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Zhao M, Wang L, Wang X, He J, Yu K, Li D. Non-neoplastic cells as prognostic biomarkers in diffuse large B-cell lymphoma: A system review and meta-analysis. TUMORI JOURNAL 2024:3008916231221636. [PMID: 38183180 DOI: 10.1177/03008916231221636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
The microenvironment of diffuse large B-cell lymphoma (DLBCL) is composed of various components, including immune cells and immune checkpoints, some of which have been correlated with the prognosis of DLBCL, but their results remain controversial. Therefore, we conducted a systematic review and meta-analysis to investigate the association between the microenvironment and prognosis in DLBCL. We searched PubMed, Web of Science, and EMBASE for relevant articles between 2001 and 2022. Twenty-five studies involving 4495 patients with DLBCL were included in the analysis. This meta-analysis confirmed that high densities of Foxp3+Tregs and PD-1+T cells are good indicators for overall survival (OS) in DLBCL, while high densities of programmed cell death protein ligand1(PD-L1)-positive expression cells and T-cell immunoglobulin-and mucin domain-3-containing molecule 3 (TIM-3)-positive expression tumor-infiltrating cells (TILs) play a contrary role in OS. Additionally, higher numbers of T-cell intracytoplasmic antigen-1(TIA-1)-positive expression T cells imply better OS and progression-free survival (PFS), while high numbers of lymphocyte activation gene(LAG)-positive expression TILs predict bad OS and PFS. Various non-tumoral cells in the microenvironment play important roles in the prognosis of DLBCL.
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Affiliation(s)
- Min Zhao
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Pathology, Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
| | - Lixing Wang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Xingyu Wang
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Juan He
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Kuai Yu
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
- Department of Pathology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Li
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Pathology, Chongqing Medical University, Chongqing, China
- Molecular Medicine Diagnostic and Testing Center of Chongqing Medical University, Chongqing, China
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2
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Aggressive Cutaneous Lymphomas and Their Mimics. Surg Pathol Clin 2023; 16:361-383. [PMID: 37149363 DOI: 10.1016/j.path.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Cutaneous lymphomas encompass a heterogeneous group of neoplasms with a wide spectrum of clinical presentations, histopathologic features, and prognosis. Because there are overlapping pathologic features among indolent and aggressive forms and with systemic lymphomas that involve the skin, clinicopathologic correlation is essential. Herein, the clinical and histopathologic features of aggressive cutaneous B- and T-cell lymphomas are reviewed. Indolent cutaneous lymphomas/lymphoproliferative disorders, systemic lymphomas, and reactive processes that may mimic these entities are also discussed. This article highlights distinctive clinical and histopathologic features, increases awareness of rare entities, and presents new and evolving developments in the field.
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Menguy S, Prochazkova-Carlotti M, Azzi-Martin L, Ferté T, Bresson-Bepoldin L, Rey C, Vergier B, Merlio JP, Beylot-Barry M, Pham-Ledard A. Proliferative Tumor-Infiltrating Lymphocytes' Abundance within the Microenvironment Impacts Clinical Outcome in Cutaneous B-Cell Lymphomas. J Invest Dermatol 2023; 143:124-133.e3. [PMID: 35970476 DOI: 10.1016/j.jid.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/29/2022] [Accepted: 06/15/2022] [Indexed: 10/15/2022]
Abstract
Primary cutaneous large B-cell lymphoma, leg-type (PCLBCL-LT) is the most aggressive primary cutaneous B-cell lymphoma (PCBCL). Tumor microenvironment has a crucial role in tumor development, and tumor-infiltrating lymphocytes (TILs) can be targeted by immunotherapies. We characterized TILs in 20 PCBCLs to identify the tumor microenvironment features associated with clinical outcomes. We developed a seven‒multiplex immunofluorescence panel using Opal staining and image analysis using HALO software. In PCLBCL-LT, TILs were sparsely intermingled within tumor infiltrate in contrast to those in indolent PCBCL where TILs were scattered around tumor nodule edges with variable tumor infiltration. In PCLBCL-LT, TILs were composed of CD8 and CD4, whereas CD4 was predominant in indolent PCBCL. Proliferative TILs (CD3+Ki-67+ cells) were more abundant in PCLBCL-LT (P = 0.0036) than in indolent PCBCL. In PCLBCL-LT, proliferative TILs' abundance tended to be associated with better progression-free survival. These data were confirmed in a second independent cohort of 23 cases showing that proliferative TILs were more abundant in PCLBCL-LT (P = 0.0205) and that in PCLBCL-LT, high CD3+Ki-67+ cell density was associated with better progression-free survival (P = 0.002). These distinct TILs composition and distribution among PCBCL suggest that proliferative T lymphocytes represent a good prognostic factor in PCLBCL-LT and that stimulating their functions may represent a therapeutic approach.
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Affiliation(s)
- Sarah Menguy
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France; Pathology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Martina Prochazkova-Carlotti
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France
| | - Lamia Azzi-Martin
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France
| | - Thomas Ferté
- Department of Public Health, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Laurence Bresson-Bepoldin
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France
| | | | - Béatrice Vergier
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France; Pathology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Jean-Philippe Merlio
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France; Tumor Biology and Tumor Bank Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Marie Beylot-Barry
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France; Dermatology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Anne Pham-Ledard
- INSERM U1312, Bordeaux Institute of Oncology, Translational Research on Oncodermatology and Rare Skin Diseases, Bordeaux University, Bordeaux, France; Dermatology Department, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
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4
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Krenitsky A, Klager S, Hatch L, Sarriera-Lazaro C, Chen PL, Seminario-Vidal L. Update in Diagnosis and Management of Primary Cutaneous B-Cell Lymphomas. Am J Clin Dermatol 2022; 23:689-706. [PMID: 35854102 DOI: 10.1007/s40257-022-00704-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
Primary cutaneous lymphomas are a rare group of diseases, with an estimated incidence of 0.5-1 case per 100,000 people per year. Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. There are three main subtypes of pCBCL: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. To date, treatment recommendations for cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. Recently, the pharmacotherapeutic landscape has expanded to include drugs that may modify the underlying disease pathology of pCBCLs, representing new therapeutic modalities for this rare group of diseases. Novel therapies used for other systemic B-cell lymphomas show promise for the treatment of pCBCLs and are being increasingly considered. These new therapies are divided into five main groups: monoclonal antibodies, immune checkpoint inhibitors, small-molecule inhibitors, bispecific T-cell engaging, and chimeric antigen receptor T cell. In this review, we discuss the clinical, histopathological, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management. These emerging treatment strategies for B-cell lymphomas and cutaneous B-cell lymphomas may represent novel first-line options for the management of these rare diseases.
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Affiliation(s)
- Amanda Krenitsky
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA.
| | - Skylar Klager
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
| | - Leigh Hatch
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Pei Ling Chen
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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5
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Russo D, Travaglino A, Varricchio S, Pace M, Cretella P, Baldo A, Severino A, Picardi M, Mascolo M. Prognostic value of Bcl2 and Bcl6 in primary cutaneous large B-cell lymphoma: A systematic review and meta-analysis. Pathol Res Pract 2022; 232:153812. [PMID: 35220171 DOI: 10.1016/j.prp.2022.153812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/10/2022] [Accepted: 02/18/2022] [Indexed: 12/19/2022]
Abstract
AIMS To assess the prognostic value of Bcl2 and Bcl6 in primary cutaneous diffuse large B-cell lymphoma (pcDLBCL), through a systematic review and meta-analysis. METHODS Electronic databases were searched from their inception to April 2021 for studies reporting Bcl2 and Bcl6 expression and survival outcomes in pcDLBCL series. Kaplan-Meier and Cox regression survival analyses with hazard ratio calculation were performed for overall survival (OS), with a significant p-value< 0.05. RESULTS Eight studies with 148 patients were included. OS was significantly decreased in Bcl2-pos itive pcDLBCLs (5-year OS= 52.9 ± 5.2%) compared to Bcl2 negative pcDLBCLs (5-year OS= 86.6 ± 7.2%), with a HR of 4.615 (95% CI, 1.827-11.657; p = 0.001); no significant difference in OS was found between Bcl6-positive pcDLBCLs (5-year OS= 61.3 ± 6.5%) and Bcl6-negative pcDLBCLs (5-year OS= 56.8 ± 7.2%), with a HR of 0.789 (95% CI, 0.462-1.350; p = 0.388). CONCLUSIONS In pcDLBCL, Bcl2 expression is a strong unfavourable prognostic marker; Bcl6 does not seem to be associated with survival instead. Further studies are necessary in this field.
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Affiliation(s)
- Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy
| | - Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy; Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy
| | - Mirella Pace
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy
| | - Pasquale Cretella
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy
| | - Antonello Baldo
- Dermatology Section, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Alessandro Severino
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, University of Naples "Federico II", Naples, Italy.
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6
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Chang C, Chen YP, Medeiros LJ, Chen TY, Chang KC. Higher infiltration of intratumoral CD25+ FOXP3+ lymphocytes correlates with a favorable prognosis in patients with diffuse large B-cell lymphoma. Leuk Lymphoma 2020; 62:76-85. [PMID: 32962457 DOI: 10.1080/10428194.2020.1817438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Regulatory T-cells (Tregs) play an important role in cancer immunity but their prognostic impact is controversial in diffuse large B-cell lymphoma (DLBCL). Intratumoral Tregs in DLBCL (n = 70) were evaluated by double-stained CD25 and FOXP3 lymphocytes in formalin-fixed paraffin-embedded tissues, and correlated with clinicopathologic features. We found that increased numbers of intratumoral FOXP3+ lymphocytes (>2.4/HPF) and CD25 + FOXP3+ lymphocytes (>0.8/HPF) are favorable prognosticators (p = .004 and p < .001, respectively) in DLBCL patients, along with age <70 years, stage I-II disease, normal serum LDH level and low IPI scores (p < .001, .002, .002, and <.001, respectively). On multivariate analyses, a higher number of CD25 + FOXP3+ lymphocytes retained prognostic significance (p = .040). Interestingly, higher Treg infiltration correlated with increased infiltration by cytotoxic T-lymphocytes (γ = 0.294, p = .038) and nodal location (γ = 0.390, p = .004), but not with infiltration by CD123+ plasmacytoid dendritic cells, which were reported to induce Tregs with immune tolerance. Therefore, congruent with literature meta-analyses, higher intratumoral CD25 + FOXP3+ lymphocytes have a beneficial impact on DLBCL.
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Affiliation(s)
- Chen Chang
- Department of Pathology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Ping Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tsai-Yun Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Kung-Chao Chang
- Department of Pathology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Department of Pathology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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7
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Dumont M, Battistella M, Ram-Wolff C, Bagot M, de Masson A. Diagnosis and Treatment of Primary Cutaneous B-Cell Lymphomas: State of the Art and Perspectives. Cancers (Basel) 2020; 12:cancers12061497. [PMID: 32521744 PMCID: PMC7352758 DOI: 10.3390/cancers12061497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022] Open
Abstract
Primary cutaneous B-cell lymphomas are rare entities that develop primarily in the skin. They constitute a heterogeneous group that represents around a quarter of primary cutaneous lymphomas. The 2018 update of the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification differentiates primary cutaneous marginal zone lymphoma and primary cutaneous follicle center lymphoma with an indolent course from primary cutaneous diffuse large B-cell lymphoma, leg type with an aggressive behavior. The broad spectrum of clinical presentations and the disease course marked by frequent relapses are diagnostic and therapeutic challenges. The classification of these diseases has been refined in recent years, which allows to better define their immunopathogenesis and specific management. In the present article, we review the main clinico-biological characteristics and the current therapeutic options of these three main subsets. Based on the recent therapeutic advances in nodal B-cell lymphomas, we focus on the development of novel treatment options applicable to primary cutaneous B-cell lymphomas, including targeted therapies, combination treatments and immunotherapeutic approaches, and cover basic, translational and clinical aspects aiming to improve the treatment of cutaneous B-cell lymphomas.
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Affiliation(s)
- Maëlle Dumont
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
| | - Maxime Battistella
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Pathology, APHP, Saint-Louis Hospital, F-75010 Paris, France
| | - Caroline Ram-Wolff
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
| | - Martine Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Correspondence: ; Tel.: +33-1-53-72-20-93; Fax: +33-1-42-49-40-38
| | - Adèle de Masson
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
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8
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Class-switched Primary Cutaneous Marginal Zone Lymphomas Are Frequently IgG4-positive and Have Features Distinct From IgM-positive Cases. Am J Surg Pathol 2019; 43:1403-1412. [DOI: 10.1097/pas.0000000000001363] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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9
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Felcht M, Klemke CD, Nicolay JP, Weiss C, Assaf C, Wobser M, Schlaak M, Hillen U, Moritz R, Tantcheva-Poor I, Nashan D, Beyer M, Dippel E, Müller CSL, Sachse MM, Meiss F, Géraud C, Marx A, Goerdt S, Geissinger E, Kempf W. Primär kutanes diffus-großzelliges B-Zell-Lymphom, NOS oder leg type: klinische, morphologische und prognostische Unterschiede. J Dtsch Dermatol Ges 2019; 17:275-286. [PMID: 30920753 DOI: 10.1111/ddg.13773_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Moritz Felcht
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg und Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Mannheim, Deutschland.,European Center of Angioscience, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - Claus-Detlev Klemke
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg und Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Mannheim, Deutschland.,Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - Jan Peter Nicolay
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg und Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Mannheim, Deutschland
| | - Christel Weiss
- Abteilung für Medizinische Statistik, Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Klinikum Krefeld, Krefeld, Deutschland
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Julius-Maximilians- Universität, Würzburg, Deutschland
| | - Max Schlaak
- Klinik für Dermatologie und Venerologie, Universität zu Köln, Köln, Deutschland
| | - Uwe Hillen
- Klinik für Dermatologie und Hauttumorzentrum, Universitätsklinikum Essen-Duisburg, Essen-Duisburg, Deutschland
| | - Rose Moritz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Bochum, Deutschland.,Universitäts- und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Halle (Saale)
| | | | | | - Marc Beyer
- Hauttumorcentrum Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Edgar Dippel
- Hautklinik, Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | - Cornelia Sigrid Lissi Müller
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - Michael Max Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven, Bremerhaven, Deutschland.,Hautklinik Bremen, Deutschland
| | - Frank Meiss
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Deutschland
| | - Cyrill Géraud
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg und Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Mannheim, Deutschland.,European Center of Angioscience, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - Alexander Marx
- Pathologisches Institut, Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland
| | - Sergij Goerdt
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg und Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Mannheim, Deutschland.,European Center of Angioscience, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - Eva Geissinger
- Institut für Pathologie, Julius-Maximilians-Universität, Würzburg, Deutschland
| | - Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Schweiz.,Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz
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10
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Felcht M, Klemke CD, Nicolay JP, Weiss C, Assaf C, Wobser M, Schlaak M, Hillen U, Moritz R, Tantcheva-Poor I, Nashan D, Beyer M, Dippel E, Müller CSL, Sachse MM, Meiss F, Géraud C, Marx A, Goerdt S, Geissinger E, Kempf W. Primary cutaneous diffuse large B-cell lymphoma, NOS and leg type: Clinical, morphologic and prognostic differences. J Dtsch Dermatol Ges 2019; 17:275-285. [PMID: 30851152 DOI: 10.1111/ddg.13773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Primary cutaneous diffuse large B-cell lymphoma, NOS (PCLBCL/NOS) is a rare PCLBCL. Only few data are available for this tumor. The aim of this study was to identify clinical and/or immunohistochemical markers (in addition to Bcl-2) that characterize PCLBCL/NOS, assist in differentiating it from PCLBCL, leg type (PCLBCL/LT) and help to assess the clinical course/prognosis. PATIENTS AND METHODS Bcl-2- PCLBCL/NOS) cases (n = 14 were compared with Bcl-2+ PCLBCL/LT cases (n = 29). RESULTS PCLBCL/NOS patients were younger, predominantly male and had better survival rates than patients with PCLBCL/LT. Patients with PCLBCL/NOS presented more often with larger plaques limited to one or two contiguous body regions, whereas PCLBCL/LT cases often presented with disseminated lesions. Neoplastic cells had a higher proliferation rate (Ki67) in PCLBCL/LT patients. The tumor microenvironment of PCLBCL/NOS had a more prominent CD3+ infiltrate. Overall survival data for the whole cohort (n = 37) revealed that female gender and Bcl-2 expression correlated with a worse survival rate. Bcl-6 expression and centroblastic subtype correlated with better outcomes. None of the other markers studied (e.g. GCB/non-GCB subtype) correlated with survival rate. CONCLUSIONS PCLBCL/NOS and PCLBCL/LT differ in their clinical behavior and outcomes. Bcl-2 still seems to be the best marker for discriminating between these two subgroups. Bcl-2, female gender and Bcl-6 represent prognostic markers for PCLBCL.
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Affiliation(s)
- Moritz Felcht
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.,European Center of Angioscience, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.,Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Germany
| | - Jan Peter Nicolay
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
| | - Christel Weiss
- Department of Medical Statistics, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Chalid Assaf
- Department of Dermatology, Hospital of Krefeld, Krefeld, Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergy, Julius-Maximilians-University, Würzburg, Germany
| | - Max Schlaak
- Department of Dermatology, University of Cologne, Cologne, Germany
| | - Uwe Hillen
- Department of Dermatology and Skin Tumor Center, University Hospital Essen-Duisburg, Essen-Duisburg, Germany
| | - Rose Moritz
- Department of Dermatology, Venereology and Allergy, University Hospital Bochum, Bochum, Germany.,Department of Dermatology and Venereology, University Hospital and Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Dorothee Nashan
- Department of Dermatology, Hospital of Dortmund, Dortmund, Germany
| | - Marc Beyer
- Skin Cancer Center Charité, Department of Dermatology and Allergy, Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Edgar Dippel
- Department of Dermatology, Hospital of Ludwigshafen, Ludwigshafen, Germany
| | | | - Michael Max Sachse
- Department of Dermatology, Allergy and Phlebology, Hospital of Bremerhaven, Bremerhaven, Germany.,Department of Dermatology, Hospital of Bremen, Bremen, Germany
| | - Frank Meiss
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.,European Center of Angioscience, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Alexander Marx
- Department of Pathology, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.,European Center of Angioscience, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Eva Geissinger
- Institute of Pathology, Julius-Maximilians-University, Würzburg, Germany
| | - Werner Kempf
- Kempf and Pfaltz, Histologische Diagnostik, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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11
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Bauer C, Abdul Pari AA, Umansky V, Utikal J, Boukamp P, Augustin HG, Goerdt S, Géraud C, Felcht M. T-lymphocyte profiles differ between keratoacanthomas and invasive squamous cell carcinomas of the human skin. Cancer Immunol Immunother 2018; 67:1147-1157. [PMID: 29799076 PMCID: PMC11028118 DOI: 10.1007/s00262-018-2171-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 05/10/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND T-lymphocytes are involved in tumor progression and regression. Actinic keratoses (AK) are atypical proliferations of keratinocytes of the skin. Some AK progress into invasive cutaneous squamous cell carcinomas (cSCC). Keratoacanthomas (KA) are either classified as a cSCC subtype or a benign tumor with histologic resemblance to well-differentiated cSCC as it is supposed to regress spontaneously. In contrast, cSCC represent malignant tumors that may metastasize. OBJECTIVES To compare the T-lymphocyte profiles of AK, KA and cSCC in relation to PD-L1 expression. METHODS Tissue micro-arrays of 103 cases of AK, 43 cases of KA and 106 cases of cSCC were stained by immunohistochemistry for E-cadherin, CD3, CD4, CD8, FOXp3, and the receptor-ligand pair PD-1/PD-L1. Immunohistological scores were computationally determined to assess PD-L1 expression as well as the expression profiles of T-lymphocytes. RESULTS AK had lower numbers of CD3+ and PD-1+ cells compared to KA and lower numbers of CD3+, CD8+ and PD-1+ cells in comparison with cSCC. KA showed significantly higher numbers of CD4+ and FOXp3+ cells as well as lower numbers of CD8+ cells in comparison with invasive cSCC. cSCC expressed significantly more PD-L1 in comparison with AK and KA. Among cSCC PD-L1 expression was higher in moderately and poorly-differentiated cSCC than in well-differentiated cSCC. Increased PD-L1 expression also correlated with increased numbers of CD4+, CD8+ and FOXp3+ cells in cSCC. CONCLUSIONS Tumor-associated T-lymphocyte infiltrates showed significant differences between AK, KA and invasive cSCC. PD-L1 expression correlated with invasion of T-cell infiltrates in invasive cSCC.
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Affiliation(s)
- Corinne Bauer
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - Ashik Ahmed Abdul Pari
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Viktor Umansky
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jochen Utikal
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Petra Boukamp
- Genetics of Skin Carcinogenesis, German Cancer Research Center (DKFZ), Heidelberg, Germany
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Hellmut G Augustin
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Section of Molecular and Clinical Dermatology, Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Moritz Felcht
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University and Centre of Excellence of Dermatology of Baden-Württemberg, Mannheim, Germany.
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Division of Vascular Oncology and Metastasis, German Cancer Research Center (DKFZ-ZMBH Alliance), Heidelberg, Germany.
- German Cancer Consortium, Heidelberg, Germany.
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12
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PD-L1 and PD-L2 Are Differentially Expressed by Macrophages or Tumor Cells in Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type. Am J Surg Pathol 2018; 42:326-334. [DOI: 10.1097/pas.0000000000000983] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Kim Y, Won C, Chang S, Lee M, Choi J, Lee W. Expression of programmed death-1 in cutaneous extranodal natural killer/T-cell lymphoma and its effect on clinical findings and biological behaviour. J Eur Acad Dermatol Venereol 2017; 31:821-827. [DOI: 10.1111/jdv.14165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Y.J. Kim
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - C.H. Won
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S.E. Chang
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - M.W. Lee
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - J.H. Choi
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - W.J. Lee
- Department of Dermatology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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14
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Heller A, Gaida MM, Männle D, Giese T, Scarpa A, Neoptolemos JP, Hackert T, Strobel O, Hoheisel JD, Giese NA, Bauer AS. Stratification of pancreatic tissue samples for molecular studies: RNA-based cellular annotation procedure. Pancreatology 2015; 15:423-31. [PMID: 26118650 DOI: 10.1016/j.pan.2015.05.480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/30/2015] [Accepted: 05/31/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Meaningful profiling of pancreatic cancer samples is particularly challenging due to their complex cellular composition. Beyond tumor cells, surgical biopsies contain desmoplastic stroma with infiltrating inflammatory cells, adjacent normal parenchyma, and "non-pancreatic tissues". The risk of misinterpretation rises when the heterogeneous cancer tissues are sub-divided into smaller fragments for multiple analytic procedures. Pre-analytic histological evaluation is the best option to characterize pancreatic tissue samples. Our aim was to develop a complement or alternative procedure to determine the cellular composition of pancreatic cancerous biopsies, basing on intra-analytic molecular annotation. A standard process for sample stratification at a molecular level does not yet exist. Particularly in the case of retrospective or data depository-based studies, when hematoxylin-eosin stained sections are not available, it supports the correct interpretation of expression profiles. METHODS A five-gene transcriptional signature (RNACellStrat) was defined that allows cell type-specific stratification of pancreatic tissues. Testing biopsy material from biobanks with this procedure demonstrated high correspondence of molecular (qRT-PCR and microarray) and histologic (hematoxylin-eosin stain) evaluations. RESULTS Notably, about a quarter of randomly selected samples (tissue fragments) were exposed as inappropriate for subsequent clinico-pathological interpretation. CONCLUSIONS Via immediate intra-analytical procedure, our RNA-based stratification RNACellStrat increases the accuracy and reliability of the conclusions drawn from diagnostic and prognostic molecular information.
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Affiliation(s)
- Anette Heller
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany.
| | - Matthias M Gaida
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - D Männle
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Giese
- Institute of Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Aldo Scarpa
- Department of Pathology and ARC-NET Research Centre, University of Verona, Verona, Italy
| | - John P Neoptolemos
- National Institute for Health Research, Pancreas Biomedical Research Unit and the Liverpool Experimental Cancer Medicine Centre, Liverpool, UK
| | - Thilo Hackert
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Strobel
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Jörg D Hoheisel
- Functional Genome Analysis, German Research Cancer Center, Heidelberg, Germany
| | - Nathalia A Giese
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany.
| | - Andrea S Bauer
- Functional Genome Analysis, German Research Cancer Center, Heidelberg, Germany
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15
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Teichert M, Stumpf C, Booken N, Wobser M, Nashan D, Hallermann C, Mogler C, Müller CSL, Becker JC, Moritz RKC, Andrulis M, Nicolay JP, Goerdt S, Thomas M, Klemke CD, Augustin HG, Felcht M. Aggressive primary cutaneous B-cell lymphomas show increased Angiopoietin-2-induced angiogenesis. Exp Dermatol 2015; 24:424-9. [PMID: 25776770 DOI: 10.1111/exd.12688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/19/2022]
Abstract
Primary cutaneous large B-cell lymphomas, leg type (PCLBCL/LT) are primary cutaneous B-cell lymphoma (PCBCL) with an intermediate prognosis. Therefore, antracycline-based polychemotherapy combined with rituximab has been recommended as first-line treatment. Yet, despite this regimen, the 5-year survival rate remains 50-66% only. Angiogenesis, the formation of a vascular network, is essential for the pathogenesis of nodal lymphomas. So far, no study has analysed angiogenesis and its key factors in PCLBCL/LT. The present study was aimed at characterizing angiogenesis in PCLBCL/LT to identify the angiogenic molecules as potential therapeutic targets. The intra-tumoral microvessel density (MVD) was assessed by immunohistochemical studies of CD20 and CD31. The MVD was higher in PCLBCL/LT compared with indolent PCBCL. Analyses of open-source microarray data showed correlation between the angiogenic molecule angiopoietin-2 (Ang-2) and pan-endothelial cell markers. ELISA studies determined a shift between Ang-2 and Ang-1 towards Ang-2 in the peripheral blood of PCLBCL/LT patients. Immunofluorescence costainings against the Ang receptor Tie2/angiogenic integrins/CD34 revealed that the vasculature in both aggressive and indolent PCBCL tumors harbours an endothelial cell subpopulation with reduced expression of Tie2. In contrast, the alternative Ang-2 binding partners, angiogenic integrins, are strongly expressed in PCBCL. In line with these findings, downstream targets of Ang-2-integrin signalling, that is phosphorylation of focal adhesion kinase at Tyr397, and sprouting angiogenesis are enhanced in PCLBCL/LT. Our data present Ang-2 as a promising therapeutic target and anti-angiogenic therapy as a new line in treatment of PCLBCL/LT as a hitherto intractable disease.
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Affiliation(s)
- Martin Teichert
- Division of Vascular Oncology and Metastasis, German Cancer Research Centre Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany
| | - Christine Stumpf
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Nina Booken
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Marion Wobser
- Department of Dermatology, Venereology and Allergy, Julius-Maximilians-University, Würzburg, Germany
| | - Dorothee Nashan
- Department of Dermatology, Hospital of Dortmund, Dortmund, Germany
| | | | - Carolin Mogler
- Division of Vascular Oncology and Metastasis, German Cancer Research Centre Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany.,Institute of Pathology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Cornelia S L Müller
- Department of Dermatology, Venereology and Allergy, Saarland University Hospital, Homburg/Saar, Germany
| | - Jürgen C Becker
- Translational Skin Cancer Research, Deutsches Konsortium für Translationale Krebsforschung (DKTK), University Hospital Essen
| | - Rose K C Moritz
- Department of Dermatology, Venereology and Allergy, University of Bochum, Bochum, Germany
| | - Mindaugas Andrulis
- Institute of Pathology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Markus Thomas
- Discovery Oncology, Pharmaceutical Research and Early Development (pRED), Roche Diagnostics GmbH, Penzberg, Germany
| | - Claus-Detlev Klemke
- Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Hellmut G Augustin
- Division of Vascular Oncology and Metastasis, German Cancer Research Centre Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany.,Department of Vascular Biology and Tumor Angiogenesis (CBTM), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Moritz Felcht
- Division of Vascular Oncology and Metastasis, German Cancer Research Centre Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany.,Department of Dermatology, Venereology and Allergy, University Medical Centre Mannheim, Centre of Excellence of Dermatology of Baden-Württemberg, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
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16
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Pinheiro D, Chang YM, Bryant H, Szladovits B, Dalessandri T, Davison LJ, Yallop E, Mills E, Leo C, Lara A, Stell A, Polton G, Garden OA. Dissecting the regulatory microenvironment of a large animal model of non-Hodgkin lymphoma: evidence of a negative prognostic impact of FOXP3+ T cells in canine B cell lymphoma. PLoS One 2014; 9:e105027. [PMID: 25119018 PMCID: PMC4132014 DOI: 10.1371/journal.pone.0105027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 07/19/2014] [Indexed: 02/06/2023] Open
Abstract
The cancer microenvironment plays a pivotal role in oncogenesis, containing a number of regulatory cells that attenuate the anti-neoplastic immune response. While the negative prognostic impact of regulatory T cells (Tregs) in the context of most solid tissue tumors is well established, their role in lymphoid malignancies remains unclear. T cells expressing FOXP3 and Helios were documented in the fine needle aspirates of affected lymph nodes of dogs with spontaneous multicentric B cell lymphoma (BCL), proposed to be a model for human non-Hodgkin lymphoma. Multivariable analysis revealed that the frequency of lymph node FOXP3+ T cells was an independent negative prognostic factor, impacting both progression-free survival (hazard ratio 1.10; p = 0.01) and overall survival (hazard ratio 1.61; p = 0.01) when comparing dogs showing higher than the median FOXP3 expression with those showing the median value of FOXP3 expression or less. Taken together, these data suggest the existence of a population of Tregs operational in canine multicentric BCL that resembles thymic Tregs, which we speculate are co-opted by the tumor from the periphery. We suggest that canine multicentric BCL represents a robust large animal model of human diffuse large BCL, showing clinical, cytological and immunophenotypic similarities with the disease in man, allowing comparative studies of immunoregulatory mechanisms.
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Affiliation(s)
- Dammy Pinheiro
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Yu-Mei Chang
- Research Office, The Royal Veterinary College, London, United Kingdom
| | - Hannah Bryant
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Balazs Szladovits
- Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Tim Dalessandri
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Lucy J. Davison
- Henry Wellcome Building, Centre for Cellular and Molecular Physiology, University of Oxford, Oxford, United Kingdom
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth Yallop
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Emily Mills
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Chiara Leo
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Ana Lara
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Anneliese Stell
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Gerry Polton
- Oncology Service, North Downs Specialist Referrals, Bletchingley, Surrey, United Kingdom
| | - Oliver A. Garden
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
- * E-mail:
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17
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Li YL, Gu KS, Pan YY, Jiao Y, Zhai ZM. Peripheral blood lymphocyte/monocyte ratio at the time of first relapse predicts outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma. BMC Cancer 2014; 14:341. [PMID: 24884604 PMCID: PMC4033684 DOI: 10.1186/1471-2407-14-341] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 05/08/2014] [Indexed: 12/21/2022] Open
Abstract
Background Despite the use of modern immunochemotherapy regimens, a significant proportion of diffuse large B-cell lymphoma (DLBCL) patients will relapse. We proposed absolute lymphocyte count/absolute monocyte count ratio (ALC/AMC ratio) as a new prognostic factor in relapsed or primary refractory DLBCL. Methods We retrospectively analyzed 163 patients who have been diagnosed with relapsed or primary refractory DLBCL. The overall survival (OS) and progression-free survival (PFS) were measured from the time of first relapse. The Cox proportional hazards model was used to evaluate ALC/AMC ratio as prognostic factors for OS and PFS. Results On univariate and multivariate analysis performed with factors included in the saaIPI, early relapse, prior exposure to rituximab and autologous stem-cell transplantation (ASCT), the ALC/AMC ratio at the time of first relapse remained an independent predictor of PFS and OS (PFS: P < 0.001; OS: P < 0.001). Patients with lower ALC/AMC ratio (<2.0) had lower overall response rate, 1-year PFS and 2-year OS rate compared with those with higher ALC/AMC ratio (≥2.0). Moreover, the ALC/AMC ratio can provide additional prognostic information when superimposed on the saaIPI. Conclusions Lower ALC/AMC ratio at the time of first relapse is a adverse prognostic factor for OS and PFS in relapsed or primary refractory DLBCL, and leads to the identification of high-risk patients otherwise classified as low/intermediate risk by the saaIPI alone.
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Affiliation(s)
| | | | | | | | - Zhi-Min Zhai
- Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, People's Republic of China.
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18
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Li LF, Wang HQ, Liu XM, Ren XB. Epirubicin inhibits soluble CD25 secretion by Treg cells isolated from diffuse large B-cell lymphoma patients. Asian Pac J Cancer Prev 2014; 14:1721-4. [PMID: 23679263 DOI: 10.7314/apjcp.2013.14.3.1721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the effect of epirubicin on soluble CD25 (sCD25) secretion by CD4+CD25+ regulatory T (Treg) cells isolated from diffuse large B-cell lymphoma (DLBCL) patients. METHODS Treg cells were isolated from the peripheral blood mononuclear cells isolated from the newly diagnosed DBLCL patients. The concentration of sCD25 in the supernatant was determined with a commercial sCD25 (IL-2R) enzyme-linked immunosorbent assay (ELISA) kit. The fluorescence intensity of CD25 was detected by flow cytometry. RESULTS Cell survival rate was significantly decreased along with the increase of epirubicin concentration after treatment for 24 h. There was also a significant difference in the concentration of sCD25 between the epirubicin group and the control group (P<0.01). A positive correlation between the Treg cells survival rate and the concentration of sCD25 was detected (r=0.993, P<0.01). When equal numbers of CD4+CD25+ Treg cells of the epirubicin group and the control group were cultured for another 24 h without epirubicin the CD25 fluorescence intensity on the surface of Treg cells was obviously higher in the epirubicin group than that in the control group (P<0.01), while the sCD25 concentration in the supernatant in the epirubicin group was significantly lower than that in the control group (P<0.05). CONCLUSION Epirubicin may improve the body's immune functions by inhibiting the sCD25 secretion by Treg cells in DLBCL patients.
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Affiliation(s)
- Lan-Fang Li
- Department of Lymphoma, Sino-US Center of Lymphoma and Leukemia, Tianjin Medical University Cancer Hospital and Institute, Tianjin, China.
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19
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Mitteldorf C, Bieri M, Wey N, Kerl K, Kamarachev J, Pfaltz M, Kutzner H, Roncador G, Tomasini D, Kempf W. Expression of programmed death-1 (CD279) in primary cutaneous B-cell lymphomas with correlation to lymphoma entities and biological behaviour. Br J Dermatol 2013; 169:1212-8. [DOI: 10.1111/bjd.12579] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 12/12/2022]
Affiliation(s)
- C. Mitteldorf
- Department of Dermatology; Klinikum Hildesheim GmbH; Hildesheim Germany
| | - M. Bieri
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - N. Wey
- Department of Pathology; University Hospital Zürich; Zürich Switzerland
| | - K. Kerl
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - J. Kamarachev
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - M. Pfaltz
- Department of Psychiatry and Psychotherapy; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
| | - H. Kutzner
- Dermatopathologie Friedrichshafen Bodensee; Friedrichshafen Germany
| | - G. Roncador
- Centro Nacional de Investigaciones Oncologicas; Madrid Spain
| | - D. Tomasini
- Department of Dermatology; Hospital of Busto Arsizio; Busto Arsizio Italy
| | - W. Kempf
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
- Kempf und Pfaltz; Histologische Diagnostik; Research Unit; Seminarstrasse 1 CH-8042 Zürich Switzerland
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20
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Liu XQ, Lu K, Feng LL, Ding M, Gao JM, Ge XL, Wang X. Up-regulated expression of indoleamine 2,3-dioxygenase 1 in non-Hodgkin lymphoma correlates with increased regulatory T-cell infiltration. Leuk Lymphoma 2013; 55:405-14. [PMID: 23682557 DOI: 10.3109/10428194.2013.804917] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Indoleamine 2,3-dioxygenase 1 (IDO1), which is a key enzyme in tryptophan metabolism expressed in some subsets of normal and neoplastic cells, participates in tumor-induced tolerance. However, the mechanisms involved are not clearly understood. A hypothesis suggests that IDO1 may be involved in proliferation and conversion of regulatory T cells (Tregs). In this study, we evaluated the levels of IDO1 and forkhead box P3 (FoxP3) in non-Hodgkin lymphoma (NHL) tissues and performed ex vivo experiments to investigate the role of IDO1 on T-cell tolerance in NHL. The results showed that expressions of IDO1 mRNA and protein were coincidentally higher in NHL tissues than in reactive hyperplasia of lymph node tissues. Up-regulation of IDO1 was correlated with later clinical phases, larger tumors and higher serum lactate dehydrogenase (LDH), and indicated a worse prognosis. FoxP3 mRNA and protein levels were markedly increased alongside elevated IDO1 levels. Co-culture of murine CD4 + CD25- T cells with A20 cells could initiate the conversion of CD4 + CD25+ T cells, which showed a suppressive function in the mixed lymphocyte reaction. Moreover, the potent inhibitor of IDO1, 1-methyl-l-tryptophan, attenuated the conversion of CD4 + CD25- T cells into CD4 + CD25+ FoxP3 + T cells. The results suggested that up-regulation of IDO1 in NHL tissues could induce local immune tolerance by favoring development and infiltration of FoxP3 + Tregs through the conversion of CD4 + CD25- T cells into CD4 + CD25+ FoxP3 + T cells in the tumor microenvironment. This could be a novel mechanism of NHL escape from immune control.
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Affiliation(s)
- Xiao-Qian Liu
- Department of Hematology, Provincial Hospital Affiliated to Shandong University , Jinan, Shandong , P. R. China
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Procházka V, Jarošová M, Prouzová Z, Nedomová R, Papajík T, Indrák K. Immune Escape Mechanisms in Diffuse Large B-Cell Lymphoma. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/208903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most frequent subtype of non-Hodgkin lymphomas in Western countries. Implementation of immunotherapy using monoclonal antibodies to therapeutic protocols has led to dramatic improvements in overall survival. DLBCL became a model of a successful immunochemotherapy concept. Despite this fact, there is still a proportion of patients who do not respond to or relapse early after treatment. Growing evidence suggests that host antitumor immunity is suppressed by lymphoma cells in many ways. First, host cytotoxic T cells are directly suppressed by interaction with programmed cell death (PD) ligand on lymphoma cell surface and a similar mechanism enhances the activity of suppressive regulatory T cells (Tregs). Second, tumor cells escape host cytotoxic cells due to lower immunogenicity caused by reduced expression of HLA antigens. Both mechanisms have an origin in primary genetic events in lymphomagenesis. Rearrangement of MHC class II transcriptional activator (CIITA) gene and amplification of Janus kinase (JAK2) gene lead to enhanced expression of PD ligands 1 and 2, higher proliferation activity, and lower expression of HLA. This paper summarizes current knowledge about clinically relevant immune escape mechanisms in DLBCL.
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Affiliation(s)
- V. Procházka
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc 77520, Czech Republic
| | - M. Jarošová
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc 77520, Czech Republic
| | - Z. Prouzová
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - R. Nedomová
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc 77520, Czech Republic
| | - T. Papajík
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc 77520, Czech Republic
| | - K. Indrák
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 6, Olomouc 77520, Czech Republic
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