1
|
Zhang J, Zhou S, Jiang S, He F, Tu Y, Hu H. Imatinib mesylate reduces c-MYC expression in double-hit lymphoma cells by suppressing inducible cytidine deaminase. J Cancer Res Clin Oncol 2024; 150:426. [PMID: 39299959 DOI: 10.1007/s00432-024-05939-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 09/03/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Double-hit lymphoma (DHL) with c-MYC gene translocation is highly aggressive and has a poor prognosis. In DHL cells, activation-induced cytidine deaminase (AID) promotes antibody class switch recombination (CSR), ultimately leading to c-MYC gene translocation caused by Myc/IgH DNA double-strand breaks. However, currently there is still no method to suppress the expression of AID. METHODS In this study, we compared the clinical significance of AID expression in DHL, Additionally, two human double-hit lymphoma cell lines were used to analyze the effect of imatinib mesylate on c-MYC in vitro, and the therapeutic effect was also evaluated in xenograft mouse models. RESULTS Imatinib mesylate downregulated the AID and c-MYC proteins in patients with chronic myelogenous leukemia associated with DHL. In addition, imatinib mesylate reduced AID and c-MYC expression in SU-DHL-4 and OCI-Ly18 DHL cells. Imatinib mesylate exerted significant inhibitory effects on the proliferation and metastasis of SU-DHL-4 and OCI-Ly18 cells. Finally, imatinib mesylate reduced not only tumor burden in DHL mouse models, but also AID and c-MYC expression in vivo. CONCLUSION These findings reveal that imatinib mesylate effectively reduces the carcinogenic function of c-MYC in DHL, providing novel strategies for developing therapies targeting c-MYC-driven DHL.
Collapse
MESH Headings
- Imatinib Mesylate/pharmacology
- Animals
- Humans
- Cytidine Deaminase/genetics
- Cytidine Deaminase/metabolism
- Mice
- Proto-Oncogene Proteins c-myc/metabolism
- Proto-Oncogene Proteins c-myc/genetics
- Xenograft Model Antitumor Assays
- Cell Line, Tumor
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Female
- Antineoplastic Agents/pharmacology
- Translocation, Genetic
- Male
- Cell Proliferation/drug effects
- Lymphoma/drug therapy
- Lymphoma/pathology
- Lymphoma/genetics
- Lymphoma/metabolism
- Gene Expression Regulation, Neoplastic/drug effects
Collapse
Affiliation(s)
- JingCheng Zhang
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Sheng Zhou
- Department of Hematology, Lanxi People's Hospital, Lanxi, 321100, China
| | - SiSi Jiang
- Department of Internal Medicine, Yongkang Traditional Chinese Medicine Hospital, Yongkang, 321000, China
| | - Fang He
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - Yan Tu
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China
| | - HuiXian Hu
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, China.
| |
Collapse
|
2
|
Feng Y, Wu L, Gu T, Hu Y, Huang H. How can we improve the successful identification of patients suitable for CAR-T cell therapy? Expert Rev Mol Diagn 2024:1-16. [PMID: 39258858 DOI: 10.1080/14737159.2024.2399152] [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: 01/30/2023] [Accepted: 08/28/2024] [Indexed: 09/12/2024]
Abstract
INTRODUCTION In recent years, chimeric antigen receptor T (CAR-T) cell therapy has resulted in a breakthrough in the treatment of patients with refractory or relapsed hematological malignancies. However, the identification of patients suitable for CAR-T cell therapy needs to be improved. AREAS COVERED CAR-T cell therapy has demonstrated excellent efficacy in hematological malignancies; however, views on determining when to apply CAR-T cells in terms of the evaluation of patient characteristics remain controversial. EXPERT OPINION We reviewed the current feasibility and challenges of CAR-T cell therapy in the most common hematological malignancies and classified them according to the disease type and treatment priority, to guide clinicians and researchers in applying and investigating CAR-T cells furtherly.
Collapse
Affiliation(s)
- Youqin Feng
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, Zhejiang, China
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, China
| | - Longyuan Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, Zhejiang, China
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, China
| | - Tianning Gu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, Zhejiang, China
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, China
| | - Yongxian Hu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, Zhejiang, China
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, China
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, China
- Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, China
| |
Collapse
|
3
|
Syrykh C, DI Proietto V, Brion E, Copie-Bergman C, Jardin F, Dartigues P, Gaulard P, Jo Molina T, Briere J, Oberic L, Haioun C, Tilly H, Maussion C, Morel M, Schiratti JB, Laurent C. MYC Rearrangement Prediction from LYSA Whole Slide Images in Large B-cell Lymphoma: A Multi-centric Validation of Self-supervised Deep Learning Models. Mod Pathol 2024:100610. [PMID: 39265953 DOI: 10.1016/j.modpat.2024.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 07/25/2024] [Accepted: 09/03/2024] [Indexed: 09/14/2024]
Abstract
Large B-cell lymphoma (LBCL) is a heterogeneous lymphoid malignancy in which MYC gene rearrangement (MYC-R) is associated with a poor prognosis, prompting the recommendation for more intensive treatment. MYC-R detection relies on fluorescence in situ hybridization (FISH) method which is time consuming, expensive and not available in all laboratories. Automating MYC-R detection on hematoxylin and eosin (HE) stained whole slide images (WSI) of LBCL would decrease the need for costly molecular testing and improve pathologists' productivity. We developed an interpretable deep learning (DL) algorithm to detect MYC-R considering recent advances in self-supervised learning and providing an extensive comparison of seven feature extractors and six multiple instance learning models, themselves. Four different multicentric cohorts, including 1 247 LBCL patients, were used for training and validation. The best DL model reached an average ROC AUC score of 81.9% during cross-validation on the largest LBCL cohort, and ROC AUC scores ranging from 62.2% to 74.5% when evaluated on other unseen cohorts. In addition, we demonstrated that using this model as a pre-screening tool (with a false-negative rate of 0%), FISH testing would be avoided in 35% of cases. This work demonstrates the feasibility of developing a medical device to efficiently detect MYC gene rearrangement on HE WSI in daily practice.
Collapse
Affiliation(s)
| | | | | | - Christiane Copie-Bergman
- LYSA (The Lymphoma Study Association) and LYSARC (The Lymphoma Academic Research Organisation), Pierre-Bénite, France
| | - Fabrice Jardin
- Department of Hematology and U1245, Henri Becquerel Center, IRIB, Normandy University, Rouen, France
| | - Peggy Dartigues
- Department of Pathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Philippe Gaulard
- Department of Pathology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France; Mondor Institute for Biomedical Research, INSERM U955, Faculty of Medicine, University of Paris-Est Créteil, Créteil, France
| | - Thierry Jo Molina
- Department of Pathology, Necker Enfants Malades Hospital, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Institut Imagine, Unité INSERM 1163, Paris, France
| | - Josette Briere
- Department of Hematology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Diderot, Paris, France
| | - Lucie Oberic
- Department of Hematology, IUCT Oncopole, Toulouse, France
| | - Corine Haioun
- Department of Hematology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Hervé Tilly
- Department of Hematology and U1245, Henri Becquerel Center, IRIB, Normandy University, Rouen, France
| | | | | | | | - Camille Laurent
- Department of Pathology, IUCT Oncopole, Toulouse, France; INSERM, U1037, Research Center In Cancer of Toulouse, laboratoire d'excellence TOUCAN, Toulouse, France.
| |
Collapse
|
4
|
Tan D, Chan JY, Wudhikarn K, Wong RSM, Poon L, Norasetthada L, Huang TC, Tse E. Unmet Needs in the First-Line Treatment of Diffuse Large B-cell Lymphoma: Expert Recommendations From the Asia-Pacific Region With a Focus on the Challenging Subtypes. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024; 24:e320-e328. [PMID: 38853026 DOI: 10.1016/j.clml.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/11/2024]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma, accounting for around 30-60% of all cases. The management of DLBCL in Asia has several unmet needs due to the diversity of the population, the heterogeneity of local clinical guidelines for DLBCL and the wide disparity in resources and healthcare systems across different regions. Rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) is widely recognized as the standard first-line treatment for DLBCL; however, alternative regimens are required to improve patient outcomes in challenging subtypes, such as patients with high International Prognostic Index scores, old/frail patients, and patients with double-hit and double-expressor DLBCL or concurrent central nervous system disease. This review article draws from the expertise of practicing hematologists/oncologists in the region, with the aim of integrating data from current scientific evidence to address the unmet needs and unique socioeconomic challenges faced by challenging high risk patient groups in the Asia-Pacific region.
Collapse
Affiliation(s)
- Daryl Tan
- Clinic for Lymphoma, Myeloma and Blood Disorders, Mount Elizabeth Novena Hospital, Singapore.
| | | | - Kitsada Wudhikarn
- Division of Hematology and Center of Excellence in Translational Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Raymond Siu Ming Wong
- Sir Y.K. Pao Centre for Cancer & Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - Limei Poon
- Department of Hematology-Oncology, National University Cancer Institute Singapore, Singapore
| | - Lalita Norasetthada
- Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tai-Chung Huang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Eric Tse
- Department of Medicine, University of Hong Kong, Hong Kong
| |
Collapse
|
5
|
Shi Y, Xu Y, Shen H, Jin J, Tong H, Xie W. Advances in biology, diagnosis and treatment of DLBCL. Ann Hematol 2024; 103:3315-3334. [PMID: 39017945 PMCID: PMC11358236 DOI: 10.1007/s00277-024-05880-z] [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: 11/03/2023] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Diffuse large B-cell lymphoma (DLBCL), with approximately 150,000 new cases worldwide each year, represent nearly 30% of all cases of non-Hodgkin lymphoma (NHL) and are phenotypically and genetically heterogeneous. A gene-expression profile (GEP) has identified at least three major subtypes of DLBCL, each of which has distinct clinical, biological, and genetic features: activated B-cell (ABC)-like DLBCL, germinal-center B-cell (GCB)-like DLBCL, and unclassified. Different origins are associated with different responses to chemotherapy and targeted agents. Despite DLBCL being a highly heterogeneous disease, more than 60% of patients with DLBCL can be cured after using rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) to inhibit the growth of cancer cells while targeting the CD20 receptor. In recent decades, the improvement of diagnostic levels has led to a refinement classification of DLBCL and the development of new therapeutic approaches. The objective of this review was to summarize the latest studies examining genetic lesions and therapies for DLBCL.
Collapse
Affiliation(s)
- Yuanfei Shi
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Yi Xu
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Huafei Shen
- International Health Care Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jie Jin
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Hongyan Tong
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Wanzhuo Xie
- Department of Hematology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
| |
Collapse
|
6
|
Xue B, Liu Y, Zhou J, Zhou L, Ye S, Lu Y, Zhang W, Xiu B, Liang A, Li P, Lu Y, Qian W, Luo X. CD19 CAR-T treatment shows limited efficacy in r/r DLBCL with double expression and TP53 alterations. Cytotherapy 2024:S1465-3249(24)00802-8. [PMID: 39217529 DOI: 10.1016/j.jcyt.2024.07.011] [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: 04/15/2024] [Revised: 07/18/2024] [Accepted: 07/18/2024] [Indexed: 09/04/2024]
Abstract
OBJECT Autologous CD19 chimeric antigen receptor T-cell therapy (CAR-T) significantly modifies the natural course of chemorefractory diffuse large B-cell lymphoma (DLBCL). However, 25% to 50% of patients with relapsed/refractory DLBCL still do not achieve remission. Therefore, investigating new molecular prognostic indicators that affect the effectiveness of CAR-T for DLBCL and developing novel combination therapies are crucial. METHODS Data from 73 DLBCL patients who received CD19 CAR-T (Axi-cel or Relma-cel) were retrospectively collected from Shanghai Tongji Hospital of Tongji University, The Second Affiliated Hospital Zhejiang University School of Medicine, and The Affiliated People's Hospital of Ningbo University. Prior to CD19 CAR-T-cell transfusions, the patients received fludarabine and cyclophosphamide chemotherapy regimen. RESULTS Our study revealed that relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) patients with both Double-expression (MYC > 40% and BCL2 > 50%) and TP53 alterations tend to have a poorer clinical prognosis after CAR-T therapy, even when CAR-T therapy is used in combination with other therapies. However, CAR-T therapy was found to be effective in patients with only TP53 alterations or DE status, suggesting that their prognosis is in line with that of patients without TP53 alterations or DE status. CONCLUSIONS Our study suggests that r/r DLBCL patients with both DE status and TP53 alterations treated with CAR-T therapy are more likely to have a poorer clinical prognosis. However, CAR-T therapy has the potential to improve the prognosis of patients with only TP53 alterations or DE status to be similar to that of patients without these abnormalities.
Collapse
Affiliation(s)
- Bin Xue
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yifan Liu
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Zhou
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lili Zhou
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shiguang Ye
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Lu
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wenjun Zhang
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bing Xiu
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Aibin Liang
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ping Li
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Ying Lu
- Department of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, China.
| | - Wenbin Qian
- Department of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Xiu Luo
- Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|
7
|
Yimpak P, Bumroongkit K, Tantiworawit A, Rattanathammethee T, Aungsuchawan S, Daroontum T. Immunohistochemistry-based investigation of MYC, BCL2, and Ki-67 protein expression and their clinical impact in diffuse large B-cell lymphoma in upper Northern Thailand. PLoS One 2024; 19:e0307253. [PMID: 39038016 PMCID: PMC11262692 DOI: 10.1371/journal.pone.0307253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 07/02/2024] [Indexed: 07/24/2024] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma (NHL) that accounts for approximately 25-40% of all NHL cases. The objective of this study was to investigate the protein expression, clinical impact, and prognostic role of MYC, BCL2, and Ki-67 in Thai DLBCL patients. A retrospective analysis was conducted on 100 DLBCL patients diagnosed between January 2018 and December 2019. Immunohistochemistry was used to assess the expression of MYC, BCL2, and Ki-67. The study revealed a significant association between extranodal involvement and positive cases of MYC and BCL2. MYC expressions were associated with Ki-67 expression, while BCL2 positivity was associated with the non-germinal center B-cell (non-GCB) subtype. However, there were no significant differences in the three-year overall survival (OS) and three-year progression-free survival (PFS) rates when using cut-off points of ≥ 40% for MYC, ≥ 50% for BCL2, and ≥ 70% for Ki-67. Notably, DLBCL cases with co-expression of MYC and BCL2 exhibited significantly inferior three-year OS compared to other cases (0% vs. 53%; p = 0.020). Multivariate analysis identified age ≥ 60 years and Eastern Cooperative Oncology Group (ECOG) performance status as independent prognostic factors. In conclusion, MYC, BCL2, and Ki-67 expression can serve as prognostic biomarkers; however, their prognostic value may vary based on the specific cut-off values used. Therefore, determining the appropriate threshold for each biomarker based on individual laboratory analyses and clinical outcomes is crucial.
Collapse
MESH Headings
- Humans
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Proto-Oncogene Proteins c-bcl-2/genetics
- Ki-67 Antigen/metabolism
- Male
- Female
- Proto-Oncogene Proteins c-myc/metabolism
- Proto-Oncogene Proteins c-myc/genetics
- Middle Aged
- Thailand/epidemiology
- Aged
- Adult
- Immunohistochemistry
- Retrospective Studies
- Prognosis
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Young Adult
Collapse
Affiliation(s)
- Phuttirak Yimpak
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokkan Bumroongkit
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Tantiworawit
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanawat Rattanathammethee
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirinda Aungsuchawan
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Teerada Daroontum
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
8
|
Coelho J, Roush SM, Xu AM, Puranam K, Mponda M, Kasonkanji E, Mulenga M, Tomoka T, Galeotti J, Brownlee A, Ghadially H, Damania B, Painschab M, Merchant A, Gopal S, Fedoriw Y. HIV and prior exposure to antiretroviral therapy alter tumour composition and tumour: T-cell associations in diffuse large B-cell lymphoma. Br J Haematol 2024; 205:194-206. [PMID: 38769021 PMCID: PMC11245366 DOI: 10.1111/bjh.19531] [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: 03/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of lymphoma worldwide, accounting for up to 40% of new non-Hodgkin Lymphoma (NHL) globally. People living with HIV are up to 17 times more likely to develop NHL, and as such, DLBCL is the leading cause of cancer death in this high-risk population. While histologically indistinguishable, HIV-associated (HIV+) and HIV-negative (HIV-) DLBCL are molecularly distinct, and biological differences may have implications for the development of future therapeutic interventions. Further, the impact of immunologic differences in people with HIV, including preceding ART, remains largely unknown. Here, we investigate the impact of HIV infection and ART exposure on the clinical features of DLBCL and T-cell immune response by performing imaging mass cytometry on our unique patient cohort in Malawi. In this cohort, HIV infection is positively prognostic, and HIV+/ART-naïve patients have the best outcomes. No established biomarkers other than Ki67 are associated with HIV or ART status, and the only tumour-intrinsic biomarkers that remain prognostic are MYC and MYC/BCL2 protein co-expression. Finally, TCR clonality is associated with distinct tumour-T cell interactions by HIV/ART status, indicating differential anti-tumour immune responses. We demonstrate previously undescribed HIV and ART-related differences in the DLBCL tumour microenvironment.
Collapse
Affiliation(s)
- Jenny Coelho
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina (UNC), Chapel Hill, NC, USA
| | - Sophia M. Roush
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina (UNC), Chapel Hill, NC, USA
| | - Alexander M. Xu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Marriam Mponda
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Edwards Kasonkanji
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Maurice Mulenga
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Tamiwe Tomoka
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Jonathan Galeotti
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina (UNC), Chapel Hill, NC, USA
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Amy Brownlee
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina (UNC), Chapel Hill, NC, USA
| | - Hormas Ghadially
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Blossom Damania
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- Department of Microbiology and Immunology, School of Medicine, UNC, Chapel Hill, NC, USA
| | - Matthew Painschab
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- Division of Hematology, Department of Medicine, UNC, Chapel Hill, NC
| | - Akil Merchant
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Division of Hematology and Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Satish Gopal
- National Cancer Institute Center for Global Health, Rockville, MD, USA
| | - Yuri Fedoriw
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina (UNC), Chapel Hill, NC, USA
- UNC Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| |
Collapse
|
9
|
Nickles M, Hunt S, Turcios-Escobar S, Babwah A, Mobayed N, Murga-Zamalloa C, Bain M, Quigley J, Rubinstein P, Galvez C. Richter Syndrome Presenting as Subcutaneous Nodules and a Dermal Plaque. Am J Dermatopathol 2024; 46:443-446. [PMID: 38648045 DOI: 10.1097/dad.0000000000002720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
ABSTRACT Richter syndrome (RS) describes a phenomenon in which a patient with chronic lymphocytic leukemia (CLL) develops an aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL). Reports of cutaneous RS remain exceedingly rare. We report a 61-year-old woman with relapsed/refractory CLL presenting with several subcutaneous nodules on her arms and legs and a single dermal plaque on her abdomen. Skin biopsy revealed a diagnosis of DLBCL, ABC-type, and her clinical status rapidly deteriorated following diagnosis. We review the variety of clinical presentations of cutaneous RS, its association with CLL, risk factors for RS development in CLL patients, and the distinctive histopathologic and immunophenotypic features of DLBCL. We hope to highlight the importance of prompt skin biopsy in patients with CLL presenting with progressive skin lesions and increase awareness of this aggressive clinical syndrome.
Collapse
Affiliation(s)
- Melissa Nickles
- Department of Dermatology, University of Illinois, Chicago, IL
| | - Samantha Hunt
- Department of Dermatology, University of Illinois, Chicago, IL
| | | | - Amaara Babwah
- Department of Hematology, University of Illinois, Chicago, IL; and
| | - Nisreen Mobayed
- Department of Internal Medicine, University of Illinois, Chicago, IL
| | | | - Michelle Bain
- Department of Dermatology, University of Illinois, Chicago, IL
| | - John Quigley
- Department of Hematology, University of Illinois, Chicago, IL; and
| | - Paul Rubinstein
- Department of Hematology, University of Illinois, Chicago, IL; and
| | - Carlos Galvez
- Department of Hematology, University of Illinois, Chicago, IL; and
| |
Collapse
|
10
|
Wasifuddin M, Ilerhunmwuwa NP, Becerra H, Hakobyan N, Shrestha N, Uche IN, Lin H, Abowali H, Zheng J, Yadav R, Pokhrel A, Enayati L, Hare M, Hehr R, Kozii K, Gibadullin B, Avezbakiyev B, Wang JC. Racial disparities in the incidence and survival outcomes in diffuse large B-cell lymphoma in adolescents and young adults. Eur J Haematol 2024. [PMID: 38890006 DOI: 10.1111/ejh.14255] [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: 04/21/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
Diffuse large B-cell Lymphoma (DLBCL) is an aggressive subtype of non-Hodgkin lymphoma (NHL). The disease generally occurs in older patients. Although at a lower prevalence, the disease also occurs in the adolescent and young adult group (AYA). There is paucity of data in the literature on racial and ethnic disparities in the incidence and survival outcomes of DLBCL in the AYA group. The objective of our study is to demonstrate the disparities in these outcomes. Utilizing SEER, we obtained data on patient demographics, incidence, and survival from 2000 to 2020. We observed statistically significant reduced incidence of DLBCL in all racial groups, except the non-Hispanic Asian and Pacific Islander group (NHAPI). The non-Hispanic Black group (NHB) had one of the lowest survival despite showing the largest decrease in incidence in DLBCL. The differences in the survival could be secondary to socioeconomic factors, however other reasons need to be explored. The increased incidence among the NHAPI group mirrors that of large population-based studies in East Asian countries, however, underlying reasons have not been elucidated.
Collapse
Affiliation(s)
- Mustafa Wasifuddin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | | | - Henry Becerra
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Narek Hakobyan
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Neharika Shrestha
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ifeanyi Nnamdi Uche
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Htet Lin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Hesham Abowali
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Jin Zheng
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ruchi Yadav
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Akriti Pokhrel
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Ladan Enayati
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Mitchell Hare
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Rohan Hehr
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Khrystyna Kozii
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Bulat Gibadullin
- Department of Medicine, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Boris Avezbakiyev
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| | - Jen-Chin Wang
- Division of Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York, USA
| |
Collapse
|
11
|
Negara I, Tomuleasa C, Buruiana S, Efremov DG. Molecular Subtypes and the Role of TP53 in Diffuse Large B-Cell Lymphoma and Richter Syndrome. Cancers (Basel) 2024; 16:2170. [PMID: 38927876 PMCID: PMC11201917 DOI: 10.3390/cancers16122170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy and a heterogeneous entity comprised of several biologically distinct subtypes. Recently, novel genetic classifications of DLBCL have been resolved based on common mutational patterns indicative of distinct pathways of transformation. However, the complicated and costly nature of the novel classifiers has precluded their inclusion into routine practice. In view of this, the status of the TP53 gene, which is mutated or deleted in 20-30% of the cases, has emerged as an important prognostic factor for DLBCL patients, setting itself apart from other predictors. TP53 genetic lesions are particularly enriched in a genetic subtype of DLBCL that shares genomic features with Richter Syndrome, highlighting the possibility of a subset of DLBCL arising from the transformation of an occult chronic lymphocytic leukemia-like malignancy, such as monoclonal B-cell lymphocytosis. Patients with TP53-mutated DLBCL, including those with Richter Syndrome, have a particularly poor prognosis and display inferior responses to standard chemoimmunotherapy regimens. The data presented in this manuscript argue for the need for improved and more practical risk-stratification models for patients with DLBCL and show the potential for the use of TP53 mutational status for prognostication and, in prospect, treatment stratification in DLBCL.
Collapse
Affiliation(s)
- Ivan Negara
- Molecular Hematology Unit, International Centre for Genetic Engineering and Biotechnology, 34149 Trieste, Italy
- Department of Internal Medicine, Hematology, “Nicolae Testemitanu” State University of Medicine and Pharmacy, 2004 Chisinau, Moldova;
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Sanda Buruiana
- Department of Internal Medicine, Hematology, “Nicolae Testemitanu” State University of Medicine and Pharmacy, 2004 Chisinau, Moldova;
| | - Dimitar G. Efremov
- Molecular Hematology Unit, International Centre for Genetic Engineering and Biotechnology, 34149 Trieste, Italy
- Macedonian Academy of Sciences and Arts, 1000 Skopje, North Macedonia
| |
Collapse
|
12
|
Silkenstedt E, Salles G, Campo E, Dreyling M. B-cell non-Hodgkin lymphomas. Lancet 2024; 403:1791-1807. [PMID: 38614113 DOI: 10.1016/s0140-6736(23)02705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 07/31/2023] [Accepted: 11/30/2023] [Indexed: 04/15/2024]
Abstract
B-cell lymphomas occur with an incidence of 20 new cases per 100 000 people per year in high-income countries. They can affect any organ and are characterised by heterogeneous clinical presentations and courses, varying from asymptomatic, to indolent, to very aggressive cases. Since the topic of B-cell non-Hodgkin lymphomas was last reviewed in The Lancet in 2017, a deeper understanding of the biological background of this heterogeneous group of malignancies, the availability of new diagnostic methods, and the development and implementation of new targeted and immunotherapeutic approaches have improved our ability to treat patients. This Seminar provides an overview of the pathobiology, classification, and prognostication of B-cell non-Hodgkin lymphomas and summarises the current knowledge and standard of care regarding biology and clinical management of the most common subtypes of mature B-cell non-Hodgkin lymphomas. It also highlights new findings in deciphering the molecular background of disease development and the implementation of new therapeutic approaches, particularly those targeting the immune system.
Collapse
Affiliation(s)
| | - Gilles Salles
- Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Elias Campo
- Department of Pathology, Hospital Clinic, Institute for Biomedical Research August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | | |
Collapse
|
13
|
Daddacha W, Monroe D, Schlafstein A, Withers A, Thompson E, Danelia D, Luong N, Sesay F, Rath S, Usoro E, Essien M, Jung A, Jiang J, Hu J, Mahboubi B, Williams A, Steinbeck J, Yang X, Buchwald Z, Dynan W, Switchenko J, Kim B, Khan M, Jaye D, Yu D. SAMHD1 expression contributes to doxorubicin resistance and predicts survival outcomes in diffuse large B-cell lymphoma patients. NAR Cancer 2024; 6:zcae007. [PMID: 38406263 PMCID: PMC10894040 DOI: 10.1093/narcan/zcae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 01/31/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a commonly diagnosed, aggressive non-Hodgkin's lymphoma. While R-CHOP chemoimmunotherapy is potentially curative, about 40% of DLBCL patients will fail, highlighting the need to identify biomarkers to optimize management. SAMHD1 has a dNTPase-independent role in promoting resection to facilitate DNA double-strand break (DSB) repair by homologous recombination. We evaluated the relationship of SAMHD1 levels with sensitivity to DSB-sensitizing agents in DLBCL cells and the association of SAMHD1 expression with clinical outcomes in 79 DLBCL patients treated with definitive therapy and an independent cohort dataset of 234 DLBCL patients. Low SAMHD1 expression, Vpx-mediated, or siRNA-mediated degradation/depletion in DLBCL cells was associated with greater sensitivity to doxorubicin and PARP inhibitors. On Kaplan-Meier log-rank survival analysis, low SAMHD1 expression was associated with improved overall survival (OS), which on subset analysis remained significant only in patients with advanced stage (III-IV) and moderate to high risk (2-5 International Prognostic Index (IPI)). The association of low SAMHD1 expression with improved OS remained significant on multivariate analysis independent of other adverse factors, including IPI, and was validated in an independent cohort. Our findings suggest that SAMHD1 expression mediates doxorubicin resistance and may be an important prognostic biomarker in advanced, higher-risk DLBCL patients.
Collapse
Affiliation(s)
- Waaqo Daddacha
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Dominique Monroe
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Ashley J Schlafstein
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Allison E Withers
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Elizabeth B Thompson
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Diana Danelia
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nho C Luong
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Fatmata Sesay
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sandip K Rath
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Edidiong R Usoro
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Mark E Essien
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Andrew T Jung
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jinmeng G Jiang
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jiaxuan Hu
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Bijan Mahboubi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Arilyn Williams
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Julia E Steinbeck
- Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Zachary S Buchwald
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - William S Dynan
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Jeffrey M Switchenko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health and Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Baek Kim
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mohammad K Khan
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - David L Jaye
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - David S Yu
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| |
Collapse
|
14
|
Pagani C, Rusconi C, Dalla Pria A, Ravano E, Schommers P, Bastos-Oreiro M, Verga L, Gini G, Spina M, Arcaini L, Steffanoni S, Dalu D, Crucitti L, Lorenzi L, Balzarini P, Cattaneo C, Bongiovanni L, Rosenwald A, Facchetti F, Bower M, Ferreri AJM, Rossi G, Tucci A, Re A. MYC rearrangements in HIV-associated large B-cell lymphomas: EUROMYC, a European retrospective study. Blood Adv 2024; 8:968-977. [PMID: 38207206 PMCID: PMC10877133 DOI: 10.1182/bloodadvances.2023010704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/13/2024] Open
Abstract
ABSTRACT Large B-cell lymphoma (LBCL) carrying MYC rearrangement, alone or together with BCL2 and/or BCL6 translocations, have shown a poor prognosis when treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in the HIV population. Scanty data are available on the prevalence and prognostic impact of MYC rearrangements in HIV-associated LBCL. We conducted a retrospective study to evaluate the clinical effect of MYC rearrangement in HIV-associated LBCL. We evaluated clinical characteristics, treatment received, and outcome of LBCL in patients with HIV with MYC rearrangement (MYC+) and without MYC rearrangement (MYC-). A total of 155 patients with HIV who had received fluorescence in situ hybridization analysis for MYC were enrolled in 11 European centers: 43 with MYC+ and 112 MYC-. Among patients with MYC, 10 had double-/triple-hit lymphomas, and 33 had isolated MYC rearrangement (single-hit lymphoma). Patients with MYC+ had more frequently advanced stage, >2 extranodal site at presentation, and higher proliferative index. There were no significant differences in overall survival and progression-free survival (PFS) between the 2 groups. However, patients with MYC+ received more frequently intensive chemotherapy (iCT) (44%) than (R)CHOP alone (35%) or infusional treatment (DA-EPOCH-R and R-CDE) (19%). Among patients with MYC+, those who received iCT achieved a better outcome than patients who received nonintensive treatment (complete remission, 84% vs 52%; P = .028; 5-year PFS, 66% vs 36%; P = .021). Our retrospective results suggest that HIV-associated LBCL with MYC+ could be considered for an intensive therapeutic approach whenever possible, whereas (R)CHOP seems to give inferior results in this subset of patients in terms of complete remission and PFS.
Collapse
Affiliation(s)
- Chiara Pagani
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Rusconi
- Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessia Dalla Pria
- National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Emanuele Ravano
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Philipp Schommers
- Department of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mariana Bastos-Oreiro
- Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Luisa Verga
- Division of Hematology, Azienda Ospedaliera San Gerardo, Monza, Italy
| | - Guido Gini
- Division of Hematology, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy
| | - Michele Spina
- Medical Oncology Division, Centro Riferimento Oncologico, Aviano, Italy
| | - Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Steffanoni
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Dalu
- Department of Oncology, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Lara Crucitti
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Luisa Lorenzi
- Pathology Unit, ASST Spedali Civili di Brescia and Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Piera Balzarini
- Pathology Unit, ASST Spedali Civili di Brescia and Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Chiara Cattaneo
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Lucia Bongiovanni
- Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Fabio Facchetti
- Pathology Unit, ASST Spedali Civili di Brescia and Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Mark Bower
- National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom
| | - Andrés J. M. Ferreri
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Giuseppe Rossi
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Tucci
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandro Re
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| |
Collapse
|
15
|
Wu C, Chen S, Wu Z, Xue J, Zhang W, Wang S, Xindong Zhao, Wu S. Chidamide and orelabrutinib synergistically induce cell cycle arrest and apoptosis in diffuse large B-cell lymphoma by regulating the PI3K/AKT/mTOR pathway. J Cancer Res Clin Oncol 2024; 150:98. [PMID: 38381215 PMCID: PMC10881688 DOI: 10.1007/s00432-024-05615-7] [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: 11/05/2023] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The initial therapeutic approach for diffuse large B-cell lymphoma (DLBCL) entails a rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen. However, 40% of patients exhibit suboptimal responses, with some experiencing relapse and refractory conditions. This study aimed to explore novel therapeutic strategies and elucidate their underlying mechanisms in DLBCL. METHODS Bioinformatics techniques were employed to scrutinize correlations between the HDAC1, HDAC2, HDAC3, HDAC10, BTK, MYC, TP53, and BCL2 genes in DLBCL. In vitro experiments were conducted using DB and SU-DHL-4 cells treated with chidamide, orelabrutinib, and a combination of both. Cell viability was assessed by cell counting kit-8. Cell apoptosis and the cell cycle were determined using flow cytometry. Reactive oxygen species (ROS) production and mitochondrial function were assessed through ROS and JC-1 staining. RNA sequencing and western blot analyses were conducted to elucidate the molecular mechanisms underlying the combined action of chidamide and orelabrutinib in DLBCL cells. RESULTS This investigation revealed markedly enhanced antiproliferative effects when chidamide was combined with orelabrutinib. Compusyn software analysis indicated a synergistic effect of chidamide and orelabrutinib in inhibiting DLBCL cell proliferation, with a combination index (CI) < 1. This synergy further manifested as augmented cell cycle arrest, apoptosis induction, the downregulation of cell cycle-associated and antiapoptotic proteins, and the upregulation of proapoptotic proteins. Furthermore, the western blot and RNA-Seq findings suggested that combining chidamide and orelabrutinib modulated the PI3K/AKT/mTOR signaling pathway, thereby promoting DLBCL cell cycle arrest and apoptosis. CONCLUSION The findings of this study provide a compelling justification for the clinical utilization of chidamide and orelabrutinib to treat relapsed/refractory DLBCL.
Collapse
Affiliation(s)
- Chunyan Wu
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Shilv Chen
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Zhimin Wu
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Jiao Xue
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Wen Zhang
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Shan Wang
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China
| | - Xindong Zhao
- Department of Medicine, Qingdao University, Qingdao, China
| | - Shaoling Wu
- Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China.
| |
Collapse
|
16
|
Boltežar L, Rožman S, Gašljević G, Grčar Kuzmanov B, Jezeršek Novaković B. Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana. Biomedicines 2024; 12:275. [PMID: 38397877 PMCID: PMC10886998 DOI: 10.3390/biomedicines12020275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
High-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are known for their aggressive clinical course and so are the ones with MYC and BCL2 protein overexpression. The optimal therapy for these lymphomas remains to be elucidated. A retrospective analysis of all diffuse large B-cell lymphomas and high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements diagnosed between 2017 and 2021 at the Institute of Oncology Ljubljana, Slovenia, has been performed. Only patients with double-expressor lymphoma (DEL), double-hit lymphoma (DHL), or triple-hit lymphoma (THL) were included. Demographic and clinical parameters were assessed, as well as progression-free survival (PFS) and overall survival (OS). In total, 161 cases out of 309 (161/309; 52,1%) were classified as DEL. Sixteen patients had DHL, MYC/BCL2 rearrangement was observed in eleven patients, and MYC/BCL6 rearrangement was observed in five patients. Five patients were diagnosed with THL. Out of 154 patients (according to inclusion/exclusion criteria) included in further evaluation, one-hundred and thirty-five patients had double-expressor lymphoma (DEL), sixteen patients had DHL, and three patients had THL. In total, 169 patients were treated with R-CHOP, 10 with R-CHOP and intermediate-dose methotrexate, 19 with R-DA-EPOCH, and 16 with other regimens. The median follow-up was 22 months. The 5-year OS for the whole DEL group was 57.1% (95% CI 45.9-68.3%) and the 5-year PFS was 76.5% (95% CI 72.6-80.4%). The log-rank test disclosed no differences in survival between treatment groups (p = 0.712) while the high-risk international prognostic index (IPI) carried a significantly higher risk of death (HR 7.68, 95% CI 2.32-25.49, p = 0.001). The 5-year OS for DHL patients was 32.4% (95% CI 16.6-48.2%) while all three TH patients were deceased or lost to follow-up. Our analyses of real-life data disclose that the R-CHOP protocol with CNS prophylaxis is a successful and curative treatment for a substantial proportion of DEL patients.
Collapse
Affiliation(s)
- Lučka Boltežar
- Division of Medical Oncology, Institute of Oncology, Zaloška Cesta 2, 1000 Ljubljana, Slovenia;
- Medical Faculty, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| | - Samo Rožman
- Pharmacy, Institute of Oncology, Zaloška Cesta 2, 1000 Ljubljana, Slovenia;
| | - Gorana Gašljević
- Department of Pathology, Institute of Oncology, Zaloška Cesta 2, 1000 Ljubljana, Slovenia; (G.G.); (B.G.K.)
| | - Biljana Grčar Kuzmanov
- Department of Pathology, Institute of Oncology, Zaloška Cesta 2, 1000 Ljubljana, Slovenia; (G.G.); (B.G.K.)
| | - Barbara Jezeršek Novaković
- Division of Medical Oncology, Institute of Oncology, Zaloška Cesta 2, 1000 Ljubljana, Slovenia;
- Medical Faculty, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia
| |
Collapse
|
17
|
Pasvolsky O, Bassett RL, Ghanem S, Cuglievan B, Tewari P, Hosing C, Srour S, Ramdial J, Mahadeo KM, Khazal S, Petropoulos D, Popat U, Qazilbash M, Kebriaei P, Champlin R, Shpall EJ, Nieto Y. Characteristics and outcomes of children, adolescents and young adults with relapsed/refractory non-hodgkin lymphoma undergoing autologous stem cell transplant. BMC Cancer 2023; 23:1258. [PMID: 38124057 PMCID: PMC10734180 DOI: 10.1186/s12885-023-11712-6] [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: 05/13/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND There is paucity of data regarding outcomes of children, adolescents and young adults (CAYA) patients with non-Hodgkin lymphoma (NHL) undergoing autologous stem cell transplantation (ASCT). METHODS Patients aged 0-39 years undergoing first ASCT for NHL at MD Anderson Cancer Center between 2000 and 2020 were analyzed. RESULTS Two hundred twenty-one patients were included in the analysis, 129 (58%) were male and the median age was 32 (range 6-39) years. The most common histological subtypes were diffuse large B cell lymphoma (DLBCL) (44%), T-NHL (19%) and primary mediastinal B-Cell lymphoma (PMBCL) (19%). Younger patients (age ≤ 25) had lower incidence of DLBCL and higher incidence of PMBCL and T-NHL compared to older patients (age > 25) (P = 0.02). None of the younger patients had double hit (DH)/double expressor (DE) DLBCL, compared to 14 patients in the older age group (18%, P = 0.07). Considering the three main aggressive NHL subtypes (DLBCL, PMBCL and T-NHL), younger patients had numerically better 15-year post-transplant progression free survival (PFS) (67% vs. 54%) and overall survival (OS) (71% vs. 62%) compared to older patients, yet these differences did not reach statistical significance (P = 0.19 and P = 0.24, respectively). In multivariate analysis, not achieving a CR prior to ASCT was independently predictive of worse PFS [partial remission (PR) (HR, 3.9); stable disease (SD) (HR, 18.0), P = 0.03] and of worse OS [PR (HR, 4.2), SD (HR, 6.5) and progressive disease (HR, 4.7), P < 0.0001]. DH/DE status was an independent adverse predictor of PFS in multivariate analysis (HR 5.8, p = 0.03). Ten patients (4.5%) (all aged > 25 years) developed second primary malignancies (SPM), at a median of 34.4 (range, 1.0-196.6) months after ASCT, and SPM was the cause of death in five (50%) of them. CONCLUSIONS CAYA NHL patients aged ≤ 25 years who received ASCT presented a distinct NHL histology as compared to older CAYA patients, and none in this younger age group had DH/DE DLBCL. We observed a trend towards improved PFS and OS in younger patients. Disease status at ASCT was predictive of both PFS and OS. DH/DE status was an adverse predictor of PFS.
Collapse
Affiliation(s)
- Oren Pasvolsky
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roland L Bassett
- Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Sassine Ghanem
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Branko Cuglievan
- Department of Pediatrics Patient Care, Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Priti Tewari
- Department of Pediatrics Patient Care, Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Samer Srour
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Jeremy Ramdial
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Kris M Mahadeo
- Department of Pediatrics Patient Care, Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Sajad Khazal
- Department of Pediatrics Patient Care, Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Demetrios Petropoulos
- Department of Pediatrics Patient Care, Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Muzaffar Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center Unit 0432, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| |
Collapse
|
18
|
Qiu L, Lin P, Khanlari M, Xu J, Cohen EN, Garces S, Miranda RN, Wang W, Fang H, Bueso-Ramos CE, Medeiros LJ, Li S. The Clinicopathologic Features and Molecular Signatures of Blastoid High-Grade B Cell Lymphoma, Not Otherwise Specified. Mod Pathol 2023; 36:100349. [PMID: 37820764 DOI: 10.1016/j.modpat.2023.100349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
A small subset of high-grade B-cell lymphoma (HGBL) with blastoid morphology remains poorly understood. We assessed 55 cases of blastoid HGBL, not otherwise specified (NOS) and compared their clinicopathologic characteristics with those of 81 non-blastoid HGBL-NOS and 62 blastoid HGBL with MYC and BCL2, with or without BCL6 rearrangements (double/triple-hit lymphoma [D/THL]). Patients with blastoid HGBL-NOS showed similar clinicopathologic features to patients with blastoid D/THLs and non-blastoid HGBL-NOS, except more frequently with a history of low-grade B-cell lymphoma, bone marrow involvement, and BCL2 rearrangement (P < .05) compared to the latter. MYC rearrangement (MYC-R), detected in 40% of blastoid HGBL-NOS, was associated with aggressive clinicopathologic features and poorer overall survival, even worse than that of blastoid D/THL (P < .05). Transcriptome profiling revealed a distinct gene expression pattern with differentially expressed genes enriched in MYC and P53-targeted genes in MYC-R blastoid HGBL-NOS. Fifty-two percent of blastoid HGBL-NOS had a double hit-like signature, similar to non-blastoid HGBL-NOS (P = .73). The overall survival of the blastoid HGBL-NOS group was similar to that of the blastoid D/THL group but appeared poorer than that of its non-blastoid counterparts (P = .07). Taken together, blastoid HGBL-NOS is an aggressive B-cell lymphoma that shares overlapping clinicopathologic and genetic features with non-blastoid HGBL-NOS. MYC-R in patients with blastoid HGBL-NOS identifies a highly aggressive subgroup with distinct aggressive clinicopathologic features, unique molecular signatures, and a dismal clinical outcome.
Collapse
Affiliation(s)
- Lianqun Qiu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Evan N Cohen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sofia Garces
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| |
Collapse
|
19
|
Kosugi S, Kanno M, Inoue Y. Successful treatment of relapsed/refractory transformed aggressive B-cell lymphoma with polatuzumab vedotin combined with bendamustine and rituximab followed by non-myeloablative related HLA-haploidentical stem cell transplantation. Ann Hematol 2023; 102:3277-3278. [PMID: 37561153 DOI: 10.1007/s00277-023-05366-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/07/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Shigeki Kosugi
- Department of Hematology, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashi-Chou, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Masatoshi Kanno
- Department of Hematology, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashi-Chou, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan
| | - Yasuyuki Inoue
- Department of Hematology, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashi-Chou, Asahi-Ku, Yokohama, Kanagawa, 241-0811, Japan.
| |
Collapse
|
20
|
Su F, Lian K. Prognostic evaluation of system immune-inflammatory index and prognostic nutritional index in double expressor diffuse large B-cell lymphoma. Open Med (Wars) 2023; 18:20230819. [PMID: 37873542 PMCID: PMC10590612 DOI: 10.1515/med-2023-0819] [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: 05/08/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Predicting MYC and BCL2 double-expressor lymphoma prognosis using the system immune-inflammatory index (SII) and prognostic nutritional index (PNI) (DEL). From January 2015 to December 2021, 281 diffuse large B-cell lymphoma (DLBCL) wax blocks were used to make tissue chips. Screening double expressor lymphoma (DEL) instances involved immunocytochemistry and fluorescence in situ hybridization. Academic analysis used clinicopathological characteristics and follow-up data. SII, PNI, and DEL prognosis were correlated using univariate and multivariate cox regression analysis. The median age of 78 DEL patients is 60 (range: 43-74). SII and PNI cut-off values of 603.5, 3.07, and 144 predict PFS and OS well. Lower SII is associated with longer PFS (HR for SII = 0.34, 95% CI 0.15-0.76, P = 0.006; HR for NLR = 0.46, 95% CI 0.22-0.99, P = 0.048; HR for PLR = 0.39, 95% CI 0.17-0.94, P = 0.025; LMR = 0.39, 95%, CI 0.17-0.94, P = 0.025) and OS (HR for SII = 0.16, 95% CI 0.05-0.51, P = 0.005; HR for PNI = 0.20, 95% CI 0.06-0.62, P = 0.002). SII and PNI are promising predictors for twofold expressor DLBCL. Combining these increase prediction accuracy.
Collapse
Affiliation(s)
- Fang Su
- Department of Epidemic, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, 030013, China
| | - Ke Lian
- Department of Oncology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China
| |
Collapse
|
21
|
Wang X, He J, He H, Shuai Y, Wang L, Li Y, Huang Y, Yu K, Zhao M, Xie T, Li D. Myc rearrangement and concurrent high protein expression of C-Myc/Bcl2 carry an adverse prognosis in diffuse large B-cell lymphoma. Ann Diagn Pathol 2023; 66:152165. [PMID: 37348414 DOI: 10.1016/j.anndiagpath.2023.152165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of non-Hodgkin lymphoma, characterized by a variety of clinicopathological, histomorphological, immunophenotypic, and molecular genetic features. The subtype of DLBCL known as double-expressor lymphoma (DEL) is associated with an adverse prognosis when treated with R-CHOP. Our study aimed to investigate the clinicopathologic features of DEL and the prognostic roles of Myc rearrangement and C-Myc expression in DEL patients. PATIENTS AND METHODS We conducted a retrospective study of 145 patients who were identified through fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) testing. RESULTS We found that DEL patients were more likely to have a non-germinal center B-cell (GCB) subtype, stage III/IV disease, and a high International Prognostic Index (IPI) score. Our survival analysis indicated that Myc rearrangement and C-Myc expression were associated with poor prognosis. Although DEL patients with Myc rearrangement exhibited trends towards worse survival compared with patients without Myc rearrangement, the differences were not statistically significant (P = 0.4008). The median overall survival (OS) of DEL patients with ≥70 % C-Myc expression (DEL-C-Mychigh) was 5 months. In the DEL-C-Mychigh group, the non-GCB subtype showed nonsignificant trends towards poorer survival compared with the GCB subtype (P = 0.1042). CONCLUSION In conclusion, our study shows that a cut-off of ≥70 % for C-Myc expression in DEL patients can improve risk stratification, and suggests that more intensive treatment regimens may be necessary to improve survival in this high-risk population.
Collapse
Affiliation(s)
- Xingyu Wang
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Juan He
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Hong He
- Department of Internal Medicine, The First Branch, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yuhan Shuai
- Laboratory of Neuropsycholinguistics, Chongqing Medical University, Chongqing, China
| | - Lixin Wang
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yuanxin Li
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ying Huang
- Department of Pathology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Kuai Yu
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China; Department of Pathology, The Yongchuan Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Min Zhao
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Tao Xie
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China; Department of Ultrasound, The Daxuecheng Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Dan Li
- Department of Pathology, Faculty of Basic Medicine, Chongqing Medical University, Chongqing, China; Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, Chongqing, China; Department of Pathology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
| |
Collapse
|
22
|
Travaini LL, Botta F, Derenzini E, Lo Presti G, Ferrari ME, Airò Farulla LS, Radice T, Mazzara S, Tarella C, Pileri S, Raimondi S, Ceci F. [ 18 F]-FDG PET radiomic model as prognostic biomarker in diffuse large B-cell lymphoma. Hematol Oncol 2023; 41:674-682. [PMID: 37209024 DOI: 10.1002/hon.3171] [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: 08/26/2022] [Revised: 03/13/2023] [Accepted: 04/21/2023] [Indexed: 05/21/2023]
Abstract
To evaluate the association between radiomic features (RFs) extracted from 18 F-FDG PET/CT (18 F-FDG-PET) with progression-free survival (PFS) and overall survival (OS) in diffuse large-B-cell lymphoma (DLBCL) patients eligible to first-line chemotherapy. DLBCL patients who underwent 18 F-FDG-PET prior to first-line chemotherapy were retrospectively analyzed. RFs were extracted from the lesion showing the highest uptake. A radiomic score to predict PFS and OS was obtained by multivariable Elastic Net Cox model. Radiomic univariate model, clinical and combined clinical-radiomic multivariable models to predict PFS and OS were obtained. 112 patients were analyzed. Median follow-up was 34.7 months (Inter-Quartile Range (IQR) 11.3-66.3 months) for PFS and 41.1 (IQR 18.4-68.9) for OS. Radiomic score resulted associated with PFS and OS (p < 0.001), outperforming conventional PET parameters. C-index (95% CI) for PFS prediction were 0.67 (0.58-0.76), 0.81 (0.75-0.88) and 0.84 (0.77-0.91) for clinical, radiomic and combined clinical-radiomic model, respectively. C-index for OS were 0.77 (0.66-0.89), 0.84 (0.76-0.91) and 0.90 (0.81-0.98). In the Kaplan-Meier analysis (low-IPI vs. high-IPI), the radiomic score was significant predictor of PFS (p < 0.001). The radiomic score was an independent prognostic biomarker of survival in DLBCL patients. The extraction of RFs from baseline 18 F-FDG-PET might be proposed in DLBCL to stratify high-risk versus low-risk patients of relapse after first-line therapy, especially in low-IPI patients.
Collapse
Affiliation(s)
| | - Francesca Botta
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Enrico Derenzini
- Oncohematology Division, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Giuliana Lo Presti
- Department of Experimental Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | | | - Lighea Simona Airò Farulla
- Division of Nuclear Medicine, IEO European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Tommaso Radice
- Oncohematology Division, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Saveria Mazzara
- Haemolymphopathology Division, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Corrado Tarella
- Oncohematology Division, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Stefano Pileri
- Haemolymphopathology Division, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Ceci
- Division of Nuclear Medicine, IEO European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| |
Collapse
|
23
|
Zhou W, Miao J, Cheng Z, Wang Z, Wang J, Guo H, Wang P, Lu S, Si L, Zhang Z, Dunmall LC, Liu Y, Lemoine NR, Wang Y. Hypoxia-regulated secretion of IL-12 enhances antitumor activity and safety of CD19 CAR-T cells in the treatment of DLBCL. Mol Ther Oncolytics 2023; 30:216-226. [PMID: 37663131 PMCID: PMC10471514 DOI: 10.1016/j.omto.2023.08.009] [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: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 09/05/2023] Open
Abstract
CD19-targeted chimeric antigen receptor-modified T (CD19 CAR-T) cell therapy has been demonstrated as one of the most promising therapeutic strategies for treating B cell malignancies. However, it has shown limited treatment efficacy for diffuse large B cell lymphoma (DLBCL). This is, in part, due to the tumor heterogeneity and the hostile tumor microenvironment. Human interleukin-12 (IL-12), as a potent antitumor cytokine, has delivered encouraging outcomes in preclinical studies of DLBCL. However, potentially lethal toxicity associated with systemic administration precludes its clinical application. Here, an armed CD19 CAR expressing hypoxia-regulated IL-12 was developed (CAR19/hIL12ODD). In this vector, IL-12 secretion was restricted to hypoxic microenvironments within the tumor site by fusion of IL-12 with the oxygen degradation domain (ODD) of HIF1α. In vitro, CAR19/hIL12ODD-T cells could only secrete bioactive IL-12 under hypoxic conditions, accompanied by enhanced proliferation, robust IFN-γ secretion, increased abundance of CD4+, and central memory T cell phenotype. In vivo, adoptive transfer of CAR19/hIL12ODD-T cells significantly enhanced regression of large, established DLBCL xenografts in a novel immunodeficient Syrian hamster model. Notably, this targeted and controlled IL-12 treatment was without toxicity in this model. Taken together, our results suggest that armed CD19 CARs with hypoxia-controlled IL-12 (CAR19/hIL12ODD) might be a promising and safer approach for treating DLBCL.
Collapse
Affiliation(s)
- Wenping Zhou
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Jinxin Miao
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 45006, China
| | - Zhenguo Cheng
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Zhimin Wang
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Jianyao Wang
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Haoran Guo
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Pengju Wang
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Shuangshuang Lu
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Lingling Si
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Zhongxian Zhang
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
| | - Louisa Chard Dunmall
- Center for Cancer Biomarkers & Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, EC1M 6BQ London, UK
| | - Yanyan Liu
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Nicholas R. Lemoine
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
- Center for Cancer Biomarkers & Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, EC1M 6BQ London, UK
| | - Yaohe Wang
- Sino-British Research Centre for Molecular Oncology, National Centre for International Research in Cell and Gene Therapy, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou 450052, China
- Center for Cancer Biomarkers & Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, EC1M 6BQ London, UK
| |
Collapse
|
24
|
Al-Juhaishi T, Wang Y, Milton DR, Xu-Monette ZY, Jabbour E, Daher M, Im JS, Bashir Q, Iyer SP, Marin D, Olson AL, Popat U, Qazilbash M, Rondon G, Gulbis AM, Champlin RE, Young KH, Khouri IF. Clinical relevance of MYC/BCL2 expression and cell of origin in patients with diffuse large b-cell lymphoma treated with autologous transplant. Bone Marrow Transplant 2023; 58:1000-1007. [PMID: 37198234 PMCID: PMC11106757 DOI: 10.1038/s41409-023-02006-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
Dual expression of MYC and BCL2 proteins (double-expressor lymphoma [DEL]) as well as cell of origin (COO) are important prognostic factors in patients with diffuse large B-cell lymphoma (DLBCL) after conventional chemotherapy. We studied the prognostic impact of DEL and COO in patients with relapsed DLBCL treated with autologous stem cell transplant (ASCT). Three-hundred and three patients with stored tissue samples were identified. Classification was successful in 267 patients: 161 (60%) were DEL/non-double hit (DHL), 98 (37%) were non-DEL/non-DHL, and 8 (3%) were DEL/DHL. Compared to non-DEL/non-DHL, DEL/DHL had worse overall survival while DEL/non-DHL did not significantly differ in overall survival. On multivariable analysis, DEL/DHL, age >60 years, and >2 prior therapies, but not COO, were important prognostic factors for overall survival. When we explored the interaction of COO and BCL2 expression, patients with germinal center B-cell (GCB)/BCL2 (+) had inferior progression-free survival (PFS) compared to GCB/BCL2 (-) patients (HR, 4.97; P = 0.027). We conclude that the DEL/non-DHL and non-DEL/non-DHL subtypes of DLBCL have similar survival after ASCT. The negative impact of GCB/BCL2 (+) on PFS warrants future trials targeting BCL2 after ASCT. The inferior outcomes in DEL/DHL need to be verified in a larger number of patients.
Collapse
Affiliation(s)
- Taha Al-Juhaishi
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yingjun Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Hematopathology, Duke University Medical Center, Durham, NC, USA
| | - Denái R Milton
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zijun Y Xu-Monette
- Division of Hematopathology, Duke University Medical Center, Durham, NC, USA
| | - Elias Jabbour
- Departments of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - May Daher
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jin S Im
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qaiser Bashir
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan P Iyer
- Departments of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- The Departement of Lymphoma & Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Marin
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amanda L Olson
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Uday Popat
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Muzaffar Qazilbash
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriela Rondon
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alison M Gulbis
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard E Champlin
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Hematopathology, Duke University Medical Center, Durham, NC, USA
| | - Issa F Khouri
- Departments of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
25
|
Wang Y, Liu D, Zhang X, Zhang M, Li S, Feng X, Dong M, Ma S, Qian S, Wang Z, Zhang Y, Wang P, Mei S, Chen Q. MYC overexpression but not MYC/BCL2 double expression predicts survival in bulky mass diffuse large B-cell lymphoma patients. Cancer Med 2023; 12:18568-18577. [PMID: 37641492 PMCID: PMC10557898 DOI: 10.1002/cam4.6463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/06/2023] [Indexed: 08/31/2023] Open
Abstract
PURPOSE The prognostic factors for diffuse large B-cell lymphoma (DLBCL) have been fully explored, but prognostic information for bulky mass DLBCL patients is limited. This study aimed to analyze the prognostic value of MYC protein expression and other biological parameters in bulky mass DLBCL patients. METHODS We defined a bulky mass as a maximum tumor diameter ≥7.5 cm and studied 227 patients with de novo bulky mass DLBCL. RESULTS In all patients with bulky mass DLBCL, the 1-year and 3-year OS rates were 72.7% and 57.1%, respectively, and the 1-year and 3-year PFS rates were 52.0% and 42.5%, respectively. The MYC overexpression group (n = 140) showed significantly worse overall survival (OS; p = 0.019) and progression-free survival (PFS; p = 0.001) than the non-MYC overexpression group (n = 87). Subgroup analyses demonstrated that the MYC overexpression group was associated with inferior OS and PFS in the subgroups with the International Prognostic Index score of 3-5 (OS: p = 0.011; PFS: p < 0.001), Ann Arbor stage 3-4 (OS: p = 0.014; PFS: p < 0.001) and GCB subtype (OS: p = 0.014; PFS: p = 0.010). Consolidation radiotherapy improved OS and PFS in patients with bulky mass DLBCL (OS: p = 0.008; PFS: p = 0.004) as well as in those with MYC overexpression (OS: p = 0.001; PFS: p = 0.001). The prognostic value of MYC overexpression was maintained in a multivariate model adjusted for the International Prognostic Index. CONCLUSION MYC overexpression is a poor predictor for bulky mass DLBCL patients. Consolidation radiotherapy for residual disease after induction therapy may improve outcomes for patients with bulky mass DLBCL.
Collapse
Affiliation(s)
- Yanjie Wang
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Donglin Liu
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Xudong Zhang
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Mingzhi Zhang
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Shenglei Li
- Department of PathologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Xiaoyan Feng
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Meng Dong
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Shanshan Ma
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Siyu Qian
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Zeyuan Wang
- Department of PathologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Yue Zhang
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Pengyuan Wang
- Department of Medical OncologyXuchang Central HospitalXuchangChina
| | - Shuhao Mei
- Department of HematologyXuchang Central HospitalXuchangChina
| | - Qingjiang Chen
- Department of Oncology, Henan Province Lymphoma Treatment CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| |
Collapse
|
26
|
Shirouchi Y, Nishimura N, Mishima Y, Ishihara Y, Asai H, Tamba M, Hirano M, Hirano K, Teramoto Y, Yoshida K, Takeuchi K, Terauchi T, Maruyama D. Prognostic value of post-treatment serum soluble interleukin-2 receptor in newly diagnosed diffuse large B-cell lymphoma patients who achieved complete metabolic response following R-CHOP therapy. Sci Rep 2023; 13:13713. [PMID: 37608029 PMCID: PMC10444791 DOI: 10.1038/s41598-023-40026-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
Patients with DLBCL achieving complete metabolic response (CMR) after initial treatment with R-CHOP generally have a favourable prognosis; however, there are no established prognostic biomarkers for relapse in these patients. Soluble interleukin-2 receptor (sIL-2R) levels at diagnosis are prognostic factors in patients with DLBCL. However, the significance of post-treatment sIL-2R levels is unclear. To determine the significance of post-treatment serum sIL-2R levels on subsequent relapse and survival, we retrospectively analysed 485 patients with newly diagnosed DLBCL who received R-CHOP treatment and achieved CMR. The cumulative incidence of relapse (CIR) was significantly higher in patients with elevated post-treatment sIL-2R levels than in those with normal sIL-2R levels (five-year CIR; 38.8% vs. 12.8%). The prognostic value remained significant in multivariable analysis (hazard ratio, 2.30; p < 0.001). Five-year progression-free survival (49.0% vs. 83.5%) and overall survival (61.7% vs. 91.6%) rates were lower in patients with elevated post-treatment sIL-2R levels than in those with normal sIL-2R levels (p < 0.001 for both). In patients with newly diagnosed DLBCL who achieved CMR after R-CHOP treatment, the post-treatment serum sIL-2R level was an independent prognostic marker of subsequent relapse and survival.
Collapse
Affiliation(s)
- Yuko Shirouchi
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Noriko Nishimura
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Yuko Mishima
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Yuko Ishihara
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Hiroaki Asai
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Mikako Tamba
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Mitsuhito Hirano
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Kei Hirano
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Yukako Teramoto
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Kikuaki Yoshida
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Dai Maruyama
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31Ariake, Koto, Tokyo, Japan.
| |
Collapse
|
27
|
Shouse G, Kaempf A, Gordon MJ, Artz A, Yashar D, Sigmund AM, Smilnak G, Bair SM, Mian A, Fitzgerald LA, Bajwa A, Jaglowski S, Bailey N, Shadman M, Patel K, Stephens DM, Kamdar M, Hill BT, Gauthier J, Karmali R, Nastoupil LJ, Kittai AS, Danilov AV. A validated composite comorbidity index predicts outcomes of CAR T-cell therapy in patients with diffuse large B-cell lymphoma. Blood Adv 2023; 7:3516-3529. [PMID: 36735393 PMCID: PMC10362276 DOI: 10.1182/bloodadvances.2022009309] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/23/2022] [Accepted: 01/15/2023] [Indexed: 02/04/2023] Open
Abstract
Chimeric antigen receptor T-cell therapy (CART) has extended survival of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). However, limited durability of response and prevalent toxicities remain problematic. Identifying patients who are at high risk of disease progression, toxicity, and death would inform treatment decisions. Although the cumulative illness rating scale (CIRS) has been shown to correlate with survival in B-cell malignancies, no prognostic score has been independently validated in CART recipients. We retrospectively identified 577 patients with relapsed/refractory DLBCL indicated for CART at 9 academic centers to form a learning cohort (LC). Random survival forest modeling of overall survival (OS) and progression-free survival (PFS) was performed to determine the most influential CIRS organ systems and severity grades. The presence of a severe comorbidity (CIRS score ≥ 3) in the respiratory, upper gastrointestinal, hepatic, or renal system, herein termed "Severe4," had the greatest impact on post-CART survival. Controlling for other prognostic factors (number of prior therapies, Eastern Cooperative Oncology Group performance status, BCL6 translocation, and molecular subtype), Severe4 was strongly associated with shorter PFS and OS in the LC and in an independent single-center validation cohort (VC). Severe4 was also a significant predictor of grade ≥3 cytokine release syndrome in the LC, while maintaining this trend in the VC. Thus, our results indicate that adverse outcomes for patients with DLBCL meant to receive CART can be predicted using a simplified CIRS-derived comorbidity index.
Collapse
Affiliation(s)
- Geoffrey Shouse
- Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Andy Kaempf
- Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Max J. Gordon
- Department of Lymphoma, MD Anderson Cancer Center, Houston, TX
| | - Andy Artz
- Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - David Yashar
- Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Audrey M. Sigmund
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Gordon Smilnak
- Division of Hematology/Oncology, Northwestern University, Chicago, IL
| | - Steven M. Bair
- University of Colorado Cancer Center, University of Colorado, Aurora, CO
| | - Agrima Mian
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | | | - Amneet Bajwa
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Samantha Jaglowski
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Neil Bailey
- Center for Blood Disorders and Cellular Therapy, Swedish Cancer Institute, Seattle, WA
| | - Mazyar Shadman
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Krish Patel
- Center for Blood Disorders and Cellular Therapy, Swedish Cancer Institute, Seattle, WA
| | | | - Manali Kamdar
- University of Colorado Cancer Center, University of Colorado, Aurora, CO
| | - Brian T. Hill
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Jordan Gauthier
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Reem Karmali
- Division of Hematology/Oncology, Northwestern University, Chicago, IL
| | | | - Adam S. Kittai
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Alexey V. Danilov
- Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| |
Collapse
|
28
|
Zeremski V, Kropf S, Koehler M, Gebauer N, McPhail ED, Habermann T, Schieppati F, Mougiakakos D. Induction treatment in high-grade B-cell lymphoma with a concurrent MYC and BCL2 and/or BCL6 rearrangement: a systematic review and meta-analysis. Front Oncol 2023; 13:1188478. [PMID: 37546419 PMCID: PMC10399221 DOI: 10.3389/fonc.2023.1188478] [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: 03/17/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background and aim High-grade B cell lymphomas with concomitant MYC and BCL2 and/or BCL6 rearrangements (HGBCL-DH/TH) have a poor prognosis when treated with the standard R-CHOP-like chemoimmunotherapy protocol. Whether this can be improved using intensified regimens is still under debate. However, due to the rarity of HGBCL-DH/TH there are no prospective, randomized controlled trials (RCT) available. Thus, with this systematic review and meta-analysis we attempted to compare survival in HGBCL-DH/TH patients receiving intensified vs. R-CHOP(-like) regimens. Methods The PubMed and Web of Science databases were searched for original studies reporting on first-line treatment in HGBCL-DH/TH patients from 08/2014 until 04/2022. Studies with only localized stage disease, ≤10 patients, single-arm, non-full peer-reviewed publications, and preclinical studies were excluded. The quality of literature and the risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Random-effect models were used to compare R-CHOP-(like) and intensified regimens regarding 2-year overall survival (2y-OS) and 2-year progression-free survival (2y-PFS). Results Altogether, 11 retrospective studies, but no RCT, with 891 patients were included. Only four studies were of good quality based on aforementioned criteria. Intensified treatment could improve 2y-OS (hazard ratio [HR]=0.78 [95% confidence interval [CI] 0.63-0.96]; p=0.02) as well as 2y-PFS (HR=0.66 [95% CI 0.44-0.99]; p=0.045). Conclusions This meta-analysis indicates that intensified regimens could possibly improve 2y-OS and 2y-PFS in HGBCL-DH/TH patients. However, the significance of these results is mainly limited by data quality, data robustness, and its retrospective nature. There is still a need for innovative controlled clinical trials in this difficult to treat patient population. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42022313234.
Collapse
Affiliation(s)
- Vanja Zeremski
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Siegfried Kropf
- Department for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Michael Koehler
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Specialty Practice for Psycho-Oncology, Magdeburg, Germany
| | - Niklas Gebauer
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Luebeck, Germany
| | - Ellen D. McPhail
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Thomas Habermann
- Division of Hematology, Mayo Clinic, Rochester, MN, United States
| | | | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| |
Collapse
|
29
|
Li J, Tang X, Luo X, Liu L, Li D, Yang L. Clinicopathological analysis and specific discriminating markers of interleukin detection in cerebrospinal fluid with primary central nervous system lymphoma: results from a retrospective study. Ann Hematol 2023:10.1007/s00277-023-05301-7. [PMID: 37289220 DOI: 10.1007/s00277-023-05301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/26/2023] [Indexed: 06/09/2023]
Abstract
Primary central nervous system lymphoma (PCNSL) is special extranodal malignant non-Hodgkin lymphomas. This study analyzed clinical features and prognostic factors of PCNSL and evaluated the difference of interleukin (IL) concentrations in cerebrospinal fluid (CSF) between PCNSL and systemic non-Hodgkin lymphoma (sNHL). Patients consecutive newly diagnosed with PCNSL were recruited, the demographic and clinicopathological data were retrospectively analyzed, and the potential prognostic factors for overall survival (OS) were identified with survival analysis. 27 patients with PCNSL and 21 patients with sNHL collected CSF IL-5, IL-6, and IL-10 concentrations at diagnosis. The difference in interleukin (IL) concentrations in two diseases was analyzed to evaluate the value of IL concentrations. A total of 64 patients with PCNSL were enrolled, the median age was 54.50 years (range 16-85 years); male: female ratio was 1.91. Headache was the most common complaint symptom involved in 42.19% (27/64) of patients. Diffuse large B-cell lymphoma (DLBCL) accounted for 89.06% (57/64) of patients; other uncommon types accounted for 3.13% (2/64). In prognostic analysis, multiple lesions and Ki67 ≥ 75% expression exhibited a worse prognosis(P = 0.041), and patients with autologous hematopoietic stem cell transplantation (auto-HSCT) treatment presented superior OS (P < 0.05). In multivariate analysis, BCL2 expression was revealed as an unfavorable prognostic marker, and auto-HSCT was revealed as a favorable prognostic marker. CSF IL-10 concentration in patients with PCNSL was significantly higher than sNHL (P = 0.000) and excluded other histopathology of NHL; IL-10 value was still significantly different between DLBCL of PCNSL and sDLBCL (P = 0.003). In ROC curve analysis, the cutoff value of IL-10 was 0.43 pg/mL for the diagnosis value of PCNSL, sensitivity was 96.3%, specificity was 66.67%, and AUC was 0.84 (0.71-0.96). Although IL-6 concentration did not differ in the two groups, IL-10/IL-6 ratio was meaningful, with a cutoff value of 0.21, sensitivity of 81.48%, specificity of 80.95%, and AUC of 0.83 (0.71-0.95). This study highlights the characteristics of patients with PCNSL, potential prognostic makers also have been explained. CSF interleukin (IL) concentrations revealed IL-10 levels, and IL-10/IL-6 ratio may represent a useful biomarker in the differential diagnosis of PCNSL and sNHL.
Collapse
Affiliation(s)
- Junnan Li
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, No.1, You-Yi Road, District of Yu-Zhong, Chongqing, 400016, China
| | - Xiaoqiong Tang
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, No.1, You-Yi Road, District of Yu-Zhong, Chongqing, 400016, China
| | - Xiaohua Luo
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, No.1, You-Yi Road, District of Yu-Zhong, Chongqing, 400016, China
| | - Lin Liu
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, No.1, You-Yi Road, District of Yu-Zhong, Chongqing, 400016, China
| | - Dan Li
- Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Li Yang
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, No.1, You-Yi Road, District of Yu-Zhong, Chongqing, 400016, China.
| |
Collapse
|
30
|
Hoppe MM, Jaynes P, Shuangyi F, Peng Y, Sridhar S, Hoang PM, Liu CX, De Mel S, Poon L, Chan EHL, Lee J, Ong CK, Tang T, Lim ST, Nagarajan C, Grigoropoulos NF, Tan SY, Hue SSS, Chang ST, Chuang SS, Li S, Khoury JD, Choi H, Harris C, Bottos A, Gay LJ, Runge HF, Moutsopoulos I, Mohorianu I, Hodson DJ, Farinha P, Mottok A, Scott DW, Pitt JJ, Chen J, Kumar G, Kannan K, Chng WJ, Chee YL, Ng SB, Tripodo C, Jeyasekharan AD. Patterns of Oncogene Coexpression at Single-Cell Resolution Influence Survival in Lymphoma. Cancer Discov 2023; 13:1144-1163. [PMID: 37071673 PMCID: PMC10157367 DOI: 10.1158/2159-8290.cd-22-0998] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/29/2022] [Accepted: 02/13/2023] [Indexed: 04/19/2023]
Abstract
Cancers often overexpress multiple clinically relevant oncogenes, but it is not known if combinations of oncogenes in cellular subpopulations within a cancer influence clinical outcomes. Using quantitative multispectral imaging of the prognostically relevant oncogenes MYC, BCL2, and BCL6 in diffuse large B-cell lymphoma (DLBCL), we show that the percentage of cells with a unique combination MYC+BCL2+BCL6- (M+2+6-) consistently predicts survival across four independent cohorts (n = 449), an effect not observed with other combinations including M+2+6+. We show that the M+2+6- percentage can be mathematically derived from quantitative measurements of the individual oncogenes and correlates with survival in IHC (n = 316) and gene expression (n = 2,521) datasets. Comparative bulk/single-cell transcriptomic analyses of DLBCL samples and MYC/BCL2/BCL6-transformed primary B cells identify molecular features, including cyclin D2 and PI3K/AKT as candidate regulators of M+2+6- unfavorable biology. Similar analyses evaluating oncogenic combinations at single-cell resolution in other cancers may facilitate an understanding of cancer evolution and therapy resistance. SIGNIFICANCE Using single-cell-resolved multiplexed imaging, we show that selected subpopulations of cells expressing specific combinations of oncogenes influence clinical outcomes in lymphoma. We describe a probabilistic metric for the estimation of cellular oncogenic coexpression from IHC or bulk transcriptomes, with possible implications for prognostication and therapeutic target discovery in cancer. This article is highlighted in the In This Issue feature, p. 1027.
Collapse
Affiliation(s)
- Michal Marek Hoppe
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Patrick Jaynes
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Fan Shuangyi
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanfen Peng
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Shruti Sridhar
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Phuong Mai Hoang
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
| | - Clementine Xin Liu
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
| | - Sanjay De Mel
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Limei Poon
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Esther Hian Li Chan
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joanne Lee
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Choon Kiat Ong
- Division of Cellular and Molecular Research, National Cancer Centre Singapore, Singapore, Singapore
| | - Tiffany Tang
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Soon Thye Lim
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | | | - Soo-Yong Tan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan Swee-Shan Hue
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sheng-Tsung Chang
- Department of Pathology, Chi-Mei Medical Center, Tainan City, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan City, Taiwan
| | - Shaoying Li
- Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph D. Khoury
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Hyungwon Choi
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Carl Harris
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Laura J. Gay
- Wellcome MRC Cambridge Stem Cell Institute, Cambridge, United Kingdom
| | | | | | - Irina Mohorianu
- Wellcome MRC Cambridge Stem Cell Institute, Cambridge, United Kingdom
| | - Daniel J. Hodson
- Wellcome MRC Cambridge Stem Cell Institute, Cambridge, United Kingdom
| | | | - Anja Mottok
- BC Cancer Research Centre, Vancouver, Canada
| | | | - Jason J. Pitt
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jinmiao Chen
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore, Singapore
| | - Gayatri Kumar
- Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kasthuri Kannan
- Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wee Joo Chng
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yen Lin Chee
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siok-Bian Ng
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Claudio Tripodo
- Tumor Immunology Unit, University of Palermo, Palermo, Italy
- IFOM ETS – The AIRC Institute of Molecular Oncology, Milan, Italy
| | - Anand D. Jeyasekharan
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore
- Department of Haematology-Oncology, National University Health System, Singapore, Singapore
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
31
|
Tang G, Li S, Toruner GA, Jain P, Tang Z, Hu S, Xu J, Cheng J, Robinson M, Vega F, Medeiros LJ. Clinical impact of 5 'MYC or 3 'MYC gain/loss detected by FISH in patients with aggressive B-cell lymphomas. Cancer Genet 2023; 272-273:1-8. [PMID: 36566629 DOI: 10.1016/j.cancergen.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/07/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022]
Abstract
FISH analysis using MYC break-apart probes is a widely used technique to assess for MYC rearrangement (MYC-R). Occasionally, FISH results in atypical signal patterns, such as gain or loss of 5'MYC or 3'MYC. The clinical impact and/or relationship of these atypical signal patterns to MYC-R are unknown. In this study, we assessed 35 patients who had aggressive B-cell lymphomas and exhibited atypical FISH signal patterns: 3'MYC deletion (n = 16) or 3'MYC deletion plus 5'MYC amplification (n = 5), 5'MYC gain (n = 10), 5'MYC deletion (n = 3), and 3'MYC gain (n = 1). For comparison, we also included 9 patients who showed an unbalanced MYC-R. Patients with 5'MYC gain showed MYC expression and were often refractory to chemotherapy (n = 7) or had early relapse (n = 2). By contrast, lymphomas with 3'MYC deletion were negative or had low expression of MYC (16 of 18), and patients often responded to chemotherapy (16 of 19). The median event-free survival was 24, 6, and 4 months for patients with 3'MYC deletion, 5'MYC gain and unbalanced MYC-R, respectively (p = 0.0048). We conclude that 5'MYC gain is associated with MYC expression and a poorer prognosis and likely represents an unbalanced MYC-R. By contrast, 3'MYC deletions are not associated with MYC expression or a poorer prognosis and this finding may be unrelated to MYC-R.
Collapse
Affiliation(s)
- 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
| | - Gokce A Toruner
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Preetesh Jain
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shimin Hu
- 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
| | - Joanne Cheng
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Melissa Robinson
- 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
| |
Collapse
|
32
|
Koviazin AK, Filatova LV, Zyuzgin IS, Artemyeva AS, Poliatskin IL, Burda DS, Volchenkov SA, Elkhova SS, Semiglazova TY. The significance of upfront autologous stem cell transplantation for high-intermediate/high-risk stage IV diffuse large B-cell lymphoma. Cancer Rep (Hoboken) 2023; 6:e1786. [PMID: 36855295 PMCID: PMC10075296 DOI: 10.1002/cnr2.1786] [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: 08/31/2022] [Revised: 12/03/2022] [Accepted: 12/31/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is the most common (30%-35%) type of B-cell lymphoma. Only about 60% of all newly diagnosed advanced-stage DLBCL can be completely treated with x6 R-CHOP. High-dose chemotherapy (HDCT) followed by autologous hematopoietic stem cell transplantation in the first remission (upfront auto-HSCT) can serve as an option to improve a prognosis in these patients. AIMS This trial aimed to improve prognosis in DLBCL by upfront auto-HSCT. METHODS AND RESULTS A group of 105 patients: DLBCL NOS, age 18-65, stage IV, IPI ≥2, CR/PR after x6 R-CHOP/DA-EPOCH-R from 2010 to 2019 at NMRC of Oncology named after N.N.Petrov of MoH of Russia was retrospectively analyzed. The HSCT group included patients with upfront HDCT followed by auto-HSCT (n = 35). The control group included patients with non-invasive follow-up after induction (n = 70). Primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), response rate and relapse rate. The 3-year OS (p = .013) and 3-year PFS (p = .033) were significantly higher in the HSCT group. The 3-year OS was decreased by the occurrence of relapse (p ≤ .001) and weight loss (B-symptom) (p = .04). DEL was the negative prognostic factor for 3-year PFS in all patients (p = .001) and control group (p = .001). DA-EPOCH-R significantly increased the 3-year PFS (p = .041). CONCLUSION Upfront HDCT followed by auto-HSCT can increase 3-year OS and PFS and improve prognosis in DLBCL NOS, age 18-65, stage IV, IPI ≥2 patients.
Collapse
Affiliation(s)
- Aleksei K Koviazin
- Department of Hematology and Chemotherapy with Intensive Care Unit, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation.,Department of Innovative Methods in Therapeutic Oncology and Rehabilitation, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Larisa V Filatova
- Department of Hematology and Chemotherapy with Intensive Care Unit, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation.,Department of Innovative Methods in Therapeutic Oncology and Rehabilitation, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation.,Department of Oncology, Federal State Budgetary Educational Institution of Higher Education "North-Western State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Ilia S Zyuzgin
- Department of Hematology and Chemotherapy with Intensive Care Unit, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Anna S Artemyeva
- Laboratory of Tumor Morphology, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Ilia L Poliatskin
- Laboratory of Tumor Morphology, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Darya S Burda
- Laboratory of Tumor Morphology, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Stanislav A Volchenkov
- Department of Hematology and Chemotherapy with Intensive Care Unit, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Svetlana S Elkhova
- Department of Hematology and Chemotherapy with Intensive Care Unit, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Tatiana Yu Semiglazova
- Department of Innovative Methods in Therapeutic Oncology and Rehabilitation, NMRC of Oncology n.a. N.N.Petrov of MoH of Russia, Federal State Budgetary Institution "Petrov National Medical Cancer Research Centre" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation.,Department of Oncology, Federal State Budgetary Educational Institution of Higher Education "North-Western State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| |
Collapse
|
33
|
Nieto Y, Pasvolsky O, Bassett R, Ghanem S, Cuglievan B, Tewari P, Hosing C, Srour S, Ramdial J, Mahadeo K, Khazal S, Petropoulos D, Popat U, Qazilbash M, Kebriaei P, Champlin R, Shpall E. Characteristics and Outcomes of Children, Adolescents and Young Adults with Relapsed/Refractory Non-Hodgkin Lymphoma Undergoing Autologous Stem Cell Transplant. RESEARCH SQUARE 2023:rs.3.rs-2531406. [PMID: 36798261 PMCID: PMC9934761 DOI: 10.21203/rs.3.rs-2531406/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
There is paucity of data regarding outcomes of children, adolescents and young adults (CAYA) patients with non-Hodgkin lymphoma (NHL) undergoing autologous hematopoietic stem cell transplantation (ASCT). We analyzed 222 patients aged 0-39 years undergoing first ASCT for NHL between 2000 and 2020. The most common histological subtypes were DLBCL (44%), T-NHL (19%) and PMBCL (19%). Younger patients (age ≤ 25) had lower incidence of DLBCL and higher incidence of PMBCL and T-NHL compared to older patients (> 25 years) (P = 0.02). None of the younger patients had DH)/DE DLBCL, as compared to 14 patients in the older group (18%, P = 0.07). Younger patients had numerically better 15-year post-transplant PFS (67% vs. 54%) and OS (71% vs. 62%) compared to older patients, without statistically significant differences (P = 0.19 and P = 0.24, respectively). In MVA, not achieving a CR prior to ASCT was independently predictive of worse PFS (P < 0.0001). DH/DE status was an independent adverse predictor of PFS in MVA (HR 5.8, p = 0.03). 10 patients(4.5%) (all aged > 25 years) developed SPM Patients aged ≤ 25 years presented a distinct NHL histology as compared to older CAYA patients. Disease status at ASCT was predictive of both PFS and OS. DH/DE status was an adverse predictor of PFS.
Collapse
Affiliation(s)
- Yago Nieto
- MD Anderson Cancer Center, University of Texas
| | | | | | | | | | - Priti Tewari
- The University of Texas MD Anderson Cancer Center
| | | | - Samer Srour
- The University of Texas MD Anderson Cancer Center
| | | | - Kris Mahadeo
- The University of Texas MD Anderson Cancer Center
| | - Sajad Khazal
- The University of Texas MD Anderson Cancer Center
| | | | - Uday Popat
- The University of Texas MD Anderson Cancer Center
| | | | | | | | | |
Collapse
|
34
|
Li S, Qiu L, Xu J, Lin P, Ok CY, Tang G, McDonnell TJ, James You M, Khanlari M, Miranda RN, Medeiros LJ. High-grade B-cell lymphoma (HGBL)-NOS is clinicopathologically and genetically more similar to DLBCL/HGBL-DH than DLBCL. Leukemia 2023; 37:422-432. [PMID: 36513804 DOI: 10.1038/s41375-022-01778-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022]
Abstract
High-grade B-cell lymphoma, not otherwise specified (HGBL-NOS) is rare and data focused on these neoplasms is lacking. We studied the clinicopathologic and genetic features of 136 HGBL-NOS patients and compared them to patients with DLBCL/HGBL-DH (n = 224, defined by 5th Edition WHO) and DLBCL (n = 217). HGBL-NOS patients had clinical features similar to DLBCL/HGBL-DH patients. MYC rearrangement (MYC-R) was present in 43% of HGBL-NOS. With induction regimen similar to DLBCL/HGBL-DH patients, HGBL-NOS patients had a median overall survival (OS) of 28.9 months, similar to DLBCL/HGBL-DH (p = 0.48) but inferior to DLBCL patients (p = 0.03). R-EPOCH induction was associated with improved OS compared with R-CHOP. MYC-R, history of lymphoma, and high IPI were independent adverse prognostic factors in HGBL-NOS patients. Whole transcriptome profiling performed on a subset of HGBL-NOS cases showed a profile more similar to DLBCL/HGBL-DH than to DLBCL; 53% of HGBL-NOS had a DH-like signature (DH-like-Sig) and were enriched for MYC-R. DH-like-Sig+ HGBL-NOS patients had a poorer OS than DH-like-Sig-negative patients (p = 0.04). In conclusion, HGBL-NOS has clinicopathologic features and a gene expression profile more similar to DLBCL/HGBL-DH than to DLBCL. Cases of HGBL-NOS frequently carry MYC-R and have a DH-like-Sig+. R-EPOCH induction in HGBL-NOS appears associated with improved OS compared with standard R-CHOP.
Collapse
Affiliation(s)
- Shaoying Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States.
| | - Lianqun Qiu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Jie Xu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Pei Lin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Chi Young Ok
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Guilin Tang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Timothy J McDonnell
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - M James You
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Mahsa Khanlari
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Roberto N Miranda
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - L Jeffrey Medeiros
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| |
Collapse
|
35
|
Melchor J, Garcia-Lacarte M, Grijalba SC, Arnaiz-Leché A, Pascual M, Panizo C, Blanco O, Segura V, Novo FJ, Valero JG, Pérez-Galán P, Martinez-Climent JA, Roa S. Venetoclax improves CD20 immunotherapy in a mouse model of MYC/BCL2 double-expressor diffuse large B-cell lymphoma. J Immunother Cancer 2023; 11:jitc-2022-006113. [PMID: 36854569 PMCID: PMC9980368 DOI: 10.1136/jitc-2022-006113] [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] [Accepted: 02/12/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Approximately one-third of diffuse large B cell lymphoma (DLBCL) patients exhibit co-expression of MYC and BCL2 (double-expressor lymphoma, DEL) and have a dismal prognosis. Targeted inhibition of the anti-apoptotic protein BCL2 with venetoclax (ABT-199) has been approved in multiple B-cell malignancies and is currently being investigated in clinical trials for DLBCL. Whether BCL2 anti-apoptotic function represents a multifaceted vulnerability for DEL-DLBCL, affecting both lymphoma B cells and T cells within the tumor microenvironment, remains to be elucidated. METHODS Here, we present novel genetically engineered mice that preclinically recapitulate DEL-DLBCL lymphomagenesis, and evaluate their sensitivity ex vivo and in vivo to the promising combination of venetoclax with anti-CD20-based standard immunotherapy. RESULTS Venetoclax treatment demonstrated specific killing of MYC+/BCL2+ lymphoma cells by licensing their intrinsically primed apoptosis, and showed previously unrecognized immunomodulatory activity by specifically enriching antigen-activated effector CD8 T cells infiltrating the tumors. Whereas DEL-DLBCL mice were refractory to venetoclax alone, inhibition of BCL2 significantly extended overall survival of mice that were simultaneously treated with a murine surrogate for anti-CD20 rituximab. CONCLUSIONS These results suggest that the combination of anti-CD20-based immunotherapy and BCL2 inhibition leads to cooperative immunomodulatory effects and improved preclinical responses, which may offer promising therapeutic opportunities for DEL-DLBCL patients.
Collapse
Affiliation(s)
- Javier Melchor
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Hemato-Oncology Program, Center for Applied Medical Research (CIMA), Pamplona, Spain
| | - Marcos Garcia-Lacarte
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Hemato-Oncology Program, Center for Applied Medical Research (CIMA), Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Sara C Grijalba
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Adrián Arnaiz-Leché
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marién Pascual
- Hemato-Oncology Program, Center for Applied Medical Research (CIMA), Pamplona, Spain
| | - Carlos Panizo
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Hematology, Clinica Universidad de Navarra, Pamplona, Spain
- Current address: Department of Hematology and Hemotherapy, Hospital Universitario Donostia, San Sebastián, Spain
| | - Oscar Blanco
- Department of Pathology, Universidad de Salamanca, Salamanca, Spain
| | - Victor Segura
- Bio-informatic Unit, Center for Applied Medical Research (CIMA), Pamplona, Spain
- Current address: Data Intelligence Unit, Techedge Spain, Madrid, Spain
| | - Francisco J Novo
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Juan Garcia Valero
- Department of Hematology-Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Patricia Pérez-Galán
- Department of Hematology-Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A Martinez-Climent
- Hemato-Oncology Program, Center for Applied Medical Research (CIMA), Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Roa
- Department of Biochemistry and Genetics, Universidad de Navarra, Pamplona, Spain
- Hemato-Oncology Program, Center for Applied Medical Research (CIMA), Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
36
|
Xing L, Wang H, Liu D, He Q, Li Z. Case report: Successful management of a refractory double-expressor diffuse large B-cell lymphoma patient under the guidance of in vitro high-throughput drug sensitivity test. Front Oncol 2023; 12:1079890. [PMID: 36741708 PMCID: PMC9890053 DOI: 10.3389/fonc.2022.1079890] [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: 10/25/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction Double-expressor diffuse large B-cell lymphoma (DEL), harboring double expression of MYC and BCL2, has an inferior prognosis following standard first-line therapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). We initiated a clinical trial to treat newly diagnosed DEL with R-CHOP plus Bruton's tyrosine kinase (BTK) inhibitor (BTKi) zanubrutinib (ZR-CHOP) and achieved a high complete response (CR) rate while four patients progressed during therapy, one of them carrying ATM and CD58 mutations. We applied an in vitro high-throughput drug sensitivity test for the prediction of clinical responses to different drugs in this patient. Case presentation We report a 30-year-old female patient diagnosed with stage III (DEL), with ATM and CD58 mutations. The patient achieved partial response (PR) after two cycles of ZR-CHOP and remained PR after four cycles of ZR-CHOP, while the disease progressed after six cycles of ZR-CHOP. High-throughput drug screening using a panel of 117 compounds identified a range of therapies with efficacy for this patient. The primary tumor cells showed moderate sensitivity to bortezomib, thalidomide, and gemcitabine as a single agent and bortezomib, thalidomide, and dexamethasone (VTD) as a combined regimen. The patient was treated with two cycles of VTD regimen (bortezomib 1.3 mg/m2, d1, 4, 8, 11; thalidomide 100 mg, d1-21; dexamethasone 20 mg, d1, 2, 4, 5, 8, 9) and achieved PR with only a small lesion left. Another two cycles of VTD plus gemcitabine were then administered, and the patient achieved CR. Stem cells were mobilized, and autologous hematopoietic stem cell transplantation was carried out afterward. The patient remained CR for more than 3 months after transplantation. Conclusion In this article, we present a first-line chemoresistant DEL patient with ATM and CD58 mutations who was treated successfully with VTD plus gemcitabine under the guidance of in vitro high-throughput drug sensitivity test.
Collapse
|
37
|
Chen H, Qin Y, Liu P, Yang J, Gui L, He X, Zhang C, Zhou S, Zhou L, Yang S, Shi Y. Genetic Profiling of Diffuse Large B-Cell Lymphoma: A Comparison Between Double-Expressor Lymphoma and Non-Double-Expressor Lymphoma. Mol Diagn Ther 2023; 27:75-86. [PMID: 36401148 DOI: 10.1007/s40291-022-00621-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Data are limited regarding the genetic profiling of diffuse large B-cell lymphoma (DLBCL) with double expression of MYC and BCL2 proteins without underlying rearrangements (double-expressor lymphoma [DEL]). This study aimed to describe the genetic profiling and determine the prognostic significance in patients with DEL and in those with non-DEL. METHODS Capture-based targeted sequencing was performed on 244 patients with de novo DLBCL, not otherwise specified. Immunohistochemistry staining was performed for evaluating the MYC and BCL2 expression. RESULTS Among 244 patients, 46 patients had DEL, and 198 had non-DEL. KMT2D, CD58, EP300, PRDM1, TNFAIP3 and BCL2 gain or amplification (BCL2GA/AMP) were significantly more frequently altered in the DEL group. Alterations in the BCR/TLR (p = 0.021), B-cell development and differentiation (p = 0.004), and NF-κB (p = 0.034) pathways occurred more frequently in patients with DEL. Thirty-seven DEL patients and 132 non-DEL patients were included for survival analyses. DEL was not significantly associated with progression-free survival (PFS) (p = 0.60) and overall survival (OS) (p = 0.49). In DEL patients, after adjusting for the International Prognostic Index, BCL2 alteration (HR 2.516, 95% CI 1.027-6.161; p = 0.044) remained an independent predictor of inferior PFS. BCL2GA/AMP also predicted poor PFS, but with marginal statistical significance (HR 2.489, 95% CI 0.995-6.224; p = 0.051). CONCLUSION There was difference in profiling of altered genes and signaling pathways between the DEL group and the non-DEL group. The presence of DEL alone should not be considered as an adverse prognostic indicator, and BCL2 alteration could define a subset of patients with poor prognosis within DEL.
Collapse
Affiliation(s)
- Haizhu Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Yan Qin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Peng Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Jianliang Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Lin Gui
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Xiaohui He
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Changgong Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Shengyu Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Liqiang Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Sheng Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| |
Collapse
|
38
|
Baptista MJ, Tapia G, Muñoz‐Marmol A, Muncunill J, Garcia O, Montoto S, Gribben JG, Calaminici M, Martinez A, Veloza L, Martínez‐Trillos A, Aldamiz T, Menarguez J, Terol M, Ferrandez A, Alcoceba M, Briones J, González‐Barca E, Climent F, Muntañola A, Moraleda J, Provencio M, Abrisqueta P, Abella E, Colomo L, García‐Ballesteros C, Garcia‐Caro M, Sancho J, Ribera J, Mate J, Navarro J. Genetic and phenotypic characterisation of HIV-associated aggressive B-cell non-Hodgkin lymphomas, which do not occur specifically in this population: diagnostic and prognostic implications. Histopathology 2022; 81:826-840. [PMID: 36109172 PMCID: PMC9828544 DOI: 10.1111/his.14798] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/01/2022] [Accepted: 09/12/2022] [Indexed: 01/12/2023]
Abstract
The frequency of aggressive subtypes of B-cell non-Hodgkin lymphoma (B-NHL), such as high-grade B-cell lymphomas (HGBL) with MYC and BCL2 and/or BCL6 rearrangement (HGBL-DH/TH) or Burkitt-like lymphoma (BL) with 11q aberration, is not well known in the HIV setting. We aimed to characterise HIV-associated aggressive B-NHL according to the 2017 WHO criteria, and to identify genotypic and phenotypic features with prognostic impact. Seventy-five HIV-associated aggressive B-NHL were studied by immunohistochemistry (CD10, BCL2, BCL6, MUM1, MYC, and CD30), EBV-encoded RNAs (EBERs), and fluorescence in situ hybridisation (FISH) to evaluate the status of the MYC, BCL2, and BCL6 genes and chromosome 11q. The 2017 WHO classification criteria and the Hans algorithm, for the cell-of-origin classification of diffuse large B-cell lymphomas (DLBCL), were applied. In DLBCL cases, the frequencies of MYC and BCL6 rearrangements (14.9 and 27.7%, respectively) were similar to those described in HIV-negative patients, but BCL2 rearrangements were infrequent (4.3%). MYC expression was identified in 23.4% of DLBCL cases, and coexpression of MYC and BCL2 in 13.0%, which was associated with a worse prognosis. As for BL cases, the expression of MUM1 (30.4%) conferred a worse prognosis. Finally, the prevalence of HGBL-DH/TH and BL-like with 11q aberration are reported in the HIV setting. The phenotypic and genotypic characteristics of HIV-associated aggressive B-NHL are similar to those of the general population, except for the low frequency of BCL2 rearrangements in DLBCL. MYC and BCL2 coexpression in DLBCL, and MUM-1 expression in BL, have a negative prognostic impact on HIV-infected individuals.
Collapse
Affiliation(s)
- Maria Joao Baptista
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Gustavo Tapia
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - Ana‐María Muñoz‐Marmol
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - Josep Muncunill
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Olga Garcia
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Silvia Montoto
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - John G Gribben
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - Maria Calaminici
- Centre for Haemato‐OncologyBarts Cancer Institute, Queen Mary University of LondonLondonUK
| | - Antonio Martinez
- Department of Pathology, Hospital Clinic, IDIBAPSUniversity of BarcelonaBarcelonaSpain
| | - Luis Veloza
- Department of Pathology, Hospital Clinic, IDIBAPSUniversity of BarcelonaBarcelonaSpain
| | | | - Teresa Aldamiz
- Department of Infectious DiseasesHospital Gregorio MarañónMadridSpain
| | | | - María‐José Terol
- Department of Hematology and OncologyHospital Clínic Universitari de ValènciaValenciaSpain
| | - Antonio Ferrandez
- Department of PathologyHospital Clínic Universitari de ValènciaValenciaSpain
| | - Miguel Alcoceba
- Department of HematologyHospital Universitario de Salamanca (HUS/IBSAL), CIBERONC and Centro de Investigación del Cáncer‐IBMCC (USAL‐CSIC)SalamancaSpain
| | - Javier Briones
- Department of Hematology, Hospital de la Santa Creu i Sant PauJosep Carreras Leukaemia Research Institute (IJC)BarcelonaSpain
| | - Eva González‐Barca
- Department of HematologyICO‐Hospital Duran i ReynalsL'Hospitalet de LlobregatSpain
| | - Fina Climent
- Department of PathologyHospital Universitari de Bellvitge‐IDIBELL, L'Hospitalet de LlobregatBadalonaSpain
| | - Ana Muntañola
- Department of Clinical HematologyHospital Universitari Mutua de TerrassaTerrassaSpain
| | - José‐María Moraleda
- Department of HematologyHospital Clinico Universitario Virgen de la ArrixacaMurciaSpain
| | - Mariano Provencio
- Department of Medical OncologyHospital Universitario Puerta De HierroMajadahondaSpain
| | - Pau Abrisqueta
- Department of HematologyHospital Vall d'HebrónBarcelonaSpain
| | | | - Lluis Colomo
- Department of PathologyHospital del MarBarcelonaSpain
| | | | | | - Juan‐Manuel Sancho
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - Josep‐Maria Ribera
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| | - José‐Luis Mate
- Department of Pathology, Hospital Germans Trias i Pujol, IGTPUniversitat Autònoma de BarcelonaBadalonaSpain
| | - José‐Tomas Navarro
- Department of Hematology, ICO‐Germans Trias i Pujol Hospital, Josep Carreras Leukaemia Research Institute (IJC)Universitat Autònoma de BarcelonaBadalonaSpain
| |
Collapse
|
39
|
Zhu J, Hong X, Song YQ, Hodkinson B, Balasubramanian S, Wang S, Zhang Q, Shi Y, Huang H, Zhang H, Zhu Y, Shreeve SM, Sun S, Wang Z, Wang X, Fan Y, Wilson W, Vermeulen J. Ibrutinib and rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone in patients with previously untreated non-germinal centre B-cell-like diffuse large B-cell lymphoma: A Chinese subgroup analysis of the phase III PHOENIX trial. EJHAEM 2022; 3:1154-1164. [PMID: 36467814 PMCID: PMC9713042 DOI: 10.1002/jha2.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 06/17/2023]
Abstract
In this post hoc subgroup analysis of 200 patients enrolled in China from the phase III PHOENIX trial (N = 838, NCT01855750), addition of ibrutinib to rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) did not improve event-free survival (EFS) versus placebo+R-CHOP in the intent-to-treat (ITT; n = 200, hazard ratio [HR] = 0.83, 95% confidence interval [CI]: 0·509-1.349; p = 0.4495) or activated B-cell-like (ABC; n = 141 [based on available gene-expression profiling data], HR = 0.86, 95% CI: 0.467-1.570; p = 0.6160) subpopulations. However, ibrutinib+R-CHOP improved EFS (HR = 0·50, 95% CI: 0.251-1.003) and progression-free survival (PFS; HR = 0.48, 95% CI: 0.228-1.009) versus placebo+R-CHOP in patients aged <60 but not ≥60 years. Grade ≥3 serious treatment-emergent adverse events occurred more with ibrutinib+R-CHOP (45·6% vs. 31·3%). The percentage of patients receiving ≥6 cycles of R-CHOP was similar across treatment arms in those <60 years. A numerical trend was seen towards improved EFS and PFS with ibrutinib+R-CHOP versus placebo+R-CHOP in patients with MYC-high/BCL2-high co-expression. In this slightly younger Chinese subgroup, ibrutinib+R-CHOP did not improve EFS in the ITT and ABC subpopulations but improved outcomes with manageable safety in patients <60 years, consistent with overall PHOENIX study outcomes.
Collapse
Affiliation(s)
- Jun Zhu
- Beijing University Cancer Hospital and InstituteBeijingChina
| | | | - Yu Qin Song
- Beijing University Cancer Hospital and InstituteBeijingChina
| | - Brendan Hodkinson
- Oncology Translational ResearchJanssen Research and DevelopmentSpring HousePennsylvaniaUSA
| | | | - Songbai Wang
- Oncology Translational ResearchJanssen Research and DevelopmentRaritanNew JerseyUSA
| | - Qingyuan Zhang
- Affiliated Cancer Hospital of Harbin Medical UniversityHarbinChina
| | - Yuankai Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted DrugsBeijingChina
| | | | | | - Yan Zhu
- Janssen Research and DevelopmentRaritanNew JerseyUSA
| | | | - Steven Sun
- Clinical BiostatsJanssen Research and DevelopmentRaritanNew JerseyUSA
| | - Ze Wang
- Xian Janssen PharmaceuticalsMedical AffairsBeijingChina
| | - Xiaocan Wang
- Xian Janssen PharmaceuticalsMedical AffairsBeijingChina
| | - Yue Fan
- Oncology Translational ResearchJanssen Research and DevelopmentShanghaiChina
| | - Wyndham Wilson
- National Cancer InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Jessica Vermeulen
- Clinical OncologyJanssen Research and DevelopmentLeidenThe Netherlands
| |
Collapse
|
40
|
Silkenstedt E, Dreyling M. Aggressive Lymphome (DLBCL, MCL) – was ist neu? Dtsch Med Wochenschr 2022; 147:1449-1456. [DOI: 10.1055/a-1811-9691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Was ist neu?
DLBCL. Biologie Der kürzlich publizierte „LymphGen-Algorithmus“ differenziert 7 genetische Subtypen, die sich in der Aktivierung onkogener Signalwege, im Genexpressionsmuster, im Tumormikromilieu, der Überlebenswahrscheinlichkeit und potenzieller zielgerichteter Therapien unterscheiden.
Erstlinientherapie Der Einsatz des neuen Antikörper-Wirkstoff-Konjugats Polatuzumab-Vedotin (6 Zyklen der Kombination aus Polatuzumab + R-CHP) waren der bisherigen Erstlinien-Standardtherapie mit R-CHOP hinsichtlich 2-Jahres-PFS überlegen. Subgruppenanalysen wiesen vor allem auf eine Wirksamkeit bei Patienten mit Hochrisikofaktoren hin.
Rezidivtherapie Seit Kurzem steht mit dem gegen den CD19 gerichteten Antikörper Tafasitamab in Kombination mit dem Immunmodulator Lenalidomid eine wirksame Rezidivtherapie für jene Patientengruppe zur Verfügung, die für eine Hochdosistherapie nicht geeignet ist. In 2 Phase-III-Studien wurde kürzlich bereits im 1. Rezidiv eine Überlegenheit von CAR-T-Zellen gegenüber dem bisherigen Standard der Hochdosistherapie, gefolgt von aPBSCT, gezeigt. Mit den bispezifischen, T-Zell-rekrutierenden CD3 / CD20-Antikörpern Mosunetuzumab, Epcoritamab und Glofitamab sind derzeit weitere vielversprechende immuntherapeutische Ansätze Gegenstand aktueller Phase I/II-Studien.
MCL. Biologie Trotz der weiteren Entschlüsselung des genetischen Hintergrunds des MCL ist weiterhin nur für TP53 eine klinische Relevanz nachgewiesen.
Erstlinientherapie In der Ära der zielgerichteten Therapiestrategien wird derzeit die Bedeutung des BTK-Inhibitors Ibrutinib für die Erstlinien- und Erhaltungstherapie des MCL evaluiert. Für ältere Patienten erwies sich kürzlich die Kombination des Proteasom-Inhibitors Bortezomib, Rituximab, Cyclophosphamid, Doxorubicin und Prednisolon (VR-CAP) der bisherigen Standardtherapie mit R-CHOP überlegen. Für ältere Patienten, die für intensivere Therapieregime nicht geeignet sind, führte die Erweiterung des klassischen Regimes Rituximab + Bendamustin um Ibrutinib zu einer deutlichen Verbesserung des PFS.
Rezidivtherapie Für das rezidivierte/refraktäre MCL wurden neben dem seit Jahren zugelassenen Ibrutinib kürzlich auch die beiden Next-Generation-BTK-Inhibitoren Acalabrutinib and Zanubrutinib zugelassen. Der bcl1-Inhibitor Venetoclax bietet für Hochrisikopatienten, die nach vorangegangener Therapie mit Ibrutinib ein Rezidiv erlitten, eine vielversprechende Behandlungsmöglichkeit. Bezüglich immuntherapeutischer Therapieansätze erfolgte kürzlich die Zulassung des CD19-CAR-T-Zell-Konstrukts Brexucabtagene autoleucel ab dem 2. Rezidiv.
Collapse
|
41
|
Donati G, Amati B. MYC and therapy resistance in cancer: risks and opportunities. Mol Oncol 2022; 16:3828-3854. [PMID: 36214609 PMCID: PMC9627787 DOI: 10.1002/1878-0261.13319] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/08/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
The MYC transcription factor, encoded by the c-MYC proto-oncogene, is activated by growth-promoting signals, and is a key regulator of biosynthetic and metabolic pathways driving cell growth and proliferation. These same processes are deregulated in MYC-driven tumors, where they become critical for cancer cell proliferation and survival. As other oncogenic insults, overexpressed MYC induces a series of cellular stresses (metabolic, oxidative, replicative, etc.) collectively known as oncogenic stress, which impact not only on tumor progression, but also on the response to therapy, with profound, multifaceted consequences on clinical outcome. On one hand, recent evidence uncovered a widespread role for MYC in therapy resistance in multiple cancer types, with either standard chemotherapeutic or targeted regimens. Reciprocally, oncogenic MYC imparts a series of molecular and metabolic dependencies to cells, thus giving rise to cancer-specific vulnerabilities that may be exploited to obtain synthetic-lethal interactions with novel anticancer drugs. Here we will review the current knowledge on the links between MYC and therapeutic responses, and will discuss possible strategies to overcome resistance through new, targeted interventions.
Collapse
Affiliation(s)
- Giulio Donati
- European Institute of Oncology (IEO) – IRCCSMilanItaly
| | - Bruno Amati
- European Institute of Oncology (IEO) – IRCCSMilanItaly
| |
Collapse
|
42
|
Henry RK, Bilyk JR, Evans JJ, Lao PA, Milman T. Double-hit and triple-hit high-grade B-cell lymphoma of the ocular adnexa. Orbit 2022; 41:624-628. [PMID: 33779481 DOI: 10.1080/01676830.2021.1904426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
High-grade B-cell lymphoma (HGBL) with c-MYC and BCL2 and/or BCL6 rearrangements, also known as a double-hit and triple-hit lymphoma, is an aggressive non-Hodgkin lymphoma affecting older adults. After formal recognition of this entity in the 2017 revision of the World Health Organization Classification of lymphoid neoplasms, only two well-documented cases of triple-hit lymphoma of the orbit appear in the literature. Herein, we describe a 70-year-old man with progressive diplopia, ophthalmoplegia, and rapidly enlarging temporal mass. Biopsy revealed a tumor morphologically consistent with HGBL, coexpressing CD20, CD10, BCL6, BCL2, and c-MYC on immunohistochemical analysis. Fluorescence in-situ hybridization showed rearrangements in c-MYC and BCL-2 genes, confirming double-hit HGBL. Systemic workup revealed Ann Arbor stage IV disease. This report reviews the existing literature on ocular adnexal double-hit and triple-hit lymphoma and provides an update on the diagnostic ancillary studies, prognostic implications, and latest management for this aggressive hematolymphoid malignancy.
Collapse
Affiliation(s)
- Roger K Henry
- Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Jurij R Bilyk
- Oculoplastic and Orbital Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - James J Evans
- Department of Neurological Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Priscilla A Lao
- Oculoplastic and Orbital Surgery Service, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tatyana Milman
- Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Pathology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
43
|
Kirkegaard MK. Ocular adnexal lymphoma: Subtype‐specific clinical and genetic features. Acta Ophthalmol 2022; 100 Suppl 270:3-37. [DOI: 10.1111/aos.15248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marina Knudsen Kirkegaard
- Department of Pathology, Eye Section, Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| |
Collapse
|
44
|
Othman T, Penaloza J, Zhang S, Daniel CE, Gaut D, Oliai C, Brem EA, Baweja A, Ly J, Reid J, Pinter-Brown L, Lee M, Abdulhaq H, Tuscano J. R-CHOP Vs DA-EPOCH-R for Double-Expressor Lymphoma: A University of California Hematologic Malignancies Consortium Retrospective Analysis. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:e947-e957. [PMID: 35858904 DOI: 10.1016/j.clml.2022.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Managing double-expressor lymphomas (DEL) is controversial given the dearth of data and lack of standardized guidelines on this high-risk subset of lymphomas. No prospective and few retrospective studies limited by either their sample size or short follow-up address the question of initial treatment of choice for DEL. We performed the largest analysis to date exploring R-CHOP vs DA-EPOCH-R in DEL. METHODS Adults with DEL diagnosed from 6/2012-2/2021 at 4 unique sites were retrospectively analyzed. Progression-free survival (PFS) was the primary endpoint. Key secondary endpoints include overall survival (OS), overall and complete response rates (ORR and CRR), cumulative incidence of relapse, and autologous hematopoietic cell transplantation (autoHCT) utilization. RESULTS 155 patients were included, 61 treated with R-CHOP and 94 with DA-EPOCH-R. 3-year PFS and OS were similar between R-CHOP and DA-EPOCH-R, 33.2% vs 57.2%,(P = .063), and 72.2% vs 71.6% (P = .43) after median follow-up times of 2.43 and 2.89 years, respectively. Patients <65 had improved PFS with DA-EPOCH-R, hazard ratio 0.41 (P = .01). CRR and ORR rates were also similar. Relapse rates were not statistically different, 51.9% vs 28.6% (P = .069). AutoHCT utilization was higher with R-CHOP vs DA-EPOCH-R, 23.0% vs 8.5% (P = .017). CONCLUSIONS Our findings do not support the use of DA-EPOCH-R over R-CHOP for DEL. Patients <65 years may experience longer PFS with DA-EPOCH-R, but limitations to the analysis make this interpretation difficult.
Collapse
Affiliation(s)
- Tamer Othman
- University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | - Juan Penaloza
- Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA
| | - Shiliang Zhang
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Claire E Daniel
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Daria Gaut
- Division of Hematology Oncology, David Geffen School of Medicine and University of California, Los Angeles, CA
| | - Caspian Oliai
- Division of Hematology Oncology, David Geffen School of Medicine and University of California, Los Angeles, CA
| | - Elizabeth A Brem
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, Orange, CA
| | - Abinav Baweja
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, Orange, CA
| | - Jane Ly
- University of California Irvine Department of Pathology and Laboratory Medicine, Orange, CA
| | - Jack Reid
- University of California Irvine Department of Pathology and Laboratory Medicine, Orange, CA
| | - Lauren Pinter-Brown
- Division of Hematology and Oncology, Department of Medicine, University of California Irvine, Orange, CA
| | - Matthew Lee
- Department of Medicine, University of California San Francisco, Fresno campus. Fresno, CA
| | - Haifaa Abdulhaq
- Department of Medicine, University of California San Francisco, Fresno campus. Fresno, CA
| | - Joseph Tuscano
- University of California Davis Comprehensive Cancer Center, Sacramento, CA.
| |
Collapse
|
45
|
Zhan J, Yang S, Zhang W, Zhou D, Zhang Y, Wang W, Wei C. DA-EPOCH-R improves the prognosis of patients with double-expressor lymphoma: A single-center retrospective study and meta-analysis. Medicine (Baltimore) 2022; 101:e30620. [PMID: 36197215 PMCID: PMC9509123 DOI: 10.1097/md.0000000000030620] [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] [Received: 01/18/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Double-expressor lymphoma (DEL) is associated with a poor prognosis. The standard treatment for patients with DEL remains controversial. A comparison of the safety and feasibility of R-CHOP and DA-EPOCH-R as the first-line therapy for patients with DEL is urgently needed. METHODS The clinical and treatment outcomes of 75 DEL patients were retrospectively analyzed. The role of DA-EPOCH-R was determined and compared to that of R-CHOP in DEL patients. PubMed, Embase, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to November 1, 2021 and were evaluated by Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Articles comparing DA-EPOCH-R versus R-CHOP in patients with DEL were included. RESULTS Overall, 49 and 26 DEL patients received R-CHOP and DA-EPOCH-R, respectively. Although the difference in response for patients who received R-CHOP and DA-EPOCH-R was not significant (P = .347), DA-EPOCH-R may improve the prognosis compared to R-CHOP (P = .056 for progression-free survival [PFS], P = .009 for overall survival [OS]). A systematic review and meta-analysis including 412 DEL patients in six articles were conducted. The event rate for 3-year PFS was significantly lower in patients receiving DA-EPOCH-R treatment than in those undergoing R-CHOP treatment (OR = 0.63, 95% CI = 0.42-0.94, P = .02), whereas no statistically significant difference was found in the HRs for both PFS and OS or the event rate for 3-year OS. CONCLUSION The results of this study indicated that DA-EPOCH-R might improve the prognosis of DEL patients compared with R-CHOP.
Collapse
Affiliation(s)
- Jing Zhan
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shijie Yang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chong Wei
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
46
|
Tang SH, Tian L, Zhao W, Wang J, Ke XY. [Clinical features and prognosis of 166 cases of MYC/BCL2 double-expression diffuse large B-cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:771-777. [PMID: 36709172 PMCID: PMC9613496 DOI: 10.3760/cma.j.issn.0253-2727.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Indexed: 01/30/2023]
Abstract
Objective: To investigate the clinical features and prognosis of MYC/BCL2 double-expression diffuse large B-cell lymphoma (DEL) . Methods: The clinical data, including clinical characteristics, survival, and prognostic factors, of 166 patients with DEL treated at Peking University Third Hospital from January 2016 to December 2020 were retrospectively analyzed. Results: A total of 410 patients with diffuse large B-cell lymphoma were collected, including 166 cases (40.5%) of DEL. There were 82 males and 84 females with a median age of 63.5 (21-95) years at diagnosis. A total of 110 patients (66.3%) were aged over 60 years at initial diagnosis, 106 patients (106/163, 65.0%) had elevated lactate dehydrogenase (LDH) at diagnosis, 74 patients (74/160, 46.2%) had β(2) microglobulin level over 3 mg/L at diagnosis, and 107 patients (107/163, 65.6%) had≥2 extranodal involvement. Sixty-five patients (65/166, 39.2%) had B symptoms, 131 patients (131/165, 79.4%) had stage Ⅲ and Ⅳ disease at initial diagnosis, 41 patients (41/161, 25.5%) had an International Prognostic Index (IPI) score of 0-2 at initial diagnosis, and 38 patients (38/161, 23.6%) had an IPI score of 3 at initial diagnosis. Eighty-two patients (82/161, 50.9%) had an IPI score of 4-5 at initial diagnosis. Nine (9/56, 16.1%) patients with DEL had MYD88 and CD79B mutations. Univariate analysis showed that age over 60 years (P=0.004) , increased β(2) microglobulin level (P=0.002) , and high IPI score (P=0.003) were associated with poor overall survival (OS) . Increased β(2) microglobulin level (P=0.031) , LDH level (P=0.017) , stage Ⅲ-Ⅳ (P=0.001) , high IPI score (P=0.013) , immunohistochemical p53 mutation (P=0.049) , and PIM1 mutation (P=0.039) were associated with poor progression-free survival (PFS) . Multivariate analysis showed that IPI score of 4-5 was an independent risk factor for the prognosis of DEL (HR=2.622, 95% CI 1.398-4.917, P=0.003) . Survival analysis showed that there was a significant difference in the PFS between patients with DEL and those without DEL (65.6% vs 75.1%, P=0.002) . However, there was no significant difference in the OS (81.8% vs 83.6%, P=0.226) . In patients with DEL, the overall response rate of R-EPOCH regimen was higher than that of RCHOP or RCHOP-like regimen (81.5% vs 63.4%, P=0.004) . Conclusion: DEL is a group of aggressive lymphomas with relatively poor PFS. The R-EPOCH regimen may improve the overall prognosis of patients.
Collapse
Affiliation(s)
- S H Tang
- Department of Hematology, Peking University Third Hospital, Beijing 100083, China
| | - L Tian
- Department of Hematology, Peking University Third Hospital, Beijing 100083, China
| | - W Zhao
- Department of Hematology, Peking University Third Hospital, Beijing 100083, China
| | - J Wang
- Department of Hematology, Peking University Third Hospital, Beijing 100083, China
| | - X Y Ke
- Department of Hematology, Peking University Third Hospital, Beijing 100083, China
| |
Collapse
|
47
|
Jain MD, Ziccheddu B, Coughlin CA, Faramand R, Griswold AJ, Reid KM, Menges M, Zhang Y, Cen L, Wang X, Hussaini M, Landgren O, Davila ML, Schatz JH, Locke FL, Maura F. Whole-genome sequencing reveals complex genomic features underlying anti-CD19 CAR T-cell treatment failures in lymphoma. Blood 2022; 140:491-503. [PMID: 35476848 PMCID: PMC9353150 DOI: 10.1182/blood.2021015008] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/12/2022] [Indexed: 11/20/2022] Open
Abstract
CD19-directed chimeric antigen receptor (CAR-19) T cells are groundbreaking immunotherapies approved for use against large B-cell lymphomas. Although host inflammatory and tumor microenvironmental markers associate with efficacy and resistance, the tumor-intrinsic alterations underlying these phenomena remain undefined. CD19 mutations associate with resistance but are uncommon, and most patients with relapsed disease retain expression of the wild-type receptor, implicating other genomic mechanisms. We therefore leveraged the comprehensive resolution of whole-genome sequencing to assess 51 tumor samples from 49 patients with CAR-19-treated large B-cell lymphoma. We found that the pretreatment presence of complex structural variants, APOBEC mutational signatures, and genomic damage from reactive oxygen species predict CAR-19 resistance. In addition, the recurrent 3p21.31 chromosomal deletion containing the RHOA tumor suppressor was strongly enriched in patients for whom CAR T-cell therapy failed. Pretreatment reduced expression or monoallelic loss of CD19 did not affect responses, suggesting CAR-19 therapy success and resistance are related to multiple mechanisms. Our study showed that tumor-intrinsic genomic alterations are key among the complex interplay of factors that underlie CAR-19 efficacy and resistance for large B-cell lymphomas.
Collapse
Affiliation(s)
- Michael D Jain
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Bachisio Ziccheddu
- Division of Hematology, Department of Medicine
- Sylvester Comprehensive Cancer Center
| | - Caroline A Coughlin
- Medical Scientist Training Program
- Sheila and David Fuente Graduate Program in Cancer Biology, and
| | - Rawan Faramand
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Anthony J Griswold
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL
| | - Kayla M Reid
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Meghan Menges
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | | | - Ling Cen
- Department of Biostatistics and Bioinformatics and
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics and
| | - Mohammad Hussaini
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Ola Landgren
- Division of Hematology, Department of Medicine
- Sylvester Comprehensive Cancer Center
| | - Marco L Davila
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Jonathan H Schatz
- Division of Hematology, Department of Medicine
- Sylvester Comprehensive Cancer Center
| | - Frederick L Locke
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Francesco Maura
- Division of Hematology, Department of Medicine
- Sylvester Comprehensive Cancer Center
| |
Collapse
|
48
|
Ethiraj P, Sasi B, Holder KN, Lin AP, Qiu Z, Jaafar C, Elkhalili A, Desai P, Saksena A, Ritter JP, Aguiar RCT. Cyclic-AMP signalling, MYC and hypoxia-inducible factor 1α intersect to regulate angiogenesis in B-cell lymphoma. Br J Haematol 2022; 198:349-359. [PMID: 35411936 DOI: 10.1111/bjh.18196] [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: 12/14/2021] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023]
Abstract
Angiogenesis and MYC expression associate with poor outcome in diffuse large B-cell lymphoma (DLBCL). MYC promotes neo-vasculature development but whether its deregulation in DLBCL contributes to angiogenesis is unclear. Examination of this relationship may uncover novel pathogenic regulatory circuitry as well as anti-angiogenic strategies in DLBCL. Here, we show that MYC expression positively correlates with vascular endothelial growth factor (VEGF) expression and angiogenesis in primary DLBCL biopsies, independently of dual expressor status or cell-of-origin classification. We found that MYC promotes VEGFA expression, a correlation that was validated in large datasets of mature B-cell tumours. Using DLBCL cell lines and patient-derived xenograft models, we identified the second messenger cyclic-AMP (cAMP) as a potent suppressor of MYC expression, VEGFA secretion and angiogenesis in DLBCL in normoxia. In hypoxia, cAMP switched targets and suppressed hypoxia-inducible factor 1α, a master regulator of VEGFA/angiogenesis in low oxygen environments. Lastly, we used the phosphodiesterase 4b (Pde4b) knockout mouse to demonstrate that the cAMP/PDE4 axis exercises additional anti-angiogenesis by directly targeting the lymphoma microenvironment. In conclusion, MYC could play a direct role in DLBCL angiogenesis, and modulation of cAMP levels, which can be achieved with clinical grade PDE4 inhibitors, has cell and non-cell autonomous anti-angiogenic activity in DLBCL.
Collapse
Affiliation(s)
- Purushoth Ethiraj
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Binu Sasi
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Kenneth N Holder
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - An-Ping Lin
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Zhijun Qiu
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Carine Jaafar
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Alia Elkhalili
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Parth Desai
- Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Annapurna Saksena
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Jacob P Ritter
- Department of Pathology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Ricardo C T Aguiar
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
- South Texas Veterans Health Care System, Audie Murphy VA Hospital, San Antonio, Texas, USA
| |
Collapse
|
49
|
Kong H, Zhu H, Zheng X, Jiang M, Chen L, Lan L, Ren J, Luo X, Zheng J, Zheng Z, Chen Z, Hu J, Yang T. Machine Learning Models for the Diagnosis and Prognosis Prediction of High-Grade B-Cell Lymphoma. Front Immunol 2022; 13:919012. [PMID: 35686130 PMCID: PMC9171399 DOI: 10.3389/fimmu.2022.919012] [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: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 11/15/2022] Open
Abstract
High-grade B-cell lymphoma (HGBL) is a newly introduced category of rare and heterogeneous invasive B-cell lymphoma (BCL), which is diagnosed depending on fluorescence in situ hybridization (FISH), an expensive and laborious analysis. In order to identify HGBL with minimal workup and costs, a total of 187 newly diagnosed BCL patients were enrolled in a cohort study. As a result, the overall survival (OS) and progression-free survival (PFS) of the HGBL group were inferior to those of the non-HGBL group. HGBL (n = 35) was more likely to have a high-grade histomorphology appearance, extranodal involvement, bone marrow involvement, and whole-body maximum standardized uptake (SUVmax). The machine learning classification models indicated that histomorphology appearance, Ann Arbor stage, lactate dehydrogenase (LDH), and International Prognostic Index (IPI) risk group were independent risk factors for diagnosing HGBL. Patients in the high IPI risk group, who are CD10 positive, and who have extranodal involvement, high LDH, high white blood cell (WBC), bone marrow involvement, old age, advanced Ann Arbor stage, and high SUVmax had a higher risk of death within 1 year. In addition, these models prompt the clinical features with which the patients should be recommended to undergo a FISH test. Furthermore, this study supports that first-line treatment with R-CHOP has dismal efficacy in HGBL. A novel induction therapeutic regimen is still urgently needed to ameliorate the poor outcome of HGBL patients.
Collapse
Affiliation(s)
- Hui Kong
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Haojie Zhu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaoyun Zheng
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Meichen Jiang
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lushan Chen
- Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Lingqiong Lan
- Department of Hematology, The Second Hospital of Longyan, Longyan, China
| | - Jinhua Ren
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaofeng Luo
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Zheng
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhihong Zheng
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhizhe Chen
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianda Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ting Yang
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| |
Collapse
|
50
|
Strüßmann T, Glatzki F, Engelhardt M, Mertelsmann R, Duyster J, Finke J, Marks R. Favourable outcomes of double-hit/double-expressor lymphoma and high-grade B-cell lymphoma, not otherwise specified after early dose-intensive treatment and up-front autologous stem cell transplantation: a single-centre retrospective experience. Br J Haematol 2022; 198:776-779. [PMID: 35620830 DOI: 10.1111/bjh.18280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/28/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Tim Strüßmann
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Franziska Glatzki
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monika Engelhardt
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roland Mertelsmann
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Justus Duyster
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Finke
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reinhard Marks
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|