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Luedersen J, Stadt UZ, Richter J, Oschlies I, Klapper W, Rosenwald A, Kalinova M, Simonitsch-Klupp I, Siebert R, Zimmermann M, Qi M, Nakel J, Scheinemann K, Knörr F, Attarbaschi A, Kabickova E, Woessmann W, Damm-Welk C. Variant ALK-fusion positive anaplastic large cell lymphoma (ALCL): A population-based paediatric study of the NHL-BFM study group. Br J Haematol 2024; 204:1894-1898. [PMID: 38279625 DOI: 10.1111/bjh.19308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/08/2023] [Accepted: 01/10/2024] [Indexed: 01/28/2024]
Abstract
Frequency, distribution and prognostic meaning of ALK-partner genes other than NPM1 in ALK-positive anaplastic large-cell lymphoma (ALCL) are unknown. Forty-nine of 316 ALCL diagnosed in the NHL-BFM study group showed no nuclear ALK expression suggestive of a variant ALK-partner; 41 were analysed by genomic capture high-throughput sequencing or specific RT-PCRs. NPM1::ALK was detected in 13 cases. Among the 28 patients with a non-NPM1::ALK-fusion partner, ATIC (n = 8; 29%) and TPM3 (n = 9; 32%) were the most common. Five of eight patients with ATIC::ALK-positive ALCL relapsed, none of nine with TPM3::ALK. Variant ALK-partners are rare and potentially associated with different prognoses.
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Affiliation(s)
- Jette Luedersen
- Paediatric Haematology and Oncology and NHL-BFM Study Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Udo Zur Stadt
- Paediatric Haematology and Oncology and CoALL Study Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Richter
- Department of Pathology, Haematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ilske Oschlies
- Department of Pathology, Haematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfram Klapper
- Department of Pathology, Haematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Andreas Rosenwald
- Department of Pathology, University of Wuerzburg, Wuerzburg, Germany
| | - Marketa Kalinova
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University Prague and University Hospital in Motol, Prague, Czech Republic
- Department of Pathology, 3rd Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - Reiner Siebert
- Institute of Human Genetics, Ulm University & Ulm University Medical Centre, Ulm, Germany
| | - Martin Zimmermann
- Department of Paediatric Haematology and Oncology, Hannover Medical School, and NHL-BFM Study Centre, Hannover, Germany
| | - Minyue Qi
- Bioinformatics Core, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Katrin Scheinemann
- Division of Paediatric Haematology/Oncology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
- Faculty of Health Science and Medicine, University of Lucerne, Lucerne, Switzerland
- Department of Paediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Ontario, Canada
| | - Fabian Knörr
- Paediatric Haematology and Oncology and NHL-BFM Study Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Centre HaTriCS4, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany
| | - Andishe Attarbaschi
- Department of Paediatric Haematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University Prague and University Hospital Motol, Prague, Czech Republic
| | - Wilhelm Woessmann
- Paediatric Haematology and Oncology and NHL-BFM Study Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Damm-Welk
- Paediatric Haematology and Oncology and NHL-BFM Study Centre, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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2
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El farissi MAA, Dehneh Y, Kada A, Dahamou M, Khoulali M, Oulali N, Moufid F. Uncommon spinal involvement of ALK-positive anaplastic large cell lymphoma: A pediatric case report and literature review. Radiol Case Rep 2024; 19:341-345. [PMID: 38028318 PMCID: PMC10663636 DOI: 10.1016/j.radcr.2023.10.018] [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: 06/04/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare variety of non-Hodgkin lymphoma that primarily affects children and young adults and is caused by the fusion of the nucleophosmin 1 and ALK genes, which turns on several signalling pathways. Despite the fact that ALCL frequently affects lymph nodes and extranodal sites, involvement of the central nervous system (CNS) is quite uncommon, with symptoms like pain and fever. The spinal localization may result in neurological impairments. T1WI hypointense lesions with T2WI hyperintensity can be observed on MR images, while bone sequestra can be seen in CT scans. The gold standard for diagnosis is still histology, though. Based on distinctive morphological characteristics, immunohistochemical staining can differentiate ALK-positive ALCL from other ALCLs. The prognosis for ALK-positive ALCL is typically better than ALK-negative ALCL, and treatment options include surgery followed by chemotherapy. ALK inhibitors and CAR-T cell therapy are 2 newly developed targeted treatments that have the potential to improve results. This case report illustrates the rarity of CNS ALCL and the difficulties in diagnosis and treatment by describing a 16-year-old female patient with ALCL affecting the thoracic spine and spreading to the mediastinum and surrounding tissue.
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Affiliation(s)
- Mohammed Al amine El farissi
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Youness Dehneh
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Amine Kada
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Mohamed Dahamou
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Mohamed Khoulali
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Noureddine Oulali
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
| | - Faycal Moufid
- Department of Neurosurgery, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
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3
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Noguchi K, Ikawa Y. Strategy for Pediatric Patients with Relapsed or Refractory Anaplastic Lymphoma Kinase-Positive Anaplastic Large Cell Lymphoma: A Review. Cancers (Basel) 2023; 15:5733. [PMID: 38136278 PMCID: PMC10741612 DOI: 10.3390/cancers15245733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is an aggressive T-cell lymphoma characterized by large T-cells with strong CD30 and ALK expression. Although conventional chemotherapy is effective in most patients, approximately 30% experience a relapse or refractory disease and have a poor prognosis. Several risk factors associated with poor prognosis have been identified in pediatric ALK-positive ALCL. These include morphological patterns with the small cell variant or lymphohistiocytic variant, leukemic presentation, the presence of minimal disseminated disease, or involvement of the central nervous system. Relapsed or refractory ALK-positive ALCL is often resistant to conventional chemotherapy; therefore, salvage therapy is required. In recent years, targeted therapies such as ALK inhibitors and brentuximab vedotin (BV) have been developed. ALK inhibitors block the continuous activation of ALK kinase, a driver mutation that leads to cell proliferation in ALK-positive ALCL. Additionally, BV is an antibody-drug conjugate that targets CD30-positive cells. Both ALK inhibitors and BV have displayed dramatic effects in chemoresistant ALK-positive ALCL. Weekly vinblastine treatment and hematopoietic stem cell transplantation have also been reported to be effective therapies. This article reviews pediatric ALK-positive ALCL, focusing on risk factors and treatment strategies for pediatric patients with relapsed or refractory ALK-positive ALCL.
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Affiliation(s)
| | - Yasuhiro Ikawa
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Ishikawa, Japan;
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4
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Klapper W. [Lymphomas in children and adolescents]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:338-347. [PMID: 37608069 DOI: 10.1007/s00292-023-01216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Lymphomas in children and adolescents differ from adulthood in relative frequency and variety of entities. In addition, young patients are cared for according to the specific standards of pediatric lymphoma study groups. OBJECTIVE To present lymphomas of diagnostic and clinical relevance in the pediatric and adolescent group. MATERIAL AND METHODS Selective literature research ( http://www.ncbi.nlm.nih.gov ) was combined with clinico-pathological experience of the authors. RESULTS Children and adolescents are much more likely to suffer from aggressive and precursor cell lymphoma than is the case in adulthood. Unlike adult patients, Burkitt lymphomas and diffuse large B‑cell lymphomas are not treated fundamentally differently. Entities that have been described relatively recently and are particularly common in young patients are high-grade B‑cell lymphoma with 11q aberrations and large-cell B‑cell lymphoma with IRF4 translocations. CONCLUSION Lymphoma diagnosis in children and adolescents is characterized by the particular spectrum of diseases that occur at this age. Special knowledge about the clinical relevance of the diagnoses in childhood is helpful in order to enable rapid clinical decision making.
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Affiliation(s)
- Wolfram Klapper
- Institut für Pathologie, Sektion Hämatopathologie und Lymphknotenregister, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Arnold-Heller-Str. 3, Haus U33, 24105, Kiel, Deutschland.
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5
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Shimaguchi C, Mizuguchi K, Fujita K, Shimoda T, Ikeda H. Cytological examination of peripheral blood cell block to diagnose small cell variant ALK-positive anaplastic large cell lymphoma. Cytopathology 2023; 34:626-629. [PMID: 37522608 DOI: 10.1111/cyt.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/11/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
In small cell variant ALK-positive anaplastic large cell lymphoma (SC-ALCL), large hallmark cells are few and the preponderance are small- to medium-sized tumour cells. The cell block method is advantageous in SC-ALCL with small numbers of CD30-positive hallmark cells, in order to evaluate cell morphology and marker expression simultaneously. Accurate diagnosis of ALK-positive anaplastic large cell lymphoma (ALK+ ALCL) requires detection of CD30-positive hallmark cells. In small cell variant ALCL (SC-ALCL), large hallmark cells are few with the preponderance being small- to medium-sized tumour cells. The cell block method is advantageous in SC-ALCL with small numbers of CD30-positive hallmark cells in order to evaluate cell morphology and marker expression simultaneously.
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Affiliation(s)
- Chie Shimaguchi
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Keishi Mizuguchi
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Kazuki Fujita
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Tsubasa Shimoda
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroko Ikeda
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
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6
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Zhu LJ, Zhu J, Lu SY, Wang J, Sun FF, Huang JT, Que Y, Huang H, Huang HQ, Zhen ZZ, Sun XF, Zhang YZ. [Clinical characteristics and prognosis of pediatric relapsed/refractory anaplastic large cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:854-856. [PMID: 38049339 PMCID: PMC10694085 DOI: 10.3760/cma.j.issn.0253-2727.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 12/06/2023]
Affiliation(s)
- L J Zhu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China Department of Oncology, the First People's Hospital of Yu Lin, Yulin 537000, China
| | - J Zhu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - S Y Lu
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - J Wang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - F F Sun
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - J T Huang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - Y Que
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - H Huang
- Department of Internal Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - H Q Huang
- Department of Internal Medicine, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Z Z Zhen
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - X F Sun
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
| | - Y Z Zhang
- Department of Pediatric Oncology, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, National Key Laboratory of Malignant Tumor Prevention and Treatment in South China, Guangzhou 510060, China
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7
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Drieux F, Lemonnier F, Gaulard P. How molecular advances may improve the diagnosis and management of PTCL patients. Front Oncol 2023; 13:1202964. [PMID: 37427095 PMCID: PMC10328093 DOI: 10.3389/fonc.2023.1202964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Peripheral T-cell lymphomas (PTCL) comprised more than 30 rare heterogeneous entities, representing 10 to 15% of adult non-Hodgkin lymphomas. Although their diagnosis is still mainly based on clinical, pathological, and phenotypic features, molecular studies have allowed for a better understanding of the oncogenic mechanisms involved and the refinement of many PTCL entities in the recently updated classifications. The prognosis remains poor for most entities (5-year overall survival < 30%), with current conventional therapies based on anthracyclin-based polychemotherapy regimen, despite many years of clinical trials. The recent use of new targeted therapies appears to be promising for relapsed/refractory patients, such as demethylating agents in T-follicular helper (TFH) PTCL. However further studies are needed to evaluate the proper combination of these drugs in the setting of front-line therapy. In this review, we will summarize the oncogenic events for the main PTCL entities and report the molecular targets that have led to the development of new therapies. We will also discuss the development of innovative high throughput technologies that aid the routine workflow for the histopathological diagnosis and management of PTCL patients.
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Affiliation(s)
- Fanny Drieux
- Service d’Anatomie et de Cytologie Pathologiques, INSERM U1245, Centre Henri Becquerel, Rouen, France
| | - François Lemonnier
- Unité hémopathies Lymphoïdes, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
- Institut Mondor de Recherche Biomédicale, INSERM U955, Université Paris Est Créteil, Créteil, France
| | - Philippe Gaulard
- Institut Mondor de Recherche Biomédicale, INSERM U955, Université Paris Est Créteil, Créteil, France
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
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8
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Beishuizen A, Mellgren K, Andrés M, Auperin A, Bacon CM, Bomken S, Burke GAA, Burkhardt B, Brugieres L, Chiang AKS, Damm-Welk C, d'Amore E, Horibe K, Kabickova E, Khanam T, Kontny U, Klapper W, Lamant L, Le Deley MC, Loeffen J, Macintyre E, Mann G, Meyer-Wentrup F, Michgehl U, Minard-Colin V, Mussolin L, Oschlies I, Patte C, Pillon M, Reiter A, Rigaud C, Roncery L, Salaverria I, Simonitsch-Klupp I, Uyttebroeck A, Verdu-Amoros J, Williams D, Woessmann W, Wotherspoon A, Wrobel G, Zimmermann M, Attarbaschi A, Turner SD. Improving outcomes of childhood and young adult non-Hodgkin lymphoma: 25 years of research and collaboration within the framework of the European Intergroup for Childhood Non-Hodgkin Lymphoma. Lancet Haematol 2023; 10:e213-e224. [PMID: 36858678 DOI: 10.1016/s2352-3026(22)00374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 03/03/2023]
Abstract
The European Intergroup for Childhood Non-Hodgkin Lymphoma (EICNHL) was established 25 years ago with the goal to facilitate clinical trials and research collaborations in the field both within Europe and worldwide. Since its inception, much progress has been made whereby major improvements in outcomes have been achieved. In this Review, we describe the different diagnostic entities of non-Hodgkin lymphoma in children and young adults describing key features of each entity and outlining clinical achievements made in the context of the EICNHL framework. Furthermore, we provide an overview of advances in biopathology with an emphasis on the role of biological studies and how they have shaped available treatments. Finally, for each entity, we describe future goals, upcoming clinical trials, and highlight areas of research that require our focus going forward.
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Affiliation(s)
- Auke Beishuizen
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; The Netherlands and Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Karin Mellgren
- Department of Paediatric Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mara Andrés
- Department of Pediatric Oncology, University Hospital Le Fe, Valencia, Spain
| | - Anne Auperin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Chris M Bacon
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Bomken
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - G A Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Birgit Burkhardt
- Department of Pediatric Hematology, Oncology, and BMT, University Hospital Muenster, Münster, Germany
| | - Laurence Brugieres
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alan K S Chiang
- Department of Pediatrics & AdolescentMedicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Christine Damm-Welk
- Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Emanuele d'Amore
- Department of Pathological Anatomy, San Bortolo Hospital, Vicenza, Italy
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University & University Hospital Motol, Prague, Czech Republic
| | - Tasneem Khanam
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Udo Kontny
- Section of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatric and Adolescent Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section, University of Schleswig-Holstein, Kiel, Germany
| | - Laurence Lamant
- Université Toulouse III-Paul Sabatier, Laboratoire d'Excellence Toulouse Cancer-TOUCAN, Équipe Labellisée La Ligue Contre Le Cancer, Inserm, Toulouse, France
| | | | - Jan Loeffen
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Elizabeth Macintyre
- Onco-hematology, Université Paris Cité and Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Georg Mann
- Pediatric Hematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Friederike Meyer-Wentrup
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Ulf Michgehl
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Lara Mussolin
- Istituto di Ricerca Pediatrica Città della Speranza, Padua, Italy; Pediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, Padova University Hospital, Padova, Italy
| | - Ilske Oschlies
- Institute of Pathology, Hematopathology Section, University of Schleswig-Holstein, Kiel, Germany
| | - Catherine Patte
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Marta Pillon
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, Padova University Hospital, Padova, Italy
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus Liebig-University Giessen, Giessen, Germany
| | - Charlotte Rigaud
- Department of Pediatric Hematology, Oncology, and BMT, University Hospital Muenster, Münster, Germany
| | - Leila Roncery
- St Anna Children's Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospital Leuven,KU Leuven, Leuven, Belgium
| | - Jaime Verdu-Amoros
- Department of Pediatric Hematology and Oncology, University Hospital Valencia, Valencia, Spain
| | - Denise Williams
- Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Grazyna Wrobel
- Bone Marrow Transplantation and Pediatric Hematology and Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Martin Zimmermann
- Hannover Medical School, Department of Pediatric Hematology and Oncology, Hannover, Germany
| | - Andishe Attarbaschi
- St Anna Children's Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK; Central European Institute for Technology, Masaryk University, Brno, Czech Republic.
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9
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Rigaud C, Knörr F, Brugières L, Woessmann W. Diagnosis and management of ALK-positive anaplastic large cell lymphoma in children and adolescents. Best Pract Res Clin Haematol 2023; 36:101444. [PMID: 36907641 DOI: 10.1016/j.beha.2023.101444] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a CD30-positive T cell lymphoma characterized by signalling from constitutively activated ALK fusion proteins. Most children and adolescents present in advanced stages, often with extranodal disease and B symptoms. The current front-line therapy standard of six cycles polychemotherapy reaches an event-free survival of 70%. The strongest independent prognostic factors are minimal disseminated disease and early minimal residual disease. At relapse, ALK-inhibitors, Brentuximab Vedotin, Vinblastine, or second line chemotherapy are effective re-inductions. Survival at relapse exceeds 60-70% with consolidation according to the time of relapse (Vinblastine monotherapy or allogeneic hematopoietic stem cell transplantation) so that the overall survival reaches 95%. It needs to be shown whether check-point inhibitors or long-term ALK-inhibition may substitute for transplantation. The future necessitates international cooperative trials testing whether a shift of paradigm to a chemotherapy-free regimen can cure ALK-positive ALCL.
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Affiliation(s)
- Charlotte Rigaud
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.
| | - Fabian Knörr
- NHL-BFM Study Centre and Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany; Mildred Scheel Cancer Career Centre HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.
| | - Wilhelm Woessmann
- NHL-BFM Study Centre and Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany.
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10
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Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas. Diagnostics (Basel) 2022; 12:diagnostics12082001. [PMID: 36010351 PMCID: PMC9407466 DOI: 10.3390/diagnostics12082001] [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: 07/17/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells. PTCLs comprise numerous disease entities, with over 30 distinct entities listed in the latest WHO classification. They predominantly affect adults and elderly people and usually exhibit an aggressive clinical course with poor prognosis. According to their presentation, PTCLs can be divided into nodal, extranodal or cutaneous, and leukemic types. The most frequent primary sites of PTCLs are lymph nodes, with over half of cases showing nodal presentation. Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified. Adult T-cell leukemia/lymphoma also frequently affects lymph nodes. Recent pathological and molecular findings in nodal PTCLs have profoundly advanced the identification of tumor signatures and the refinement of the classification. Therefore, the therapies and pathological diagnosis of nodal PTCLs are continually evolving. This paper aims to provide a summary and update of the pathological and molecular features of nodal PTCLs, which will be helpful for diagnostic practice.
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11
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Small cell/lymphohistiocytic morphology is associated with peripheral blood involvement, CD8 positivity and retained T-cell antigens, but not outcome in adults with ALK+ anaplastic large cell lymphoma. Mod Pathol 2022; 35:412-418. [PMID: 34628481 DOI: 10.1038/s41379-021-00944-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/08/2021] [Accepted: 09/27/2021] [Indexed: 11/08/2022]
Abstract
Several morphologic variants of ALK+ anaplastic large cell lymphoma (ALCL) are recognized. The small cell (SC) and lymphohistiocytic (LH) variants are reported to be associated with poorer outcome in children with ALK + ALCL. In this study of 102 adults with ALK + ALCL, there were 18 (18%) cases of SC and/or LH variants. Patients with SC/LH ALK + ALCL more often had peripheral blood involvement than patients with non-SC/LH neoplasms (60% vs 0%, p = 0.02). There were no other significant differences in clinical features between patients with SC/LH versus non-SC/LH ALK + ALCL. Compared with non-SC/LH cases of ALK + ALCL, neoplasms with SC/LH features were more often positive for CD2 (92% vs. 36%, p = 0.0007), CD3 (81% vs. 15%, p = 0.0001), CD7 (80% vs. 37%, p = 0.03), and CD8 (54% vs. 7%, p = 0.0006). There were no other significant differences in the immunophenotype between SC/LH and non-SC/LH ALK + ALCL cases. The initial chemotherapy regimens and the response rates were similar between patients with ALK + ALCL with SC/LH patterns versus those with non-SC/LH patterns. After a median follow-up of 30.8 months (range, 0.3-208 months), patients with high (>3) International Prognostic Index (IPI) scores had significantly shorter overall survival than patients with low (<3) IPI scores (p = 0.003). However, there was no significant difference in overall or progression-free survival between patients with SC/LH versus non-SC/LH ALK + ALCL (p = 0.99 and p = 0.94, respectively). We conclude that, in adults with ALK + ALCL, SC and LH variants are associated with peripheral blood involvement and a CD8 + immunophenotype with retention of T-cell markers (CD2, CD3, and CD7). However, in contrast with children with ALK + ALCL, SC and LH variants appear to have no impact on prognosis in adults with ALK + ALCL.
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12
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Gene Expression Signature Associated with Clinical Outcome in ALK-Positive Anaplastic Large Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13215523. [PMID: 34771686 PMCID: PMC8582782 DOI: 10.3390/cancers13215523] [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: 09/27/2021] [Revised: 10/15/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Anaplastic large cell lymphomas associated with ALK translocation have a good outcome after CHOP treatment; however, the 2-year relapse rate remains at 30%. Microarray gene-expression profiling, high throughput RT-qPCR, and RNA sequencing of 48 ALK-positive anaplastic large cell lymphoma (ALK+ ALCL) samples obtained at diagnosis enable the identification of genes associated with clinical outcome. More particularly, our molecular signatures indicate that the FN1 gene, a matrix key regulator, might also be involved in the prognosis and the therapeutic response in anaplastic lymphomas. Abstract Anaplastic large cell lymphomas associated with ALK translocation have a good outcome after CHOP treatment; however, the 2-year relapse rate remains at 30%. Microarray gene-expression profiling of 48 samples obtained at diagnosis was used to identify 47 genes that were differentially expressed between patients with early relapse/progression and no relapse. In the relapsing group, the most significant overrepresented genes were related to the regulation of the immune response and T-cell activation while those in the non-relapsing group were involved in the extracellular matrix. Fluidigm technology gave concordant results for 29 genes, of which FN1, FAM179A, and SLC40A1 had the strongest predictive power after logistic regression and two classification algorithms. In parallel with 39 samples, we used a Kallisto/Sleuth pipeline to analyze RNA sequencing data and identified 20 genes common to the 28 genes validated by Fluidigm technology—notably, the FAM179A and FN1 genes. Interestingly, FN1 also belongs to the gene signature predicting longer survival in diffuse large B-cell lymphomas treated with CHOP. Thus, our molecular signatures indicate that the FN1 gene, a matrix key regulator, might also be involved in the prognosis and the therapeutic response in anaplastic lymphomas.
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13
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Tariq H, Pearse W, Moravek MR, Gao J, Chen YH, Chen QC. Refractory hemophagocytic lymphohistiocytosis in an adult patient with occult ALK-Positive anaplastic large cell lymphoma and a heterozygous MEFV mutation. Leuk Lymphoma 2021; 63:495-498. [PMID: 34612144 DOI: 10.1080/10428194.2021.1984458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Hamza Tariq
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - William Pearse
- Robert H Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Michael Robert Moravek
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Yi-Hua Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qing Ching Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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14
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Liang HC, Costanza M, Prutsch N, Zimmerman MW, Gurnhofer E, Montes-Mojarro IA, Abraham BJ, Prokoph N, Stoiber S, Tangermann S, Lobello C, Oppelt J, Anagnostopoulos I, Hielscher T, Pervez S, Klapper W, Zammarchi F, Silva DA, Garcia KC, Baker D, Janz M, Schleussner N, Fend F, Pospíšilová Š, Janiková A, Wallwitz J, Stoiber D, Simonitsch-Klupp I, Cerroni L, Pileri S, de Leval L, Sibon D, Fataccioli V, Gaulard P, Assaf C, Knörr F, Damm-Welk C, Woessmann W, Turner SD, Look AT, Mathas S, Kenner L, Merkel O. Super-enhancer-based identification of a BATF3/IL-2R-module reveals vulnerabilities in anaplastic large cell lymphoma. Nat Commun 2021; 12:5577. [PMID: 34552066 PMCID: PMC8458384 DOI: 10.1038/s41467-021-25379-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL), an aggressive CD30-positive T-cell lymphoma, comprises systemic anaplastic lymphoma kinase (ALK)-positive, and ALK-negative, primary cutaneous and breast implant-associated ALCL. Prognosis of some ALCL subgroups is still unsatisfactory, and already in second line effective treatment options are lacking. To identify genes defining ALCL cell state and dependencies, we here characterize super-enhancer regions by genome-wide H3K27ac ChIP-seq. In addition to known ALCL key regulators, the AP-1-member BATF3 and IL-2 receptor (IL2R)-components are among the top hits. Specific and high-level IL2R expression in ALCL correlates with BATF3 expression. Confirming a regulatory link, IL-2R-expression decreases following BATF3 knockout, and BATF3 is recruited to IL2R regulatory regions. Functionally, IL-2, IL-15 and Neo-2/15, a hyper-stable IL-2/IL-15 mimic, accelerate ALCL growth and activate STAT1, STAT5 and ERK1/2. In line, strong IL-2Rα-expression in ALCL patients is linked to more aggressive clinical presentation. Finally, an IL-2Rα-targeting antibody-drug conjugate efficiently kills ALCL cells in vitro and in vivo. Our results highlight the importance of the BATF3/IL-2R-module for ALCL biology and identify IL-2Rα-targeting as a promising treatment strategy for ALCL. Anaplastic large cell lymphoma (ALCL) is an aggressive T-cell lymphoma often with poor prognosis. To identify genes defining ALCL cell state and dependencies, the authors here characterize ALCL-specific super-enhancers and describe the BATF3/IL-2R−module as a therapeutic opportunity for ALCL.
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Affiliation(s)
- Huan-Chang Liang
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria.,European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK
| | - Mariantonia Costanza
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Group Biology of Malignant Lymphomas, Max-Delbrück-Center (MDC) for Molecular Medicine, Berlin, Germany.,Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, and Experimental and Clinical Research Center (ECRC), a joint cooperation between the MDC and Charité, Berlin, Germany
| | - Nicole Prutsch
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Mark W Zimmerman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elisabeth Gurnhofer
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria
| | - Ivonne A Montes-Mojarro
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Institute of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Brian J Abraham
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nina Prokoph
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Stefan Stoiber
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory (CDL) for Applied Metabolomics, Medical University of Vienna, Vienna, Austria
| | - Simone Tangermann
- Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Cosimo Lobello
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Jan Oppelt
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | | | - Thomas Hielscher
- German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Shahid Pervez
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | | | - Daniel-Adriano Silva
- Institute for Protein Design, University of Washington, Seattle, WA, USA.,Department of Biochemistry, University of Washington, Seattle, WA, USA.,Division of Life Science, The Hong Kong University of Science and Technology, Kowloon, Hong Kong
| | - K Christopher Garcia
- Departments of Molecular and Cellular Physiology and Structural Biology, Stanford University School of Medicine, Stanford, CA, USA.,Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - David Baker
- Institute for Protein Design, University of Washington, Seattle, WA, USA.,Department of Biochemistry, University of Washington, Seattle, WA, USA.,Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Martin Janz
- Group Biology of Malignant Lymphomas, Max-Delbrück-Center (MDC) for Molecular Medicine, Berlin, Germany.,Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, and Experimental and Clinical Research Center (ECRC), a joint cooperation between the MDC and Charité, Berlin, Germany
| | - Nikolai Schleussner
- Group Biology of Malignant Lymphomas, Max-Delbrück-Center (MDC) for Molecular Medicine, Berlin, Germany.,Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, and Experimental and Clinical Research Center (ECRC), a joint cooperation between the MDC and Charité, Berlin, Germany
| | - Falko Fend
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Institute of Pathology and Neuropathology, University Hospital and Comprehensive Cancer Center Tübingen, Tübingen, Germany
| | - Šárka Pospíšilová
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.,Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Andrea Janiková
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Jacqueline Wallwitz
- Department of Pharmacology, Physiology and Microbiology, Division Pharmacology, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Dagmar Stoiber
- Department of Pharmacology, Physiology and Microbiology, Division Pharmacology, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Ingrid Simonitsch-Klupp
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Stefano Pileri
- Division of Haematopathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Laurence de Leval
- Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - David Sibon
- Hematology Department, Necker University Hospital, Assistance Publique-Hôpitaux de Paris, and Institut Necker-Enfants Malades, INSERM UMR1151 (Normal and pathological lymphoid differentiation), Université de Paris, Paris, France
| | - Virginie Fataccioli
- Department of Pathology, Henri Mondor University Hospital, AP-HP, INSERM U955, University Paris East, Créteil, France
| | - Philippe Gaulard
- Department of Pathology, Henri Mondor University Hospital, AP-HP, INSERM U955, University Paris East, Créteil, France
| | - Chalid Assaf
- Department of Dermatology, HELIOS Hospital Krefeld, Krefeld, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Knörr
- Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Christine Damm-Welk
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Wilhelm Woessmann
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Suzanne D Turner
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.,Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - A Thomas Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Stephan Mathas
- European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK. .,Group Biology of Malignant Lymphomas, Max-Delbrück-Center (MDC) for Molecular Medicine, Berlin, Germany. .,Department of Hematology, Oncology, and Cancer Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, and Experimental and Clinical Research Center (ECRC), a joint cooperation between the MDC and Charité, Berlin, Germany. .,German Cancer Consortium (DKTK) German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Lukas Kenner
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria. .,European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK. .,Christian Doppler Laboratory (CDL) for Applied Metabolomics, Medical University of Vienna, Vienna, Austria. .,Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria. .,Center for Biomarker Research in Medicine (CBMed) Core Lab 2, Medical University of Vienna, Vienna, Austria.
| | - Olaf Merkel
- Department of Pathology, Unit of Experimental and Laboratory Animal Pathology, Medical University of Vienna, Vienna, Austria. .,European Research Initiative on ALK-Related Malignancies (ERIA), Suzanne Turner, Cambridge, UK.
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15
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Noguchi K, Ikawa Y, Takenaka M, Sakai Y, Fujiki T, Kuroda R, Wada T. Characterisation of two tumour cell populations in the small cell variant of anaplastic lymphoma kinase-positive anaplastic large cell lymphoma. Br J Haematol 2021; 196:241-243. [PMID: 34420216 DOI: 10.1111/bjh.17776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Kazuhiro Noguchi
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yasuhiro Ikawa
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mika Takenaka
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yuta Sakai
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Toshihiro Fujiki
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Rie Kuroda
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Taizo Wada
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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16
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Iwafuchi H, Nakazawa A, Sekimizu M, Mori T, Osumi T, Iijima-Yamashita Y, Ohki K, Kiyokawa N, Fukano R, Saito AM, Horibe K, Kobayashi R. Clinicopathological features and prognostic significance of programmed death ligand 1 in pediatric ALK-positive anaplastic large cell lymphoma: results of the ALCL99 treatment in Japan. Hum Pathol 2021; 116:112-121. [PMID: 34363798 DOI: 10.1016/j.humpath.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/17/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022]
Abstract
Programmed cell death 1/programmed death ligand 1 (PD-1/PD-L1) blockade is a promising therapy for hematological malignancies. However, the association of PD-L1 expression with the clinicopathological features and prognosis in pediatric ALK-positive anaplastic large cell lymphoma (ALCL) remains unclear. Using PD-L1/ALK immunofluorescence double staining, we evaluated the PD-L1 expression on tumor cells/tumor-infiltrating immune cells (TIICs) and the quantity of TIICs in 54 children with ALK-positive ALCL treated with the ALCL99 protocol. The percentages of PD-L1-positive tumor cells were significantly lower in patients with skin/mediastinum involvement, clinical high-risk group, present minimal disseminated disease (MDD), and a low ALK-antibody titer. The percentages of PD-L1-positive TIICs were significantly higher in patients with absent MDD. The percentages of TIICs were significantly lower in patients with absent MDD and a common morphological pattern. We classified patients according to the PD-L1 expression on tumor cells (Tumor-PD-L1), PD-L1 expression on TIICs (TIIC-PD-L1), and quantity of TIICs (TIIC-quantity). The progression-free survival (PFS) did not differ between Tumor-PD-L1high and Tumor-PD-L1low ALCL; TIIC-PD-L1high and TIIC-PD-L1low ALCL; and TIIC-quantityhigh and TIIC-quantitylow ALCL. According to the combined parameters of Tumor-PD-L1 and TIIC-quantity, Tumor-PD-L1high/TIIC-quantityhigh ALCL had a worse 5-year PFS than other ALCL (50% versus 83%; P = .009). Tumor-PD-L1high/TIIC-quantityhigh ALCL remained a significant prognostic factor in multivariate analysis (P = .044). This is the first study to demonstrate that a high tumoral PD-L1 expression with a high quantity of TIICs was associated with a poor prognosis in pediatric ALK-positive ALCL. The tumor microenvironment of ALK-positive ALCL may be relevant to the clinicopathological features and prognosis.
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Affiliation(s)
- Hideto Iwafuchi
- Department of Pathology, Shizuoka Children's Hospital, Shizuoka, 420-8660, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan.
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, 330-8777, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, 157-8535, Japan
| | - Yuka Iijima-Yamashita
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, 755-8505, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, 003-0006, Japan
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17
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Mason EF, Kovach AE. Update on Pediatric and Young Adult Mature Lymphomas. Clin Lab Med 2021; 41:359-387. [PMID: 34304770 DOI: 10.1016/j.cll.2021.03.018] [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: 10/21/2022]
Abstract
After acute leukemia and brain and central nervous system tumors, mature lymphomas represent the third most common cancer in pediatric patients. Non-Hodgkin lymphoma accounts for approximately 60% of lymphoma diagnoses in children, with the remainder representing Hodgkin lymphoma. Among non-Hodgkin lymphomas in pediatric patients, aggressive lymphomas, such as Burkitt lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma, predominate. This article summarizes the epidemiologic, histopathologic, and molecular features of selected mature systemic B-cell and T-cell lymphomas encountered in this age group.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 4603A TVC, Nashville, TN 37232-5310, USA.
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #32, Los Angeles, CA 90027, USA
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18
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Rigaud C, Abbas R, Grand D, Minard-Colin V, Aladjidi N, Buchbinder N, Garnier N, Plat G, Couec ML, Duplan M, Lambilliotte A, Schmitt C, Leblanc T, Lamant L, Brugières L. Should treatment of ALK-positive anaplastic large cell lymphoma be stratified according to minimal residual disease? Pediatr Blood Cancer 2021; 68:e28982. [PMID: 33687135 DOI: 10.1002/pbc.28982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/30/2021] [Accepted: 02/12/2021] [Indexed: 11/09/2022]
Abstract
In anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALK+ ALCL), positive minimal residual disease (MRD+) after the first chemotherapy course was proven of strong prognostic significance. We aimed to validate these results in 138 French patients. Eighty-seven patients had a detectable minimal disseminated disease at diagnosis (MDD+). Early MRD assessment was performed in 33 of 87 patients and was positive in 18 and negative in 15 (MRD-). Three-year progression-free survival was significantly correlated with the MDD/MRD status: 81.1% in MDD-, 69.6% in MDD+/MRD-, and 15.2% in MDD+/MRD+ patients. In conclusion, we confirmed on an independent cohort that the MDD/MRD status has strong prognosis significance in ALK+ ALCL.
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Affiliation(s)
- Charlotte Rigaud
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Rachid Abbas
- Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - David Grand
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Véronique Minard-Colin
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | | | | | | | - Geneviève Plat
- Pediatric Oncology, Toulouse University Hospital, Toulouse, France
| | | | - Mylène Duplan
- Pediatric Oncology, Angers University Hospital, Angers, France
| | | | | | - Thierry Leblanc
- Pediatric Hematology, Robert Debré Hospital-APHP, Paris, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Laurence Brugières
- Children and Adolescent Oncology Department, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
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19
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Role of Microenvironment in Non-Hodgkin Lymphoma: Understanding the Composition and Biology. ACTA ACUST UNITED AC 2021; 26:206-216. [PMID: 32496454 DOI: 10.1097/ppo.0000000000000446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Lymphoma microenvironment is a dynamic and well-orchestrated network of various immune and stromal cells that is indispensable for tumor cell survival, growth, migration, immune escape, and drug resistance. Recent progress has enhanced our knowledge of the pivotal role of microenvironment in lymphomagenesis. Understanding the characteristics, functions, and contributions of various components of the tumor niche, along with its bidirectional interactions with tumor cells, is paramount. It offers the potential to identify new therapeutic targets with the ability to restore antitumor immune surveillance and eliminate the protumoral factors contributed by the tumor niche.
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20
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Minimal Disease Monitoring in Pediatric Non-Hodgkin's Lymphoma: Current Clinical Application and Future Challenges. Cancers (Basel) 2021; 13:cancers13081907. [PMID: 33921029 PMCID: PMC8071445 DOI: 10.3390/cancers13081907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022] Open
Abstract
Minimal residual disease (MRD) detection is established routine practice for treatment stratification in leukemia and used for treatment optimization in adult lymphomas. Minimal disease studies in childhood non-Hodgkin lymphomas are challenged by stratified treatment in different subtypes, high cure rates, low patient numbers, limited initial tumor material, and early progression. Current clinical applications differ between the subtypes. A prognostic value of minimal disseminated disease (MDD) could not yet be clearly established for lymphoblastic lymphoma using flow cytometry and PCR-based methods for T-cell receptor (TCR) or immunoglobulin (IG) rearrangements. MYC-IGH fusion sequences or IG rearrangements enable minimal disease detection in Burkitt lymphoma and -leukemia. An additional prognostic value of MDD in Burkitt lymphoma and early MRD in Burkitt leukemia is implicated by single studies with risk-adapted therapy. MDD and MRD determined by PCR for ALK-fusion transcripts are independent prognostic parameters for patients with ALK-positive anaplastic large cell lymphoma (ALCL). They are introduced in routine clinical practice and used for patient stratification in clinical studies. Early MRD might serve as an endpoint for clinical trials and for guiding individual therapy. Validation of MDD and MRD as prognostic parameters is required for all subtypes but ALCL. Next-generation sequencing-based methods may provide new options and applications for minimal disease evaluation in childhood lymphomas.
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21
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McCarthy P, Harford J, O'Marcaigh A, Malone A, Evans P, Sills A, Storey L, Rooney S, Betts D, O'Sullivan MJ, McDermott M, Bond J, Trinquand A, Smith OP. Ongoing excellent outcomes with reduced toxicities following integration of molecular targeted therapies in pediatric anaplastic large cell lymphoma. Leuk Lymphoma 2021; 62:1995-1999. [PMID: 33685326 DOI: 10.1080/10428194.2021.1894644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Peter McCarthy
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland
| | - John Harford
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Aengus O'Marcaigh
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Andrea Malone
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Pamela Evans
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Aoife Sills
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Lorna Storey
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Sean Rooney
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - David Betts
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Maureen J O'Sullivan
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Michael McDermott
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Jonathan Bond
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland.,National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Amélie Trinquand
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Owen P Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland
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22
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Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1. Blood 2021; 137:3595-3603. [PMID: 33684925 PMCID: PMC8462406 DOI: 10.1182/blood.2020009806] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/24/2021] [Indexed: 11/20/2022] Open
Abstract
The addition of brentuximab vedotin was tolerable and prevented relapses, and EFS compares favorably with conventional chemotherapy. The study confirmed that minimal disseminated disease detection in peripheral blood was prognostic, with a significant impact on EFS.
Approximately 30% of pediatric patients with anaplastic large cell lymphoma (ALCL) relapse. Although brentuximab vedotin has demonstrated excellent activity in ALCL, it has not been used for newly diagnosed patients. Children’s Oncology Group (COG) trial ANHL12P1 determined the toxicity and efficacy of brentuximab vedotin with chemotherapy in children with newly diagnosed nonlocalized anaplastic large cell lymphoma kinase (ALK)+/CD30+ ALCL. From 2013 to 2017, 68 children with ALK+ ALCL were enrolled and received brentuximab vedotin. All patients received 5-day prophase, followed by 6 cycles of chemotherapy. Brentuximab vedotin was given on day 1 of each of the 6 cycles. Of the 67 patients eligible for toxicity evaluation, 66 completed all 6 cycles of chemotherapy, resulting in 399 evaluable cycles. There were no toxic deaths, no case of progressive multifocal leukoencephalopathy syndrome, and no case of grade 3 or 4 neuropathy. The 2-year event-free survival (EFS) was 79.1% (95% confidence interval [CI], 67.2-87.1). The 2-year overall survival (OS) was 97.0% (95% CI, 88.1-99.2). Fourteen patients relapsed. Eleven of 14 (79%) relapses occurred within 10 months of diagnosis; only 1 patient (1.5%) relapsed during therapy. Quantitative reverse transcription polymerase chain reaction for NPM-ALK at baseline (minimal disseminated disease) demonstrated prognostic value for EFS (P = .0004). Overall, the addition of brentuximab vedotin to standard chemotherapy does not add significant toxicity or alter the desired interval between cycles. The addition of brentuximab vedotin prevented relapses during therapy, and the OS and EFS estimates compare favorably with results obtained using conventional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01979536.
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23
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Congras A, Hoareau-Aveilla C, Caillet N, Tosolini M, Villarese P, Cieslak A, Rodriguez L, Asnafi V, Macintyre E, Egger G, Brousset P, Lamant L, Meggetto F. ALK-transformed mature T lymphocytes restore early thymus progenitor features. J Clin Invest 2021; 130:6395-6408. [PMID: 33141118 DOI: 10.1172/jci134990] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 08/11/2020] [Indexed: 12/15/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is a mature T cell neoplasm that often expresses the CD4+ T cell surface marker. It usually harbors the t(2;5) (p23;q35) translocation, leading to the ectopic expression of NPM-ALK, a chimeric tyrosine kinase. We demonstrated that in vitro transduction of normal human CD4+ T lymphocytes with NPM-ALK results in their immortalization and malignant transformation. The tumor cells displayed morphological and immunophenotypical characteristics of primary patient-derived anaplastic large cell lymphomas. Cell growth, proliferation, and survival were strictly dependent on NPM-ALK activity and include activation of the key factors STAT3 and DNMT1 and expression of CD30 (the hallmark of anaplastic large-cell lymphoma). Implantation of NPM-ALK-transformed CD4+ T lymphocytes into immunodeficient mice resulted in the formation of tumors indistinguishable from patients' anaplastic large cell lymphomas. Integration of "Omic" data revealed that NPM-ALK-transformed CD4+ T lymphocytes and primary NPM-ALK+ ALCL biopsies share similarities with early T cell precursors. Of note, these NPM-ALK+ lymphoma cells overexpress stem cell regulators (OCT4, SOX2, and NANOG) and HIF2A, which is known to affect hematopoietic precursor differentiation and NPM-ALK+ cell growth. Altogether, for the first time our findings suggest that NPM-ALK could restore progenitor-like features in mature CD30+ peripheral CD4+ T cells, in keeping with a thymic progenitor-like pattern.
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Affiliation(s)
- Annabelle Congras
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Coralie Hoareau-Aveilla
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Nina Caillet
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Marie Tosolini
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Pôle Technologique du CRCT, Plateau Bioinformatique, Toulouse, France
| | - Patrick Villarese
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Agata Cieslak
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Laura Rodriguez
- Etablissement Français du Sang, Nouvelle Aquitaine, INSERM U1035, Université de Bordeaux, Bordeaux, France
| | - Vahid Asnafi
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Elisabeth Macintyre
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Gerda Egger
- Department of Pathology, Medical University Vienna, Vienna, Austria.,Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
| | - Pierre Brousset
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France
| | - Laurence Lamant
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France.,European Research Initiative on ALK-Related Malignancies, Cambridge, United Kingdom, Vienna, Austria, and Toulouse, France
| | - Fabienne Meggetto
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France.,European Research Initiative on ALK-Related Malignancies, Cambridge, United Kingdom, Vienna, Austria, and Toulouse, France
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24
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Nambiyar K, Gupta K, Debi U, Sinha SK, Kochhar R. ALK+ Anaplastic large cell lymphoma with extensive cardiac involvement: A rare case report and review of the literature. AUTOPSY AND CASE REPORTS 2021; 11:e2020231. [PMID: 33968818 PMCID: PMC8020592 DOI: 10.4322/acr.2020.231] [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] [Indexed: 01/06/2023] Open
Abstract
Cardiac lymphoma is a rare entity. In this setting, the secondary involvement of the heart is far more frequent than the primary cardiac lymphoma. Herein, we present an autopsy case of a disseminated anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma with a dominant mediastinal involvement. Extensive cardiac infiltration with the near replacement of the myocardial wall by the neoplastic cells was observed. A total of nine isolated case reports of anaplastic large cell lymphoma with cardiac involvement were found in the English-language literature, and a widespread cardiac and thymic infiltration by the systemic ALK-positive anaplastic large cell lymphoma has not been documented. An incidental regenerative nodule was also identified in the liver. The patient died of pulmonary thromboembolism and cardiac arrest.
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Affiliation(s)
- Kaniyappan Nambiyar
- Postgraduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Kirti Gupta
- Postgraduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Uma Debi
- Postgraduate Institute of Medical Education and Research, Department of Radiodiagnosis and imaging, Chandigarh, India
| | - Saroj Kant Sinha
- Postgraduate Institute of Medical Education and Research, Department of Gastroenterology, Chandigarh, India
| | - Rakesh Kochhar
- Postgraduate Institute of Medical Education and Research, Department of Gastroenterology, Chandigarh, India
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25
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Mohapatra S, Padhi S, Panigrahi M, Mishra P, Patra S, Sable M, Thakur B, Nayak M, Panigrahi A. Pulmonary anaplastic large-cell lymphoma: A case-based systematic review of world literature. J Cancer Res Ther 2021; 17:1297-1306. [DOI: 10.4103/jcrt.jcrt_1089_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Quelen C, Grand D, Sarot E, Brugières L, Sibon D, Pradines A, Laurent C, Brousset P, Lamant L. Minimal Residual Disease Monitoring Using a 3'ALK Universal Probe Assay in ALK-Positive Anaplastic Large-Cell Lymphoma: ddPCR, an Attractive Alternative Method to Real-Time Quantitative PCR. J Mol Diagn 2020; 23:131-139. [PMID: 33246076 DOI: 10.1016/j.jmoldx.2020.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/06/2020] [Accepted: 11/03/2020] [Indexed: 12/20/2022] Open
Abstract
In ALK-positive anaplastic large-cell lymphomas, positive qualitative PCR for NPM1-anaplastic lymphoma kinase (ALK) in peripheral blood and/or bone marrow at diagnosis and during treatment are associated with a higher risk of treatment failure. Real-time quantitative PCR allows identification of very high risk patients. However, this latter technique initially designed for patients with lymphomas carrying the most frequent NPM1-ALK translocation necessitates calibration curves, limiting interlaboratory reproducibility. An ALK universal quantitative PCR based on 3'ALK transcript amplification was designed to allow the detection of all ALK fusion transcripts. The absolute concordance of 3'ALK quantitative PCR results were validated with the routine NPM1-ALK qualitative and quantitative PCR on 46 samples. The universality of ALK fusion transcript detection also was validated on TPM3-, ALO17-, and ATIC-ALK-positive samples, and the EML4-ALK-positive cell line. Digital droplet PCR using the 3'ALK universal probe showed highly concordant results with 3'ALK universal quantitative PCR. A major benefit of digital droplet PCR is a reduced experimental set-up compared with quantitative PCR, without generation of standard curves, leading to a reliable protocol for multilaboratory validation in multicenter clinical trials essential for this rare pathology. Our ALK universal method could be used for the screening of ALK fusion transcripts in liquid biopsy specimens of other ALK-positive tumors, including non-small cell lung carcinomas.
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Affiliation(s)
- Cathy Quelen
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Université Toulouse III-Paul-Sabatier, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - David Grand
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Emeline Sarot
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif
| | - David Sibon
- Department of Hematology, Hopital Necker-Enfants Malades, Paris, France
| | - Anne Pradines
- Medical Laboratory, Claudius Regaud Institute, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Camille Laurent
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - Pierre Brousset
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France.
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27
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Lyapichev KA, Tang G, Li S, You MJ, Cheng TJ, Miranda RN, Iyer S, Yin CC, Konoplev S, Bueso-Ramos C, Vega F, Medeiros LJ, Xu J. MYC expression is associated with older age, common morphology, increased MYC copy number, and poorer prognosis in patients with ALK+ anaplastic large cell lymphoma. Hum Pathol 2020; 108:22-31. [PMID: 33221344 DOI: 10.1016/j.humpath.2020.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/26/2022]
Abstract
The role of MYC dysregulation has been studied extensively in B-cell lymphomas, but little is known about its significance in T cell lymphomas. This study, for the first time in the literature, assessed the clinicopathologic and prognostic significance of MYC expression in ALK+ anaplastic large cell lymphoma (ALCL) cases. Using ≥50% as the cutoff value for positive MYC expression by immunohistochemistry, 17 of 46 (37%) cases were MYC+. Patients with MYC+ tumors were older (median age, 39 versus 29 years, p = 0.04) and more often showed a common morphologic pattern (100% versus 69%, p = 0.02), when compared with those with MYC-negative tumors. By fluorescence in situ hybridization analysis, 9 of 31 (29%) cases showed increased MYC copy number, and 1 of 31 (3%) case had an MYC rearrangement, and the remaining 21 (68%) cases showed no MYC aberrations. Among the cases with increased MYC copy number, 5 of 8 (62%) cases showed MYC copy gain and/or amplification and 3 of 8 (38%) had polysomy 8. MYC expression was associated with increased MYC copy number (p = 0.01). MYC expression, but not increased MYC copy number, correlated with shorter overall survival (OS) (p = 0.03). In conclusion, MYC expression identified a distinct group of ALK + ALCL patients with more aggressive behavior and shorter OS. Our data suggest that MYC expression is an adverse prognostic factor and may be useful in stratifying or predicting the prognosis of patients with ALK+ ALCL.
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Affiliation(s)
- Kirill A Lyapichev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - M James You
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Tingsing J Cheng
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Swaminathan Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sergej Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Carlos Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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28
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Mussolin L, Le Deley MC, Carraro E, Damm-Welk C, Attarbaschi A, Williams D, Burke A, Horibe K, Nakazawa A, Wrobel G, Mann G, Csóka M, Uyttebroeck A, Fernández-Delgado Cerdá R, Beishuizen A, Mellgren K, Burkhardt B, Klapper W, Turner SD, d’Amore ES, Lamant L, Reiter A, Woessmann W, Brugières L, Pillon M. Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma: Long Term Results of the International ALCL99 Trial. Cancers (Basel) 2020; 12:cancers12102747. [PMID: 32987765 PMCID: PMC7598675 DOI: 10.3390/cancers12102747] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/14/2022] Open
Abstract
With the aim of describing the long-term follow-up and to define the prognostic role of the clinical/pathological/molecular characteristics at diagnosis for childhood, adolescent and young adults affected by anaplastic large cell lymphoma (ALCL), we analyzed 420 patients aged up to 22 years homogeneously treated within the international ALCL99 trial. The 10-year progression free survival (PFS) was 70% and overall survival was 90%, rare late relapses occurred but no secondary malignancies were reported. Among clinical/pathological characteristics, only patients presenting a small cell/lymphohistiocytic (SC/LH) pattern were independently associated with risk of failure (hazard ratio = 2.49). Analysis of minimal disseminated disease (MDD), available for 162 patients, showed that both SC/LH pattern (hazard ratio = 2.4) and MDD positivity (hazard ratio = 2.15) were significantly associated with risk of failure in multivariate analysis. Considering MDD and SC/LH results, patients were separated into three biological/pathological (bp) risk groups: a high-risk group (bpHR) including MDD-positive patients with SC/LH pattern; a low-risk group (bpLR) including MDD-negative patients without SC/LH pattern; and an intermediate-risk group (bpIR) including remaining patients. The 10-year PFS was 40%, 75% and 86% for bpHR, bpIR and bpLR, respectively (p < 0.0001). These results should be considered in the design of future ALCL trials to tailor individual treatments.
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Affiliation(s)
- Lara Mussolin
- Maternal and Child Health Department, Padua University, 35128 Padua, Italy;
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padua, Italy
- Correspondence: ; Tel.: +39-049-8215565; Fax: +39-049-9640150
| | | | - Elisa Carraro
- Maternal and Child Health Department, Padua University, 35128 Padua, Italy;
| | - Christine Damm-Welk
- University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany; (C.D.-W.); (W.W.)
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria; (A.A.); (G.M.)
| | - Denise Williams
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; (D.W.); (A.B.)
| | - Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; (D.W.); (A.B.)
| | - Keizo Horibe
- Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan;
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children’s Medical Center, Saitama 330-8777, Japan;
| | - Grazyna Wrobel
- Department of Bone Marrow Transplantation, Children Oncology and Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Georg Mann
- Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria; (A.A.); (G.M.)
| | - Monika Csóka
- 2nd Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary;
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, 3000 Leuven, Belgium;
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
| | - Karin Mellgren
- Department of Pediatric Haematology and Oncology, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden;
| | - Birgit Burkhardt
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, D-48149 Muenster, Germany;
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology, University Hospital Schleswig Holstein, D-24105 Kiel, Germany;
| | - Suzanne D. Turner
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK;
- Central European Institute of Technology (CEITEC), Masaryk University, 60200 Brno, Czech Republic
| | | | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, France—Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France;
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus Liebig-University Giessen, 35390 Giessen, Germany;
| | - Wilhelm Woessmann
- University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany; (C.D.-W.); (W.W.)
| | - Laurence Brugières
- Department of Pediatrics and Adolescents Oncology, Gustave Roussy, 94800 Villejuif, France;
| | - Marta Pillon
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, 35128 Padua, Italy;
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Del Baldo G, Abbas R, Woessmann W, Horibe K, Pillon M, Burke A, Beishuizen A, Rigaud C, Le Deley MC, Lamant L, Brugières L. Neuro-meningeal relapse in anaplastic large-cell lymphoma: incidence, risk factors and prognosis - a report from the European intergroup for childhood non-Hodgkin lymphoma. Br J Haematol 2020; 192:1039-1048. [PMID: 32648260 DOI: 10.1111/bjh.16755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/25/2020] [Indexed: 12/26/2022]
Abstract
Relapses involving the central nervous system (CNS) are rare in children and adolescents with ALK+ anaplastic large cell lymphoma (ALCL) treated with regimens including CNS prophylaxis. Early identification of patients at high-risk for CNS relapse would enable stratification and better adaptation of initial treatment especially in the light of the upcoming targeted therapies with limited CNS penetration. We analyzed clinical and histological data of all ALK+ALCL patients with CNS relapse registered in ALCL99-database with the aim to describe risk factors and outcome. Characteristics of patients with no relapse, relapse without CNS involvement and CNS relapse were compared. At a median follow-up of 8 years (0.05-18 years), a CNS involvement was reported at first or subsequent relapse in 26/618 patients. Median interval between initial diagnosis and first CNS relapse was 8 months (IQR 5.55-10.61/range 1.31-130.69). The 5-year cumulative risk of CNS relapse was 4% (95% CI 2.9-5.5). Bone marrow involvement, peripheral blasts and CNS involvement at diagnosis were more frequent in patients with CNS relapse than in patients with no relapse or with relapse with no CNS involvement. The treatment of CNS relapse was heterogeneous. The median survival after CNS relapse was 23.7 months. Eleven patients were alive at last follow-up. Three-year overall survival after CNS relapse was 48.70% (95% CI 30.52-67.23).
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Affiliation(s)
- Giada Del Baldo
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France.,Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rachid Abbas
- UVSQ, CESP, INSERM, Université Paris-Saclay, Université Paris-Sud, Villejuif, France
| | - Wilhelm Woessmann
- Department of Paediatric Haematology and Oncology, University Hospital, Hamburg-Eppendorf, Germany
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Marta Pillon
- Department of Women's and Children's Health, Paediatric Haemato-Oncology, University Hospital of Padova, Padova, Italy
| | - Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Charlotte Rigaud
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France
| | - Marie-Cécile Le Deley
- UVSQ, CESP, INSERM, Université Paris-Saclay, Université Paris-Sud, Villejuif, France.,Department of Methodology and Biostatistics, Centre Oscar Lambret, Lille, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France
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30
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Decreased MYC-associated factor X (MAX) expression is a new potential biomarker for adverse prognosis in anaplastic large cell lymphoma. Sci Rep 2020; 10:10391. [PMID: 32587329 PMCID: PMC7316730 DOI: 10.1038/s41598-020-67500-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/03/2020] [Indexed: 12/27/2022] Open
Abstract
MYC-associated factor X (MAX) is a protein in the basic helix-loop-helix leucine zipper family, which is ubiquitously and constitutively expressed in various normal tissues and tumors. MAX protein mediates various cellular functions such as proliferation, differentiation, and apoptosis through the MYC-MAX protein complex. Recently, it has been reported that MYC regulates the proliferation of anaplastic large cell lymphoma. However, the expression and function of MAX in anaplastic large cell lymphoma remain to be elucidated. We herein investigated MAX expression in anaplastic large cell lymphoma (ALCL) and peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) and found 11 of 37 patients (30%) with ALCL lacked MAX expression, whereas 15 of 15 patients (100%) with PTCL-NOS expressed MAX protein. ALCL patients lacking MAX expression had a significantly inferior prognosis compared with patients having MAX expression. Moreover, patients without MAX expression significantly had histological non-common variants, which were mainly detected in aggressive ALCL cases. Immunohistochemical analysis showed that MAX expression was related to the expression of MYC and cytotoxic molecules. These findings demonstrate that lack of MAX expression is a potential poor prognostic biomarker in ALCL and a candidate marker for differential diagnosis of ALCL and PTCL-NOS.
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31
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Kourentzi K, Crum M, Patil U, Prebisch A, Chavan D, Vu B, Zeng Z, Litvinov D, Zu Y, Willson RC. Recombinant expression, characterization, and quantification in human cancer cell lines of the Anaplastic Large-Cell Lymphoma-characteristic NPM-ALK fusion protein. Sci Rep 2020; 10:5078. [PMID: 32193476 PMCID: PMC7081362 DOI: 10.1038/s41598-020-61936-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/05/2020] [Indexed: 11/09/2022] Open
Abstract
Systemic anaplastic large cell lymphoma (ALCL) is an aggressive T-cell lymphoma most commonly seen in children and young adults. The majority of pediatric ALCLs are associated with the t(2;5)(p23;q35) translocation which fuses the Anaplastic Lymphoma Kinase (ALK) gene with the Nucleophosmin (NPM) gene. The NPM-ALK fusion protein is a constitutively-active tyrosine kinase, and plays a major role in tumor pathogenesis. In an effort to advance novel diagnostic approaches and the understanding of the function of this fusion protein in cancer cells, we expressed in E. coli, purified and characterized human NPM-ALK fusion protein to be used as a standard for estimating expression levels in cultured human ALCL cells, a key tool in ALCL pathobiology research. We estimated that NPM-ALK fusion protein is expressed at substantial levels in both Karpas 299 and SU-DHL-1 cells (ca. 4-6 million molecules or 0.5-0.7 pg protein per cell; based on our in-house developed NPM-ALK ELISA; LOD of 40 pM) as compared to the ubiquitous β-actin protein (ca. 64 million molecules or 4.5 pg per lymphocyte). We also compared NPM-ALK/ β-actin ratios determined by ELISA to those independently determined by two-dimensional electrophoresis and showed that the two methods are in good agreement.
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Affiliation(s)
- Katerina Kourentzi
- Department of Chemical & Biomolecular Engineering, University of Houston, Houston, TX, 77204, USA.
| | - Mary Crum
- Department of Chemical & Biomolecular Engineering, University of Houston, Houston, TX, 77204, USA
| | - Ujwal Patil
- Department of Biology & Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Ana Prebisch
- Department of Chemical & Biomolecular Engineering, University of Houston, Houston, TX, 77204, USA
| | - Dimple Chavan
- Department of Biology & Biochemistry, University of Houston, Houston, TX, 77204, USA
| | - Binh Vu
- Department of Chemical & Biomolecular Engineering, University of Houston, Houston, TX, 77204, USA
| | - Zihua Zeng
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Dmitri Litvinov
- Department of Electrical & Computer Engineering, University of Houston, Houston, TX, USA
| | - Youli Zu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA.
| | - Richard C Willson
- Department of Chemical & Biomolecular Engineering, University of Houston, Houston, TX, 77204, USA.
- Department of Biology & Biochemistry, University of Houston, Houston, TX, 77204, USA.
- Escuela de Medicina y Ciencias de la Salud ITESM, Monterrey, Mexico.
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32
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Lovisa F, Di Battista P, Gaffo E, Damanti CC, Garbin A, Gallingani I, Carraro E, Pillon M, Biffi A, Bortoluzzi S, Mussolin L. RNY4 in Circulating Exosomes of Patients With Pediatric Anaplastic Large Cell Lymphoma: An Active Player? Front Oncol 2020; 10:238. [PMID: 32175280 PMCID: PMC7056873 DOI: 10.3389/fonc.2020.00238] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/12/2020] [Indexed: 12/20/2022] Open
Abstract
Emerging evidence indicates that extracellular vesicles, particularly exosomes, play a role in several biological processes and actively contribute to cancer development and progression, by carrying and delivering proteins, transcripts and small RNAs (sRNAs). There is high interest in studying exosomes of cancer patients both to develop non-invasive liquid biopsy tests for risk stratification and to elucidate their possible involvement in disease mechanisms. We profiled by RNA-seq the sRNA content of circulating exosomes of 20 pediatric patients with Anaplastic Large Cell Lymphoma (ALCL) and five healthy controls. Our analysis disclosed that non-miRNA derived sRNAs constitute the prominent fraction of sRNA loaded in exosomes and identified 180 sRNAs significantly more abundant in exosomes of ALCL patients compared to controls. YRNA fragments, accounting for most of exosomal content and being significantly increased in ALCL patients, were prioritized for further investigation by qRT-PCR. Quantification of RNY4 fragments and full-length sequences disclosed that the latter are massively loaded into exosomes of ALCL patients with more advanced and aggressive disease. These results are discussed in light of recent findings on the role of RNY4 in the modulation of tumor microenvironment.
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Affiliation(s)
- Federica Lovisa
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Piero Di Battista
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Enrico Gaffo
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Carlotta C Damanti
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Anna Garbin
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Ilaria Gallingani
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Elisa Carraro
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Marta Pillon
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Alessandra Biffi
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy.,Gene Therapy Program, Dana Farber/Boston Children's Cancer and Blood Disorders Centers, Boston, MA, United States
| | - Stefania Bortoluzzi
- Department of Molecular Medicine, University of Padova, Padova, Italy.,CRIBI Interdepartmental Research Center for Innovative Biotechnologies (CRIBI), University of Padova, Padova, Italy
| | - Lara Mussolin
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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33
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Shen J, Medeiros LJ, Li S, Wang SA, Lin P, Khanlari M, Iyer SP, Yin CC, Tang G, Jorgensen JL, Hu S, Miranda RN, Xu J. CD8 expression in anaplastic large cell lymphoma correlates with noncommon morphologic variants and T-cell antigen expression suggesting biological differences with CD8-negative anaplastic large cell lymphoma. Hum Pathol 2020; 98:1-9. [PMID: 32032618 DOI: 10.1016/j.humpath.2020.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/14/2020] [Accepted: 01/28/2020] [Indexed: 02/07/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm characterized by uniformly strong CD30 expression and common absence of T-cell markers. Most ALCL cases express CD4, but a small subset of ALCL cases has been reported to express CD8. Little is known about the clinicopathologic and prognostic features of CD8+ ALCL. In this study, CD8 was assessed in 158 patients with systemic ALCL: CD8 was positive in 13 of 67 (19%) ALK+ and 13 of 91 (14%) ALK-negative neoplasms. In ALK+ ALCL, the CD8+ subgroup more often showed a noncommon morphologic pattern (69% vs 13%, P = .0001) and was more often positive for CD2 (100% vs 45%, P = .001), CD3 (92% vs 24%, P = .0001), and CD7 (100% vs. 39%, P = .002), but less frequently positive for CD25 (50% vs. 100%, P = .02). Patients with ALK+ ALCL and CD8+ neoplasms also had a higher relapse rate (82% vs 48%, P = .05) and more often underwent stem cell transplant (73% vs 36%, P = .04). CD8 expression did not correlate with patient overall survival or progression-free survival regardless of ALK status (all P > 0.05). We conclude that CD8+ ALCL cases appear to be biologically different from the more common CD8-negative ALCL cases. Our data suggest that CD8 positivity in ALK+ ALCL helps to identify a subset of patients more prone to relapse or more in need of stem cell transplant during their clinical course, although there was no impact on survival in this cohort.
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Affiliation(s)
- Jing Shen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Hematology, Capital Medical University Beijing Friendship Hospital, Beijing, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan P Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey L Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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34
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Abstract
Anaplastic large cell lymphomas are a rare subtype of peripheral/mature T-cell lymphomas which are clinically, pathologically and genetically heterogeneous. Both ALK-positive (ALK+) and ALK-negative (ALK-) ALCL are composed of large lymphoid cells with abundant cytoplasm and pleomorphic features with horseshoe-shaped and reniform nuclei. ALK+ ALCL were considered as a definite entity in the 2008 World Health Organization classification of hematopoietic and lymphoid tissues. ALK-ALCL was included as a provisional entity in the WHO 2008 edition and in the most recent 2017 edition, it is now considered a distinct entity that includes cytogenetic subsets that appear to have prognostic implications (e.g. 6p25 rearrangements at IRF4/DUSP22 locus). ALK+ ALCLs are distinct in epidemiology and pathogenetic origin and should be distinguished from ALK-ALCL, cutaneous ALCL and breast implant associated ALCL which have distinct clinical course and pathogenetic features. Breast implant-associated ALCL is now recognized as a new provisional entity distinct from other ALK-ALCL; notably that it is a noninvasive disease associated with excellent outcome. In this article, we will provide an overview of the salient themes relevant to the pathology and genetic mechanisms in ALCL.
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Affiliation(s)
- Vasiliki Leventaki
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Siddharth Bhattacharyya
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States
| | - Megan S Lim
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States.
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35
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Abstract
Peripheral T-cell lymphomas (PTCLs) represent a heterogeneous group of uncommon malignancies derived from mature T cells and usually characterised by an aggressive clinical course. Their clinical presentation, localisation and pattern of dissemination are highly variable, but the majority of cases present as nodal diseases. The recently revised classification of lymphomas has incorporated many new molecular genetic data derived from gene expression profiling and next generation sequencing studies, which refine the definition and diagnostic criteria of several entities. Nevertheless, the distinction of PTCL from various reactive conditions, and the diagnosis of PTCL subtypes remains notably challenging. Here, an updated summary of the clinicopathological and molecular features of the most common nodal-based PTCLs (angioimmunoblastic T-cell lymphoma and other nodal lymphomas derived from follicular T helper cells, anaplastic large cell lymphomas and peripheral T-cell lymphoma, not otherwise specified) is presented. Practical recommendations in the diagnostic approach to nodal T-cell lymphoproliferations are presented, including indications for the appropriate use and interpretation of ancillary studies. Finally, we discuss commonly encountered diagnostic problems, including pitfalls and mimics in the differential diagnosis with various reactive conditions, and the criteria that allow proper identification of distinct PTCL entities.
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Affiliation(s)
- Laurence de Leval
- Institute of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland.
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36
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Damm-Welk C, Kutscher N, Zimmermann M, Attarbaschi A, Schieferstein J, Knörr F, Oschlies I, Klapper W, Woessmann W. Quantification of minimal disseminated disease by quantitative polymerase chain reaction and digital polymerase chain reaction for NPM-ALK as a prognostic factor in children with anaplastic large cell lymphoma. Haematologica 2019; 105:2141-2149. [PMID: 31649129 PMCID: PMC7395281 DOI: 10.3324/haematol.2019.232314] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/24/2019] [Indexed: 01/20/2023] Open
Abstract
Detection of minimal disseminated disease is a validated prognostic factor in ALK-positive anaplastic large cell lymphoma. We previously reported that quantification of minimal disease by quantitative real-time polymerase chain reaction (RQ-PCR) in bone marrow applying a cut-off of 10 copies NPM-ALK/104 copies of ABL1 identifies very high-risk patients. In the present study, we aimed to confirm the prognostic value of quantitative minimal disseminated disease evaluation and to validate digital polymerase chain reaction (dPCR) as an alternative method. Among 91 patients whose bone marrow was analyzed by RQ-PCR, more than 10 normalized copy-numbers correlated with stage III/IV disease, mediastinal and visceral organ involvement and low anti-ALK antibody titers. The cumulative incidence of relapses of 18 patients with more than 10 normalized copy-numbers of NPM-ALK was 61±12% compared to 21±5% for the remaining 73 patients (P=0.0002). Results in blood correlated with those in bone marrow (r=0.74) in 70 patients for whom both materials could be tested. Transcripts were quantified by RQ-PCR and dPCR in 75 bone marrow and 57 blood samples. Copy number estimates using dPCR and RQ-PCR correlated in 132 samples (r=0.85). Applying a cut-off of 30 copies NPM-ALK/104 copies ABL1 for quantification by dPCR, almost identical groups of patients were separated as those separated by RQ-PCR. In summary, the prognostic impact of quantification of minimal disseminated disease in bone marrow could be confirmed for patients with anaplastic large cell lymphoma. Blood can substitute for bone marrow. Quantification of minimal disease by dPCR provides a promising tool to facilitate harmonization of minimal disease measurement between laboratories and for clinical studies.
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Affiliation(s)
- Christine Damm-Welk
- NHL-BFM Study Center, Department of Pediatric Hematology and Oncology, Giessen, Germany
| | - Nina Kutscher
- NHL-BFM Study Center, Department of Pediatric Hematology and Oncology, Giessen, Germany
| | - Martin Zimmermann
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Jutta Schieferstein
- NHL-BFM Study Center, Department of Pediatric Hematology and Oncology, Giessen, Germany
| | - Fabian Knörr
- Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ilske Oschlies
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, Kiel, Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, Kiel, Germany
| | - Wilhelm Woessmann
- NHL-BFM Study Center, Department of Pediatric Hematology and Oncology, Giessen, Germany .,Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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37
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Menter T, Tzankov A. Lymphomas and Their Microenvironment: A Multifaceted Relationship. Pathobiology 2019; 86:225-236. [PMID: 31574515 DOI: 10.1159/000502912] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/24/2019] [Indexed: 11/19/2022] Open
Abstract
It has become evident that the microenvironment - lymphocytes, macrophages, fibroblasts as well as the extracellular matrix, cytokines, chemokines, and a plethora of other cells, structures and substances residing in the vicinity of tumor cells - plays an important part in the maintenance of cancer growth and survival. This is also relevant in lymphomas. In this review, we give an outline on the importance of the microenvironment for tumors in general and lymphomas in particular, by highlighting certain basic principles of tumor-microenvironment interaction. The relationship of lymphomas and their microenvironment is multifaceted: lymphoma cells need growth factors and cytokines derived from microenvironmental cells for their sustenance and growth. On the contrary, many lymphomas silence or at least deregulate the immune system to escape recognition and subsequent elimination by immune cells, while giving advantage to suppressive microenvironmental compounds such as M2 polarized macrophages, regulatory T-cells, mast cells, and immunosuppressive fibroblasts. We also give a detailed insight across different lymphoma types to show the variety of tumor-microenvironment interactions. Due to its tremendous importance, the microenvironment has also become a new target for oncologic therapy. The most important finding concerning lymphomas with a focus on immunomodulatory substances is also, therefore, highlighted.
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Affiliation(s)
- Thomas Menter
- Institute of Medical Genetics and Pathology, University of Basel Hospital, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Medical Genetics and Pathology, University of Basel Hospital, Basel, Switzerland,
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38
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Cairo MS, Beishuizen A. Childhood, adolescent and young adult non-Hodgkin lymphoma: current perspectives. Br J Haematol 2019; 185:1021-1042. [PMID: 30729513 PMCID: PMC6897376 DOI: 10.1111/bjh.15764] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The 6th International Symposium on Childhood, Adolescent and Young Adult (CAYA) Non-Hodgkin Lymphoma (NHL) was held in Rotterdam, Netherlands, 26-29 September, 2018. This summary manuscript is a perspective on the presentations from the plenary scientific sessions, including wellness and survivorship, B-cell NHL, AYA lymphoma, translational NHL biology, lymphoma immunology, bone marrow transplantation and cell therapy, T/Natural Killer cell lymphoma, anaplastic large cell lymphoma, lymphoblastic lymphoma, novel lymphoma therapeutics and Hodgkin lymphoma. The symposium was attended by over 260 registrants from 42 different countries and included young, middle and senior investigators. Finally, the Angelo Rosolen, MD, Memorial Lecture was delivered by Alfred Reiter, MD.
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Affiliation(s)
- Mitchell S. Cairo
- Departments of Pediatrics, Medicine, Pathology, Microbiology& Immunology, and Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA
| | - Auke Beishuizen
- Division of Paediatric Haemato-Oncology, Princess Maxima Centre for Paediatric Oncology, Utrecht
- Department of Paediatric Oncology/Haematology, Erasmus MC - Sophia Children’s Hospital, Rotterdam, The Netherlands
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39
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Graetz D, Crews KR, Azzato EM, Singh RK, Raimondi S, Mason J, Valentine M, Mullighan CG, Holland A, Inaba H, Leventaki V. Leukemic presentation of ALK-positive anaplastic large cell lymphoma with a novel partner, poly(A) binding protein cytoplasmic 1 (PABPC1), responding to single-agent crizotinib. Haematologica 2019; 104:e218-e221. [PMID: 30819904 DOI: 10.3324/haematol.2018.215103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Dylan Graetz
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Kristine R Crews
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, TN
| | - Elizabeth M Azzato
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Ravi K Singh
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Susana Raimondi
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - John Mason
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Marcus Valentine
- Department of Cytogenetics, St. Jude Children's Research Hospital, Memphis, TN
| | | | - Ashley Holland
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Hiroto Inaba
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Vasiliki Leventaki
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN .,Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
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40
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Larose H, Burke GAA, Lowe EJ, Turner SD. From bench to bedside: the past, present and future of therapy for systemic paediatric ALCL, ALK. Br J Haematol 2019; 185:1043-1054. [PMID: 30681723 DOI: 10.1111/bjh.15763] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Anaplastic large cell lymphoma (ALCL) is a T cell Non-Hodgkin Lymphoma that mainly presents in paediatric and young adult patients. The majority of cases express a chimeric fusion protein resulting in hyperactivation of anaplastic lymphoma kinase (ALK) as the consequence of a chromosomal translocation. Rarer cases lack expression of ALK fusion proteins and are categorised as ALCL, ALK-. An adapted regimen of an historic chemotherapy backbone is still used to this day, yielding overall survival (OS) of over 90% but with event-free survival (EFS) at an unacceptable 70%, improving little over the past 30 years. It is clear that continued adaption of current therapies will probably not improve these statistics and, for progress to be made, integration of biology with the design and implementation of future clinical trials is required. Indeed, advances in our understanding of the biology of ALCL are outstripping our ability to clinically translate them; laboratory-based research has highlighted a plethora of potential therapeutic targets but, with high survival rates combined with a scarcity of funding and patients to implement paediatric trials of novel agents, progress is slow. However, advances must be made to reduce the side-effects of intensive chemotherapy regimens whilst maintaining, if not improving, OS and EFS.
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Affiliation(s)
- Hugo Larose
- Department of Pathology, Division of Cellular and Molecular Pathology, University of Cambridge, Cambridge, UK.,European Research Initiative for ALK-related malignancies (www.erialcl.net), Cambridge, UK
| | - G A Amos Burke
- Department of paediatric oncology, Addenbrooke's Hospital, Cambridge, UK
| | - Eric J Lowe
- Division of Pediatric Hematology-Oncology, Children's Hospital of the Kings Daughter, Norfolk, Virginia, USA
| | - Suzanne D Turner
- Department of Pathology, Division of Cellular and Molecular Pathology, University of Cambridge, Cambridge, UK.,European Research Initiative for ALK-related malignancies (www.erialcl.net), Cambridge, UK
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Abstract
T-cell lymphomas (TCL) are uncommon non-Hodgkin lymphomas that often have an aggressive clinical course. Patients typically have limited treatment options upon relapse and a dismal prognosis after progression despite newly approved therapies. New therapeutic approaches for these orphan diseases are very much needed and a greater understanding of the role of nonmalignant immune cells in the tumor microenvironment may allow for an improved antitumor immune response. The tumor microenvironment is a key component in tumor evasion and typically results in an ineffective T-cell response to the tumor cells despite a significant inflammatory response. A better understanding of the tumor microenvironment therefore, in an effort to overcome the barriers to an effective immune response, would help in developing novel therapeutic approaches to treat and improve outcomes of these diseases. Immune checkpoint blockade to reinvigorate suppressed T-cell, or modulation of the CD47-SIRPalpha axis to promote macrophage phagocytosis, would be such targets. However, whether modulating the immune response using each pathway alone or whether a combination approach is necessary has yet to be determined.
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Affiliation(s)
- N Nora Bennani
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stephen M Ansell
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
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Abstract
Lymphomas in adolescents and young adults represent approximately one quarter of all cancers in this age group. Historically, adolescent and young adult cancer patients represent a unique population with diverging issues surrounding psychosocial hardships/barriers, economics, and lack of standardization of therapeutic approaches.Furthermore, the biologic differences within the adolescent and young adult population seen in various lymphoma subtypes likely play a role in overall outcomes for this group. Without an organized approach to clinical and translational research for adolescent and young adult patients within specialized treatment centers, this population may continue to experience inferior results. Here we look at the current perspectives of adolescent and young adult lymphomas with respect to disease biology, clinical characteristics, treatment, and prognosis of this unique lymphoma population.
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43
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John TD, Naik S, Leung K, Sasa G, Martinez C, Krance RA. Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma. Pediatr Transplant 2018; 22:e13210. [PMID: 29719098 DOI: 10.1111/petr.13210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 12/26/2022]
Abstract
Relapsed ALK-positive ALCL often is responsive to CRZ monotherapy. The subsequent role of allogeneic HCT after achieving second remission is poorly understood. We report 6 children who underwent allogeneic HCT for relapsed ALCL after CRZ. Age at transplant ranged from 10.7 to 22.6 years. Follow-up ranged from 0.9 to 4.5 years. All patients engrafted. Three of 4 patients that received a reduced-toxicity conditioning regimen containing fludarabine, alemtuzumab, and low-dose irradiation showed progressive mixed chimerism. Five patients remain in remission. One patient developed isolated CNS relapse 3.6 years after HCT despite a lack of previous CNS involvement. No acute transplant-related complications were experienced. One patient developed chronic renal disease secondary to transplant-associated microangiopathy and one patient chronic GVHD secondary to DLI. Ultimately, allogeneic HCT appears safe and potentially curative after remission induction with CRZ. The role of conditioning therapy, ablative or reduced intensity, remains uncertain for patients' post-CRZ monotherapy, and further studies may be warranted.
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Affiliation(s)
- Tami D John
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
| | - Swati Naik
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
| | - Kathryn Leung
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA
| | - Ghadir Sasa
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
| | - Caridad Martinez
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
| | - Robert A Krance
- Department of Pediatrics, Center for Cell and Gene Therapy, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
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Hochberg J, Flower A, Brugieres L, Cairo MS. NHL in adolescents and young adults: A unique population. Pediatr Blood Cancer 2018; 65:e27073. [PMID: 29741220 DOI: 10.1002/pbc.27073] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 02/07/2018] [Accepted: 03/04/2018] [Indexed: 12/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies with high incidence in adolescents and young adults (AYAs). The most common diseases include diffuse large B-cell lymphoma, anaplastic large cell lymphoma, Burkitt lymphoma, lymphoblastic lymphoma, and primary mediastinal large B-cell lymphoma. In comparison to younger children and adults, AYAs (15-39 years) with NHL present a specific set of challenges including variations in tumor biology, inconsistent treatment, pharmacodynamics, and psychosocial barriers. While survival of AYAs with NHL has improved, cure rates remain suboptimal. Incorporation of novel agents into pediatric-inspired treatment regimens specifically designed for NHL in AYAs has led to improved outcomes. Consideration of AYAs as a distinct population in the diagnosis and treatment of NHL is encouraged.
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Affiliation(s)
- Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, New York
| | - Allyson Flower
- Department of Pediatrics, New York Medical College, Valhalla, New York.,Department of Microbiology & Immunology, New York Medical College, Valhalla, New York
| | | | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, New York.,Department of Microbiology & Immunology, New York Medical College, Valhalla, New York.,Department of Medicine, New York Medical College, Valhalla, New York.,Department of Pathology, New York Medical College, Valhalla, New York.,Department of Cell Biology & Anatomy, New York Medical College, Valhalla, New York
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Hudson S, Wang D, Middleton F, Nevaldine BH, Naous R, Hutchison RE. Crizotinib induces apoptosis and gene expression changes in ALK+ anaplastic large cell lymphoma cell lines; brentuximab synergizes and doxorubicin antagonizes. Pediatr Blood Cancer 2018; 65:e27094. [PMID: 29697184 DOI: 10.1002/pbc.27094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) shows 60-70% event free survival with standard treatments. Targeted therapies are being tested for increased benefit and/or reduced toxicity, but interactions with standard agents are not well known. METHODS We exposed four ALCL cell lines to two targeted agents, crizotinib and brentuximab vedotin, and to two standard agents, doxorubicin and vinblastine. For each agent and combination, we measured apoptosis and expression of approximately 300 previously annotated genes of interest using targeted RNA-sequencing. An aurora kinase inhibitor, alisertib, was similarly tested for gene expression effects. RESULTS Only crizotinib, alone or in combination, showed significant effects (adjusted P < 0.05) on expression and apoptosis. One hundred and nine of 277 gene expressions showed crizotinib-associated differential expression, mostly downregulation, 62 associated with apoptosis, and 28 associated with both crizotinib and apoptosis. Doxorubicin was antagonistic with crizotinib on gene expression and apoptosis. Brentuximab was synergistic with crizotinib in apoptosis, and not antagonistic in gene expression. Vinblastine also appeared synergistic with crizotinib but did not achieve statistical significance. Alisertib did not show significant expression changes. CONCLUSIONS Our data suggest that crizotinib induces apoptosis through orderly changes in cell signaling associated with ALK inhibition. Expression effects of crizotinib and associated apoptosis are antagonized by doxorubicin, but apoptosis is synergized by brentuximab vedotin and possibly vinblastine. These findings suggest that concurrent use of crizotinib and doxorubicin may be counterproductive, while the pairing of crizotinib with brentuximab (or vinblastine) may increase efficacy. Alisertib did not induce expression changes at cytotoxic dosage.
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Affiliation(s)
- Sandra Hudson
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Frank Middleton
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Barbara H Nevaldine
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Rana Naous
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
| | - Robert E Hutchison
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
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46
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Jaing TH, Chang TY, Chen SH, Wen YC, Chuang WY, Yang CP. Small cell variant of ALK-positive anaplastic large cell lymphoma with primary subcutaneous presentation: A case report. Medicine (Baltimore) 2018; 97:e11222. [PMID: 29952979 PMCID: PMC6039684 DOI: 10.1097/md.0000000000011222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE The rare morphological variant of anaplastic large cell lymphoma (ALCL) may pose a challenge in diagnosis, especially when presentation primarily involves skin lesions. PATIENT CONCERNS Here we describe a rare case of small cell variant of ALCL in an 11-year-old girl. DIAGNOSIS We performed clinical, morphological, and immunohistochemical analyses of developed cutaneous nodules. INTERVENTIONS Pathologists should consider this small cell variant in ALCL differential diagnosis, as early and correct diagnosis has important clinical implications. OUTCOMES Allogeneic hematopoietic stem cell transplantation appears to be a promising treatment option for small cell variant of ALCL. LESSONS Histological diagnosis of small cell variant of ALCL is challenging among pediatricians because of its low incidence and atypical presentation. We provide a short review of the small cell variant of ALCL to facilitate the diagnosis of this difficult-to-recognize entity.
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Affiliation(s)
- Tang-Her Jaing
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University
| | - Tsung-Yen Chang
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University
| | - Shih-Hsiang Chen
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University
| | - Yu-Chuan Wen
- Department of Nursing, Chang Gung University and Memorial Hospital
| | - Wen-Yu Chuang
- Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taoyuan, Taiwan
| | - Chao-Ping Yang
- Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University
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47
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Stadler S, Singh VK, Knörr F, Damm-Welk C, Woessmann W. Immune Response against ALK in Children with ALK-Positive Anaplastic Large Cell Lymphoma. Cancers (Basel) 2018; 10:cancers10040114. [PMID: 29642597 PMCID: PMC5923369 DOI: 10.3390/cancers10040114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 12/26/2022] Open
Abstract
Patients with anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) mount a humoral and cellular immune response against ALK. More than 90% of children and adolescents with ALK-positive ALCL have detectable anti-ALK antibodies in serum or plasma, and the antibody titer inversely correlates with the risk of relapse. ALK-specific CD8 and CD4 T cell responses have been described in patients with ALK-positive ALCL. Vaccination with ALK DNA led to protection against lymphoma growth in a murine model. Collectively, these data suggest that the ALK-specific immune response is involved in the control of the disease. The characteristics of the humoral and cellular immune response against ALK as well as tumor immune escape mechanisms have been increasingly investigated. However, tumor and host factors contributing to the individual immune response against ALK are still largely unknown. Depending on the individual strength of the immune response and its determinants, individualized immunological approaches might be appropriate for the consolidation of ALCL patients. Strategies such as ALK vaccination could be effective for those with a pre-existing anti-tumor immunity, while an allogeneic blood stem cell transplantation or check-point inhibition could be effective for others.
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Affiliation(s)
- Serena Stadler
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Vijay Kumar Singh
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Fabian Knörr
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Christine Damm-Welk
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
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48
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Montes-Mojarro IA, Steinhilber J, Bonzheim I, Quintanilla-Martinez L, Fend F. The Pathological Spectrum of Systemic Anaplastic Large Cell Lymphoma (ALCL). Cancers (Basel) 2018; 10:cancers10040107. [PMID: 29617304 PMCID: PMC5923362 DOI: 10.3390/cancers10040107] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/30/2018] [Accepted: 04/02/2018] [Indexed: 12/11/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL) represents a group of malignant T-cell lymphoproliferations that share morphological and immunophenotypical features, namely strong CD30 expression and variable loss of T-cell markers, but differ in clinical presentation and prognosis. The recognition of anaplastic lymphoma kinase (ALK) fusion proteins as a result of chromosomal translocations or inversions was the starting point for the distinction of different subgroups of ALCL. According to their distinct clinical settings and molecular findings, the 2016 revised World Health Organization (WHO) classification recognizes four different entities: systemic ALK-positive ALCL (ALK+ ALCL), systemic ALK-negative ALCL (ALK− ALCL), primary cutaneous ALCL (pC-ALCL), and breast implant-associated ALCL (BI-ALCL), the latter included as a provisional entity. ALK is rearranged in approximately 80% of systemic ALCL cases with one of its partner genes, most commonly NPM1, and is associated with favorable prognosis, whereas systemic ALK− ALCL shows heterogeneous clinical, phenotypical, and genetic features, underlining the different oncogenesis between these two entities. Recognition of the pathological spectrum of ALCL is crucial to understand its pathogenesis and its boundaries with other entities. In this review, we will focus on the morphological, immunophenotypical, and molecular features of systemic ALK+ and ALK− ALCL. In addition, BI-ALCL will be discussed.
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Affiliation(s)
- Ivonne A Montes-Mojarro
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076 Tübingen, Germany.
| | - Julia Steinhilber
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076 Tübingen, Germany.
| | - Irina Bonzheim
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076 Tübingen, Germany.
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076 Tübingen, Germany.
| | - Falko Fend
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center Tübingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076 Tübingen, Germany.
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49
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Congras A, Caillet N, Torossian N, Quelen C, Daugrois C, Brousset P, Lamant L, Meggetto F, Hoareau-Aveilla C. Doxorubicin-induced loss of DNA topoisomerase II and DNMT1- dependent suppression of MiR-125b induces chemoresistance in ALK-positive cells. Oncotarget 2018; 9:14539-14551. [PMID: 29581862 PMCID: PMC5865688 DOI: 10.18632/oncotarget.24465] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 11/20/2017] [Indexed: 12/04/2022] Open
Abstract
Systemic anaplastic large-cell lymphoma (ALCL) is a childhood T cell neoplasm defined by the presence or absence of translocations that lead to the ectopic expression of anaplastic lymphoma kinase (ALK), with nucleophosmin-ALK (NPM-ALK) fusions being the most common. Polychemotherapy involving doxorubicin is the standard first-line treatment but for the 25 to 35% of patients who relapse and develop resistance the prognosis remains poor. We studied the potential role of the microRNA miR-125b in the development of resistance to doxorubicin in NPM-ALK(+) ALCL. Our results show that miR-125b expression is repressed in NPM-ALK(+) cell lines and patient samples through hypermethylation of its promoter. NPM-ALK activity, in cooperation with DNA topoisomerase II (Topo II) and DNA methyltransferase 1 (DNMT1), is responsible for miR-125b repression through DNA hypermethylation. MiR-125b repression was reversed by the inhibition of DNMTs with decitabine or the inhibition of DNA topoisomerase II with either doxorubicin or etoposide. In NPM-ALK(+) cell lines, doxorubicin treatment led to an increase in miR-125b levels by inhibiting the binding of DNMT1 to the MIR125B1 promoter and downregulating the pro-apoptotic miR-125b target BAK1. Reversal of miR-125b silencing, increased miR-125b levels and reduced BAK1 expression also led to a lower efficacy of doxorubicin, suggestive of a pharmacoresistance mechanism. In line with this, miR-125b repression and increased BAK1 expression correlated with early relapse in human NPM-ALK(+) ALCL primary biopsies. Collectively our findings suggest that miR-125b could be used to predict therapeutic outcome in NPM-ALK(+) ALCL.
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Affiliation(s)
- Annabelle Congras
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Equipe Labelisée LIGUE 2017
| | - Nina Caillet
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Equipe Labelisée LIGUE 2017
| | - Nouritza Torossian
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France
| | - Cathy Quelen
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Equipe Labelisée LIGUE 2017
| | - Camille Daugrois
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France
| | - Pierre Brousset
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Institut Carnot Lymphome-CALYM, 31024, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer-TOUCAN, 31024, Toulouse, France.,European Research Initiative on ALK-related malignancies (ERIA) (http://www.erialcl.net/).,Equipe Labelisée LIGUE 2017
| | - Laurence Lamant
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Institut Carnot Lymphome-CALYM, 31024, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer-TOUCAN, 31024, Toulouse, France.,European Research Initiative on ALK-related malignancies (ERIA) (http://www.erialcl.net/).,Equipe Labelisée LIGUE 2017
| | - Fabienne Meggetto
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Institut Carnot Lymphome-CALYM, 31024, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer-TOUCAN, 31024, Toulouse, France.,European Research Initiative on ALK-related malignancies (ERIA) (http://www.erialcl.net/).,Equipe Labelisée LIGUE 2017
| | - Coralie Hoareau-Aveilla
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 CRCT, F-31000 Toulouse, France.,Equipe Labelisée LIGUE 2017
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50
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Mauz-Körholz C, Ströter N, Baumann J, Botzen A, Körholz K, Körholz D. Pharmacotherapeutic Management of Pediatric Lymphoma. Paediatr Drugs 2018; 20:43-57. [PMID: 29127674 DOI: 10.1007/s40272-017-0265-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) comprise approximately 15% of all childhood malignancies. Cure rates for both lymphoma entities have evolved tremendously during the last couple of decades, raising the 5-year survival rates to almost 100% for HL and to 85% for NHL. The mainstay therapy for both malignancies is still chemotherapy-with different regimens recommended for different types of disease. In HL, combined modality treatment, i.e., chemotherapy followed by radiotherapy, has long been the standard regimen. In order to reduce long-term side effects, such as second malignancies, most major pediatric HL consortia have studied response-based radiotherapy reduction strategies over the last 3 decades. For recurrent disease, high-dose chemotherapy followed by an autologous or an allogeneic hematopoietic stem-cell transplant is an option. No targeted agents have yet gained regulatory approval for use in pediatric patients with lymphoma. For adult lymphoma patients, the CD20 antibody rituximab and the CD30 antibody-drug conjugate brentuximab vedotin are targeted agents used regularly in first- and second-line treatment regimens. More recently, immune checkpoint inhibitors, phosphatidyl-inositol-3-kinase inhibitors, and Bruton's tyrosine kinase inhibitors appear to be very promising new treatment options in adult lymphoma. Here, we discuss the current experience with these types of agents in pediatric lymphoma patients.
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Affiliation(s)
- Christine Mauz-Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Feulgenstraße 12, 35392, Giessen, Germany. .,Medical Faculty of the Martin-Luther-University of Halle-Wittenberg, Halle, Germany.
| | - Natascha Ströter
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Feulgenstraße 12, 35392, Giessen, Germany
| | - Julia Baumann
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Feulgenstraße 12, 35392, Giessen, Germany
| | - Ante Botzen
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Feulgenstraße 12, 35392, Giessen, Germany
| | - Katharina Körholz
- Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.,Clinical Cooperation Unit Pediatric Oncology, German Cancer Research center (DKFZ), Heidelberg, Germany
| | - Dieter Körholz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Justus-Liebig University of Giessen, Feulgenstraße 12, 35392, Giessen, Germany
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