1
|
Clarke SE, Fuller KA, Erber WN. Chromosomal defects in multiple myeloma. Blood Rev 2024; 64:101168. [PMID: 38212176 DOI: 10.1016/j.blre.2024.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/01/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
Multiple myeloma is a plasma cell neoplasm driven by primary (e.g. hyperdiploidy; IGH translocations) and secondary (e.g. 1q21 gains/amplifications; del(17p); MYC translocations) chromosomal events. These are important to detect as they influence prognosis, therapeutic response and disease survival. Currently, cytogenetic testing is most commonly performed by interphase fluorescence in situ hybridisation (FISH) on aspirated bone marrow samples. A number of variations to FISH methodology are available, including prior plasma cell enrichment and incorporation of immunophenotypic plasma cell identification. Other molecular methods are increasingly being utilised to provide a genome-wide view at high resolution (e.g. single nucleotide polymorphism (SNP) microarray analysis) and these can detect abnormalities in most cases. Despite their wide application at diagnostic assessment, both FISH and SNP-array have relatively low sensitivity, limiting their use for identification of prognostically significant low-level sub-clones or for disease monitoring. Next-generation sequencing is increasingly being used to detect mutations and new FISH techniques such as by flow cytometry are in development and may address some of the current test limitations. Here we review the primary and secondary cytogenetic aberrations in myeloma and discuss the range of techniques available for their assessment.
Collapse
Affiliation(s)
- Sarah E Clarke
- School of Biomedical Sciences, The University of Western Australia (M504), Crawley, WA 6009, Australia; Department of Haematology, PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Murdoch, WA 6150, Australia.
| | - Kathryn A Fuller
- School of Biomedical Sciences, The University of Western Australia (M504), Crawley, WA 6009, Australia.
| | - Wendy N Erber
- School of Biomedical Sciences, The University of Western Australia (M504), Crawley, WA 6009, Australia; PathWest Laboratory Medicine WA, Royal Perth Hospital, Perth, WA 6000, Australia.
| |
Collapse
|
2
|
Veryaskina YA, Titov SE, Kovynev IB, Pospelova TI, Zhimulev IF. The Profile of MicroRNA Expression in Bone Marrow in Non-Hodgkin’s Lymphomas. Diagnostics (Basel) 2022; 12:diagnostics12030629. [PMID: 35328182 PMCID: PMC8947746 DOI: 10.3390/diagnostics12030629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 12/04/2022] Open
Abstract
Non-Hodgkin’s lymphomas (NHLs) are a heterogeneous group of malignant lymphomas that can occur in both lymph nodes and extranodal sites. Bone marrow (BM) is the most common site of extranodal involvement in NHL. The objective of this study is to determine the unique profile of miRNA expression in BM affected by NHL, with the possibility of a differential diagnosis of NHL from reactive BM changes and acute leukemia (AL). A total of 180 cytological samples were obtained by sternal puncture and aspiration biopsy of BM from the posterior iliac spine. All the cases were patients before treatment initiation. The study groups were NHL cases (n = 59) and AL cases (acute lymphoblastic leukemia (n = 25) and acute myeloid leukemia (n = 49)); the control group consisted of patients with non-cancerous blood diseases (NCBDs) (n = 48). We demonstrated that expression levels of miRNA-124, miRNA-221, and miRNA-15a are statistically significantly downregulated, while the expression level of let-7a is statistically significantly upregulated more than 2-fold in BM in NHL compared to those in AL and NCBD. ROC analysis revealed that let-7a/miRNA-124 is a highly sensitive and specific biomarker for a differential diagnosis of BM changes in NHL from those in AL and NCBD. Therefore, we conclude that analysis of miRNA expression levels may be a promising tool for early diagnosis of NHL.
Collapse
Affiliation(s)
- Yuliya A. Veryaskina
- Laboratory of Gene Engineering, Institute of Cytology and Genetics, SB RAS, 630090 Novosibirsk, Russia
- Correspondence:
| | - Sergei E. Titov
- Laboratory of Molecular Genetics, Department of the Structure and Function of Chromosomes, Institute of Molecular and Cellular Biology, SB RAS, 630090 Novosibirsk, Russia; (S.E.T.); (I.F.Z.)
- AO Vector-Best, 630117 Novosibirsk, Russia
| | - Igor B. Kovynev
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, 630091 Novosibirsk, Russia; (I.B.K.); (T.I.P.)
| | - Tatiana I. Pospelova
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, 630091 Novosibirsk, Russia; (I.B.K.); (T.I.P.)
| | - Igor F. Zhimulev
- Laboratory of Molecular Genetics, Department of the Structure and Function of Chromosomes, Institute of Molecular and Cellular Biology, SB RAS, 630090 Novosibirsk, Russia; (S.E.T.); (I.F.Z.)
| |
Collapse
|
3
|
Moshref Razavi H. Bone Marrow Involvement by Aggressive B Cell Lymphoma Undetected by Aspirate Immunophenotyping. J Hematol 2021; 10:14-17. [PMID: 33643504 PMCID: PMC7891908 DOI: 10.14740/jh766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022] Open
Abstract
Staging for newly diagnosed lymphoma is an essential diagnostic step aimed at not only estimating prognosis but also refining the ensuing therapeutic pathway. Bone marrow is routinely sampled for this reason. Morphological assessment of the bone marrow aspirate and biopsy remains the gold standard approach. Nonetheless, ancillary testing such as aspirate immunophenotyping is also used with the aim to increase sensitivity and add diagnostic utility, e.g., to provide proof of clonality. Both of these techniques are fraught with shortcomings and concordance is often not perfect. Cases of infiltrative lymphoma identified by morphology, and not detected by flow cytometry highlights the dangers of over reliance on aspirate immunophenotyping. Under sampling, disintegration, fibrosis and hemodilution are but some causes of a false negative flow result. Therefore, neither technique is sufficient in isolation. In this submission, a case of such a discrepancy is presented as an introduction for review of literature that highlights this phenomenon.
Collapse
Affiliation(s)
- Habib Moshref Razavi
- Fraser Health Authority, The Royal Columbian Hospital, 330 East Columbia Street New Westminster, BC, V3L 3W7, Canada.
| |
Collapse
|
4
|
Mayerhoefer ME, Riedl CC, Kumar A, Dogan A, Gibbs P, Weber M, Staber PB, Huicochea Castellanos S, Schöder H. [18F]FDG-PET/CT Radiomics for Prediction of Bone Marrow Involvement in Mantle Cell Lymphoma: A Retrospective Study in 97 Patients. Cancers (Basel) 2020; 12:cancers12051138. [PMID: 32370121 PMCID: PMC7281173 DOI: 10.3390/cancers12051138] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023] Open
Abstract
Biopsy is the standard for assessment of bone marrow involvement in mantle cell lymphoma (MCL). We investigated whether [18F]FDG-PET radiomic texture features can improve prediction of bone marrow involvement in MCL, compared to standardized uptake values (SUV), and whether combination with laboratory data improves results. Ninety-seven MCL patients were retrospectively included. SUVmax, SUVmean, SUVpeak and 16 co-occurrence matrix texture features were extracted from pelvic bones on [18F]FDG-PET/CT. A multi-layer perceptron neural network was used to compare three combinations for prediction of bone marrow involvement—the SUVs, a radiomic signature based on SUVs and texture features, and the radiomic signature combined with laboratory parameters. This step was repeated using two cut-off values for relative bone marrow involvement: REL > 5% (>5% of red/cellular bone marrow); and REL > 10%. Biopsy demonstrated bone marrow involvement in 67/97 patients (69.1%). SUVs, the radiomic signature, and the radiomic signature with laboratory data showed AUCs of up to 0.66, 0.73, and 0.81 for involved vs. uninvolved bone marrow; 0.68, 0.84, and 0.84 for REL ≤ 5% vs. REL > 5%; and 0.69, 0.85, and 0.87 for REL ≤ 10% vs. REL > 10%. In conclusion, [18F]FDG-PET texture features improve SUV-based prediction of bone marrow involvement in MCL. The results may be further improved by combination with laboratory parameters.
Collapse
Affiliation(s)
- Marius E. Mayerhoefer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (C.R.); (P.G.); (S.H.C.); (H.S.)
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
- Correspondence: ; Tel.: +1-646-961-5030
| | - Christopher C. Riedl
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (C.R.); (P.G.); (S.H.C.); (H.S.)
| | - Anita Kumar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Ahmet Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Peter Gibbs
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (C.R.); (P.G.); (S.H.C.); (H.S.)
| | - Michael Weber
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Philipp B. Staber
- Department of Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Sandra Huicochea Castellanos
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (C.R.); (P.G.); (S.H.C.); (H.S.)
| | - Heiko Schöder
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (C.R.); (P.G.); (S.H.C.); (H.S.)
| |
Collapse
|
5
|
Sircar A, Chowdhury SM, Hart A, Bell WC, Singh S, Sehgal L, Epperla N. Impact and Intricacies of Bone Marrow Microenvironment in B-cell Lymphomas: From Biology to Therapy. Int J Mol Sci 2020; 21:E904. [PMID: 32019190 PMCID: PMC7043222 DOI: 10.3390/ijms21030904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/26/2020] [Accepted: 01/29/2020] [Indexed: 12/14/2022] Open
Abstract
Lymphoma, a group of widely prevalent hematological malignancies of lymphocyte origin, has become the focus of significant clinical research due to their high propensity for refractory/relapsed (R/R) disease, leading to poor prognostic outcomes. The complex molecular circuitry in lymphomas, especially in the aggressive phenotypes, has made it difficult to find a therapeutic option that can salvage R/R disease. Furthermore, the association of lymphomas with the Bone Marrow (BM) microenvironment has been found to portend worse outcomes in terms of heightened chances of relapse and acquired resistance to chemotherapy. This review assesses the current therapy options in three distinct types of lymphomas: diffuse large B-cell lymphoma, follicular lymphoma and mantle cell lymphoma. It also explores the role of the BM tumor microenvironment as a secure 'niche' for lymphoma cells to grow, proliferate and survive. It further evaluates potential mechanisms through which the tumor cells can establish molecular connections with the BM cells to provide pro-tumor benefits, and discusses putative therapeutic strategies for disrupting the BM-lymphoma cell communication.
Collapse
Affiliation(s)
| | | | | | | | | | - Lalit Sehgal
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA; (A.S.); (S.M.C.); (A.H.); (W.C.B.); (S.S.)
| | - Narendranath Epperla
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA; (A.S.); (S.M.C.); (A.H.); (W.C.B.); (S.S.)
| |
Collapse
|
6
|
Chauhan S, Pradhan S, Mohanty R, Saini A, Devi K, Sahu MC. Evaluation of sensitivity and specificity of bone marrow trephine biopsy tests in an Indian teaching hospital. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2017.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sima Chauhan
- Department of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDepartment of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| | - Sarita Pradhan
- Department of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDepartment of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| | - Ripunjaya Mohanty
- Department of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDepartment of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| | - Abhishek Saini
- Department of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDepartment of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| | - Kumudini Devi
- Department of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDepartment of Pathology (Division of Lab Haematology), IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| | - Mahesh Chandra Sahu
- Directorate of Medical Research, IMS and SUM Hospital, Siksha O Anusandhan University, K8, Kalinga Nagar, Bhubaneswar 751003, IndiaDirectorate of Medical Research, IMS and SUM Hospital, Siksha O Anusandhan University, K8 , Kalinga Nagar , Bhubaneswar, 751003, India
| |
Collapse
|
7
|
Radiographic Enlargement of Mandibular Canal as an Extranodal Primary Non-Hodgkin's Lymphoma Early Sign in an Asymptomatic Patient. Case Rep Dent 2017; 2017:9193165. [PMID: 28299210 PMCID: PMC5337308 DOI: 10.1155/2017/9193165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 01/31/2017] [Indexed: 01/01/2023] Open
Abstract
Non-Hodgkin's lymphoma (NHL) is a lymphoproliferative disorder, from a subgroup of heterogeneous hematologic malignancies; the term “extranodal” refers to malignant involvement of tissues other than lymph nodes, tonsils, spleen, pharyngeal lymphatic ring, or thymus. Only 0.6% of all NHL are at mandible alone, and it may involve the inferior alveolar canal. We describe a case of bilateral enlargement of the mandibular canal without symptomatology, which was shown in a panoramic radiograph and cone beam computed tomography in a rehabilitation routine exam, as an early sign of primary extranodal NHL.
Collapse
|
8
|
Park Y, Park BB, Jeong JY, Kim WY, Jang S, Shin BK, Lee DS, Han JH, Park CJ, Suh C, Kim I, Chi HS. Assessment of bone marrow involvement in patients with lymphoma: report on a consensus meeting of the Korean Society of Hematology Lymphoma Working Party. Korean J Intern Med 2016; 31:1030-1041. [PMID: 27809449 PMCID: PMC5094919 DOI: 10.3904/kjim.2015.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 10/14/2016] [Indexed: 02/01/2023] Open
Abstract
In September 2011, the Korean Society of Hematology Lymphoma Working Party held a nationwide conference to establish a consensus for assessing bone marrow (BM) involvement in patients with lymphoma. At this conference, many clinicians, hematopathologists, and diagnostic hematologists discussed various topics for a uniform consensus in the evaluation process to determine whether the BM is involved. Now that the discussion has matured sufficiently to be published, we herein describe the consensus reached and limitations in current methods for assessing BM involvement in patients with lymphoma.
Collapse
Affiliation(s)
- Yong Park
- Department of Internal Medicine, Korea University School of Medicine, Seoul, Korea
| | - Byung Bae Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji Yun Jeong
- Department of Pathology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Wook Youn Kim
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Bong Kyung Shin
- Department of Pathology, Korea University School of Medicine, Seoul, Korea
| | - Dong Soon Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheolwon Suh
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Cheolwon Suh, M.D. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3209 Fax: +82-2-3010-6961 E-mail:
| | - Insun Kim
- Department of Pathology, Korea University School of Medicine, Seoul, Korea
| | - Hyun-Sook Chi
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Berget E, Helgeland L, Liseth K, Løkeland T, Molven A, Vintermyr OK. Prognostic value of bone marrow involvement by clonal immunoglobulin gene rearrangements in follicular lymphoma. J Clin Pathol 2014; 67:1072-7. [PMID: 25233852 PMCID: PMC4251203 DOI: 10.1136/jclinpath-2014-202382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Aims We aimed to evaluate the prognostic value of routine use of PCR amplification of immunoglobulin gene rearrangements in bone marrow (BM) staging in patients with follicular lymphoma (FL). Methods Clonal rearrangements were assessed by immunoglobulin heavy and light-chain gene rearrangement analysis in BM aspirates from 96 patients diagnosed with FL and related to morphological detection of BM involvement in biopsies. In 71 patients, results were also compared with concurrent flow cytometry analysis. Results BM involvement was detected by PCR in 34.4% (33/96) of patients. The presence of clonal rearrangements by PCR was associated with advanced clinical stage (I–III vs IV; p<0.001), high FL International Prognostic Index (FLIPI) score (0–1, 2 vs ≥3; p=0.003), and detection of BM involvement by morphology and flow cytometry analysis (p<0.001 for both). PCR-positive patients had a significantly poorer survival than PCR-negative patients (p=0.001, log-rank test). Thirteen patients positive by PCR but without morphologically detectable BM involvement, had significantly poorer survival than patients with negative morphology and negative PCR result (p=0.002). The poor survival associated with BM involvement by PCR was independent of the FLIPI score (p=0.007, Cox regression). BM involvement by morphology or flow cytometry did not show a significant impact on survival. Conclusions Our results showed that routine use of PCR-based clonality analysis significantly improved the prognostic impact of BM staging in patients with FL. BM involvement by PCR was also an independent adverse prognostic factor.
Collapse
Affiliation(s)
- Ellen Berget
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Lars Helgeland
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Knut Liseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Turid Løkeland
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Anders Molven
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Olav Karsten Vintermyr
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Johansson U, Bloxham D, Couzens S, Jesson J, Morilla R, Erber W, Macey M. Guidelines on the use of multicolour flow cytometry in the diagnosis of haematological neoplasms. British Committee for Standards in Haematology. Br J Haematol 2014; 165:455-88. [PMID: 24620735 DOI: 10.1111/bjh.12789] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
12
|
Kim Y, Kim M, Kim Y, Han JH, Han K. Estimation of bone marrow cellularity using digital image nucleated cell counts in patients receiving chemotherapy. Int J Lab Hematol 2014; 36:548-54. [DOI: 10.1111/ijlh.12186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 11/28/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Y. Kim
- Department of Laboratory Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - M. Kim
- Department of Laboratory Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - Y. Kim
- Department of Laboratory Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J. H. Han
- Department of Computer Science and Engineering; Pohang University of Science and Technology; Pohang Korea
| | - K. Han
- Department of Laboratory Medicine; College of Medicine; The Catholic University of Korea; Seoul Korea
| |
Collapse
|
13
|
Second-Generation Tyrosine Kinase Inhibitors (Tki) as Salvage Therapy for Resistant or Intolerant Patients to Prior TKIs. Mediterr J Hematol Infect Dis 2014; 6:e2014003. [PMID: 24455112 PMCID: PMC3894843 DOI: 10.4084/mjhid.2014.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/26/2013] [Accepted: 11/11/2013] [Indexed: 11/08/2022] Open
Abstract
With the advent of target therapies, imatinib became the mainstay for treatment of chronic myeloid leukemia. However, despite the brilliant results obtained with this drug, more than 30% of patients discontinue therapy in long-term due to several reasons, including failure and/or intolerance. Second-generation tyrosine kinase inhibitors (TKIs) are more potent drugs and have expanded inhibition against a broad spectrum of mutations resistant to imatinib. Both nilotinib and dasatinib have demonstrated in vitro and in vivo clinical activity against different types of mutations and various forms of resistance. However, patients with T315I mutation do not obtain an advantage from these drugs and a third generation inhibitor ponatinib, a pan-BCR drug, was tested with significant results. In this review, we report the results of second-and third-generation TKIs tested as second or third line therapy in patients resistant and/or intolerant to previous inhibitors.
Collapse
|
14
|
Comparative evaluation of bone marrow aspirate with trephine biopsy in hematological disorders and determination of optimum trephine length in lymphoma infiltration. Mediterr J Hematol Infect Dis 2014; 6:e2014002. [PMID: 24455111 PMCID: PMC3894839 DOI: 10.4084/mjhid.2014.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/22/2013] [Indexed: 01/05/2023] Open
Abstract
Introduction Bone marrow examination is an indispensable diagnostic tool to evaluate neoplastic and non neoplastic hematological diseases. Aims To compare bone marrow aspirate with trephine biopsy in hematological disorders. To determine the optimum trephine preprocessing length in lymphoma infiltration. Methods Diagnostic comparison was done between simultaneous bone marrow aspirates and trephine biopsies in 449 patients. Biopsies were fixed in formalin, decalcified in 5.5% EDTA and routinely processed. Concordance rates and validity parameters for aspirate were calculated. Three deeper sections of trephine biopsy, cut at 0.1–0.2 mm intervals, were assessed for lymphoma involvement. Proportion of biopsies showing marrow infiltration by lymphoma cells was plotted against trephine length and correlation was assessed. Results Aspirate had a high sensitivity for acute leukemia (89.4%) and multiple myeloma (88.5%), moderate for NHL (67.6%) and nonhematopoietic metastases (58.3%) and low for aplastic anemia (38.5%) and Hodgkin lymphoma (5%). Aspirate has no role in granulomatous myelitis and myelofibrosis. Lymphoma positivity increased with trephine length, with maximum positivity (68.9%) seen in 17–20 mm group and no further gain beyond 20 mm. (lymphoma positivity ≤16mm=40.3% and ≥17mm=66.1%, p=0.0011). Conclusion Aspirate has a high specificity; its sensitivity depends upon the type of disease. Apart from few conditions, in which aspirate alone is sufficient, biopsy is mandatory in most. Preprocessing trephine length of 17–20 mm examined at multiple deeper levels was found optimal for assessing lymphoma positivity.
Collapse
|
15
|
Sovani V, Harvey C, Haynes AP, McMillan AK, Clark DM, O'Connor SR. Bone marrow trephine biopsy involvement by lymphoma: review of histopathological features in 511 specimens and correlation with diagnostic biopsy, aspirate and peripheral blood findings. J Clin Pathol 2013; 67:389-95. [PMID: 24327662 DOI: 10.1136/jclinpath-2013-201520] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS This study aimed to evaluate the key features of bone marrow trephine (BMT) biopsy involvement by lymphoma. METHODS 511 cases were assessed for percentage of marrow involvement, pattern of involvement (diffuse, nodular, paratrabecular, interstitial or intrasinusoidal), presence/absence of granulomas, stromal fibrosis and necrosis, presence/absence of neoplastic/reactive follicles and discordance with other biopsy sites. Correlation with aspirate and peripheral blood findings was made in a subset of 345 patients (167 aspirates, 178 blood). RESULTS The most frequent subtype was follicular lymphoma (26.2%) followed by extranodal marginal zone (23.1%), lymphoplasmacytic (19.2%), diffuse large B cell (DLBCL) (12.5%), Hodgkin (HL) (5.7%) and mantle cell lymphomas (4.3%). The predominant pattern in follicular lymphoma was paratrabecular. Marginal zone lymphomas of all types and lymphoplasmacytic lymphoma showed a relatively even distribution between diffuse, interstitial, paratrabecular and nodular patterns. The majority of mantle cell lymphoma cases showed either diffuse or nodular patterns. A diffuse pattern was common in DLBCL and Burkitt lymphomas. An intrasinusoidal pattern was seen only in extranodal and splenic marginal zone lymphomas. Granulomas and fibrosis were uncommon in small cell B cell lymphomas but frequent in DLBCL and HL. Aspirate and trephine results concurred in 73.8% of cases overall, but this varied widely between subtypes. Peripheral blood involvement rates by lymphoma also varied, with a mean of 37.1%. CONCLUSIONS Different lymphomas often demonstrate reliably characteristic architectural patterns of marrow involvement which can help differentiate them even when cytological features do not permit this, and marrow stromal and other background changes may also be useful pointers towards a particular lymphoma subtype.
Collapse
Affiliation(s)
- Vishakha Sovani
- Department of Histopathology, Nottingham University Hospital, , Nottingham, UK
| | | | | | | | | | | |
Collapse
|
16
|
Hehne S, Schäfer SM, Richter P, Geier C, Chen Y, von Deimling A, Petersen I. Bone marrow biopsies of patients with hematopoietic and lymphoid disorders – epidemiology, chromosomal aberrations and molecular pathology. Pathol Res Pract 2012; 208:510-7. [DOI: 10.1016/j.prp.2012.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 04/23/2012] [Accepted: 05/03/2012] [Indexed: 12/22/2022]
|
17
|
Aubry OA, Spangler EA, Schleis SE, Smith AN. Evaluation of bone marrow aspirates from multiple sites for staging of canine lymphoma and mast cell tumours. Vet Comp Oncol 2012; 12:58-66. [DOI: 10.1111/j.1476-5829.2012.00331.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 03/23/2012] [Indexed: 12/23/2022]
Affiliation(s)
- O. A. Aubry
- Department of Clinical Sciences; Auburn University; Auburn AL USA
- Southern California Veterinary Specialty Hospital; Irvine CA USA
| | - E. A. Spangler
- Department of Pathobiology; Auburn University; Auburn AL USA
| | - S. E. Schleis
- Department of Clinical Sciences; Auburn University; Auburn AL USA
| | - A. N. Smith
- Department of Clinical Sciences; Auburn University; Auburn AL USA
| |
Collapse
|
18
|
Abstract
In the setting of hematological neoplasms, changes in the bone marrow (BM) stroma might arise from pressure exerted by the neoplastic clone in shaping a supportive microenvironment, or from chronic perturbation of the BM homeostasis. Under such conditions, alterations in the composition of the BM stroma can be profound, and could emerge as relevant prognostic factors. In this Review, we delineate the multifaceted contribution of the BM stroma to the pathobiology of several hematological neoplasms, and discuss the impact of stromal modifications on the natural course of these diseases. Specifically, we highlight the involvement of BM stromal components in lymphoid and myeloid malignancies, and present the most relevant processes responsible for remodeling the BM stroma. The role of bystander BM stromal elements in the setting of hematological neoplasms is discussed, strengthening the rationale for treatment strategies that target the BM stroma.
Collapse
|
19
|
Gong X, Lu X, Wu X, Xu R, Tang Q, Xu G, Wang L, Zhang X, Zhao X. Role of bone marrow imprints in haematological diagnosis: a detailed study of 3781 cases. Cytopathology 2010; 23:86-95. [DOI: 10.1111/j.1365-2303.2010.00825.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Merli M, Arcaini L, Boveri E, Rattotti S, Picone C, Passamonti F, Tenore A, Sozzani L, Lucioni M, Varettoni M, Rizzi S, Morello L, Ferretti V, Pascutto C, Paulli M, Lazzarino M. Assessment of bone marrow involvement in non-Hodgkin’s lymphomas: comparison between histology and flow cytometry. Eur J Haematol 2010; 85:405-15. [DOI: 10.1111/j.1600-0609.2010.01503.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
21
|
Moulin-Romsee G, Hindié E, Cuenca X, Brice P, Decaudin D, Bénamor M, Brière J, Anitei M, Filmont JE, Sibon D, de Kerviler E, Moretti JL. (18)F-FDG PET/CT bone/bone marrow findings in Hodgkin's lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging. Eur J Nucl Med Mol Imaging 2010; 37:1095-105. [PMID: 20204358 DOI: 10.1007/s00259-009-1377-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 12/24/2009] [Indexed: 12/19/2022]
Abstract
PURPOSE Accurate staging of Hodgkin's lymphoma (HL) is necessary in selecting appropriate treatment. Bone marrow trephine biopsy (BMB) is the standard procedure for depicting bone marrow involvement. BMB is invasive and explores a limited part of the bone marrow. (18)F-FDG PET/CT is now widely used for assessing response to therapy in HL and a baseline study is obtained to improve accuracy. The aim of this retrospective analysis was to assess whether routine BMB remains necessary with concomitant (18)F-FDG PET/CT. METHODS Data from 83 patients (newly diagnosed HL) were reviewed. All patients had received contrast-enhanced CT, BMB and (18)F-FDG PET/CT. Results of BMB were not available at the time of (18)F-FDG PET/CT imaging. RESULTS Seven patients had lymphomatous involvement on BMB. Four patients had bone involvement on conventional CT (two with negative BMB). All patients with bone marrow and/or bone lesions at conventional staging were also diagnosed on (18)F-FDG PET/CT scan. PET/CT depicted FDG-avid bone/bone marrow foci in nine additional patients. Four of them had only one or two foci, while the other had multiple foci. However, the iliac crest, site of the BMB, was not involved on (18)F-FDG PET/CT. Osteolytic/sclerotic lesions matching FDG-avid foci were visible on the CT part of PET/CT in three patients. MRI ordered in three other patients suggested bone marrow involvement. Interim and/or end-therapy (18)F-FDG PET/CT documented response of FDG-avid bone/bone marrow foci to chemotherapy in every patient. CONCLUSION (18)F-FDG PET/CT highly improves sensitivity for diagnosis of bone/bone marrow lesions in HL compared to conventional staging.
Collapse
Affiliation(s)
- Gerard Moulin-Romsee
- Service de Médicine Nucléaire, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris 7, 1, avenue Claude Vellefaux, 75475, Paris cedex 10, France
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
|
23
|
Ioannou MG, Stathakis E, Lazaris AC, Papathomas T, Tsiambas E, Koukoulis GK. Immunohistochemical evaluation of 95 bone marrow reactive plasmacytoses. Pathol Oncol Res 2008; 15:25-9. [PMID: 18553158 DOI: 10.1007/s12253-008-9069-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2008] [Accepted: 05/20/2008] [Indexed: 12/25/2022]
Abstract
We histologically and immunohistochemically studied 95 bone marrow (BM) reactive plasmacytoses. Ten biopsies from plasma cell myeloma (PCM) patients served as a control group. In addition, we studied 10 monoclonal gammopathy of undetermined significance (MGUS) cases. Histologically, plasmacytosis varied between 5% and 25% with an interstitial pattern of plasma cell (PC) distribution being characteristically displayed. Immunohistochemically, we did not find any CD56/NCAM nor cyclin D1 expression in all biopsies (95 of 95, 100%), not even a weak, doubtful one; PCs were all polyclonal and CD138 positive. On the contrary, myeloma-associated PCs showed monoclonality for kappa- or lambda- light chain and strong CD56/NCAM immunoreactivity (8 of 10, 80%); four of them were cyclin D1 positive. Osteoblasts exhibited similar CD56/NCAM expression in both groups. Our data confirm the diagnostic utility of CD56/NCAM in the phenotypic characterization of polyclonal plasma cells, suggesting an important role of this particular immunomarker in the BM trephine study of polyclonal versus neoplastic plasmacytic infiltrations.
Collapse
Affiliation(s)
- Maria G Ioannou
- Department of Pathology, Medical School, University of Thessaly, Larisa, Greece
| | | | | | | | | | | |
Collapse
|
24
|
Current Awareness in Hematological Oncology. Hematol Oncol 2008. [DOI: 10.1002/hon.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|