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Morisaka H, Sano H, Yamamoto M, Takaishi M, Nakajima H, Ogasawara F, Togitani K, Tashiro M, Kubo T, Ueda H, Fujii N, Sano S. Therapeutic efficacy of allogenic haematopoietic stem cell transplantation from an appropriate sibling donor to a patient with subcutaneous panniculitis-like T-cell lymphoma with a germline homozygous HAVCR2 mutation. J Eur Acad Dermatol Venereol 2024. [PMID: 38421052 DOI: 10.1111/jdv.19926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Hiroyuki Morisaka
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
- Department of Dermatology, Integrated Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hozumi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Mayuko Yamamoto
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Mikiro Takaishi
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Hideki Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Fumiya Ogasawara
- Department of Hematology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Kazuto Togitani
- Department of Hematology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Mari Tashiro
- Clinical Genetics Department, Kochi Medical School Hospital, Nankoku, Japan
| | - Toru Kubo
- Clinical Genetics Department, Kochi Medical School Hospital, Nankoku, Japan
- Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Hiroko Ueda
- Department of Hematology and Oncology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Nobuharu Fujii
- Division of Blood Transfusion, Okayama University Hospital, Okayama, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Japan
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Vahabi SM, Bahramian S, Esmaeili F, Danaei B, Kalantari Y, Fazeli P, Sadeghi S, Hajizadeh N, Assaf C, Etesami I. JAK Inhibitors in Cutaneous T-Cell Lymphoma: Friend or Foe? A Systematic Review of the Published Literature. Cancers (Basel) 2024; 16:861. [PMID: 38473222 DOI: 10.3390/cancers16050861] [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: 01/25/2024] [Revised: 02/17/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of lymphoid neoplasms with high relapse rates and no curative treatment other than allogeneic stem cell transplantation (allo-SCT). CTCL is significantly influenced by disruption of JAK/STAT signaling. Therefore, Janus kinase (JAK) inhibitors may be promising for CTCL treatment. This study is a systematic review aiming to investigate the role of JAK inhibitors in the treatment of CTCL, including their efficacy and safety. Out of 438 initially searched articles, we present 13 eligible ones. The overall response rate (ORR) in the treatment with JAK inhibitors in clinical trials was 11-35%, although different subtypes of CTCL showed different ORRs. Mycosis fungoides showed an ORR of 14-45%, while subcutaneous-panniculitis-like T-cell lymphoma (SPTCL) displayed an ORR ranging from 75% to 100%. Five cases were reported having a relapse/incident of CTCL after using JAK inhibitors; of these, three cases were de novo CTCLs in patients under treatment with a JAK inhibitor due to refractory arthritis, and two cases were relapsed disease after graft-versus-host disease treatment following allo-SCT. In conclusion, using JAK inhibitors for CTCL treatment seems promising with acceptable side effects, especially in patients with SPTCL. Some biomarkers, like pS6, showed an association with better responses. Caution should be taken when treating patients with an underlying autoimmune disease and prior immunosuppression.
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Affiliation(s)
| | - Saeed Bahramian
- School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Farzad Esmaeili
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Bardia Danaei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Yasamin Kalantari
- School of Medicine, Tehran University of Medical Sciences, Tehran 1461884513, Iran
| | | | - Sara Sadeghi
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Nima Hajizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Chalid Assaf
- Department of Dermatology and Venerology, Helios Klinikum Krefeld, 47805 Krefeld, Germany
- Institute for Molecular Medicine, Medical School Hamburg, 20457 Hamburg, Germany
| | - Ifa Etesami
- Departments of Dermatology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran 1983969411, Iran
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Knauft J, Schenk T, Ernst T, Schnetzke U, Hochhaus A, La Rosée P, Birndt S. Lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH): a scoping review unveils clinical and diagnostic patterns of a lymphoma subgroup with poor prognosis. Leukemia 2024; 38:235-249. [PMID: 38238443 PMCID: PMC10844097 DOI: 10.1038/s41375-024-02135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 02/07/2024]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome driven by pathologic activation of cytotoxic T-lymphocytes and macrophages. Despite advances in diagnostics and management, adult patients with lymphoma-associated HLH (LA-HLH) harbor particularly poor prognosis and optimal treatment remains challenging. As systematic data on LA-HLH are scarce, we aimed to synthesize research evidence by thorough analysis of the published literature in PubMed (MEDLINE-database) within the context of a scoping review. Of 595 search results, 132 articles providing information on 542 patients were reviewed and analyzed. Median patient age was 60 years (range, 18-98) with male predominance (62.7%). B- and T-NHL were equally represented (45.6% and 45.2%), Hodgkin's lymphoma was reported in 8.9% of the cases. The majority of patients (91.6%) presented in Ann-Arbor-Stages III and IV, and bone marrow infiltration was observed in a significant proportion of patients (61.5%). Soluble CD25 levels were markedly elevated (median 10,000 U/ml), with levels beyond 10,000 U/ml indicating unfavorable prognosis for 30-day and overall survival. 66.8% of the patients died after median 5.1 months. LA-HLH remains a clinical challenge requiring specialized management. Timely diagnosis and appropriate lymphoma-specific treatment are of utmost importance to enhance patient outcomes.
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Affiliation(s)
- Johanna Knauft
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Thomas Schenk
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Thomas Ernst
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Ulf Schnetzke
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Paul La Rosée
- Klinik für Innere Medizin II, Onkologie, Hämatologie, Immunologie, Infektiologie und Palliativmedizin, Schwarzwald-Baar Klinikum, Villingen-Schwenningen, Germany
| | - Sebastian Birndt
- Klinik für Innere Medizin II, Hämatologie und internistische Onkologie, Universitätsklinikum Jena, Jena, Germany.
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Savage KJ, De Leval L. Introduction to the peripheral T-cell lymphoma review series: advances in molecular characterization, classification refinement and treatment optimization. Haematologica 2023; 108:3204-3210. [PMID: 38037798 PMCID: PMC10690918 DOI: 10.3324/haematol.2023.282719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 08/29/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Kerry J Savage
- Center for Lymphoid Cancer, Division of Medical Oncology, BC Cancer and the University of British Columbia, British Columbia.
| | - Laurence De Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne
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Song D, Wang J, Zhang J, Hu J, Wu C, Wang Z. Case Report: HAVCR2 mutation-associated Hemophagocytic lymphohistiocytosis. Front Immunol 2023; 14:1271324. [PMID: 38077348 PMCID: PMC10701531 DOI: 10.3389/fimmu.2023.1271324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Germline HAVCR2 mutation has been reported to be associated with subcutaneous panniculitis-like T-cell lymphoma (SPTCL) leading to Hemophagocytic lymphohistiocytosis (HLH). Several studies have indicated that HAVCR2 mutation can cause HLH even in the absence of lymphoma, though the exact mechanism remains unclear. In this article, we reported five cases of HAVCR2 mutation-associated HLH. Our analysis revealed an elevated level of IL-1RA in the serum of these patients. Furthermore, we investigated the potential mechanisms underlying HLH associated with HAVCR2 mutation based on changes in cytokine levels. Our findings suggest that HAVCR2 mutation may represent a distinct genetic defect underlying HLH, differing from traditional primary HLH.
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Affiliation(s)
| | | | | | | | | | - Zhao Wang
- Department of Hematology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China
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Zhang N, Zhang S, Ma L, Qiu L, Meng QL, Cai J, Xu Z, Yao H, Fan FY. Case report: Successful treatment of Chidamide in a refractory/recurrent SPTCL with ARID1A mutation on the basis of CHOP plus auto-HSCT. Medicine (Baltimore) 2023; 102:e35413. [PMID: 37800816 PMCID: PMC10552963 DOI: 10.1097/md.0000000000035413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/06/2023] [Indexed: 10/07/2023] Open
Abstract
RATIONALE Subcutaneous panniculitis like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma that belongs to peripheral T cell lymphomas, of which the overall prognosis is poor. Chidamide, a deacetylase inhibitor, has been approved for the treatment of peripheral T cell lymphomas. However, due to the rare occurrence of SPTCL, it is currently unknown whether Chidamide is effective for all SPTCL patients and whether there are molecular markers that can predict its therapeutic effect on SPTCL. PATIENT CONCERNS AND DIAGNOSES The patient was a sixteen-year-old male and underwent subcutaneous nodule biopsy which showed SPTCL. Next-generation sequencing revealed AT-rich interaction domain 1A (ARID1A) mutation, and positron emission tomography/computed tomography showed scattered subcutaneous fluorodeoxyglucose metabolic lesions throughout the body. INTERVENTIONS AND OUTCOMES During the first 3 CHOP (cyclophosphamide, doxorubicin, vindesine, and prednisone) treatment, the patient relapsed again after remission, and the successive addition of methotrexate and cyclosporine did not make the patient relapsing again. Then, after adding Chidamide to the last 3 CHOP treatment, the patient was relieved again. The patient underwent autologous hematopoietic stem cell transplantation (auto-HSCT) after completing a total of 8 cycles of chemotherapy, and continued maintenance therapy with Chidamide after auto-HSCT. Currently, the patient has been in continuous remission for 35 months. LESSONS SUBSECTIONS This case is the first report of a refractory/recurrent SPTCL with ARID1A mutation treated with Chidamide. The treatment of Chidamide on the basis of CHOP plus auto-HSCT therapy achieved good results, suggesting that ARID1A may act as a molecular marker to predict the therapeutic effect of Chidamide on SPTCL patients, which helps to improve the precision of SPTCL treatment and the overall prognosis of SPTCL patients.
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Affiliation(s)
- Nan Zhang
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Shan Zhang
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Lei Ma
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Ling Qiu
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Qing-Li Meng
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Jiao Cai
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Zhen Xu
- Department of Pathology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Hao Yao
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
| | - Fang-Yi Fan
- Department of Hematology, People’s Liberation Army the General Hospital of Western Theater Command, Chengdu, Sichuan, China
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