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Lebecque B, Besombes J, Dannus LT, De Antonio M, Cacheux V, Grèze V, Montagnon V, Veronese L, Tchirkov A, Tournilhac O, Berger MG, Veyrat-Masson R. Faster clinical decisions in B-cell acute lymphoblastic leukaemia: A single flow cytometric 12-colour tube improves diagnosis and minimal residual disease follow-up. Br J Haematol 2024; 204:1872-1881. [PMID: 38432068 DOI: 10.1111/bjh.19390] [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: 01/12/2024] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Assessing minimal residual disease (MRD) in B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) is essential for adjusting therapeutic strategies and predicting relapse. Quantitative polymerase chain reaction (qPCR) is the gold standard for MRD. Alternatively, flow cytometry is a quicker and cost-effective method that typically uses leukaemia-associated immunophenotype (LAIP) or different-from-normal (DFN) approaches for MRD assessment. This study describes an optimized 12-colour flow cytometry antibody panel designed for BCP-ALL diagnosis and MRD monitoring in a single tube. This method robustly differentiated hematogones and BCP-ALL cells using two specific markers: CD43 and CD81. These and other markers (e.g. CD73, CD66c and CD49f) enhanced the specificity of BCP-ALL cell detection. This innovative approach, based on a dual DFN/LAIP strategy with a principal component analysis method, can be used for all patients and enables MRD analysis even in the absence of a diagnostic sample. The robustness of our method for MRD monitoring was confirmed by the strong correlation (r = 0.87) with the qPCR results. Moreover, it simplifies and accelerates the preanalytical process through the use of a stain/lysis/wash method within a single tube (<2 h). Our flow cytometry-based methodology improves the BCP-ALL diagnosis efficiency and MRD management, offering a complementary method with considerable benefits for clinical laboratories.
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Affiliation(s)
- Benjamin Lebecque
- Hématologie Biologique, CHU Clermont-Ferrand, Estaing, Clermont-Ferrand, France
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Joevin Besombes
- Hématologie Biologique, CHU Clermont-Ferrand, Estaing, Clermont-Ferrand, France
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Louis-Thomas Dannus
- Hématologie Biologique, CHU Clermont-Ferrand, Estaing, Clermont-Ferrand, France
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marie De Antonio
- Unité de Biostatistiques, Direction de la Recherche Clinique et de l'Innovation, Centre Hospitalier Universitaire de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Victoria Cacheux
- Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
| | - Victoria Grèze
- CHU Clermont-Ferrand, Service Hématologie Oncologie Pédiatrique, Hôpital Estaing, Clermont-Ferrand, France
| | - Valentin Montagnon
- Hématologie Biologique, CHU Clermont-Ferrand, Estaing, Clermont-Ferrand, France
| | - Lauren Veronese
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
- Cytogénétique Médicale, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand, France
| | - Andrei Tchirkov
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
- Cytogénétique Médicale, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand, France
| | - Olivier Tournilhac
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
- Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
| | - Marc G Berger
- Hématologie Biologique, CHU Clermont-Ferrand, Estaing, Clermont-Ferrand, France
- Equipe d'Accueil EA7453 CHELTER, Université Clermont Auvergne, Clermont-Ferrand, France
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Salem DA, Scott D, McCoy CS, Liewehr DJ, Venzon DJ, Arons E, Kreitman RJ, Stetler-Stevenson M, Yuan CM. Differential Expression of CD43, CD81, and CD200 in Classic Versus Variant Hairy Cell Leukemia. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 96:275-282. [PMID: 31077558 DOI: 10.1002/cyto.b.21785] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/05/2019] [Accepted: 04/19/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hairy cell leukemia (HCL) and hairy cell leukemia variant (HCLv) are rare diseases with overlapping clinicopathological features. Features distinguishing HCL from HCLv include expression of CD25, CD123, CD200, annexin-A1, and the presence of BRAF V600E mutation. HCLv typically lacks these markers, but they may occur in a subgroup of HCL patients with an aggressive clinical course. We examined CD43, CD81, CD79b, and CD200 expression in HCL and HCLv. METHODS Multiparametric flow cytometry (FCM) was performed on blood from 59 HCL and 15 HCLv patients for protocol entry. Mean fluorescent intensity (MFI) of CD43, CD79b, CD81, and CD200 was determined (for CD200, n = 17 and 7, respectively). RESULTS Median MFI of HCL vs HCLv was 545 vs 272 for CD43, 602 vs 2,450 for CD81, 4,962 vs 1,969 for CD79b, and 11,652 vs 1,405 for CD200, respectively. Analysis of the median differences, HCL minus HCLv (and their 95% confidence intervals and P-values) indicated that CD43 MFI (estimated median difference (95% CI): 212 [72-413; P = 0.0027) and CD200 MFI (9,883 [3,514-13,434]; P < 0.0001) were higher in HCL than in HCLv, while CD81 MFI (-1,858 [-2,604 to -1,365]; P < 0.0001) was lower in HCL than in HCLv. CD79b MFI HCL median was more than double that of HCLv, but the observed difference (1,571 [-739 to 4,417]) was consistent with the null hypothesis of no difference (P = 0.13). CONCLUSIONS CD200, CD43, and CD81 are likely differentially expressed between HCL and HCLv, reflecting their differing disease biology. Inclusion of these markers in FCM is potentially informative. © 2019 International Clinical Cytometry Society.
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Affiliation(s)
- Dalia A Salem
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland.,Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Drake Scott
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland
| | | | - David J Liewehr
- Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, Maryland
| | - David J Venzon
- Biostatistics and Data Management Section, CCR, NCI, NIH, Bethesda, Maryland
| | - Evgeny Arons
- Laboratory of Molecular Biology, Clinical Immunotherapy Section, CCR, NCI, NIH, Bethesda, Maryland
| | - Robert J Kreitman
- Laboratory of Molecular Biology, Clinical Immunotherapy Section, CCR, NCI, NIH, Bethesda, Maryland
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3
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Carrion C, Guérin E, Gachard N, le Guyader A, Giraut S, Feuillard J. Adult Bone Marrow Three-Dimensional Phenotypic Landscape of B-Cell Differentiation. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:30-38. [DOI: 10.1002/cyto.b.21747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/18/2018] [Accepted: 10/17/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Claire Carrion
- UMR CNRS 7276, Contrôle de la Réponse Immune et des Lymphoproliférations; Université de Limoges; Limoges France
| | - Estelle Guérin
- UMR CNRS 7276, Contrôle de la Réponse Immune et des Lymphoproliférations; Université de Limoges; Limoges France
- Laboratoire d'Hématologie; CHU Dupuytren; Limoges France
| | - Nathalie Gachard
- UMR CNRS 7276, Contrôle de la Réponse Immune et des Lymphoproliférations; Université de Limoges; Limoges France
- Laboratoire d'Hématologie; CHU Dupuytren; Limoges France
| | - Alexandre le Guyader
- Service de Chirurgie Cardiovasculaire et Thoracique et Angiologie; CHU Dupuytren; Limoges France
| | - Stéphane Giraut
- Service d'Hématologie Clinique et Thérapie Cellulaire; CHU Dupuytren; Limoges France
| | - Jean Feuillard
- UMR CNRS 7276, Contrôle de la Réponse Immune et des Lymphoproliférations; Université de Limoges; Limoges France
- Laboratoire d'Hématologie; CHU Dupuytren; Limoges France
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Defendenti C, Atzeni F, Malandrin S, Ardizzone S, Almasio PL, Saibeni S, Bezzio C, Bollani S, Salerno R, Declich P, Sarno Z, Bruno S, Talotta R, Sarzi-Puttini P. Anti-tumour necrosis factor-α antibodies and B cell homeostasis in human inflammatory bowel diseases. Int Immunopharmacol 2017; 54:329-335. [PMID: 29197269 DOI: 10.1016/j.intimp.2017.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/05/2017] [Accepted: 11/12/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The expression of CD70 on T cells is greatly enhanced by antigen-presenting cell (APC)-associated signals, such as tumour necrosis factor(TNF)-α, which is constitutionally high in patients with inflammatory bowel disease (IBD). Experimentally, the chronic activation of CD27 as a result of the constitutive expression of CD70 leads to the demise of B cells in bone marrow (BM) and the secondary lymphoid organs. The aim of this study was to assess the number and phenotype of circulating B cell in untreated IBD patients and their counterparts treated with biological anti-TNF drugs. METHODS The study involved 13 untreated IBD patients, 36 IBD patients treated with biological drugs, and 10 healthy controls. The B cell phenotypes were assessed by means of flow cytometry using monoclonal antibodies specific for CD20, CD19, CD3, CD27 and CD43. In order to evaluate B cell development in bone marrow and peripheral B cell activation, we identified four B cell subsets: hematogones (HBs: CD20+19+3-27-43+), memory B cells (MBs: CD20+19+3-27+43-), pre-plasmablasts (PPBs: CD20+19+3-27+43+), and plasmablasts (PBs: CD20-19+3-27+43+). RESULTS The total number of B cells in the untreated patients was three times lower than that in the patients treated with biological drug (p<0.001), and half that in the healthy controls (p=0.03). The between-group differences (including the healthy donors) were statistically significant in the case of HBs and MBs, but not in the case of PPBs and PBs. Only one treated patient showed a transiently large increase in PPBs. There were statistically significant differences in all of the parameters between the untreated patients and those receiving biological therapy, and in some cases between the untreated patients and healthy controls, but never between the controls and the treated patients. Four non-responders to anti-TNF therapy had a smaller number of total circulating B cells than the untreated patients. CONCLUSIONS Anti-TNF drugs disinhibit B cell production in IBD patients, but maintain the constant homeostasis of circulating B cells. The presence of individual variations may allow the activity of anti-TNF drugs to be monitored by studying B cell subgroups.
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Affiliation(s)
| | | | - Sergio Malandrin
- Microbiology and Virology Unit, ASST Ospedale San Gerardo, Monza, Italy
| | - Sandro Ardizzone
- Division of Gastroenterology, ASST Fatebenefratelli Sacco Buzzi, Milan, Italy
| | - Piero Luigi Almasio
- Biomedical Department of Internal and Specialized Medicine (DI.BI.M.I.S.), University of Palermo, Palermo, Italy
| | - Simone Saibeni
- Division of Gastroenterology, Guido Salvini Hospital, Rho, Italy
| | - Cristina Bezzio
- Division of Gastroenterology, Guido Salvini Hospital, Rho, Italy
| | - Simona Bollani
- Division of Gastroenterology, ASST Fatebenefratelli Sacco Buzzi, Milan, Italy
| | - Raffaele Salerno
- Division of Gastroenterology, ASST Fatebenefratelli Sacco Buzzi, Milan, Italy
| | - Paolo Declich
- Division of Pathology, ASST della Valtellina e dell'Alto Lario, Sondrio, Italy
| | - Zoe Sarno
- Laboratory, ASST Fatebenefratelli Sacco Buzzi, Milan, Italy
| | | | - Rossella Talotta
- Rheumatology Unit, ASST Fatebenefratelli Sacco Buzzi, Milan, Italy
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Treaba DO, Chen A, Ellermeier C, DeNardo B, Altura R. Oil Red O positive vacuolated blasts in a case of CD45 negative, CD19 negative B-lymphoblastic leukemia. HUMAN PATHOLOGY: CASE REPORTS 2016. [DOI: 10.1016/j.ehpc.2015.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Kuhn E, Dorji T, Rodriguez J, Rosai J. Extramedullary Erythropoiesis in Chronic Subdural Hematoma Simulating Metastatic Small Round Cell Tumor. Int J Surg Pathol 2016; 15:288-91. [PMID: 17652539 DOI: 10.1177/1066896907302534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report two cases of extramedullary erythropoiesis within chronic subdural hematoma that caused diagnostic confusion. In both cases, the initial favored diagnosis by the submitting pathologists was that of a metastatic malignant tumor, including lymphoma, carcinoma, and malignant melanoma. In both cases, the subdural chronic hematoma contained cohesive clusters of small round blue cells with scant cytoplasm and round hyperchromatic nuclei. In both cases, some mitotic figures were identified. There was no gross or microscopic evidence of a meningeal mass lesion. The erythroblastic nature of the cells was confirmed using immunohistochemistry for CD43, glycophorin A, and erythropoietin A. It is important for surgical pathologists to be aware of this benign process and not to overinterpret it as either a primary or metastatic malignant tumor.
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MESH Headings
- Aged
- Antigens, CD34/genetics
- Antigens, CD34/metabolism
- Brain Neoplasms/diagnosis
- Brain Neoplasms/metabolism
- Brain Neoplasms/pathology
- Carcinoma, Small Cell/diagnosis
- Carcinoma, Small Cell/metabolism
- Carcinoma, Small Cell/pathology
- Diagnosis, Differential
- Erythropoiesis
- Erythropoietin/genetics
- Erythropoietin/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Glycophorins/genetics
- Glycophorins/metabolism
- Hematoma, Subdural, Chronic/diagnosis
- Hematoma, Subdural, Chronic/metabolism
- Hematoma, Subdural, Chronic/pathology
- Hematopoiesis, Extramedullary
- Humans
- Male
- Middle Aged
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Affiliation(s)
- Elisabetta Kuhn
- Centro Consulenze Anatomia Patologica Oncologica, Department of Pathology, Centro Diagnostico Italiano, Milan, Italy.
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Wang YF, Jiang YM, Gao J, Zhou P, Zhang G. [Prognostic value of bone marrow hematogones in childhood B-lineage acute lymphoblastic leukemia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2016; 18:292-296. [PMID: 27097570 PMCID: PMC7390085 DOI: 10.7499/j.issn.1008-8830.2016.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To study the prognostic value of hematogones (HGs) for childhood B-lineage acute lymphoblastic leukemia (B-ALL) during consolidation chemotherapy. METHODS A retrospective analysis was conducted for 196 children with newly-diagnosed B-ALL. They were divided into high-risk group (n=55), intermediate-risk group (n=69), and low-risk group (n=72) by risk stratification, and into complete remission group (n=165) and relapse group (n=31) by clinical outcome. The European BIOMED-1 standard flow cytometry for minimal residual disease (MRD) was used to determine the number of HGs during consolidation chemotherapy. The Kaplan-Meier survival curve was used to assess event-free survival (EFS). RESULTS The high-risk group had a significantly lower number of HGs than the intermediate-risk and low-risk groups (P<0.05). The number of HGs in the complete remission group was significantly higher than in the relapse group (P<0.05). The children with HGs ≤1.0% had a significantly lower EFS than those with HGs <1.0% (P<0.05). CONCLUSIONS HGs can be used to assess the treatment outcome and prognosis in children with B-ALL, and proliferation of HGs reflects the good effect of chemotherapy in such children.
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Affiliation(s)
- Yue-Fan Wang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
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Carulli G, Ottaviano V, Sammuri P, Domenichini C, Guerri V, Rousseau M, Ciancia EM, Ciabatti E, Petrini M. Kinetics of hematogones in bone marrow samples from patients with non-Hodgkin lymphomas treated with rituximab-containing regimens: a flow cytometric study. Int J Hematol 2015; 102:59-66. [PMID: 25953308 DOI: 10.1007/s12185-015-1798-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 01/17/2023]
Abstract
Treatment with rituximab, either alone or in combination with antiblastic drugs, causes significant depletion of circulating B-lymphocytes and modifications of B cell maturation in the bone marrow. In the present study, we analyzed the kinetics of hematogones in bone marrow samples from 55 patients suffering from non-Hodgkin lymphomas and treated with rituximab-containing regimens. Maturation arrest at the level of stage 2 hematogones, along with complete depletion of naïve, mature B-lymphocytes, was observed as short-term effects (2 months after completion of chemo-immunotherapy). Further bone marrow samples, obtained 12 months after the last rituximab infusion in 21 patients undergoing long-term follow-up and treated with rituximab maintenance therapy, showed complete normalization of B-lymphocyte ontogeny. Hypogammaglobulinemia developed in 26 patients, and was still observed in nine of the 21 patients undergoing long-term follow-up. Our study provides novel data on hematogone kinetics in the setting of patients with non-Hodgkin lymphomas treated with chemo-immunotherapy containing rituximab and with rituximab maintenance. Our observations show that hypogammaglobulinemia can persist in a significant percentage of patients, despite complete recovery of B-lymphocyte ontogeny.
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Affiliation(s)
- Giovanni Carulli
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa, 56126, Pisa, Italy,
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9
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Carulli G, Ottaviano V, Guerri V, Giuntini S, Sammuri P, Ciancia EM, Azzarà A. Multiparameter Flow Cytometry to Detect Hematogones and to Assess B-lymphocyte clonality in Bone Marrow Samples from Patients with Non-Hodgkin Lymphomas. Hematol Rep 2014; 6:5381. [PMID: 25013717 PMCID: PMC4091289 DOI: 10.4081/hr.2014.5381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 06/03/2014] [Indexed: 11/23/2022] Open
Abstract
Hematogones are precursors of B-lymphocytes detected in small numbers in the bone marrow. Flow cytometry is the most useful tool to identify hematogones and, so far, 4-color methods have been published. In addition, flow cytometry is used in the diagnosis and follow-up of lymphomas. We developed a flow cytometric 7-color method to enumerate hematogones and to assess B-lymphocyte clonality for routine purposes. We evaluated 171 cases of B-cell non-Hodgkin lymphomas, either at diagnosis or in the course of follow-up. By our diagnostic method, which was carried out by the combination K/λ/CD20/CD19/CD10/CD45/CD5, we were able to detect hematogones in 97.6% of samples and to distinguish normal B-lymphocytes, neoplastic lymphocytes and hematogones in a single step. The percentage of hematogones showed a significant inverse correlation with the degree of neoplastic infiltration and, when bone marrow samples not involved by disease were taken into consideration, resulted higher in patients during follow-up than in patients evaluated at diagnosis.
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Affiliation(s)
- Giovanni Carulli
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
| | - Virginia Ottaviano
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
| | - Valentina Guerri
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
| | - Stefano Giuntini
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
| | - Paola Sammuri
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
| | | | - Antonio Azzarà
- Division of Hematology, Department of Clinical and Experimental Medicine, Santa Chiara Hospital, University of Pisa , Italy
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Chantepie S, Cornet E, Salaün V, Reman O. Hematogones: An overview. Leuk Res 2013; 37:1404-11. [DOI: 10.1016/j.leukres.2013.07.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 07/19/2013] [Indexed: 11/25/2022]
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Fai Chow K, Sevilla DW, Colovai AI, Bhagat G, Alobeid B. Hematogones are markedly decreased in chronic myeloid leukemia: multiparametric flow cytometric analysis. Leuk Lymphoma 2011; 52:680-6. [DOI: 10.3109/10428194.2010.547641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Sevilla DW, El-Mallawany NK, Emmons FN, Alexander S, Bhagat G, Alobeid B. Spectrum of childhood Epstein-Barr virus-associated T-cell proliferations and bone marrow findings. Pediatr Dev Pathol 2011; 14:28-37. [PMID: 20367453 DOI: 10.2350/09-12-0753-oa.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Systemic Epstein-Barr virus-positive (EBV+) T-cell lymphoproliferative disorder of childhood is a recently described entity. The majority of such cases have been reported from Asia, which suggests an underlying genetic predisposition. We analyzed the clinicopathologic characteristics of 5 children with EBV+ T-cell lymphoid proliferations evaluated and treated at our institute over a 2-year period. There were 3 males and 2 females of Latino (n = 4) or Caucasian (n = 1) heritage with a median age of 5 years (age range 2-18 years). All patients presented with EBV infection (acute, n = 4) with elevated serum EBV viral loads at the time of diagnosis and had systemic manifestations, including fever, hepatosplenomegaly, and pancytopenia. The bone marrow biopsies showed EBV+/CD8+ T-cell lymphocytosis in all patients, with variable degrees of histiocytosis, plasmacytosis, and hemophagocytosis. Interestingly, there was marked and consistent depletion of mature and precursor B cells in the marrow (<1% of total marrow cellularity) in all patients. Three of the patients died of disease-associated complications 2 to 12 weeks after initial diagnosis. Our study describes the detailed bone marrow findings, contributes to the growing number of cases of systemic EBV+ T-cell lymphoproliferative disorder of childhood occurring in the Western hemisphere, and documents this disorder in patients from the Caribbean countries.
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Affiliation(s)
- Deborah W Sevilla
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, NY, USA
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13
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Sevilla DW, Colovai AI, Emmons FN, Bhagat G, Alobeid B. Hematogones: a review and update. Leuk Lymphoma 2009; 51:10-9. [DOI: 10.3109/10428190903370346] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Mitrovic Z, Ilic I, Nola M, Aurer I, Sonicki Z, Basic-Kinda S, Radman I, Ajdukovic R, Labar B. CD43 expression is an adverse prognostic factor in diffuse large B-Cell lymphoma. ACTA ACUST UNITED AC 2009; 9:133-7. [PMID: 19406723 DOI: 10.3816/clm.2009.n.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND CD43 is a transmembrane glycoprotein expressed in different hematopoietic cells, including some subsets of B lymphocytes. About a quarter of diffuse large B-cell lymphomas (DLBCLs) express CD43, but its prognostic significance is unknown. PATIENTS AND METHODS We analyzed the prognostic effect of immunohistochemically determined CD43 expression in 119 patients with newly diagnosed DLBCL. All were treated with CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone)-like chemotherapy, 57 without and 62 with rituximab. RESULTS A total of 31 DLBCL cases (26%) expressed CD43. Patients with CD43+ and CD43- lymphomas did not differ regarding sex, International Prognostic Index (IPI) factors and score, rituximab treatment, presence of bulky disease, or germinal center subtype. Median follow-up was 45 months. Patients with CD43+ DLBCL had significantly lower complete response rates (59% vs. 80%; P = .019), 2-year event-free survival (EFS) rates (34% vs. 64%; P = .003), and overall survival (OS) rates (45% vs. 76%; P = .002). The prognostic significance of CD43 expression was retained in multivariate analysis (relative risk [RR] 2.04; P = .013 for EFS; RR 2.17; P = .016 for OS). In subgroup analysis, the effect of CD43 expression was significant in patients treated with rituximab and those with low IPI, whereas it was not reached in patients treated without rituximab. The effect was not observed in patients with high IPI. CONCLUSION These results indicate that CD43 expression is an important independent adverse prognostic factor in DLBCL.
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Affiliation(s)
- Zdravko Mitrovic
- Division of Hematology, Department of Medicine, University Hospital Center and Medical School University of Zagreb, Croatia.
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Sevilla DW, Emmons FN, Bai X, Colovai A, Bhagat G, Alobeid B. The pattern of cytoplasmic IgM expression in the context of the three currently recognised maturational stages of hematogones. Leuk Lymphoma 2009; 50:642-4. [DOI: 10.1080/10428190802699357] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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