunotherapies, venetoclax, BET-inhibitors, and demethylating agents. The epidemiologic, clinical, diagnostic, molecular, and therapeutic features of BPDCN are thoroughly revised in order to contribute to an up-to-date approach to this tumour that has remained an orphan disease for too long.
Collapse
Affiliation(s)
- Maria Rosaria Sapienza
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Alessandro Pileri
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, School of Medicine, Via Massarenti 1, 40138 Bologna, Italy.
| | - Enrico Derenzini
- Division of Haematology, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy.
| | - Federica Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Giovanna Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Stefano Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Angelica Calleri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Nicola Pimpinelli
- Dermatology Unit, Department of Health and Science, University of Florence, School of Medicine, Viale Michelangiolo 104, 50100 Firenze, Italy.
| | - Valentina Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Stefano Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| |
Collapse
|
8
|
Kutane Lymphome. MEDIKAMENTÖSE TUMORTHERAPIE IN DER DERMATO-ONKOLOGIE 2019. [PMCID: PMC7121154 DOI: 10.1007/978-3-662-58012-7_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Kutane Lymphome (cutaneous lymphomas: CL) umfassen die Gruppe der kutanen T-Zell-Lymphome (cutaneous T-cell lymphomas: CTCL), kutanen B-Zell-Lymphome (cutaneous B-cell lymphomas: CBCL) und die sog. hämatodermischen Neoplasien (HN). CL gehören zur Gruppe der Non-Hodgkin-Lymphome (NHL) und stellen in der Subgruppe der extranodalen NHL die zweithäufigste Gruppe hinter den gastrointestinalen Lymphomen dar (Jaffe et al. 2009). Man unterscheidet zwischen primären und sekundären CL. Primäre CL haben ihren Ursprung in der Haut und bleiben in der Regel darauf auch längere Zeit beschränkt, während sekundäre CL kutane Manifestationen von primär nodalen oder extranodalen Lymphomen darstellen (Willemze 2005). Die primären CL unterscheiden sich hinsichtlich klinischem Verlauf, Therapieoptionen und Prognose erheblich von nodalen und extrakutanen Lymphomen. So zeigen z. B. die primär kutanen CD30+-T-Zell-Lymphome einen gutartigen Verlauf, wogegen die nodalen Varianten als aggressiv eingestuft werden. Da die CL zumeist weniger aggressiv sind, werden sie auch weniger aggressiv behandelt.
Collapse
|
9
|
Sapienza MR, Abate F, Melle F, Orecchioni S, Fuligni F, Etebari M, Tabanelli V, Laginestra MA, Pileri A, Motta G, Rossi M, Agostinelli C, Sabattini E, Pimpinelli N, Truni M, Falini B, Cerroni L, Talarico G, Piccioni R, Amente S, Indio V, Tarantino G, Brundu F, Paulli M, Berti E, Facchetti F, Dellino GI, Bertolini F, Tripodo C, Rabadan R, Pileri SA. Blastic plasmacytoid dendritic cell neoplasm: genomics mark epigenetic dysregulation as a primary therapeutic target. Haematologica 2018; 104:729-737. [PMID: 30381297 PMCID: PMC6442957 DOI: 10.3324/haematol.2018.202093] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/30/2018] [Indexed: 01/01/2023] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy for which there is still no effective therapy. In order to identify genetic alterations useful for a new treatment design, we used whole-exome sequencing to analyze 14 BPDCN patients and the patient-derived CAL-1 cell line. The functional enrichment analysis of mutational data reported the epigenetic regulatory program to be the most significantly undermined (P<0.0001). In particular, twenty-five epigenetic modifiers were found mutated (e.g. ASXL1, TET2, SUZ12, ARID1A, PHF2, CHD8); ASXL1 was the most frequently affected (28.6% of cases). To evaluate the impact of the identified epigenetic mutations at the gene-expression and Histone H3 lysine 27 trimethylation/acetylation levels, we performed additional RNA and pathology tissue-chromatin immunoprecipitation sequencing experiments. The patients displayed enrichment in gene signatures regulated by methylation and modifiable by decitabine administration, shared common H3K27-acetylated regions, and had a set of cell-cycle genes aberrantly up-regulated and marked by promoter acetylation. Collectively, the integration of sequencing data showed the potential of a therapy based on epigenetic agents. Through the adoption of a preclinical BPDCN mouse model, established by CAL-1 cell line xenografting, we demonstrated the efficacy of the combination of the epigenetic drugs 5’-azacytidine and decitabine in controlling disease progression in vivo.
Collapse
Affiliation(s)
- Maria Rosaria Sapienza
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Francesco Abate
- Department of Systems Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Federica Melle
- Division of Haematopathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefania Orecchioni
- Laboratory of Hematology-Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Fuligni
- Department of Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Maryam Etebari
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Valentina Tabanelli
- Division of Haematopathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Antonella Laginestra
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Alessandro Pileri
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy.,Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Italy
| | - Giovanna Motta
- Division of Haematopathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Maura Rossi
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Claudio Agostinelli
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Elena Sabattini
- Hematopathology Unit, Department of Experimental, Diagnostic, and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
| | - Nicola Pimpinelli
- Division of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Italy
| | - Mauro Truni
- Pathological Anatomy Histology & Cytogenetics, Niguarda Cancer Center, Niguarda-Ca' Granda Hospital, Milan, Italy
| | - Brunangelo Falini
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), University and Hospital of Perugia, Italy
| | - Lorenzo Cerroni
- Universitätsklinik für Dermatologie und Venerologie, LKH-Universitatsklinikum Graz, Austria
| | - Giovanna Talarico
- Laboratory of Hematology-Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Rossana Piccioni
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy
| | - Stefano Amente
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples 'Federico II', Italy
| | - Valentina Indio
- "Giorgio Prodi" Cancer Research Center, University of Bologna, Italy
| | | | - Francesco Brundu
- Department of Systems Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Marco Paulli
- Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS San Matteo Policlinic, Pavia, Italy
| | - Emilio Berti
- Department of Dermatology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinic and Milan University, Milan, Italy
| | - Fabio Facchetti
- Pathology Section, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Gaetano Ivan Dellino
- Department of Experimental Oncology, European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Francesco Bertolini
- Laboratory of Hematology-Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Claudio Tripodo
- Tumor Immunology Unit, Department of Health Science, Human Pathology Section, University of Palermo School of Medicine, Italy
| | - Raul Rabadan
- Department of Systems Biology, Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Stefano A Pileri
- Division of Haematopathology, IEO European Institute of Oncology IRCCS, Milan, Italy
| |
Collapse
|
10
|
Lin CY, Wu MY, Kuo TT, Lu PH. Cutaneous blastic plasmacytoid dendritic cell neoplasm: Report of a case and review of the literature. DERMATOL SIN 2017. [DOI: 10.1016/j.dsi.2017.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
11
|
Laribi K, Denizon N, Besançon A, Farhi J, Lemaire P, Sandrini J, Truong C, Ghnaya H, Baugier de Materre A. Blastic Plasmacytoid Dendritic Cell Neoplasm: From Origin of the Cell to Targeted Therapies. Biol Blood Marrow Transplant 2016; 22:1357-1367. [DOI: 10.1016/j.bbmt.2016.03.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 03/19/2016] [Indexed: 12/31/2022]
|
12
|
Pagano L, Valentini CG, Grammatico S, Pulsoni A. Blastic plasmacytoid dendritic cell neoplasm: diagnostic criteria and therapeutical approaches. Br J Haematol 2016; 174:188-202. [PMID: 27264021 DOI: 10.1111/bjh.14146] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare haematological malignancy derived from the precursors of plamacytoid dendritic cells, with an aggressive clinical course and high frequency of cutaneous and bone marrow involvement. Neoplastic cells express CD4, CD43 (also termed SPN), CD45RA and CD56 (also termed NCAM1), as well as the plasmacytoid dendritic cell-associated antigens CD123 (also termed IL3RA), BDCA-2 (also termed CD303, CLEC4E) TCL1 and CTLA1 (also termed GZMB). The median survival is only a few months as the tumour exhibits a progressive course despite initial response to chemotherapy. The best modality of treatment remains to be defined. Generally, patients receive acute leukaemia-like induction, according to acute myeloid leukaemia (AML)-type or acute lymphoid leukaemia (ALL)-type regimens. The frequent neuromeningeal involvement indicates systematic pre-emptive intrathecal chemotherapy in addition to intensive chemotherapy. Allogeneic haematopoietic stem cell transplantation (HSCT), particularly when performed in first remission, may improve the survival. Preliminary data suggest a potential role for immunomodulatory agents and novel targeted drugs. Herein epidemiology, clinical manifestations, diagnosis and management of BPDCN will be presented. In detail, this review focuses on the therapeutic aspects of BPDCN, proposing a treatment algorithm for the management of the disease, including induction chemotherapy, allogeneic HSCT and intrathecal prophylaxis at different steps of treatment, according to compliance, biological and clinical characteristics of patients.
Collapse
Affiliation(s)
- Livio Pagano
- Institute of Haematology, Catholic University, Rome, Italy
| | | | - Sara Grammatico
- Division of Haematology, Department of Cellular Biotechnologies and Haematology, "Sapienza University", Rome, Italy
| | - Alessandro Pulsoni
- Division of Haematology, Department of Cellular Biotechnologies and Haematology, "Sapienza University", Rome, Italy
| |
Collapse
|
13
|
Tang Z, Tang G, Wang SA, Lu X, Young KH, Bueso-Ramos CE, Alvarado Y, Medeiros LJ, Khoury JD. Simultaneous deletion of 3'ETV6 and 5'EWSR1 genes in blastic plasmacytoid dendritic cell neoplasm: case report and literature review. Mol Cytogenet 2016; 9:23. [PMID: 26925167 PMCID: PMC4769509 DOI: 10.1186/s13039-016-0232-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/22/2016] [Indexed: 12/11/2022] Open
Abstract
Background Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy. Based on literature reports of limited cases, over 50 % of BPDCN have chromosomal abnormalities, but no single chromosomal change has been identified as diagnostic of this entity. Case presentation In this report, we present a case of BPDCN with complicated chromosomal abnormalities involving chromosomes 12 and 22 and resulting in a simultaneous partial deletion of ETV6 and EWSR1. Notably, these aberrations were identified in bone marrow myeloid precursors in the absence of bone marrow involvement by BPDCN. Conclusion Analysis of 46 BPDCN cases with abnormal karyotypes (45 from literature reports plus this case) showed that 12p- is one of the most common structural aberrations in BPDCN. The ETV6 and CDKN1B on 12p deserve further investigations as potential markers of BPDCN.
Collapse
Affiliation(s)
- Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Xinyan Lu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Yesid Alvarado
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA
| |
Collapse
|
14
|
Neoplasms derived from plasmacytoid dendritic cells. Mod Pathol 2016; 29:98-111. [PMID: 26743477 DOI: 10.1038/modpathol.2015.145] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/10/2015] [Indexed: 01/29/2023]
Abstract
Plasmacytoid dendritic cell neoplasms manifest in two clinically and pathologically distinct forms. The first variant is represented by nodular aggregates of clonally expanded plasmacytoid dendritic cells found in lymph nodes, skin, and bone marrow ('Mature plasmacytoid dendritic cells proliferation associated with myeloid neoplasms'). This entity is rare, although likely underestimated in incidence, and affects predominantly males. Almost invariably, it is associated with a myeloid neoplasm such as chronic myelomonocytic leukemia or other myeloid proliferations with monocytic differentiation. The concurrent myeloid neoplasm dominates the clinical pictures and guides treatment. The prognosis is usually dismal, but reflects the evolution of the associated myeloid leukemia rather than progressive expansion of plasmacytoid dendritic cells. A second form of plasmacytoid dendritic cells tumor has been recently reported and described as 'blastic plasmacytoid dendritic cell neoplasm'. In this tumor, which is characterized by a distinctive cutaneous and bone marrow tropism, proliferating cells derive from immediate CD4(+)CD56(+) precursors of plasmacytoid dendritic cells. The diagnosis of this form can be easily accomplished by immunohistochemistry, using a panel of plasmacytoid dendritic cells markers. The clinical course of blastic plasmacytoid dendritic cell neoplasm is characterized by a rapid progression to systemic disease via hematogenous dissemination. The genomic landscape of this entity is currently under intense investigation. Recurrent somatic mutations have been uncovered in different genes, a finding that may open important perspectives for precision medicine also for this rare, but highly aggressive leukemia.
Collapse
|
15
|
Yu H, Zhang P, Yin X, Yin Z, Shi Q, Cui Y, Liu G, Wang S, Piccaluga PP, Jiang T, Zhang L. Human BDCA2+CD123+CD56+ dendritic cells (DCs) related to blastic plasmacytoid dendritic cell neoplasm represent a unique myeloid DC subset. Protein Cell 2015; 6:297-306. [PMID: 25779340 PMCID: PMC4383756 DOI: 10.1007/s13238-015-0140-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 12/25/2014] [Indexed: 11/13/2022] Open
Abstract
Dendritic cells (DCs) comprise two functionally distinct subsets: plasmacytoid DCs (pDCs) and myeloid DCs (mDCs). pDCs are specialized in rapid and massive secretion of type I interferon (IFN-I) in response to nucleic acids through Toll like receptor (TLR)-7 or TLR-9. In this report, we characterized a CD56+ DC population that express typical pDC markers including CD123 and BDCA2 but produce much less IFN-I comparing with pDCs. In addition, CD56+ DCs cluster together with mDCs but not pDCs by genome-wide transcriptional profiling. Accordingly, CD56+ DCs functionally resemble mDCs by producing IL-12 upon TLR4 stimulation and priming naïve T cells without prior activation. These data suggest that the CD56+ DCs represent a novel mDC subset mixed with some pDC features. A CD4+CD56+ hematological malignancy was classified as blastic plasmacytoid dendritic cell neoplasm (BPDCN) due to its expression of characteristic molecules of pDCs. However, we demonstrated that BPDCN is closer to CD56+ DCs than pDCs by global gene-expression profiling. Thus, we propose that the CD4+CD56+ neoplasm may be a tumor counterpart of CD56+ mDCs but not pDCs.
Collapse
Affiliation(s)
- Haisheng Yu
- Key Laboratory of Immunity and Infection, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China.,Graduate School of the Chinese Academy of Sciences, Beijing, 100080 China
| | - Peng Zhang
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China.,Graduate School of the Chinese Academy of Sciences, Beijing, 100080 China
| | - Xiangyun Yin
- Key Laboratory of Immunity and Infection, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China.,Graduate School of the Chinese Academy of Sciences, Beijing, 100080 China
| | - Zhao Yin
- Department of Cardiology, 306th Hospital of PLA, Beijing, 100101 China
| | - Quanxing Shi
- Department of Cardiology, 306th Hospital of PLA, Beijing, 100101 China
| | - Ya Cui
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China
| | - Guanyuan Liu
- Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020 China
| | - Shouli Wang
- Department of Cardiology, 306th Hospital of PLA, Beijing, 100101 China
| | - Pier Paolo Piccaluga
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, 40126 Italy
| | - Taijiao Jiang
- Key Laboratory of Protein and Peptide Pharmaceuticals, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China
| | - Liguo Zhang
- Key Laboratory of Immunity and Infection, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101 China
| |
Collapse
|
16
|
Blessing or curse? Proteomics in granzyme research. Proteomics Clin Appl 2014; 8:351-81. [DOI: 10.1002/prca.201300096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/29/2013] [Accepted: 12/21/2013] [Indexed: 01/08/2023]
|
17
|
Shi Y, Wang E. Blastic plasmacytoid dendritic cell neoplasm: a clinicopathologic review. Arch Pathol Lab Med 2014; 138:564-9. [PMID: 24678689 DOI: 10.5858/arpa.2013-0101-rs] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm is a rare entity grouped with the acute myeloid leukemia-related precursor neoplasms in the 2008 World Health Organization classification. It was previously postulated to originate from natural killer cells, T cells, or monocytes but is now believed to arise from the plasmacytoid dendritic cell. The pathogenesis of blastic plasmacytoid dendritic cell neoplasm is not well understood, although the neoplasm demonstrates frequent deletion of tumor suppressor genes, including RB1, CDKN1B, CDKN2A, and TP53. Blastic plasmacytoid dendritic cell neoplasm is a clinically aggressive tumor that often initially presents as cutaneous lesions and subsequently progresses to bone marrow involvement and leukemic dissemination. It is characterized by enhanced expression of CD56, CD4, and CD123, which can be detected by flow cytometry/immunohistochemistry. The differential diagnoses include myeloid sarcoma/acute myeloid leukemia, T-cell lymphoblastic leukemia/lymphoma, NK-cell lymphoma/leukemia, and some mature T-cell lymphomas/leukemias. Patients usually respond to initial chemotherapy but often relapse. Stem cell transplant may improve survival.
Collapse
Affiliation(s)
- Yang Shi
- From the Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | | |
Collapse
|
18
|
Chou YH, Lin RY, Lee MS, Wu HP, Lin CP, Wu CY. Bruise-like cutaneous lesions as the early presentation of blastic plasmacytoid dendritic cell neoplasm. DERMATOL SIN 2014. [DOI: 10.1016/j.dsi.2013.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
19
|
Lencastre A, Cabete J, João A, Farinha P, Ferreira G, Lestre S. Blastic plasmacytoid dendritic cell neoplasm. An Bras Dermatol 2014; 88:158-61. [PMID: 24346907 PMCID: PMC3876014 DOI: 10.1590/abd1806-4841.20132388] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 01/13/2013] [Indexed: 11/30/2022] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm is a rare and aggressive hematodermic
neoplasia with frequent cutaneous involvement and leukemic dissemination. We report
the case of a 76-year-old man with a 2 month history of violaceous nodules and a
tumor with stony consistency, located on the head, and mandibular, cervical and
supraclavicular lymphadenopathies. Multiple thoracic and abdominal adenopathies were
identified on computerized tomography. Flow cytometry analysis of the skin, lymph
node and bone marrow biopsies demonstrated the presence of plasmocytoid dendritic
cell neoplastic precursor cells (CD4+, CD45+, CD56+ and CD123+ phenotype). After
initial clinical and laboratorial complete remission with chemotherapy, the patient
died due to relapse of the disease associated with the appearance of a cervical mass
with medullary compromise.
Collapse
Affiliation(s)
- André Lencastre
- Centro Hospitalar de Lisboa Central, EPE, Hospital de Santo António dos Capuchos, Dermatology Service, Lisbon, Portugal
| | - Joana Cabete
- Hospital Center of Central Lisbon, EPE, Santo António dos Capuchos Hospital, Dermatology Service, Lisbon, Portugal
| | - Alexandre João
- Centro Hospitalar de Lisboa Central, EPE, Hospital de Santo António dos Capuchos, Dermatology Service, Lisbon, Portugal
| | - Pedro Farinha
- Centro Hospitalar de Lisboa Central, EPE, Hospital de Santo António dos Capuchos, Pathology Department, Service of Pathological Anatomy, Lisbon, Portugal
| | - Gilda Ferreira
- Centro Hospitalar de Lisboa Central, EPE, Hospital de Santo António dos Capuchos, Lisbon, Portugal
| | - Sara Lestre
- Centro Hospitalar de Lisboa Central, EPE, Hospital de Santo António dos Capuchos, Dermatology Service, Lisbon, Portugal
| |
Collapse
|
20
|
Sapienza MR, Fuligni F, Agostinelli C, Tripodo C, Righi S, Laginestra MA, Pileri A, Mancini M, Rossi M, Ricci F, Gazzola A, Melle F, Mannu C, Ulbar F, Arpinati M, Paulli M, Maeda T, Gibellini D, Pagano L, Pimpinelli N, Santucci M, Cerroni L, Croce CM, Facchetti F, Piccaluga PP, Pileri SA. Molecular profiling of blastic plasmacytoid dendritic cell neoplasm reveals a unique pattern and suggests selective sensitivity to NF-kB pathway inhibition. Leukemia 2014; 28:1606-16. [PMID: 24504027 PMCID: PMC4294271 DOI: 10.1038/leu.2014.64] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/07/2014] [Accepted: 01/28/2014] [Indexed: 12/12/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease of controversial origin recently recognized as a neoplasm deriving from plasmacytoid dendritic cells (pDCs). Nevertheless, it remains an orphan tumor with obscure biology and dismal prognosis. To better understand the pathobiology of BPDCN and discover new targets for effective therapies, the gene expression profile (GEP) of 25 BPDCN samples was analyzed and compared with that of pDCs, their postulated normal counterpart. Validation was performed by immunohistochemistry (IHC), whereas functional experiments were carried out ex vivo. For the first time at the molecular level, we definitely recognized the cellular derivation of BPDCN that proved to originate from the myeloid lineage and in particular, from resting pDCs. Furthermore, thanks to an integrated bioinformatic approach we discovered aberrant activation of the NF-kB pathway and suggested it as a novel therapeutic target. We tested the efficacy of anti-NF-kB-treatment on the BPDCN cell line CAL-1, and successfully demonstrated by GEP and IHC the molecular shutoff of the NF-kB pathway. In conclusion, we identified a molecular signature representative of the transcriptional abnormalities of BPDCN and developed a cellular model proposing a novel therapeutic approach in the setting of this otherwise incurable disease.
Collapse
Affiliation(s)
- M R Sapienza
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - F Fuligni
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - C Agostinelli
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - C Tripodo
- Department of Health Science, Tumour Immunology Unit, Human Pathology Section University of Palermo School of Medicine, Palermo, Italy
| | - S Righi
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - M A Laginestra
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - A Pileri
- Department of Surgery and Translational Medicine - Division Dermatology, University of Florence, Florence, Italy
| | - M Mancini
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - M Rossi
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - F Ricci
- Department of Hematology, Oncology and Laboratory Medicine, Transfusion Medicine Service, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - A Gazzola
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - F Melle
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - C Mannu
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - F Ulbar
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - M Arpinati
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - M Paulli
- Anatomic Pathology Section, University of Pavia Medical School, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione Policlinico, San Matteo, Pavia, Italy
| | - T Maeda
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - D Gibellini
- Department of Experimental, Diagnostic, and Specialty Medicine, Microbiology Section, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - L Pagano
- Institute of Hematology, Catholic University, Rome, Italy
| | - N Pimpinelli
- Department of Surgery and Translational Medicine - Division Dermatology, University of Florence, Florence, Italy
| | - M Santucci
- Department of Surgery and Translational Medicine, Pathologic Anatomy Division, University of Florence, Florence, Italy
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C M Croce
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - F Facchetti
- Department of Molecular and Translational Medicine, Pathology Section, University of Brescia, Brescia, Italy
| | - P P Piccaluga
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | - S A Pileri
- Department of Experimental, Diagnostic, and Specialty Medicine, Hematopathology & Hematology Sections, Molecular Pathology Laboratory, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy
| | | |
Collapse
|
21
|
Kutane Lymphome. MEDIKAMENTÖSE TUMORTHERAPIE IN DER DERMATO-ONKOLOGIE 2014. [PMCID: PMC7122836 DOI: 10.1007/978-3-642-24837-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Kutane Lymphome (cutaneous lymphomas: CL) umfassen die Gruppe der kutanen T-Zell-Lymphome (cutaneous T-cell lymphomas: CTCL), kutanen B-Zell-Lymphome (cutaneous B-cell lymphomas: CBCL) und die sog. hämatodermischen Neoplasien (HN). CL gehören zur Gruppe der Non-Hodgkin-Lymphome (NHL) und stellen in der Subgruppe der extranodalen NHL die zweithäufigste Gruppe hinter den gastrointestinalen Lymphomen dar (Jaffe et al. 2009). Man unterscheidet zwischen primären und sekundären CL. Primäre CL
haben ihren Ursprung in der Haut und bleiben in der Regel darauf auch längere Zeit beschränkt, während sekundäre LymphomekutaneCL kutane Manifestationen von primär nodalen oder extranodalen Lymphomen darstellen (Willemze 2005). Die primären CL unterscheiden sich hinsichtlich klinischem Verlauf, Therapieoptionen und Prognose erheblich von nodalen und extrakutanen Lymphomen. So zeigen z. B. die primär kutanen CD30+ Lymphome einen gutartigen Verlauf, wogegen die nodalen Varianten als aggressiv eingestuft werden. Da die CL zumeist weniger aggressiv sind, werden sie weniger aggressiv behandelt.
Collapse
|
22
|
|
23
|
Borchiellini D, Ghibaudo N, Mounier N, Del Giudice P, Quinsat D, Ticchioni M, Perrin C, Cardot Leccia N, Lacour JP. Blastic plasmacytoid dendritic cell neoplasm: a report of four cases and review of the literature. J Eur Acad Dermatol Venereol 2012; 27:1176-81. [PMID: 22455538 DOI: 10.1111/j.1468-3083.2012.04503.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Blastic plasmacytoid dendritic cell neoplasm (BPDCN), formerly known as agranular CD4(+) /CD56(+) haematodermic neoplasm (CD4/CD56 HN), is a rare distinct form of lymphoma-like entity known of dermatologists because of its marked predilection for cutaneous involvement, and its aggressive behaviour. Moreover, the association or the evolution to an acute leukaemia entity that still expresses CD4 and CD56 markers is almost systematic. This new described entity of 'CD4(+) /CD56(+) leukaemia' or 'leukaemia of plasmacytoid dendritic cell lineage' has a poor prognostic and may lead to include haematopoietic stem cell transplantation in the treatment strategy as early as possible. REPORT OF CASES We report here four cases presenting with skin lesions and haematological signs. One of the patients underwent allogeneic stem cell transplantation, with a relapse-free survival of 40 months. We discuss the diagnosis features as well as the treatment options. CONCLUSION A collaborative work between dermatologists and onco-haematologists is essential to give patients the best chance of complete and long-term response.
Collapse
Affiliation(s)
- D Borchiellini
- Department of Haematology, Archet Hospital, University of Nice, France
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Gilis L, Lebras L, Bouafia-Sauvy F, Espinouse D, Felman P, Berger F, Salles G, Coiffier B, Michallet AS. Sequential combination of high dose methotrexate and L-asparaginase followed by allogeneic transplant: a first-line strategy for CD4+/CD56+ hematodermic neoplasm. Leuk Lymphoma 2012; 53:1633-7. [PMID: 22260159 DOI: 10.3109/10428194.2012.656627] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
25
|
Cronin DM, George TI, Reichard KK, Sundram UN. Immunophenotypic analysis of myeloperoxidase-negative leukemia cutis and blastic plasmacytoid dendritic cell neoplasm. Am J Clin Pathol 2012; 137:367-76. [PMID: 22338048 DOI: 10.1309/ajcp9is9kfsvwkgh] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Myeloid leukemia cutis (LC) and blastic plasmacytoid dendritic cell neoplasm (BPDCN) are morphologically indistinguishable malignancies that frequently manifest in the skin. Separating myeloperoxidase-negative LC from BPDCN may be particularly challenging. We identified a panel of immunohistochemical stains to distinguish myeloid LC (23 cases) from BPDCN (12 cases): myeloperoxidase, which stained 7 cases (30%) of LC and 0 cases (0%) of BPDCN; CD56, which stained 12 cases (52%) of LC and all 12 cases (100%) of BPDCN; CD4, which stained 2 cases (9%) of LC and all 12 cases (100%) of BPDCN; CD123, which stained 4 cases (17%) of LC and 10 cases (83%) of BPDCN; and Tcl-1, which stained 2 cases (9%) of LC and 9 (82%) of 11 cases of BPDCN. It is interesting that CD33 was not helpful; it stained 18 (78%) cases of LC and 11 cases (92%) of BPDCN. Our results indicate that a panel that includes CD4, CD56, CD123, and Tcl-1 can appropriately distinguish between these 2 entities.
Collapse
|
26
|
Agliano A, Martin-Padura I, Marighetti P, Gregato G, Calleri A, Prior C, Redrado M, Calvo A, Bertolini F. Therapeutic effect of lenalidomide in a novel xenograft mouse model of human blastic NK cell lymphoma/blastic plasmacytoid dendritic cell neoplasm. Clin Cancer Res 2011; 17:6163-73. [PMID: 21856771 DOI: 10.1158/1078-0432.ccr-11-0212] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Blastic natural killer (NK) cell lymphoma/blastic plasmacytoid dendritic cell neoplasm (BNKL) is a rare and aggressive neoplasia characterized by infiltration of blast CD4(+)/CD56(+) cells in the skin, the bone marrow, and peripheral blood. Currently, more efforts are required to better define molecular and biological mechanisms associated with this pathology. To the best of our knowledge, no mouse model recapitulated human BNKL so far. EXPERIMENTAL DESIGN Primary bone marrow cells from a BNKL patient were injected in nonobese diabetes/severe combined immunodeficient interleukin (IL) 2rγ(-/-) mice with the intent to generate the first BNKL orthotopic mouse model. Moreover, because of the lack of efficient treatments for BNKL, we treated mice with lenalidomide, an immunomodulatory and antiangiogenic drug. RESULTS We generated in mice a fatal disease resembling human BNKL. After lenalidomide treatment, we observed a significant reduction in the number of peripheral blood, bone marrow, and spleen BNKL cells. Tumor reduction parallels with a significant decrease in the number of circulating endothelial and progenitor cells and CD31(+) murine endothelial cells. In mice treated with lenalidomide, BNKL levels of active caspase-3 were significantly augmented, thus showing proapoptotic and cytotoxic effects of this drug in vivo. An opposite result was found for proliferating cell nuclear antigen, a proliferation marker. CONCLUSIONS Our BNKL model might better define the cellular and molecular mechanisms involved in this disease, and lenalidomide might be considered for the future therapy of BNKL patients.
Collapse
Affiliation(s)
- Alice Agliano
- Laboratory of Hematology-Oncology, European Institute of Oncology, Milan, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Li Y, Li Z, Lin HL, Chen XH, Li B. Primary cutaneous blastic plasmacytoid dendritic cell neoplasm without extracutaneous manifestation: Case report and review of the literature. Pathol Res Pract 2011; 207:55-9. [DOI: 10.1016/j.prp.2010.05.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2009] [Revised: 04/26/2010] [Accepted: 05/19/2010] [Indexed: 11/16/2022]
|
28
|
Chang HJ, Lee MD, Yi HG, Lim JH, Lee MH, Shin JH, Choi SJ, Moon Y, Nahm CH, Kim CS. A case of blastic plasmacytoid dendritic cell neoplasm initially mimicking cutaneous lupus erythematosus. Cancer Res Treat 2010; 42:239-43. [PMID: 21253327 PMCID: PMC3021744 DOI: 10.4143/crt.2010.42.4.239] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 05/23/2010] [Indexed: 11/21/2022] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease. The prognosis is poor in most cases with rapid progression despite administering chemotherapy. A 67-year-old man complained of skin rashes on his back and this spread to the trunk, face, arms and thighs, and he was initially diagnosed with cutaneous lupus erythematosus according to the skin biopsy. The skin rashes then became aggravated on a trial of low dose methylprednisolone for 3 months. Repeated skin biopsy revealed a diffuse infiltration of lymphoid cells with medium sized nuclei, positive for CD4 and CD56, negative for Epstein-Barr virus (EBV), indicating a diagnosis of BPDCN. Further workups confirmed stage IVA BPDCN involving the skin, multiple lymph nodes, the peripheral blood and the bone marrow. He was treated with six cycles of combination chemotherapy consisting of ifosphamide, methotrexate, etoposide, prednisolone and L-asparaginase, and he achieved a partial response. Herein we report on a rare case of BPDCN that was initially misinterpreted as cutaneous lupus erythematosus.
Collapse
Affiliation(s)
- Hye Jung Chang
- Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Choi KW, Lee KY, Lee YK, Ku BS, Kim HS, Kim YH, Kim KH. CD4-/CD56+/CD123+ Hematodermic Neoplasm Showing Early Liver Metastasis. Ann Dermatol 2010; 22:186-90. [PMID: 20548910 DOI: 10.5021/ad.2010.22.2.186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2009] [Revised: 04/25/2009] [Accepted: 05/06/2009] [Indexed: 11/08/2022] Open
Abstract
Hematodermic neoplasm (HN) is a clinically aggressive neoplasm with a high incidence of cutaneous involvement and a risk of leukemic dissemination. In the recent WHO-EORTC classification, the term blastic natural killer cell lymphoma has been replaced with CD4+/CD56+ HN because of its derivation from a plasmacytoid dendritic cell precursor. Cases of HN that completely lack CD4 or CD56 expression, therefore represents a diagnostic problem. A 68-year-old Korean male was diagnosed with CD4-/CD56+ HN and treated with hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, dexamethasone) at initial treatment, and then switched to high dose methotrexate/cytarabine. His disease relapsed and resulted in death from bone and brain disease 6 months after complete clinical remission, despite diagnostic workups, including a radioisotope liver scan and ultrasound-guided fine needle aspiration biopsy. Further cytogenetic studies such as comparative genomic hybridization could elucidate the genetic mechanisms in the development and progression of lymphomas. We report an unusual case of 'CD4-/CD56+/CD123+ HN' showing early liver metastasis.
Collapse
Affiliation(s)
- Kyu-Won Choi
- Department of Dermatology, College of Medicine, Dong-A University, Busan, Korea
| | | | | | | | | | | | | |
Collapse
|
30
|
Tsagarakis NJ, Kentrou NA, Papadimitriou KA, Pagoni M, Kokkini G, Papadaki H, Pappa V, Marinakis T, Anagnostopoulos NI, Vadikolia C, Anagnostopoulos A, Angelopoulou MK, Terpos E, Poziopoulos C, Anargyrou K, Rontogianni D, Papadaki T, Psarra A, Kontopidou FN, Skoumi D, Papadhimitriou SI, Paterakis G. Acute lymphoplasmacytoid dendritic cell (DC2) leukemia: Results from the Hellenic Dendritic Cell Leukemia Study Group. Leuk Res 2010; 34:438-46. [DOI: 10.1016/j.leukres.2009.09.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 09/05/2009] [Accepted: 09/05/2009] [Indexed: 01/29/2023]
|
31
|
Abstract
Cutaneous lymphoid infiltrates may pose some of the most difficult diagnostic problems in dermatopathology. Immunocytochemistry is often employed in an effort to determine whether an infiltrate is neoplastic or, in the case of clearly malignant infiltrates, to provide a specific diagnosis. The rarity of these disorders and the variant immunocytochemical profiles they may present further thwart understanding and sometimes prevent an accurate diagnosis. In this review the common immunocytochemical profiles of various cutaneous lymphomas are presented and potential pitfalls and problems considered. Immunocytochemistry is not a diagnostic test but, as in other areas of histopathology, is a highly valuable tool that requires critical interpretation within a context: so applied, it is an indispensable part of the pathologist's arsenal in evaluating lymphoid infiltrates and defining different lymphomas.
Collapse
Affiliation(s)
- Alistair Robson
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
| |
Collapse
|
32
|
Petrella T, Facchetti F. Tumoral aspects of plasmacytoid dendritic cells: What do we know in 2009? Autoimmunity 2010; 43:210-4. [DOI: 10.3109/08916930903510898] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
33
|
Wiesner T, Obenauf AC, Cota C, Fried I, Speicher MR, Cerroni L. Alterations of the cell-cycle inhibitors p27(KIP1) and p16(INK4a) are frequent in blastic plasmacytoid dendritic cell neoplasms. J Invest Dermatol 2009; 130:1152-7. [PMID: 19924135 DOI: 10.1038/jid.2009.369] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, clinically aggressive malignancy with a median survival of 12-14 months. To identify pathogenetic relevant genomic aberrations and molecular targets for therapy, we analyzed skin biopsy samples obtained from 14 patients using high-resolution array-based comparative genomic hybridization and immunostaining. Losses of chromosomes 9, 12, 13, and 15 were detected most frequently. Loss of the CDKN1B locus was the most common finding and was detected in 64% of tumors. In all but one case, the dose-dependent haploinsufficient cell-cycle inhibitor p27(KIP1), encoded by CDKN1B, was weakly expressed in the nuclei of tumor cells. Losses of the CDKN2A-ARF-CDKN2B locus occurred in 50% of patients, and in one case a distinct biallelic loss was identified. The cell-cycle inhibitor p16(INK4a), which is encoded by CDKN2A, was not expressed in tumor cells, suggesting a complete loss of function. Loss of chromosome 13, including the RB1 gene, was observed in 43% of tumors. These results imply that alterations of the cell-cycle checkpoint controlling proteins p27(KIP1), p16(INK4a), and RB1 may exert a profound effect in malignant transformation in BPDCN. The elucidation of the affected pathways may guide the development of new treatments specifically designed for this aggressive disease entity.
Collapse
Affiliation(s)
- Thomas Wiesner
- Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | | | | | | | | |
Collapse
|
34
|
Abstract
Plasmacytoid dendritic cells (PDCs) have perplexed pathologists for decades, undergoing multiple adjustments in nomenclature as their lineage and functions have been characterized. Although PDCs account for less than 0.1% of peripheral blood mononuclear cells, they serve as a principal source of interferon-alpha and are also known as interferon-I producing cells (IPCs). Upon activation in vitro, they can differentiate into dendritic cells, and recent studies have substantiated a potential role in antigen presentation. Thus, PDCs may act as a link between innate and adaptive immunity. Normally found in small quantities in primary and secondary lymphoid organs, PDCs accumulate in a variety of inflammatory conditions, including Kikuchi-Fujimoto lymphadenopathy, hyaline-vascular Castleman disease, and autoimmune diseases, and in certain malignancies such as classical Hodgkin lymphoma and carcinomas. Demonstrating potential for neoplastic transformation reflective of varying stages of maturation, clonal proliferations range from PDC nodules most commonly associated with chronic myelomonocytic leukemia to the rare but highly aggressive malignancy now known as blastic plasmacytoid dendritic cell neoplasm (BPDCN). Formerly called blastic natural killer cell lymphoma or CD4/CD56 hematodermic neoplasm, BPDCN, unlike natural killer cell lymphomas, is not associated with Epstein-Barr virus infection and is generally not curable with treatment regimens for non-Hodgkin lymphomas. In fact, this entity is no longer considered to be a lymphoma and instead represents a unique precursor hematopoietic neoplasm. Acute leukemia therapy regimens may lead to sustained clinical remission of BPDCN, with bone marrow transplantation in first complete remission potentially curative in adult patients.
Collapse
|
35
|
Central nervous system involvement in CD4+/CD56+ hematodermic neoplasm: a report of two cases. J Neurooncol 2009; 97:301-4. [PMID: 19798469 DOI: 10.1007/s11060-009-0026-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2009] [Accepted: 09/21/2009] [Indexed: 11/26/2022]
Abstract
CD4+/CD56+ hematodermic neoplasm, formerly known as blastic NK-cell lymphoma, is an uncommon, aggressive non-Hodgkin's lymphoma with cutaneous, lymph node, and bone marrow involvement at presentation. The disease is characterized by early leukemic phase; however, central nervous system involvement is rarely reported. Herein we describe two cases of CD4+/CD56+ hematodermic neoplasm with meningeal manifestation. Microscopic analysis and flow cytometry of cerebrospinal fluid proved to be diagnostic; however, imaging studies were not informative. These observations call attention to the possibility of central nervous system involvement, which could be more common than expected previously. Authors recommend routine cerebrospinal fluid analysis and prophylactic intrathecal chemotherapy in patients with this highly aggressive disease.
Collapse
|
36
|
Solitary Cutaneous Nodule of Blastic Plasmacytoid Dendritic Cell Neoplasm Progressing to Overt Leukemia Cutis After Chemotherapy: Immunohistology and FISH Analysis Confirmed the Diagnosis. Am J Dermatopathol 2009; 31:695-701. [DOI: 10.1097/dad.0b013e3181a5e13d] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
37
|
Rare natural killer cell lymphoma found during surveillance endoscopy. J Gastrointest Cancer 2009; 40:15-8. [PMID: 19714499 DOI: 10.1007/s12029-009-9084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Non-Hodgkin's lymphoma is the sixth leading cause of cancer death in the USA and comprises 2-3% of primary neoplasms. Natural killer (NK)/T cell lymphomas are subtypes of non-Hodgkin's lymphoma and are aggressive neoplastic disorders with frequent extranodal presentations. Clinically, most cases of aggressive NK cell lymphomas present in young males with massive hepatosplenic infiltration. The upper aerodigestive tract is the most common site of presentation. CASE REPORT NK/T cell lymphomas are subtypes of non-Hodgkin's lymphoma and are aggressive. CASE DISCUSSION Here we describe an unusual case of non-Hodgkin's NK/ T cell lymphoma of colon and stomach found during surveillance upper endoscopy followed by a subsequent colonoscopy.
Collapse
|
38
|
López V, Martí N, Ferrández A, Martin JM, Jordá E. An atypical presentation of a blastic plasmacytoid dendritic cell tumors. J Cutan Pathol 2009; 37:e50-2. [DOI: 10.1111/j.1600-0560.2009.01334.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Fontaine J, Thomas L, Balme B, Ronger-Savle S, Traullé C, Petrella T, Dalle S. Haematodermic CD4+CD56+ neoplasm: complete remission after methotrexate-asparaginase treatment. Clin Exp Dermatol 2009; 34:e43-5. [DOI: 10.1111/j.1365-2230.2008.03100.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
40
|
Narita M, Watanabe N, Yamahira A, Hashimoto S, Tochiki N, Saitoh A, Kaji M, Nakamura T, Furukawa T, Toba K, Fuse I, Aizawa Y, Takahashi M. A leukemic plasmacytoid dendritic cell line, PMDC05, with the ability to secrete IFN-alpha by stimulation via Toll-like receptors and present antigens to naïve T cells. Leuk Res 2009; 33:1224-32. [PMID: 19443030 DOI: 10.1016/j.leukres.2009.03.047] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 03/03/2009] [Accepted: 03/24/2009] [Indexed: 11/15/2022]
Abstract
We established a plasmacytoid dendritic cell (pDC) line (PMDC05) from leukemia cells of pDC leukemia. PMDC05 cells were positive for CD4, CD56, CD33, HLA-DR, CD123 (IL-3Ralpha) and CD86 in the absence of lineage markers. mRNA of TLR1, TLR2, TLR4, TLR7 and TLR9 was clearly expressed and among these TLRs, TLR7 was prominent. Production of IFN-alpha and IL-12 in PMDC05 was enhanced by the stimulation with CpG-A and LPS, respectively. PMDC05 possessed a considerable antigen presenting ability, which was enhanced by culturing with IL3, influenza virus or LPS. PMDC05 could be a useful tool for investigating the pathophysiology of pDCL.
Collapse
Affiliation(s)
- Miwako Narita
- Laboratory of Hematology and Oncology, Graduate School of Health Sciences, Niigata University, Niigata, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
CD4/CD56 malignancies are rare hematologic neoplasms, which have recently been shown to represent the malignant counterpart of plasmacytoid dendritic cells (pDC). A 5-year-old boy initially presented with multiple subcutaneous lesions on his upper and lower extremities. Skin biopsy results showed large atypical lymphoid cells in the dermis. The blast cells were stained with CD4 and CD56. In the bone marrow aspirate, 20% of the blast cells were found. The patient was diagnosed as acute unclassified leukemia and received chemotherapy designed for the treatment of acute myeloid leukemia. He achieved a complete remission that lasted for 8 months. However, multiple subcutaneous lesions recurred 1 month after the end of the therapy, with increasing blast cells in his blood. Immunophenotypically, the blast cells were positive for CD2, CD4, CD7, and CD56, and negative for CD3, CD13, CD19, CD33, and CD34 antigens. The blast cells were positive for CD123 (interleukin-3 receptor alpha chain) and blood dendritic cell antigen-2, which are expressed on pDC. The patient was diagnosed as acute leukemia derived from pDC. The CD4, CD56, CD3, CD13, CD19, CD33 profile is highly suggestive of this disease, and the CD123 and blood dendritic cell antigen-2 markers are useful in helping to diagnose pDC leukemia.
Collapse
|
42
|
Garnache-Ottou F, Feuillard J, Ferrand C, Biichle S, Trimoreau F, Seilles E, Salaun V, Garand R, Lepelley P, Maynadié M, Kuhlein E, Deconinck E, Daliphard S, Chaperot L, Beseggio L, Foisseaud V, Macintyre E, Bene MC, Saas P, Jacob MC. Extended diagnostic criteria for plasmacytoid dendritic cell leukaemia. Br J Haematol 2009; 145:624-36. [PMID: 19388928 DOI: 10.1111/j.1365-2141.2009.07679.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The diagnosis of plasmacytoid dendritic cell leukaemia (pDCL) is based on the immunophenotypic profile: CD4(+) CD56(+) lineage(neg) CD45RA(+)/RO(neg) CD11c(neg) CD116(low) CD123(+) CD34(neg) CD36(+) HLA-DR(+). Several studies have reported pDCL cases that do not express this exact profile or expressing some lineage antigens that could thus be misdiagnosed. This study aimed to validate pDCL-specific markers for diagnosis by flow-cytometry or quantitative reverse transcription polymerase chain reaction on bone marrow samples. Expression of markers previously found in normal pDC was analysed in 16 pDCL, four pDCL presenting an atypical phenotype (apDCL) and 113 non-pDC - lymphoid or myeloid - acute leukaemia. CD123 was expressed at significantly higher levels in pDCL and apDCL. BDCA-2 was expressed on 12/16 pDCL and on 2/4 apDCL, but was never detected in the 113 non-pDC acute leukaemia cases. BDCA-4 expression was found on 13/16 pDCL, but also in 12% of non-pDC acute leukaemia. High levels of LILRA4 and TCL1A transcripts distinguished pDCL and apDCL from all other acute leukaemia (except B-cell acute lymphoblastic leukaemia for TCL1A). We thus propose a diagnosis strategy, scoring first the CD4(+) CD56(+/-) MPO(neg) cCD3(neg) cCD79a(neg) CD11c(neg) profile and then the CD123(high), BDCA-2 and BDCA-4 expression. Atypical pDCL can be also identified this way and non-pDC acute leukaemia excluded: this scoring strategy is useful for diagnosing pDCL and apDCL.
Collapse
Affiliation(s)
- Francine Garnache-Ottou
- INSERM UMR645, Université of Franche-Comté, Etablissement Français du Sang Bourgogne Franche-Comté, 1 boulevard A. Fleming, Besançon, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Muljono A, Graf NS, Arbuckle S. Primary cutaneous lymphoblastic lymphoma in children: series of eight cases with review of the literature. Pathology 2009; 41:223-8. [DOI: 10.1080/00313020902756246] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
44
|
|
45
|
García-Melgares Linares ML, Martínez Casimiro L, Linares García M, Pérez Ferriols A. [Plasmacytoid dendritic cell leukemia/lymphoma]. Rev Clin Esp 2008; 208:420-1. [PMID: 18817706 DOI: 10.1157/13126349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
46
|
Stetsenko GY, McFarlane R, Kalus A, Olerud J, Cherian S, Fromm J, George E, Argenyi Z. CD4+/CD56+ hematodermic neoplasm: report of a rare variant with a T-cell receptor gene rearrangement. J Cutan Pathol 2008; 35:579-84. [DOI: 10.1111/j.1600-0560.2007.00845.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Olsen RJ, Chang CC, Herrick JL, Zu Y, Ehsan A. Acute leukemia immunohistochemistry: a systematic diagnostic approach. Arch Pathol Lab Med 2008; 132:462-75. [PMID: 18318587 DOI: 10.5858/2008-132-462-aliasd] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2007] [Indexed: 11/06/2022]
Abstract
CONTEXT The diagnosis and classification of leukemia is becoming increasingly complex. Current classification schemes incorporate morphologic features, immunophenotype, molecular genetics, and clinical data to specifically categorize leukemias into various subtypes. Although sophisticated methodologies are frequently used to detect characteristic features conferring diagnostic, prognostic, or therapeutic implications, a thorough microscopic examination remains essential to the pathologic evaluation. Detailed blast immunophenotyping can be performed with lineage- and maturation-specific markers. Although no one marker is pathognomonic for one malignancy, a well-chosen panel of antibodies can efficiently aid the diagnosis and classification of acute leukemias. OBJECTIVE To review important developments from recent and historical literature. General immunohistochemical staining patterns of the most commonly encountered lymphoid and myeloid leukemias are emphasized. The goal is to discuss the immunostaining of acute leukemias when flow cytometry and genetic studies are not available. DATA SOURCES A comprehensive review was performed of the relevant literature indexed in PubMed (National Library of Medicine) and referenced medical texts. Additional references were identified in the reviewed manuscripts. CONCLUSIONS Immunophenotyping of blasts using an immunohistochemical approach to lymphoid and myeloid malignancies is presented. Initial and subsequent additional antibody panels are suggested to confirm or exclude each possibility in the differential diagnosis and a general strategy for diagnostic evaluation is discussed. Although the use of immunohistochemistry alone is limited and evaluation by flow cytometry and genetic studies is highly recommended, unavoidable situations requiring analysis of formalin-fixed tissue specimens arise. When performed in an optimized laboratory and combined with a careful morphologic examination, the immunohistochemical approach represents a useful laboratory tool for classifying various leukemias.
Collapse
Affiliation(s)
- Randall J Olsen
- Department of Pathology, The Methodist Hospital, 6565 Fannin St, M227, Houston, TX 77030, USA
| | | | | | | | | |
Collapse
|
48
|
CD4+ CD56+ hematodermic/plasmacytoid dendritic cell tumor with response to pralatrexate. J Am Acad Dermatol 2008; 58:480-4. [DOI: 10.1016/j.jaad.2007.12.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2007] [Revised: 11/16/2007] [Accepted: 12/16/2007] [Indexed: 11/18/2022]
|
49
|
Piña-Oviedo S, Herrera-Medina H, Coronado H, Del Valle L, Ortiz-Hidalgo C. CD4+/CD56+ hematodermic neoplasm: presentation of 2 cases and review of the concept of an uncommon tumor originated in plasmacytoid dendritic cells expressing CD123 (IL-3 receptor alpha). Appl Immunohistochem Mol Morphol 2008; 15:481-6. [PMID: 18091395 DOI: 10.1097/01.pai.0000213139.39654.40] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CD4/CD56 hematodermic neoplasm is a rare neoplasm presenting with cutaneous nodules, lymphadenopathy, bone marrow infiltration, and an aggressive clinical course. Recently, the plasmacytoid dendritic cell origin of this neoplasm has been demonstrated. Plasmacytoid dendritic cell is a hematopoietic-derived cell implicated in the regulation of innate and adaptive cell immunity and in the production of certain regulatory cytokines. Recently it has been demonstrated that these cells express cell surface markers such as IL-3 receptor alpha (CD123). In the present report, we describe the clinical, histologic, and immunohistochemical characteristics of 2 cases of CD4/CD56 hematodermic neoplasm. Both patients were male and the age at the time of diagnosis was 36 and 75 years, respectively. Clinical findings were limited to the skin and consisted of multiple cutaneous nodules located in the thorax and extremities, some of them ulcerated. Histologically, the tumors were characterized by a nonepidermotropic, dermal and subdermal infiltration of homogeneous medium-sized cells resembling lymphoblasts or myeloblasts. Immunohistochemical characterization of the tumors showed expression of CD4, CD56, CD43, and CD123, whereas CD8, CD20, and MPO were negative. Immunoreactivity for CD3, which has been described in rare occasions, was found only in one of the cases. This characteristic profile in addition to the expression of CD123, which was detected in both cases, can be used as valuable tools in the diagnosis of this rare neoplasm.
Collapse
Affiliation(s)
- Sergio Piña-Oviedo
- Laboratory of Tissue and Cell Biology, School of Medicine, Universidad Panamericana, Donatello 59, Colonia Insurgentes Mixcoac, C.P. 03920, Mexico. City
| | | | | | | | | |
Collapse
|
50
|
The Applicability of the New WHO-EORTC Classification of Primary Cutaneous Lymphomas to a Single Referral Center. Am J Dermatopathol 2008; 30:37-44. [DOI: 10.1097/dad.0b013e31815f9841] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|