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Gleason L, Joffe D, Bhatti S, Cohen A, Banner L, Correia E, Alpdogan O, Porcu P, Nikbakht N. Recalcitrant Subcutaneous Panniculitis-Like T-Cell Lymphoma Responsive to Histone Deacetylase Inhibitor. Case Rep Oncol 2022; 15:1088-1094. [PMID: 36605220 PMCID: PMC9808134 DOI: 10.1159/000526641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/11/2022] [Indexed: 12/14/2022] Open
Abstract
Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma that usually presents with tender subcutaneous nodules on the trunk and extremities. Immunosuppressive therapy is considered first-line treatment for SPTCL, while multiagent chemotherapy is used for SPTCL complicated by hemophagocytic lymphohistiocytosis (HLH). Here, we report a 42-year-old Hispanic man that presented with a 5-year history of recurrent painful subcutaneous lesions in the absence of constitutional symptoms, lymphadenopathy, and hepatosplenomegaly. A punch biopsy revealed an atypical lymphoid infiltrate in between subcutaneous adipose lobules. Lymphocytes expressed CD3, CD8, and Beta F-1 and did not express CD4 and CD56. Based on clinical and histologic findings, the patient was diagnosed with SPTCL. In addition, laboratory findings did not demonstrate any evidence of HLH. He was initially started on both prednisone and hydroxychloroquine with no improvement. A trial of cyclosporine and methotrexate yielded no clinical improvement. As the lesions failed to resolve after treatment with multiple immunosuppressive agents, romidepsin, an intravenous histone deacetylase (HDAC) inhibitor, was initiated. After two cycles of romidepsin, the patient achieved complete clinical response. He continues to be in remission 12 months later with monthly maintenance therapy. This case illustrates that romidepsin can be useful as monotherapy for refractory SPTCL without HLH.
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Affiliation(s)
- Laura Gleason
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Daniel Joffe
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Safiyyah Bhatti
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA,Division of Hematologic Malignancies and HSCT, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Alexa Cohen
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lauren Banner
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Emily Correia
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Onder Alpdogan
- Division of Hematologic Malignancies and HSCT, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Pierluigi Porcu
- Division of Hematologic Malignancies and HSCT, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
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Ma H, O'Connor OA, Marchi E. Management of Angioimmunoblastic T-Cell Lymphoma (AITL) and other T Follicular Helper Cell lymphomas (TFH PTCL). Semin Hematol 2021; 58:95-102. [PMID: 33906727 DOI: 10.1053/j.seminhematol.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 12/26/2022]
Abstract
Despite the remarkable improvements in the treatment and outcome of patients with aggressive B-cell lymphoma, the peripheral T-cell lymphomas (PTCL) continue to carry a poor prognosis with the presently available treatment options. The PTCL are very rare diseases that account for only 10,000 to 15,000 new cases per year in the United States. The World Health Organization's 2016 classification describes 29 distinct subtypes of PTCL, thus making these both rate and incredibly heterogenous. The 2 most common forms of PTCL, for example, peripheral T-cell lymphoma-not otherwise specified and angioimmunoblastic T-cell lymphoma , have an incidence of only 2500 and 1800 cases per year respectively, in the United States.
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Affiliation(s)
- Helen Ma
- Division of Hematology/Oncology, University of California Irvine, Long Beach, CA
| | - Owen A O'Connor
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA
| | - Enrica Marchi
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA.
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Toner K, Bollard CM, Dave H. T-cell therapies for T-cell lymphoma. Cytotherapy 2019; 21:935-942. [PMID: 31320195 DOI: 10.1016/j.jcyt.2019.04.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 01/05/2023]
Abstract
T-cell lymphomas represent a subpopulation of non-Hodgkin lymphomas with poor outcomes when treated with conventional chemotherapy. A variety of novel agents have been introduced as new treatment strategies either as first-line treatment or in conjunction with chemotherapy. Immunotherapy has been demonstrated to be a promising area for new therapeutics, including monoclonal antibodies and adoptive cellular therapeutics. T-cell therapeutics have been shown to have significant success in the treatment of B-cell malignancies and are rapidly expanding as potential treatment options for other cancers including T-cell lymphomas. Although treating T-cell lymphomas with T-cell therapeutics has unique challenges, multiple targets are currently being studied both preclinically and in clinical trials.
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Affiliation(s)
- Keri Toner
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA; The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Hema Dave
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA; The George Washington School of Medicine and Health Sciences, Washington, DC, USA.
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Phillips AA, Fields PA, Hermine O, Ramos JC, Beltran BE, Pereira J, Wandroo F, Feldman T, Taylor GP, Sawas A, Humphrey J, Kurman M, Moriya J, Dwyer K, Leoni M, Conlon K, Cook L, Gonsky J, Horwitz SM. Mogamulizumab versus investigator's choice of chemotherapy regimen in relapsed/refractory adult T-cell leukemia/lymphoma. Haematologica 2018; 104:993-1003. [PMID: 30573506 PMCID: PMC6518882 DOI: 10.3324/haematol.2018.205096] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/18/2018] [Indexed: 12/30/2022] Open
Abstract
Mogamulizumab, a humanized defucosylated anti-C-C chemokine receptor 4 monoclonal antibody, has been approved in Japan for the treatment of C-C chemokine receptor 4-positive adult T-cell leukemia/lymphoma (ATL). This phase II study evaluated efficacy and safety of mogamulizumab in ATL patients with acute, lymphoma, and chronic subtypes with relapsed/refractory, aggressive disease in the US, Europe, and Latin America. With stratification by subtype, patients were randomized 2:1 to intravenous mogamulizumab 1.0 mg/kg once weekly for 4 weeks and biweekly thereafter (n=47) or investigator’s choice of chemotherapy (n=24). The primary end point was confirmed overall response rate (cORR) confirmed on a subsequent assessment at 8 weeks by blinded independent review. ORR was 11% (95%CI: 4-23%) and 0% (95%CI: 0-14%) in the mogamulizumab and chemotherapy arms, respectively. Best response was 28% and 8% in the respective arms. The observed hazard ratio for progression-free survival was 0.71 (95%CI: 0.41-1.21) and, after post hoc adjustment for performance status imbalance, 0.57 (95%CI: 0.337-0.983). The most frequent treatment-related adverse (grade ≥3) events with mogamulizumab were infusion-related reaction and thrombocytopenia (each 9%). Relapsed/refractory ATL is an aggressive, poor prognosis disease with a high unmet need. Investigator’s choice chemotherapy did not result in tumor response in this trial; however, mogamulizumab treatment resulted in 11% cORR, with a tolerable safety profile.
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Affiliation(s)
- Adrienne A Phillips
- Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
| | - Paul A Fields
- Department of Haematology Guy's and St Thomas' Hospitals NHS Trust Hospital, London, UK
| | - Olivier Hermine
- Department of Hematology, Necker University Hospital, Paris, France
| | - Juan C Ramos
- Division of Hematology/Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, FL, USA
| | - Brady E Beltran
- Hospital Nacional Edgardo Rebagliati Martins and Centro de Investigación de Medicina de Precision, Universidad de San Martin de Porres, Lima, Peru
| | | | - Farooq Wandroo
- Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, and University of Birmingham, UK
| | | | - Graham P Taylor
- National Centre for Human Retrovirology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Ahmed Sawas
- Center for Lymphoid Malignancies, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | | | | | | | - Kevin Conlon
- Warren Grant Magnuson Clinical Center, National Cancer Institute, Bethesda, MD, USA
| | - Lucy Cook
- Department of Haematology and National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, UK
| | - Jason Gonsky
- Division of Hematology/Oncology, Department of Medicine, New York City Health + Hospitals/Kings County and SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Steven M Horwitz
- Hematology/Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Zhang X, Zhu Y, Tian Y, Yan H, Ren L, Shi W, Zhu J, Zhang T. The application of the improved 3D rat testicular cells co-culture model on the in vitro toxicity research of HZ1006. Drug Chem Toxicol 2018; 42:526-535. [PMID: 29681204 DOI: 10.1080/01480545.2018.1458237] [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: 10/17/2022]
Abstract
The aims of the present research are to further validate the application of the improved three-dimensional (3 D) rat testicular cell co-culture model to evaluate the effects of various reprotoxic chemicals on the function of the main somatic cells, as well as on spermatogonial cell differentiation and even spermatogenesis, and to investigate the specific toxicant mechanisms in testes treated with HZ1006, a hydroxamate-based a hydroxamate-based histone deacetylase inhibitor (HDACI). Based on the characteristics of HZ1006, the appropriate exposure duration (8, 16, or 24 days), dosage (0, 3.125, 6.25, 12.5, or 25 μM) and toxic endpoints suitable for detection were selected in the experiments. The results showed inhibition of cell proliferation, reduced testosterone levels, and decreased spermatogonial cell meiosis-specific gene expression, as well as decreased protein levels of androgen receptor (AR) and decreased expression of the AR target gene PSA, accompanied by inhibition of Hdac6 expression after HZ1006 exposure in the 3 D rat testicular cell co-culture model. These findings indicate that the improved 3 D rat testicular cell co-culture model we have established has the potential to become a new testicular toxicity test system that can be used to test toxic characteristics and mechanisms of new compounds and has good application prospects, although more research on the model is required.
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Affiliation(s)
- Xiaofang Zhang
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Yuping Zhu
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Yijun Tian
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Han Yan
- b Shanghai Institute of Parenthood Research (National Evaluation Centre for the Toxicology of Fertility Regulating Drugs) , Shanghai , China
| | - Lijun Ren
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Wenjing Shi
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Jiangbo Zhu
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
| | - Tianbao Zhang
- a Department of Hygienic Toxicology and Center for Evaluation of Drug Safety , Second Military Medical University , Shanghai , China
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