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Arcaini L, Bommier C, Alderuccio JP, Merli M, Fabbri N, Nizzoli ME, Maurer MJ, Tarantino V, Ferrero S, Rattotti S, Talami A, Murru R, Khurana A, Mwangi R, Deodato M, Cencini E, Re F, Visco C, Feldman AL, Link BK, Delamain MT, Spina M, Annibali O, Pulsoni A, Ferreri AJ, Stelitano CC, Pennese E, Habermann TM, Marcheselli L, Han S, Reis IM, Paulli M, Lossos IS, Cerhan JR, Luminari S. Marginal zone lymphoma international prognostic index: a unifying prognostic index for marginal zone lymphomas requiring systemic treatment. EClinicalMedicine 2024; 72:102592. [PMID: 38633575 PMCID: PMC11019091 DOI: 10.1016/j.eclinm.2024.102592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Background Marginal zone lymphomas (MZL), comprised of three unique but related subtypes, lack a unifying prognostic score applicable to all the patients in need for systemic chemotherapy and/or immunotherapy. Methods Patients from the prospective NF10 study (NCT02904577) with newly diagnosed MZL and receiving frontline systemic therapy at diagnosis or after observation were used to train a prognostic model. The primary endpoint was progression-free survival (PFS) from start of treatment. The model was externally validated in a pooled analysis of two independent cohorts from the University of Iowa and Mayo Clinic Molecular Epidemiology Resource and the University of Miami. Findings We identified 501 eligible patients. After multivariable modeling, lactate dehydrogenase (LDH) above upper normal limit, hemoglobin <12 g/dL, absolute lymphocyte count <1 × 109/L, platelets <100 × 109/L, and MZL subtype (nodal or disseminated) were independently associated with inferior PFS. The proposed MZL International Prognostic index (MZL-IPI) combined these 5 factors, and we defined low (LRG, 0 factors, 27%), intermediate (IRG, 1-2 factors, 57%) and high (HRG, 3+ factors, 16%) risk groups with 5-y PFS of 85%, 66%, and 37%, respectively (c-Harrell = 0.64). Compared to the LRG, the IRG (Hazard Ratio [HR] = 2.30, 95% CI 1.39-3.80) and HRG (HR = 5.41, 95% CI 3.12-9.38) had inferior PFS. Applying the MZL-IPI to the pooled US cohort (N = 353), 94 (27%), 192 (54%), and 67 (19%) patients were classified as LRG, IRG, and HRG, respectively, and the model was validated for PFS (log-rank test p = 0.0018; c-Harrell = 0.578, 95% CI 0.54-0.62). The MZL-IPI was also prognostic for OS in both the training and the external validation sets. Interpretation MZL-IPI is a new prognostic score for use in all patients with MZL considered for systemic treatment. Funding The MER was supported by P50 CA97274 and U01 CA195568.
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Affiliation(s)
- Luca Arcaini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Côme Bommier
- Hemato-Oncology Department, DMU DHI, Hôpital Saint Louis, Paris, France
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Nicole Fabbri
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Elena Nizzoli
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Matthew J. Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Vittoria Tarantino
- Division of Hematology, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, and AOU “Città della Salute e della Scienza di Torino”, Torino, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Annalisa Talami
- Clinical and Experimental Medicine Doctorate School, Università degli Studi di Modena e Reggio Emilia, Italy
| | - Roberta Murru
- Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS G. Brotzu, Cagliari, Italy
| | | | - Raphael Mwangi
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Marina Deodato
- Division of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Emanuele Cencini
- Division of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Francesca Re
- Division of Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Carlo Visco
- Division of Hematology, San Bortolo Hospital, AULSS 8 Berica, Vicenza, Italy
| | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Brian K. Link
- Department of Internal Medicine, University of Iowa Hospitals, Iowa City, IA, USA
| | - Marcia Torresan Delamain
- Faculty of Medical of Minas Gerais, Feluma, Brazil for Faculty of Medical of Minas Gerais, Belo Horizonte, Brazil
| | - Michele Spina
- Division of Medical Oncology and Immune-Related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Ombretta Annibali
- Division of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Roma, Italy
| | - Alessandro Pulsoni
- Division of Hematology, Sapienza University – Polo Pontino, Department of Translational and Precision Medicine, S.M. Goretti Hospital, Latina, Italy
| | - Andrés J.M. Ferreri
- Lymphoma Unit, IRCCS San Raffaele Scientific Institute, and University Vita-Salute San Raffaele, Milano, Italy
| | - Caterina Cecilia Stelitano
- Division of Hematology, Grande Ospedale Metropolitano, Bianchi Melacrino Morelli, Reggio Calabria, Reggio Calabria, Italy
| | - Elsa Pennese
- Division of Hematology, Ospedale Spirito Santo, Pescara, Italy
| | | | | | - Sunwoo Han
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M. Reis
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marco Paulli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Division of Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Izidore S. Lossos
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James R. Cerhan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Stefano Luminari
- Division of Hematology, Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy
- Department CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy
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2
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Gambino S, Quaglia FM, Galasso M, Cavallini C, Chignola R, Lovato O, Giacobazzi L, Caligola S, Adamo A, Putta S, Aparo A, Ferrarini I, Ugel S, Giugno R, Donadelli M, Dando I, Krampera M, Visco C, Scupoli MT. B-cell receptor signaling activity identifies patients with mantle cell lymphoma at higher risk of progression. Sci Rep 2024; 14:6595. [PMID: 38503806 PMCID: PMC10951201 DOI: 10.1038/s41598-024-55728-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
Mantle cell lymphoma (MCL) is an incurable B-cell malignancy characterized by a high clinical variability. Therefore, there is a critical need to define parameters that identify high-risk patients for aggressive disease and therapy resistance. B-cell receptor (BCR) signaling is crucial for MCL initiation and progression and is a target for therapeutic intervention. We interrogated BCR signaling proteins (SYK, LCK, BTK, PLCγ2, p38, AKT, NF-κB p65, and STAT5) in 30 primary MCL samples using phospho-specific flow cytometry. Anti-IgM modulation induced heterogeneous BCR signaling responses among samples allowing the identification of two clusters with differential responses. The cluster with higher response was associated with shorter progression free survival (PFS) and overall survival (OS). Moreover, higher constitutive AKT activity was predictive of inferior response to the Bruton's tyrosine kinase inhibitor (BTKi) ibrutinib. Time-to-event analyses showed that MCL international prognostic index (MIPI) high-risk category and higher STAT5 response were predictors of shorter PFS and OS whilst MIPI high-risk category and high SYK response predicted shorter OS. In conclusion, we identified BCR signaling properties associated with poor clinical outcome and resistance to ibrutinib, thus highlighting the prognostic and predictive significance of BCR activity and advancing our understanding of signaling heterogeneity underlying clinical behavior of MCL.
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Affiliation(s)
- Simona Gambino
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy
| | | | - Marilisa Galasso
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy
| | - Chiara Cavallini
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Roberto Chignola
- Department of Biotechnology, University of Verona, Verona, Italy
| | - Ornella Lovato
- Research Center LURM (Interdepartmental Laboratory of Medical Research), University of Verona, Verona, Italy
| | - Luca Giacobazzi
- Department of Medicine, Section of Immunology, University of Verona, Verona, Italy
| | | | - Annalisa Adamo
- Department of Medicine, Section of Immunology, University of Verona, Verona, Italy
| | | | - Antonino Aparo
- Research Center LURM (Interdepartmental Laboratory of Medical Research), University of Verona, Verona, Italy
| | - Isacco Ferrarini
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Stefano Ugel
- Department of Medicine, Section of Immunology, University of Verona, Verona, Italy
| | - Rosalba Giugno
- Department of Computer Science, University of Verona, Verona, Italy
| | - Massimo Donadelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Biochemistry, University of Verona, Verona, Italy
| | - Ilaria Dando
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Biochemistry, University of Verona, Verona, Italy
| | - Mauro Krampera
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Carlo Visco
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy.
- Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
| | - Maria Teresa Scupoli
- Department of Engineering for Innovation Medicine, Section of Biomedicine, University of Verona, Verona, Italy.
- Research Center LURM (Interdepartmental Laboratory of Medical Research), University of Verona, Verona, Italy.
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3
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Pettinella F, Mariotti B, Lattanzi C, Bruderek K, Donini M, Costa S, Marini O, Iannoto G, Gasperini S, Caveggion E, Castellucci M, Calzetti F, Bianchetto-Aguilera F, Gardiman E, Giani M, Dusi S, Cantini M, Vassanelli A, Pavone D, Milella M, Pilotto S, Biondani P, Höing B, Schleupner MC, Hussain T, Hadaschik B, Kaspar C, Visco C, Tecchio C, Koenderman L, Bazzoni F, Tamassia N, Brandau S, Cassatella MA, Scapini P. Surface CD52, CD84, and PTGER2 mark mature PMN-MDSCs from cancer patients and G-CSF-treated donors. Cell Rep Med 2024; 5:101380. [PMID: 38242120 PMCID: PMC10897522 DOI: 10.1016/j.xcrm.2023.101380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/11/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
Precise molecular characterization of circulating polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) is hampered by their mixed composition of mature and immature cells and lack of specific markers. Here, we focus on mature CD66b+CD10+CD16+CD11b+ PMN-MDSCs (mPMN-MDSCs) from either cancer patients or healthy donors receiving G-CSF for stem cell mobilization (GDs). By RNA sequencing (RNA-seq) experiments, we report the identification of a distinct gene signature shared by the different mPMN-MDSC populations under investigation, also validated in mPMN-MDSCs from GDs and tumor-associated neutrophils (TANs) by single-cell RNA-seq (scRNA-seq) experiments. Analysis of such a gene signature uncovers a specific transcriptional program associated with mPMN-MDSC differentiation and allows us to identify that, in patients with either solid or hematologic tumors and in GDs, CD52, CD84, and prostaglandin E receptor 2 (PTGER2) represent potential mPMN-MDSC-associated markers. Altogether, our findings indicate that mature PMN-MDSCs distinctively undergo specific reprogramming during differentiation and lay the groundwork for selective immunomonitoring, and eventually targeting, of mature PMN-MDSCs.
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Affiliation(s)
- Francesca Pettinella
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Barbara Mariotti
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Chiara Lattanzi
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Kirsten Bruderek
- Research Division, Department of Otorhinolaryngology, University Hospital Essen, 45122 Essen, Germany
| | - Marta Donini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Sara Costa
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Olivia Marini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Giulia Iannoto
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Sara Gasperini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Elena Caveggion
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | | | - Federica Calzetti
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | | | - Elisa Gardiman
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Matteo Giani
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Stefano Dusi
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Maurizio Cantini
- Transfusion Medicine Department, University and Hospital Trust (AOUI), Verona, Italy
| | - Aurora Vassanelli
- Transfusion Medicine Department, University and Hospital Trust (AOUI), Verona, Italy
| | - Denise Pavone
- Transfusion Medicine Department, University and Hospital Trust (AOUI), Verona, Italy
| | - Michele Milella
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
| | - Sara Pilotto
- Section of Innovation Biomedicine - Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
| | - Pamela Biondani
- Section of Oncology, University and Hospital Trust (AOUI) of Verona, Verona, Italy
| | - Benedikt Höing
- Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | | | - Timon Hussain
- Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Cordelia Kaspar
- Department of Urology, University Hospital Essen, Essen, Germany
| | - Carlo Visco
- Section of Hematology and Bone Marrow Transplant Unit, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
| | - Cristina Tecchio
- Section of Hematology and Bone Marrow Transplant Unit, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Verona, Italy
| | - Leo Koenderman
- Department of Respiratory Medicine and Center for Translational Immunology, University Medical Center Utrecht, 3584CX Utrecht, the Netherlands
| | - Flavia Bazzoni
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Nicola Tamassia
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Sven Brandau
- Research Division, Department of Otorhinolaryngology, University Hospital Essen, 45122 Essen, Germany; German Cancer Consortium, Partner Site Essen-Düsseldorf, Essen, Germany
| | - Marco A Cassatella
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy.
| | - Patrizia Scapini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy.
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Pinto A, Ladetto M, Martelli M, Visco C, Zaja F, Guardalben E, Zinzani PL. Unmet needs in relapsed/refractory mantle cell lymphoma after failure of covalent Bruton's tyrosine kinase inhibitors: An Italian scenario. Hematol Oncol 2024; 42:e3246. [PMID: 38287533 DOI: 10.1002/hon.3246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Antonio Pinto
- Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, Fondazione 'G. Pascale', IRCCS, Naples, Italy
| | - Marco Ladetto
- Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Maurizio Martelli
- Department of Translational and Precision Medicine, Sapienza University Rome, Rome, Italy
| | - Carlo Visco
- Department of Engineering for Innovation Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Francesco Zaja
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
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5
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Visco C. Letting the mantle out of the bag. Br J Haematol 2024; 204:11-13. [PMID: 37880826 DOI: 10.1111/bjh.19137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 10/27/2023]
Abstract
Mantle cell lymphoma is a rare disease that attracts the curiosity of clinicians and scientists due to its heterogeneous clinical behaviour, that can vary from indolent forms to the most aggressive presentations among non-Hodgkin lymphomas. The report by Eyre and colleagues describes the current treatment strategies available in most countries, and offers insights to clinicians for several intriguing difficult-to-treat scenarios. Commentary on: Eyre et al. Diagnosis and management of mantle cell lymphoma: a British Society for Haematology Guideline. Br J Haematol 2024;204:108-126.
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Affiliation(s)
- Carlo Visco
- Section of Hematology, Department of Engineering for Innovation Medicine, AOUI VR, University of Verona, Verona, Italy
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6
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Xu-Monette ZY, Li Y, Snyder T, Yu T, Lu T, Tzankov A, Visco C, Bhagat G, Qian W, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Hagemeister FB, Wang Y, Go H, Ponzoni M, Ferreri AJ, Møller MB, Parsons BM, Fan X, van Krieken JH, Piris MA, Winter JN, Au Q, Kirsch I, Zhang M, Shaughnessy J, Xu B, Young KH. Tumor-Infiltrating Normal B Cells Revealed by Immunoglobulin Repertoire Clonotype Analysis Are Highly Prognostic and Crucial for Antitumor Immune Responses in DLBCL. Clin Cancer Res 2023; 29:4808-4821. [PMID: 37728879 PMCID: PMC10842978 DOI: 10.1158/1078-0432.ccr-23-1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/09/2023] [Accepted: 09/18/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE Tumor-infiltrating B lymphocytes (TIL-B) have demonstrated prognostic and predictive significance in solid cancers. In this study, we aimed to distinguish TIL-Bs from malignant B-cells in diffuse large B-cell lymphoma (DLBCL) and determine the clinical and biological significance. EXPERIMENTAL DESIGN A total of 269 patients with de novo DLBCL from the International DLBCL R-CHOP Consortium Program were studied. Ultra-deep sequencing of the immunoglobulin genes was performed to determine B-cell clonotypes. The frequencies and numbers of TIL-B clonotypes in individual repertoires were correlated with patient survival, gene expression profiling (GEP) data, and frequencies of DLBCL-infiltrating immune cells quantified by fluorescent multiplex IHC at single-cell resolution. RESULTS TIL-B abundance, evaluated by frequencies of normal B-cell clonotypes in the immunoglobulin repertoires, remarkably showed positive associations with significantly better survival of patients in our sequenced cohorts. DLBCLs with high versus low TIL-B abundance displayed distinct GEP signatures, increased pre-memory B-cell state and naïve CD4 T-cell state fractions, and higher CD4+ T-cell infiltration. TIL-B frequency, as a new biomarker in DLBCL, outperformed the germinal center (GC) B-cell-like/activated B-cell-like classification and TIL-T frequency. The identified TIL-B-high GEP signature, including genes upregulated during T-dependent B-cell activation and those highly expressed in normal GC B cells and T cells, showed significant favorable prognostic effects in several external validation cohorts. CONCLUSIONS TIL-B frequency is a significant prognostic factor in DLBCL and plays a crucial role in antitumor immune responses. This study provides novel insights into the prognostic determinants in DLBCL and TIL-B functions with important therapeutic implications.
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Affiliation(s)
- Zijun Y. Xu-Monette
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Yong Li
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Tiantian Yu
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Tingxun Lu
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | | | - Carlo Visco
- Department of Hematology, University of Verona, Verona, Italy
| | - Govind Bhagat
- Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Wenbin Qian
- Department of Hematology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | | | | | - Wayne Tam
- Weill Medical College of Cornell University, New York, NY, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, USA
| | - Eric D. Hsi
- Wake Forest University, Winston-Salem, NC, USA
| | - Fredrick B. Hagemeister
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yingjun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Heounjeong Go
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | | | | | - Xiangshan Fan
- Pathology Center, Anhui Medical University and the first Affiliated Hospital, Hefei, China
| | | | - Miguel A. Piris
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jane N. Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Qingyan Au
- NeoGenomics Laboratories, Aliso Viejo, California, USA
| | | | - Mingzhi Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - John Shaughnessy
- Myeloma Center, Winthrop P. Rockefeller Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Bing Xu
- The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Ken H. Young
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Durham, NC, USA
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7
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Chung EYL, Sartori G, Ponzoni M, Cascione L, Priebe V, Xu-Monette ZY, Fang X, Zhang M, Visco C, Tzankov A, Rinaldi A, Sgrignani J, Zucca E, Rossi D, Cavalli A, Inghirami G, Scott DW, Young KH, Bertoni F. ETS1 phosphorylation at threonine 38 is associated with the cell of origin of diffuse large B cell lymphoma and sustains the growth of tumour cells. Br J Haematol 2023; 203:244-254. [PMID: 37584198 DOI: 10.1111/bjh.19018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/17/2023]
Abstract
The transcriptional factor ETS1 is upregulated in 25% of diffuse large B cell lymphoma (DLBCL). Here, we studied the role of ETS1 phosphorylation at threonine 38, a marker for ETS1 activation, in DLBCL cellular models and clinical specimens. p-ETS1 was detected in activated B cell-like DLBCL (ABC), not in germinal centre B-cell-like DLBCL (GCB) cell lines and, accordingly, it was more common in ABC than GCB DLBCL diagnostic biopsies. MEK inhibition decreased both baseline and IgM stimulation-induced p-ETS1 levels. Genetic inhibition of phosphorylation of ETS1 at threonine 38 affected the growth and the BCR-mediated transcriptome program in DLBCL cell lines. Our data demonstrate that ETS1 phosphorylation at threonine 38 is important for the growth of DLBCL cells and its pharmacological inhibition could benefit lymphoma patients.
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Affiliation(s)
- Elaine Y L Chung
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
| | - Giulio Sartori
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
| | - Maurilio Ponzoni
- IRCCS San Raffaele Hospital Scientific Institute, Vita Salute San Raffaele University, Milan, Italy
| | - Luciano Cascione
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Valdemar Priebe
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
| | | | - Xiaosheng Fang
- Duke University Medical Center, Durham, North Carolina, USA
| | - Mingzhi Zhang
- Duke University Medical Center, Durham, North Carolina, USA
| | - Carlo Visco
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital, Basel, Switzerland
| | - Andrea Rinaldi
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
| | - Jacopo Sgrignani
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, USI, Bellinzona, Switzerland
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Davide Rossi
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Andrea Cavalli
- Faculty of Biomedical Sciences, Institute for Research in Biomedicine, USI, Bellinzona, Switzerland
| | - Giorgio Inghirami
- Pathology and Laboratory Medicine Department, Weill Cornell Medicine, New York, New York, USA
| | - David W Scott
- Centre for Lymphoid Cancer, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ken H Young
- Duke University Medical Center, Durham, North Carolina, USA
| | - Francesco Bertoni
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
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8
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Villa D, Jiang A, Visco C, Crosbie N, McCulloch R, Buege MJ, Kumar A, Bond DA, Paludo J, Maurer MJ, Thanarajasingam G, Lewis KL, Cheah CY, Baech J, El-Galaly TC, Kugathasan L, Scott DW, Gerrie AS, Lewis D. Time to progression of disease and outcomes with second-line BTK inhibitors in relapsed/refractory mantle cell lymphoma. Blood Adv 2023; 7:4576-4585. [PMID: 37307169 PMCID: PMC10425680 DOI: 10.1182/bloodadvances.2023009804] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023] Open
Abstract
Time to progression of disease (POD) after first-line (1L) therapy is prognostic in mantle cell lymphoma (MCL), although studies have included a broad range of 1L, second-line (2L), and subsequent lines of therapy. The purpose of this study was to evaluate the factors predicting outcomes in patients with relapsed/refractory (R/R) MCL exclusively initiating 2L Bruton's tyrosine kinase inhibitors (BTKis) after 1L rituximab-containing therapy. Patients were accrued from 8 international centers (7 main, 1 validation cohort). Multivariable models evaluating the association between time to POD and clinical/pathologic factors were constructed and converted into nomograms and prognostic indexes predicting outcomes in this population. A total of 360 patients were included, including 160 in the main cohort and 200 in the validation cohort. Time to POD, Ki67 ≥ 30%, and MCL International Prognostic Index (MIPI) were associated with progression-free survival (PFS2) and overall survival (OS2) from the start of 2L BTKis. C-indexes were consistently ≥0.68 in both cohorts. Web/application-based calculators based on nomograms and prognostic indexes to estimate PFS2 and OS2 were constructed. The 2L BTKi MIPI identifies 3 groups with distinct 2-year PFS2, including high risk (14%), intermediate risk (50%), and low risk (64%). Time to POD, Ki67, and MIPI are associated with survival outcomes in patients with R/R MCL receiving 2L BTKis. Simple clinical models incorporating these variables may assist in planning for alternative therapies such as chimeric antigen receptor T-cell therapy, allogeneic stem cell transplantation, or novel agents with alternative mechanisms of action.
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Affiliation(s)
- Diego Villa
- British Columbia Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, BC, Canada
| | - Aixiang Jiang
- British Columbia Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, BC, Canada
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Nicola Crosbie
- Haematology, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - Rory McCulloch
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, United Kingdom
| | - Michael J. Buege
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY
- University of Illinois Chicago College of Pharmacy, Chicago, IL
| | - Anita Kumar
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David A. Bond
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Jonas Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Matthew J. Maurer
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN
| | | | - Katharine L. Lewis
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Division of Internal Medicine, Medical School, University of Western Australia, Perth, WA, Australia
| | - Chan Y. Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Division of Internal Medicine, Medical School, University of Western Australia, Perth, WA, Australia
| | - Joachim Baech
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Haematology, Aalborg, Denmark
| | - Tarec C. El-Galaly
- Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Haematology, Aalborg, Denmark
| | | | - David W. Scott
- British Columbia Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, BC, Canada
| | - Alina S. Gerrie
- British Columbia Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, BC, Canada
| | - David Lewis
- Haematology, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
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9
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Tisi MC, Moia R, Patti C, Evangelista A, Ferrero S, Spina M, Tani M, Botto B, Celli M, Puccini B, Cencini E, Di Rocco A, Chini C, Ghiggi C, Zambello R, Zanni M, Sciarra R, Bruna R, Ferrante M, Pileri SA, Quaglia FM, Stelitano C, Re A, Volpetti S, Zilioli VR, Arcari A, Merli F, Visco C. Long-term follow-up of rituximab plus bendamustine and cytarabine in older patients with newly diagnosed MCL. Blood Adv 2023; 7:3916-3924. [PMID: 37171620 PMCID: PMC10405197 DOI: 10.1182/bloodadvances.2023009744] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/13/2023] Open
Abstract
The combination of rituximab, bendamustine, and low-dose cytarabine (R-BAC) has been studied in a phase 2 prospective multicenter study from Fondazione Italiana Linfomi (RBAC500). In 57 previously untreated elderly patients with mantle cell lymphoma (MCL), R-BAC was associated with a complete remission rate of 91% and 2-year progression-free survival (PFS) of 81% (95% confidence interval [CI], 68-89). Here, we report the long-term survival outcomes, late toxicities, and results of minimal residual disease (MRD) evaluation. After a median follow-up of 86 months (range, 57-107 months), the median overall survival (OS) and PFS were not reached. The 7-year PFS and OS rates were 55% (95% CI, 41-67), and 63% (95% CI, 49-74), respectively. Patients who responded (n = 53) had a 7-year PFS of 59% (95% CI, 44-71), with no relapse or progression registered after the sixth year. In the multivariate analysis, blastoid/pleomorphic morphology was the strongest adverse predictive factor for PFS (P = .04). Patients with an end of treatment negative MRD had better, but not significant, outcomes for both PFS and OS than patients with MRD-positive (P = 0.148 and P = 0.162, respectively). There was no signal of late toxicity or an increase in secondary malignancies during the prolonged follow-up. In conclusion, R-BAC, which was not followed by maintenance therapy, showed sustained efficacy over time in older patients with MCL. Survival outcomes compare favorably with those of other immunochemotherapy regimens (with or without maintenance), including combinations of BTK inhibitors upfront. This study was registered with EudraCT as 2011-005739-23 and at www.clinicaltrials.gov as #NCT01662050.
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Affiliation(s)
- Maria Chiara Tisi
- Hematology Unit, San Bortolo Hospital, AULSS 8 Berica, Vicenza, Italy
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale and AOU Maggiore della Carità, Novara, Italy
| | - Caterina Patti
- Oncohematology Azienda Ospedali Riuniti Villa Sofia-V. Cervello Palermo, Italy
| | - Andrea Evangelista
- Unit of Clinical Epidemiology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza and CPO Piemonte, Turin, Italy
| | - Simone Ferrero
- Hematology 1 U, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy/AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano IRCCS, Aviano, Italy
| | - Monica Tani
- Hematology, Ospedale di Ravenna, Ravenna, Italy
| | - Barbara Botto
- Hematology, Città' della Salute e della Scienza University Hospital, Torino, Italy
| | | | - Benedetta Puccini
- Department of Hematology, Careggi Hospital and University of Florence, Florence, Italy
| | - Emanuele Cencini
- UOC Ematologia, Azienda Ospedaliera Universitaria Senese & University of Siena, Siena, Italy
| | - Alice Di Rocco
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Chiara Ghiggi
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Manuela Zanni
- Hematology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale and AOU Maggiore della Carità, Novara, Italy
| | - Martina Ferrante
- Hematology 1 U, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | | | - Francesca Maria Quaglia
- Section of Hematology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Caterina Stelitano
- Grande Ospedale Metropolitano, Bianchi Melacrino Morelli, Ematologia Reggio Calabria, Reggio Calabria, Italy
| | | | - Stefano Volpetti
- Hematology Department, Santa Maria della Misericordia Hospital - ASUFC, Udine, Italy
| | | | - Annalisa Arcari
- Hematology Unit, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Carlo Visco
- Section of Hematology, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
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10
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Mazzera L, Abeltino M, Lombardi G, Cantoni AM, Jottini S, Corradi A, Ricca M, Rossetti E, Armando F, Peli A, Ferrari A, Martinelli G, Scupoli MT, Visco C, Bonifacio M, Ripamonti A, Gambacorti-Passerini C, Bonati A, Perris R, Lunghi P. MEK1/2 regulate normal BCR and ABL1 tumor-suppressor functions to dictate ATO response in TKI-resistant Ph+ leukemia. Leukemia 2023; 37:1671-1685. [PMID: 37386079 PMCID: PMC10400427 DOI: 10.1038/s41375-023-01940-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/10/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
Resistance to tyrosine kinase inhibitors (TKIs) remains a clinical challenge in Ph-positive variants of chronic myeloid leukemia. We provide mechanistic insights into a previously undisclosed MEK1/2/BCR::ABL1/BCR/ABL1-driven signaling loop that may determine the efficacy of arsenic trioxide (ATO) in TKI-resistant leukemic patients. We find that activated MEK1/2 assemble into a pentameric complex with BCR::ABL1, BCR and ABL1 to induce phosphorylation of BCR and BCR::ABL1 at Tyr360 and Tyr177, and ABL1, at Thr735 and Tyr412 residues thus provoking loss of BCR's tumor-suppression functions, enhanced oncogenic activity of BCR::ABL1, cytoplasmic retention of ABL1 and consequently drug resistance. Coherently, pharmacological blockade of MEK1/2 induces dissociation of the pentameric MEK1/2/BCR::ABL1/BCR/ABL1 complex and causes a concurrent BCRY360/Y177, BCR::ABL1Y360/Y177 and cytoplasmic ABL1Y412/T735 dephosphorylation thereby provoking the rescue of the BCR's anti-oncogenic activities, nuclear accumulation of ABL1 with tumor-suppressive functions and consequently, growth inhibition of the leukemic cells and an ATO sensitization via BCR-MYC and ABL1-p73 signaling axes activation. Additionally, the allosteric activation of nuclear ABL1 was consistently found to enhance the anti-leukemic effects of the MEK1/2 inhibitor Mirdametinib, which when combined with ATO, significantly prolonged the survival of mice bearing BCR::ABL1-T315I-induced leukemia. These findings highlight the therapeutic potential of MEK1/2-inhibitors/ATO combination for the treatment of TKI-resistant leukemia.
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Affiliation(s)
- Laura Mazzera
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Brescia, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Manuela Abeltino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Guerino Lombardi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Brescia, Italy
| | | | - Stefano Jottini
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Attilio Corradi
- Department of Veterinary Science, University of Parma, Parma, Italy
| | - Micaela Ricca
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "Bruno Ubertini", Brescia, Italy
| | - Elena Rossetti
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- National Healthcare Service (SSN-Servizio Sanitario Nazionale) ASL Piacenza, Piacenza, Italy
| | - Federico Armando
- Department of Veterinary Science, University of Parma, Parma, Italy
- University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Angelo Peli
- Department for Life Quality Studies Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Anna Ferrari
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy
| | - Giovanni Martinelli
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy
- Institute of Hematology "L. e A. Seragnoli", Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Maria Teresa Scupoli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Carlo Visco
- Department of Engineering for Innovation Medicine, Section of Hematology-University of Verona, Verona, Italy
| | - Massimiliano Bonifacio
- Department of Engineering for Innovation Medicine, Section of Hematology-University of Verona, Verona, Italy
| | - Alessia Ripamonti
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
- Adult Hematology, IRCCS San Gerardo, Monza, Italy
| | - Carlo Gambacorti-Passerini
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
- Adult Hematology, IRCCS San Gerardo, Monza, Italy
| | - Antonio Bonati
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberto Perris
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
- Centre for Molecular and Translational Oncology-COMT, University of Parma, Parma, Italy
| | - Paolo Lunghi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy.
- Centre for Molecular and Translational Oncology-COMT, University of Parma, Parma, Italy.
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11
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Moia R, Dondolin R, De Propris MS, Talotta D, Mouhssine S, Perutelli F, Reda G, Mattiello V, Rigolin GM, Motta M, Olivieri J, Fanin R, Perbellini O, Ferrarini I, Mauro FR, Del Giudice I, Laurenti L, Tomasso A, Gentile M, Frustaci AM, Tedeschi A, Gozzetti A, Stelitano C, Visco C, Moreno C, Forconi F, Marasca R, Coscia M, Rossi D, Foà R, Gaidano G. Long-term benefit of IGHV mutated patients in a real-life multicenter cohort of FCR-treated chronic lymphocytic leukemia. Hematol Oncol 2023; 41:567-570. [PMID: 36190298 DOI: 10.1002/hon.3080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Riccardo Moia
- Division of Hematology, Department of Translational Medicine, Università Del Piemonte Orientale, Novara, Italy
| | - Riccardo Dondolin
- Division of Hematology, Department of Translational Medicine, Università Del Piemonte Orientale, Novara, Italy
| | | | - Donatella Talotta
- Division of Hematology, Department of Translational Medicine, Università Del Piemonte Orientale, Novara, Italy
| | - Samir Mouhssine
- Division of Hematology, Department of Translational Medicine, Università Del Piemonte Orientale, Novara, Italy
| | - Francesca Perutelli
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Gianluigi Reda
- Hematology Unit, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Veronica Mattiello
- Hematology Unit, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gian Matteo Rigolin
- Department of Medical Sciences, Hematology Section, AOU Arcispedale S Anna, University of Ferrara, Ferrara, Italy
| | | | - Jacopo Olivieri
- Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), SOC Clinica Ematologica, Udine, Italy
| | - Renato Fanin
- Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), SOC Clinica Ematologica, Udine, Italy
| | - Omar Perbellini
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Isacco Ferrarini
- Department of Medicine, Section of Haematology, University of Verona, Verona, Italy
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Luca Laurenti
- Department of Hematology, Catholic University Hospital A. Gemelli, Rome, Italy
| | - Annamaria Tomasso
- Department of Hematology, Catholic University Hospital A. Gemelli, Rome, Italy
| | | | - Anna Maria Frustaci
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Alessandra Tedeschi
- Department of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Caterina Stelitano
- U.O.C. Ematologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Di Calabria, Italy
| | - Carlo Visco
- Department of Medicine, Section of Haematology, University of Verona, Verona, Italy
| | - Carol Moreno
- Hospital de La Santa Creu I Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Roberto Marasca
- Department of Medical Sciences, Section of Hematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Marta Coscia
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Davide Rossi
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Università Del Piemonte Orientale, Novara, Italy
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12
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Marchetti M, Visco C. Cost-Effectiveness of brexucabtagene autoleucel for relapsed/refractory mantle cell lymphoma. Leuk Lymphoma 2023; 64:1442-1450. [PMID: 37229538 DOI: 10.1080/10428194.2023.2215888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/07/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
Brexucabtagene autoleucel is a chimeric anti CD19 antigen receptor T-cell therapy that allows durable responses in relapsed/refractory (R/R) mantle cell lymphoma (MCL). The present study compared the clinical and economic outcomes of R/R MCL patients (pre-exposed to ibrutinib and chemoimmunotherapy) treated with brexucabtagene autoleucel versus Rituximab, bendamustine, cytarabine (R-BAC) in the Italian Healthcare System. A partitioned-survival model extrapolated survival and healthcare costs of R/R MCL patients over a lifetime horizon. Discounted and quality-adjusted life expectancy (QALY) was 6.40 versus 1.20 for brexucabtagene autoleucel versus R-BAC and lifetime costs were €411,403 versus €74,415, respectively, which corresponds to a cost of €64,798 per QALY gained. The results were highly sensitive to brexucabtagene autoleucel acquisition cost and to assumptions on long-term survival, therefore the cost-effectiveness of brexucabtagene autoleucel for patients with R/R MCL requires validation with longer follow-up data and in specific risk subgroups.
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Affiliation(s)
- M Marchetti
- Hematology & Transplant Unit, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - C Visco
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
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13
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Bernardelli A, Falchi L, Qiao J, Visco C. Editorial: Advances in the understanding and treatment of cutaneous lymphoma. Front Oncol 2023; 13:1190269. [PMID: 37056340 PMCID: PMC10086437 DOI: 10.3389/fonc.2023.1190269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Andrea Bernardelli
- Department of Engineering for Innovation Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Lorenzo Falchi
- Lymphoma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | - Jianjun Qiao
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Carlo Visco
- Department of Engineering for Innovation Medicine, Section of Hematology, University of Verona, Verona, Italy
- *Correspondence: Carlo Visco,
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14
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Passamonti F, Nicastri E, Di Rocco A, Guarini A, Ibatici A, Luminari S, Mikulska M, Visco C. Management of patients with lymphoma and COVID-19: Narrative review and evidence-based practical recommendations. Hematol Oncol 2023; 41:3-15. [PMID: 36251481 PMCID: PMC9874581 DOI: 10.1002/hon.3086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/29/2022] [Accepted: 10/11/2022] [Indexed: 02/03/2023]
Abstract
Patients with hematologic malignancies can be immunocompromized because of their disease, anti-cancer therapy, and concomitant immunosuppressive treatment. Furthermore, these patients are usually older than 60 years and have comorbidities. For all these reasons they are highly vulnerable to infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and have an increased risk of developing severe/critical Coronavirus disease 2019 (COVID-19) compared to the general population. Although COVID-19 vaccination has proven effective in reducing the incidence of severe/critical disease, vaccinated patients with lymphoma may not be protected as they often fail to develop a sufficient antiviral immune response. There is therefore an urgent need to address the management of patients with lymphoma and COVID-19 in the setting of the ongoing pandemic. Passive immunization with monoclonal antibodies against SARS-CoV-2 is a currently available complementary drug strategy to active vaccination for lymphoma patients, while monoclonal antibodies and antiviral drugs (remdesivir, ritonavir-boosted nirmatrelvir, and molnupiravir) have proven effective in preventing the progression to severe/critical COVID-19. In this narrative review we present the most recent data documenting the characteristics and outcomes of patients with concomitant lymphoma and COVID-19. Our ultimate goal is to provide practice-oriented guidance in the management of these vulnerable patients from diagnosis to treatment and follow-up of lymphoma. To this purpose, we will first provide an overview of the main data concerning prognostic factors and fatality rate of lymphoma patients who develop COVID-19; the outcomes of COVID-19 vaccination will also be addressed. We will then discuss current COVID-19 prophylaxis and treatment options for lymphoma patients. Finally, based on the literature and our multidisciplinary experience, we will summarize a set of indications on how to manage patients with lymphoma according to COVID-19 exposure, level of disease severity and former history of infection, as typically encountered in clinical practice.
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Affiliation(s)
- Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Hematology, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Emanuele Nicastri
- National Institute of Infectious Diseases "L. Spallanzani", IRCCS, Roma, Italy
| | - Alice Di Rocco
- Department of Cellular Biotechnologies and Hematology, Hematology Unit, Sapienza University, Roma, Italy
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Adalberto Ibatici
- Hematology Unit and Bone Marrow Transplantation, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale, IRCCS Reggio Emilia, Reggio Emilia, Italy.,Dipartimento CHIMOMO, Università di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Malgorzata Mikulska
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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15
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Riva M, Tisi MC, Bertorelle R, Famengo B, D'Amore ESG, Pizzi M, Parisi A, Boscato E, Mazzucco M, Semenzato G, Krampera M, Gherlinzoni F, Trentin L, Ruggeri M, Visco C, Stefani PM, Piazza F. IDH2 R172 mutation in angioimmunoblastic T-cell lymphoma: A retrospective multicenter case series. Eur J Haematol 2023; 110:217-220. [PMID: 36264618 DOI: 10.1111/ejh.13885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Marcello Riva
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | | | - Roberta Bertorelle
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Istituto Oncologico Veneto, Padova, Italy
| | | | | | - Marco Pizzi
- General Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Alice Parisi
- Unit of Pathology, Department of Diagnostics and Public Health, G.B. Rossi University Hospital, Verona, Italy
| | - Elena Boscato
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy
| | - Maddalena Mazzucco
- Hematology Unit, Ospedale dell'Angelo and Ospedale S. Giovanni e Paolo, Mestre Venezia, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Filippo Gherlinzoni
- Hematology Unit, Department of Medicine, Treviso General Hospital, Treviso, Italy
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Unit, Padova, Italy
| | - Marco Ruggeri
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Piero Maria Stefani
- Hematology Unit, Department of Medicine, Treviso General Hospital, Treviso, Italy
| | - Francesco Piazza
- Department of Medicine, Hematology and Clinical Immunology Unit, Padova, Italy
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16
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Rusconi C, Visco C. Putting the brain into mantle cell lymphoma. Leuk Lymphoma 2023; 64:259-260. [PMID: 36591725 DOI: 10.1080/10428194.2022.2163171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Chiara Rusconi
- Division of Hematolgy and Bone Marrow Transplantation, Foundation IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Carlo Visco
- Department of Medicine, Hematology Unit, University of Verona, Verona, Italy
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17
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Ferrarini I, Bernardelli A, Lovato E, Schena A, Krampera M, Visco C. An updated portrait of monocyte-macrophages in classical Hodgkin lymphoma. Front Oncol 2023; 13:1149616. [PMID: 36910620 PMCID: PMC10001882 DOI: 10.3389/fonc.2023.1149616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
Classical Hodgkin lymphoma (cHL) is a unique neoplastic ecosystem characterized by a heterogeneous immune infiltrate surrounding the rare malignant Hodgkin Reed-Sternberg cells. Though less abundant than T-cells, tumor-infiltrating macrophages play a pivotal role in supporting HRS survival through cell-to-cell and paracrine interactions. Traditional immunohistochemistry based upon the M1-M2 dichotomy yielded controversial results about the composition, functional role and prognostic impact of macrophages in cHL. More recent studies exploiting single-cell technologies and image analyses have highlighted the heterogeneity and the peculiar spatial arrangement of the macrophagic infiltrate, with the most immunosuppressive subpopulations lying in close proximity of HRS cells and the most tumor-hostile subsets kept far away from the neoplastic niches. High-throughput analysis of peripheral blood mononuclear cells in cHL patients have also identified a novel, potentially cytotoxic, subpopulation predicting better response to PD-1 blockade. This review examines the phenotypic profile, spatial localization and clinical impact of tumor-infiltrating macrophages and circulating monocytes in cHL, providing an up-do-date portrait of these innate immune cells with possible translational applications.
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Affiliation(s)
- Isacco Ferrarini
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Andrea Bernardelli
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Ester Lovato
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Alberto Schena
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Carlo Visco
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
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18
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Lovato E, Gangemi C, Krampera M, Visco C, Ferrarini I. Case Report: Rapid renal response to venetoclax monotherapy in a CLL patient with secondary membranous glomerulonephritis. Front Oncol 2023; 13:1108994. [PMID: 37152058 PMCID: PMC10160354 DOI: 10.3389/fonc.2023.1108994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Membranous glomerulonephritis (MGN) is a rare extra-hematological autoimmune complication of chronic lymphocytic leukemia (CLL), clinically characterized by nephrotic-range proteinuria and, less frequently, renal failure. Because of the rarity of this condition, there is no standardized treatment. Chlorambucil and fludarabine-based regimens, possibly combined with rituximab, have been historically the most frequent therapeutic approaches, with renal response obtained in about two-third of the patients. However, responses are often transient and partial. Here we describe the first patient with rituximab-refractory, CLL-related MGN successfully treated with the Bcl-2 antagonist venetoclax. Nephrotic syndrome resolved as soon as three months after venetoclax initiation, with no unexpected toxicities. At the last follow-up, 17 months after venetoclax start, renal response persists, with proteinuria below 0.5 g/24 hours. This case suggests that targeted agents, particularly Bcl-2 antagonists, might be suitable options for patients with renal autoimmune disorders arising in the context of CLL.
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Affiliation(s)
- Ester Lovato
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Concetta Gangemi
- Division of Nephrology and Dialysis, University Hospital of Verona, Verona, Italy
| | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Carlo Visco
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
| | - Isacco Ferrarini
- Section of Hematology, Department of Medicine, University of Verona, Verona, Italy
- *Correspondence: Isacco Ferrarini,
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19
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Pirosa MC, Sassone M, Kiesewetter B, Guillermo AL, Devizzi L, Domènech ED, Tucci A, Mannina D, Merli M, Salar A, Visco C, Esposito F, Bonomini L, Zucca E, Ferreri AJM, Raderer M. IELSG40/CLEO phase II trial of clarithromycin and lenalidomide in relapsed/refractory extranodal marginal zone lymphoma. Haematologica 2022. [DOI: 10.3324/haematol.2022.281963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Indexed: 12/24/2022] Open
Abstract
Not available.
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20
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Merli M, Rattotti S, Spina M, Re F, Motta M, Piazza F, Orsucci L, Ferreri AJ, Perbellini O, Dodero A, Vallisa D, Pulsoni A, Santoro A, Sacchi P, Zuccaro V, Chimienti E, Russo F, Visco C, Zignego AL, Marcheselli L, Passamonti F, Luminari S, Paulli M, Bruno R, Arcaini L. Direct-Acting Antivirals as Primary Treatment for Hepatitis C Virus-Associated Indolent Non-Hodgkin Lymphomas: The BArT Study of the Fondazione Italiana Linfomi. J Clin Oncol 2022; 40:4060-4070. [PMID: 35714311 PMCID: PMC9746784 DOI: 10.1200/jco.22.00668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We prospectively treated patients with hepatitis C virus (HCV)-associated indolent lymphomas with genotype-appropriate direct-acting antivirals (DAAs) with the aim to evaluate virologic and hematologic outcomes. No prospective studies in this setting have been published so far. METHODS FIL_BArT is a prospective, multicenter, phase II trial that evaluated genotype-appropriate DAAs in untreated HCV-positive patients with indolent lymphomas without criteria for immediate conventional antilymphoma treatment. The primary objective was sustained virologic response, whereas the main secondary objectives were overall response rate of lymphoma and progression-free survival. RESULTS Forty patients were enrolled, including 27 with marginal zone lymphoma. Median age was 68 years. Extranodal sites were involved in 14 cases (35%). Main genotypes were 1 in 16 patients and 2 in 21 patients. All patients received genotype-guided DAAs: 17 ledipasvir/sofosbuvir, eight sofosbuvir plus ribavirin, and 15 sofosbuvir/velpatasvir. All patients achieved sustained virologic response (100%). DAAs were well tolerated, with only two grade 3-4 adverse events. Overall response rate of lymphoma was 45%, including eight patients (20%) achieving complete response and 10 (25%) partial response, whereas 16 exhibited stable disease and six progressed. With a median follow-up of 37 months, two patients died (3-year overall survival 93%; 95% CI, 74 to 98) and three additional patients progressed, with a 3-year progression-free survival of 76% (95% CI, 57 to 87). CONCLUSION HCV eradication by DAAs was achieved in 100% of HCV-positive patients with indolent lymphomas not requiring immediate conventional treatment and resulted in non-negligible rate of lymphoma responses. Treatment with DAAs should be considered as the first-line therapy in this setting.
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Affiliation(s)
- Michele Merli
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Spina
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Francesca Re
- Division of Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Marina Motta
- Division of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Francesco Piazza
- Hematology and Clinical Immunology Unit, Department of Medicine—DIMED, University of Padova, Padova, Italy
| | - Lorella Orsucci
- Division of Hematology, Città della Salute e della Scienza di Torino, Torino, Italy
| | | | - Omar Perbellini
- Division of Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Anna Dodero
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Daniele Vallisa
- Division of Hematology, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Alessandro Pulsoni
- Department of Translational and Precision Medicine, Sapienza University of Roma, Roma, Italy
| | - Armando Santoro
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital-Humanitas Cancer Center, Milano, Italy
| | - Paolo Sacchi
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Emanuela Chimienti
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | - Filomena Russo
- Division of Hematology and BMT Center, Azienda Ospedaliera Universitaria, Parma, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Anna Linda Zignego
- Department of Clinical and Experimental Medicine, Interdepartmental Hepatology Center MASVE, University of Firenze, Firenze, Italy
| | | | - Francesco Passamonti
- Division of Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, University of Insubria, Varese, Italy,Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Stefano Luminari
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy,Division of Hematology, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy
| | - Marco Paulli
- Unit of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Raffaele Bruno
- Division of Infectious and Tropical Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy,Department of Molecular Medicine, University of Pavia, Pavia, Italy,Luca Arcaini, MD, Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy; e-mail:
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21
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Cox MC, Marcheselli L, Scafetta G, Visco C, Hohaus S, Annibali O, Musuraca G, Fabbri A, Cantonetti M, Pelliccia S, Papotti R, Petrucci L, Tani M, Battistini R, Arcari A, Luminari S, Lopez G, Alma E, Pupo L, Carli G, Marchesi F, Re F, Scarpino S, D'amore ESG, Larocca LM, Bianchi A, Pepe G, Natalino F, Anticoli-Borza P, Cenfra N, Andriani A, Abruzzese E, Tesei C, Leoncini L, Asioli S, Ruco L, Di Napoli A. IgM-secreting diffuse large B-cell lymphoma: results of a multicentre clinicopathological and molecular study. Leukemia 2022; 36:2719-2723. [PMID: 36127510 DOI: 10.1038/s41375-022-01706-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022]
Affiliation(s)
- M Christina Cox
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy.
| | | | - Giorgia Scafetta
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | - Stefan Hohaus
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | | | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | | | - Maria Cantonetti
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | - Sabrina Pelliccia
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Robel Papotti
- Chimomo department, university of Modena and Reggio Emilia, Modena, Italy
| | | | - Monica Tani
- Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | | | - Stefano Luminari
- Hematology Ausl IRCCS of Reggio Emilia & Chimomo department, university of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Gianluca Lopez
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Eleonora Alma
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | - Livio Pupo
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | | | | | | | - Stefania Scarpino
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | - Luigi M Larocca
- Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Roma, Italy
| | | | - Giuseppina Pepe
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | | | | | | | | | | | - Cristiano Tesei
- Fondazione Policlinico Tor Vergata, University Hospital, Rome, Italy
| | | | - Silvia Asioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Luigi Ruco
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Sapienza University, Sant'Andrea University Hospital, Rome, Italy.
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22
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Merli M, Ferrarini I, Merli F, Busca A, Mina R, Falini B, Bruna R, Cairoli R, Marchetti M, Romano A, Cavo M, Arcaini L, Trentin L, Cattaneo C, Derenzini E, Fracchiolla NS, Marchesi F, Scattolin A, Billio A, Bocchia M, Massaia M, Gambacorti‐Passerini C, Mauro FR, Gentile M, Mohamed S, Della Porta MG, Coviello E, Cilloni D, Visani G, Federici AB, Tisi MC, Cudillo L, Galimberti S, Gherlinzoni F, Pagano L, Guidetti A, Bertù L, Corradini P, Passamonti F, Visco C. SARS-CoV-2 infection in patients with chronic lymphocytic leukemia: The Italian Hematology Alliance on COVID-19 cohort. Hematol Oncol 2022; 41:128-138. [PMID: 36265128 PMCID: PMC9874469 DOI: 10.1002/hon.3092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 02/03/2023]
Abstract
COVID-19, the disease caused by SARS-CoV-2, is still afflicting thousands of people across the globe. Few studies on COVID-19 in chronic lymphocytic leukemia (CLL) are available. Here, we analyzed data from the CLL cohort of the Italian Hematology Alliance on COVID-19 (NCT04352556), which included 256 CLL patients enrolled between 25 February 2020 and 1 February 2021. Median age was 70 years (range 38-94) with male preponderance (60.1%). Approximately half of patients (n = 127) had received at least one line of therapy for CLL, including 108 (83.7%) who were on active treatment at the time of COVID-19 or received their last therapy within 12 months. Most patients (230/256, 89.9%) were symptomatic at COVID-19 diagnosis and the majority required hospitalization (n = 176). Overall, after a median follow-up of 42 days (IQR 24-96), case fatality rate was 30.1%, and it was 37.5% and 24.4% in the first (25 February 2020-22 June 2020) and second wave (23 June 2020-1 February 2021), respectively (p = 0.03). At multivariate analysis, male sex (HR 1.82, 95% CI 1.03-3.24, p = 0.04), age over than 70 years (HR 2.23, 95% CI 1.23-4.05, p = 0.01), any treatment for CLL given in the last 12 months (HR 1.72, 95% CI 1.04-2.84, p = 0.04) and COVID-19 severity (severe: HR 5.66, 95% CI 2.62-12.33, p < 0.0001; critical: HR 15.99, 95% CI 6.93-36.90, p < 0.0001) were independently associated with poor survival. In summary, we report a dismal COVID-related outcome in a significant fraction of CLL patients, that can be nicely predicted by clinical parameters.
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Affiliation(s)
- Michele Merli
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Isacco Ferrarini
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Francesco Merli
- HematologyAzienda Unità Sanitaria Locale‐Istituto di Ricovero e Cura a Carattere Scientifico Reggio EmiliaReggio EmiliaItaly
| | - Alessandro Busca
- Stem Cell Transplant CenterAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | - Roberto Mina
- Myeloma UnitDivision of HematologyUniversity of TurinAzienda Ospedaliera Universitaria Citta’ della Salute e della ScienzaTurinItaly
| | | | - Riccardo Bruna
- Division of HematologyDepartment of Translational MedicineUniversity of Eastern Piedmont and Ospedale Maggiore della CaritàNovaraItaly
| | - Roberto Cairoli
- HematologyAzienda Socio‐Sanitaria Territoriale Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Monia Marchetti
- HematologyAzienda Ospedaliera Santissimi Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | - Alessandra Romano
- HematologyDipartimento di Chirurgia e Specialità Medico ChirurgicheUniversità degli Studi di CataniaCataniaItaly
| | - Michele Cavo
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaSeràgnoli Institute of HematologyDepartment of Experimental, Diagnostic and Specialty MedicineBologna University School of MedicineBolognaItaly
| | - Luca Arcaini
- Department of Molecular MedicineUniversity of Pavia & Division of HematologyFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Livio Trentin
- Hematology and Clinical Immunology UnitDepartment of MedicineUniversity of PaduaPaduaItaly
| | - Chiara Cattaneo
- HematologyAzienda Socio‐Sanitaria Territoriale‐Spedali CiviliBresciaItaly
| | - Enrico Derenzini
- Onco‐Hematology DivisionIEO European Institute of Oncology IRCCS & Department of Health SciencesUniversity of MilanMilanItaly
| | | | - Francesco Marchesi
- Hematology and Stem Cell Transplant UnitIstituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer InstituteRomeItaly
| | | | - Atto Billio
- Division of Hematology and BMTHospital S. MaurizioBolzanoItaly
| | - Monica Bocchia
- Hematology UnitUniversity of SienaAzienda Ospedaliero Universitaria SeneseSienaItaly
| | | | | | - Francesca Romana Mauro
- HematologyDepartment of Translational and Precision MedicineSapienza University of RomeRomeItaly
| | - Massimo Gentile
- Hematology UnitDepartment of Hemato‐Oncology, Ospedale AnnunziataCosenzaItaly
| | - Sara Mohamed
- UCO EmatologiaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Matteo Giovanni Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical SciencesHumanitas UniversityMilanItaly
| | - Elisa Coviello
- Hematology and Bone Marrow TransplantIstituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San MartinoGenovaItaly
| | - Daniela Cilloni
- Department of Clinical and Biological SciencesUniversity of TurinSan Luigi HospitalTurinItaly
| | - Giuseppe Visani
- Dipartimento di Onco‐EmatologiaAzienda Ospedaliera Ospedali Riuniti Marche NordPesaroItaly
| | | | | | | | - Sara Galimberti
- Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly
| | | | - Livio Pagano
- Dipartimento di Scienze Radiologiche ed EmatologicheFondazione Policlinico Universitario A Gemelli–IRCCS–Università Cattolica del Sacro CuoreRomeItaly
| | - Anna Guidetti
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Lorenza Bertù
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Paolo Corradini
- Hematology and Bone Marrow TransplantationFondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Francesco Passamonti
- Division of HematologyUniversity Hospital Ospedale di Circolo e Fondazione Macchi ‐ASST Sette LaghiUniversity of InsubriaVareseItaly
| | - Carlo Visco
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
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23
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Carrara E, Razzaboni E, Azzini AM, De Rui ME, Pinho Guedes MN, Gorska A, Giannella M, Bussini L, Bartoletti M, Arbizzani F, Palacios‐Baena ZR, Caponcello G, Maldonado N, Rodríguez‐Baño J, Visco C, Krampera M, Tacconelli E. Predictors of clinical evolution of SARS-CoV-2 infection in hematological patients: A systematic review and meta-analysis. Hematol Oncol 2022; 41:16-25. [PMID: 36238977 PMCID: PMC9874549 DOI: 10.1002/hon.3084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/14/2022] [Accepted: 10/11/2022] [Indexed: 02/03/2023]
Abstract
Main aim of this systematic review is to quantify the risk and identify predictors of clinical evolution of SARS-CoV-2 in hematological patients compared to different control populations. Two independent reviewers screened the literature assessing clinical outcomes of SARS-CoV-2 infection in adult patients with active hematological malignancies published up to June 2021. Primary outcome was COVID-19 related mortality, secondary outcomes were hospital and intensive-care admission, mechanical ventilation (MV), and thromboembolic events. Variables related to study setting, baseline patients' demographic, comorbidities, underlying hematological disease, ongoing chemotherapy, COVID-19 presentation, and treatments were extracted. A total of 67 studies including 10,061 hematological patients and 111,143 controls were included. Most of the studies were retrospective cohorts (51 studies, 76%) and only 19 (13%) provided data for a control group. A significant increased risk of clinical progression in the hematological population compared to the controls was found in terms of COVID-19 related mortality (OR, 2.12; 95% CI, 1.77-2.54), hospitalization (OR, 1.98; 95% CI, 1.15-3.43), intensive-care admission (OR, 1.77; 95% CI, 1.38-2.26), and MV (OR, 2.17; 95% CI, 1.71-2.75). The risk remained significantly higher in the subgroup analysis comparing hematological patients versus solid cancer. Meta-regression analysis of uncontrolled studies showed that older age, male sex, and hypertension were significantly related to worse clinical outcomes of COVID-19 in hematological population. Older age and hypertension were found to be associated also to thromboembolic events. In conclusion, hematological patients have a higher risk of COVID-19 clinical progression compared to both the general population and to patients with solid cancer.
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Affiliation(s)
- Elena Carrara
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Elisa Razzaboni
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Anna Maria Azzini
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Maria Elena De Rui
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Mariana Nunes Pinho Guedes
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Anna Gorska
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
| | - Maddalena Giannella
- Department of Medical and Surgical SciencesInfectious Diseases UnitIRCCS Policlinico Sant’OrsolaUniversity of BolognaBolognaItaly
| | - Linda Bussini
- Department of Medical and Surgical SciencesInfectious Diseases UnitIRCCS Policlinico Sant’OrsolaUniversity of BolognaBolognaItaly
| | - Michele Bartoletti
- Department of Medical and Surgical SciencesInfectious Diseases UnitIRCCS Policlinico Sant’OrsolaUniversity of BolognaBolognaItaly
| | - Federica Arbizzani
- Department of Medical and Surgical SciencesInfectious Diseases UnitIRCCS Policlinico Sant’OrsolaUniversity of BolognaBolognaItaly
| | - Zaira R. Palacios‐Baena
- Department of MedicineInfectious Diseases and Microbiology UnitHospital Universitario Virgen MacarenaUniversity of SevilleBiomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)SevilleSpain
| | - Giulia Caponcello
- Department of MedicineInfectious Diseases and Microbiology UnitHospital Universitario Virgen MacarenaUniversity of SevilleBiomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)SevilleSpain
| | - Natalia Maldonado
- Department of MedicineInfectious Diseases and Microbiology UnitHospital Universitario Virgen MacarenaUniversity of SevilleBiomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)SevilleSpain
| | - Jesús Rodríguez‐Baño
- Department of MedicineInfectious Diseases and Microbiology UnitHospital Universitario Virgen MacarenaUniversity of SevilleBiomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)SevilleSpain
| | - Carlo Visco
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Mauro Krampera
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Evelina Tacconelli
- Department of Diagnostics and Public HealthDivision of Infectious DiseasesUniversity of VeronaVeronaItaly
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Bailly S, Cartron G, Chaganti S, Córdoba R, Corradini P, Düll J, Ferrarini I, Osborne W, Rosenwald A, Sancho J, Tilly H, Van Den Neste E, Viardot A, Visco C. Targeting CD19 in diffuse large B-cell lymphoma: An expert opinion paper. Hematol Oncol 2022; 40:505-517. [PMID: 35488888 PMCID: PMC9796473 DOI: 10.1002/hon.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/07/2022] [Indexed: 01/01/2023]
Abstract
The ubiquitous, early-stage expression, efficient internalization, limited off-target effects, and high disease specificity of CD19 make it an attractive therapeutic target. Currently available anti-CD19 therapies have demonstrated particular promise in patients with relapsed or refractory B-cell non-Hodgkin lymphoma. Selection of the most appropriate treatment strategy should be based on individual patient characteristics and the goal of therapy. However, evidence and knowledge about the sequencing of anti-CD19 therapies are limited. Here, we review the current evidence for CD19 as a target in diffuse large B-cell lymphoma and consider approaches to the use of anti-CD19 therapy.
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Affiliation(s)
- Sarah Bailly
- Département d’HématologieCliniques Universitaires Saint‐LucBrusselsBelgium
| | - Guillaume Cartron
- Department of HaematologyCentre Hospitalier Universitaire de MontpellierUMR‐CNRS 5535MontpellierFrance
| | | | - Raul Córdoba
- Department of HematologyFundación Jiménez Díaz University HospitalHealth Research Institute IIS‐FJDMadridSpain
| | - Paolo Corradini
- Fondazione IRCCS Istituto Nazionale dei TumoriUniversity of MilanMilanItaly
| | - Johannes Düll
- Medizinische Klinik und Poliklinik IIUniversitätsklinikum WürzburgWürzburgGermany
| | - Isacco Ferrarini
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
| | - Wendy Osborne
- Newcastle Upon Tyne Hospitals NHS Foundation TrustNewcastleUK
| | - Andreas Rosenwald
- Institute of PathologyUniversity of Würzburg, and Comprehensive Cancer Center MainfrankenWürzburgGermany
| | | | - Hervé Tilly
- Department of Hematology and U1245Centre Henri Becquerel and University of RouenRouenFrance
| | - Eric Van Den Neste
- Département d’HématologieCliniques Universitaires Saint‐LucBrusselsBelgium
| | - Andreas Viardot
- Department of Internal Medicine IIIUniversity Hospital UlmUlmGermany
| | - Carlo Visco
- Department of MedicineSection of HematologyUniversity of VeronaVeronaItaly
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25
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Steffanoni S, Calimeri T, Laurenge A, Fox CP, Soussain C, Grommes C, Tisi MC, Boot J, Crosbie N, Visco C, Arcaini L, Chaganti S, Sassone MC, Alencar A, Armiento D, Romano I, Dietrich J, Itchaki G, Bruna R, Fracchiolla NS, Arletti L, Venditti A, Booth S, Musto P, Hoang Xuan K, Batchelor T, Cwynarski K, Ferreri AJM. Impact of severe acute respiratory syndrome coronavirus-2 infection on the outcome of primary central nervous system lymphoma treatment: A study of the International PCNSL Collaborative Group. Br J Haematol 2022; 199:507-519. [PMID: 35945164 PMCID: PMC9538907 DOI: 10.1111/bjh.18396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 01/19/2023]
Abstract
To optimise management of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection identifying high-risk patients and maintaining treatment dose intensity is an important issue in patients with aggressive lymphomas. In the present study, we report on the presentation, management, and outcome of an international series of 91 patients with primary central nervous system lymphoma and SARS-CoV-2 infection. SARS-CoV-2 was diagnosed before/during first-line treatment in 64 patients, during follow-up in 21, and during salvage therapy in six. Among the 64 patients infected before/during first-line chemotherapy, 38 (59%) developed pneumonia and 26 (41%) did not clear the virus. Prolonged exposure to steroids before viral infection and/or treatment with high-dose cytarabine favoured pneumonia development and virus persistence and were associated with poorer survival; 81% of patients who did not clear virus died early from coronavirus disease 2019 (COVID-19). Vaccination was associated with lower pneumonia incidence and in-hospital mortality. Chemotherapy was initiated/resumed in 43 (67%) patients, more commonly among patients who did not develop pneumonia, cleared the virus, or did not receive steroids during infection. Chemotherapy resumption in patients with viral persistence should be indicated cautiously as it was associated with a poorer survival (6-month, 70% and 87%, p = 0.07). None of the 21 patients infected during follow-up died from COVID-19, requiring similar measures as infected subjects in the general population.
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Affiliation(s)
- Sara Steffanoni
- Lymphoma Unit, Department of Onco‐HematologyIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Teresa Calimeri
- Lymphoma Unit, Department of Onco‐HematologyIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alice Laurenge
- Service de Neurologie 2‐MazarinHôpitaux Universitaires La Pitié Salpêtrière, APHP, Sorbonne UniversitéParisFrance
| | | | - Carole Soussain
- Hôpital René Huguenin‐Institut Curie, Saint‐CloudParisFrance
| | - Christian Grommes
- Department of NeurologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | | | - Jesca Boot
- BarkingHavering and Redbridge University Hospitals NHS TrustLondonUK
| | | | - Carlo Visco
- Department of Medicine, Section of HematologyUniversity of VeronaVeronaItaly
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular MedicineUniversity of PaviaPaviaItaly
| | | | - Marianna C. Sassone
- Lymphoma Unit, Department of Onco‐HematologyIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alvaro Alencar
- Department of Hematology and OncologyUniversity of Miami/Sylvester Comprehensive Cancer CenterMiamiFloridaUSA
| | | | | | - Jorg Dietrich
- Division of Neuro‐OncologyMassachusetts General Hospital Cancer CenterBostonMassachusettsUSA
| | - Gilad Itchaki
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical CenterPetah‐TikvaIsrael
| | | | | | - Laura Arletti
- Division of HematologyAzienda USL‐IRCCS of Reggio EmiliaReggio EmiliaItaly
| | - Adriano Venditti
- Department of Biomedicine and PreventionUniversity Tor VergataRomeItaly
| | - Stephen Booth
- NIHR Oxford Biomedical Research CentreChurchill HospitalOxfordUK
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation‘Aldo Moro’ University School of Medicine, and Unit of Hematology and Stem Cell Transplantation, AOUC PoliclinicoBariItaly
| | - Khê Hoang Xuan
- Service de Neurologie 2‐MazarinHôpitaux Universitaires La Pitié Salpêtrière, APHP, Sorbonne UniversitéParisFrance
| | - Tracy T. Batchelor
- Department of NeurologyBrigham and Women’s HospitalBostonMassachusettsUSA
| | - Kate Cwynarski
- Department of HaematologyUniversity College London HospitalLondonUK
| | - Andrés J. M. Ferreri
- Lymphoma Unit, Department of Onco‐HematologyIRCCS San Raffaele Scientific InstituteMilanItaly
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26
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Rigacci L, Battistini R, Kovalchuk S, Zoli V, Puccini B, Evangelista A, Arcaini L, Flenghi L, Visco C, Mian M, Di Rocco A, Peracchio C, Gotti M, Tisi MC, Palombi F, Pozzi S, Gioia D, Viero P, Martelli M. OBINUTUZUMAB DOES NOT IMPROVE COMPLETE METHABOLIC RESPONSE BUT DOES NOT COMPROMISE MOBILIZATION OR ENGRAFTMENT OF AUTOLOGOUS PERIPHERAL BLOOD STEM CELLS IN DIFFUSE LARGE B CELL LYMPHOMA: RESULTS FROM A FIL PROSPECTIVE PHASE II STUDY (THE GIOTTO STUDY). Hematol Oncol 2022; 40:609-616. [PMID: 35612350 DOI: 10.1002/hon.3028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/06/2022]
Abstract
Salvage immunochemotherapy and transplant consolidation is the standard treatment for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We tested a combination of Obinutuzumab and DHAP for treating R/R DLBCL. The primary end point was the rate of complete metabolic response (CMR). Secondary end points were stem cell mobilization, stem cell engraftment, overall survival, and feasibility. In this prospective, phase-2, single-arm trial (EudraCT 2014-004014-17) patients received the standard three doses of Obinutuzumab for the first cycle, and then one dose. Patients with CMR were consolidated with an autologous stem cell transplantation (ASCT). An interim analysis was provided after the first 29 patients to confirm the initial null hypothesis that at least 10/29 patients would achieve CMR. Among the 29 patients evaluated for the first stage only 6 patients (6/29, 21%) achieved CMR, thus, study enrollment was stopped. Nine patients exhibited extra-hematologic toxicities ≥grade 3. Among the 19 patients that started stem cell mobilization, one failed (5%) and 18 achieved mobilization (95%). Of these 18 patients, 9 were reinfused. Mobilization was observed in 16 patients (89%) after 1 or 2 apheresis rounds. The mean number of CD34+ cells mobilized was 5.8 x 106 /Kg (median: 5.5, IQR: 5 - 6.75). The mean number of reinfused CD34+ cells in the 9 patients was 4.1 x 106 /Kg (median: 4.1, IQR: 3.5 - 5). Obinutuzumab combined with DHAP did not compromise stem cell mobilization or engraftment after ASCT in patients with DLBCL. However, Obinutuzumab+DHAP provided a lower CMR rate than expected. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Luigi Rigacci
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma.,SOD Hematology, AOU Careggi, Firenze
| | - Roberta Battistini
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma
| | | | - Valerio Zoli
- UOC Hematology and Stem Cell Transplantation, AO San Camillo Forlanini, Roma
| | | | - Andrea Evangelista
- Unit of Clinical Epidemiology, CPO Piemonte, AOU Città della Salute e della Scienza di Tori, no, Torino
| | - Luca Arcaini
- Policlinico San Matteo Pavia Fondazione IRCCS, Pavi, a.,Departement of Molecular Medicine, University of Pav, i, a
| | - Leonardo Flenghi
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Perugi, a
| | | | - Michael Mian
- Division of Hematology and BMT, General Hospital of Bolza, no
| | - Alice Di Rocco
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Rom, e
| | | | - Manuel Gotti
- Policlinico San Matteo Pavia Fondazione IRCCS, Pavi, a
| | | | - Francesca Palombi
- UOSD Ematologia e Trapianti, Istituto Nazionale Tumori Regina Elena IFO, Rom, a
| | - Samantha Pozzi
- UOC Ematologia, Azienda Ospedaliero Universitaria Mode, n, a
| | | | - Piera Viero
- UOC Ematologia dell'Ospedale dell'Angelo, Venezi, a
| | - Maurizio Martelli
- Hematology Unit, Department of Cellular Biotechnologies and Hematology, "Sapienza" University of Rome, Rom, e
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27
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Zinzani PL, Martelli M, Ferrero S, Gentile M, Laurenti L, Romana Mauro F, Sportoletti P, Tedeschi A, Varettoni M, Visco C. Use of BTK inhibitors with focus on ibrutinib in mantle cell lymphoma: an expert panel opinion statement. Hematol Oncol 2022; 40:518-527. [PMID: 35247223 DOI: 10.1002/hon.2983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/18/2022] [Accepted: 03/03/2022] [Indexed: 11/07/2022]
Abstract
The introduction of BTK inhibitors transformed the management of patients with mantle cell lymphoma (MCL). Ibrutinib, the first-in-class BTK inhibitor is now approved in more than 80 countries and there are over 20 new BTK inhibitors in development. In addition, novel agents show potential clinical activity (alone and in combination) and are in the approval phase and/or being studied in ongoing clinical trials. How does the practicing clinician decide on the optimal therapeutic strategy for this highly heterogenous disease? In July 2020 a group of experts from Italy, convened a meeting to address and provide clarification on a series of outstanding issues in the treatment of MCL with the view of providing clinical guidance on its management. This expert opinion statement represents the panel's collective analysis, evaluation, and recommendations and is made up of a series of questions and answers (in the form of a review of the pertinent literature) designed to replicate those posed by practicing clinicians in Italy but which are applicable to clinical settings worldwide. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università Degli Studi, Bologna, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - S Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Division of Haematology, University of Torino, Torino, Italy/AOU "Città Della Salute e Della Scienza di Torino", Torino, Italy
| | | | - Luca Laurenti
- Hematology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Paolo Sportoletti
- Department of Medicine, Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Alessandra Tedeschi
- Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - M Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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28
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Ferrero S, Gentile M, Laurenti L, Mauro FR, Martelli M, Sportoletti P, Visco C, Zinzani PL, Tedeschi A, Varettoni M. Use of BTK inhibitors with special focus on ibrutinib in Waldenström macroglobulinemia: an expert panel opinion statement. Hematol Oncol 2022; 40:332-340. [PMID: 35212014 DOI: 10.1002/hon.2982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/07/2022]
Abstract
The pivotal role that ibrutinib plays in the management of Waldenström macroglobulinemia (WM) is undisputed but there are ongoing questions regarding its positioning in the therapeutic algorithm of WM as well as in some peculiar clinical situations. A panel of experts from Italy was convened to provide real world recommendations on the use of BTK inhibitors in lymphoproliferative diseases in general, and in patients with WM in particular. This position paper represents the panel's collective analysis, evaluation, and opinions and is made up of a series of questions frequently asked by practicing clinicians and answers based on currently available evidence. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Ferrero
- Department of Molecular Biotechnologies and Health Sciences, Division of Haematology, University of Torino, Torino, Italy/AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | | | - Luca Laurenti
- Hematology, Università Cattolica del Sacro Cuore, Policlinico A, Gemelli, Rome, Italy
| | - Francesca Romana Mauro
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Paolo Sportoletti
- Department of Medicine, Institute of Hematology-Centro di Ricerche Emato-Oncologiche (CREO), University of Perugia, Perugia, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università degli Studi, Bologna, Italy
| | - Alessandra Tedeschi
- Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - M Varettoni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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29
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Bonfiglio F, Bruscaggin A, Guidetti F, Terzi di Bergamo L, Faderl M, Spina V, Condoluci A, Bonomini L, Forestieri G, Koch R, Piffaretti D, Pini K, Pirosa MC, Cittone MG, Arribas A, Lucioni M, Ghilardi G, Wu W, Arcaini L, Baptista MJ, Bastidas G, Bea S, Boldorini R, Broccoli A, Buehler MM, Canzonieri V, Cascione L, Ceriani L, Cogliatti S, Corradini P, Derenzini E, Devizzi L, Dietrich S, Elia AR, Facchetti F, Gaidano G, Garcia JF, Gerber B, Ghia P, Gomes da Silva M, Gritti G, Guidetti A, Hitz F, Inghirami G, Ladetto M, Lopez-Guillermo A, Lucchini E, Maiorana A, Marasca R, Matutes E, Meignin V, Merli M, Moccia A, Mollejo M, Montalban C, Novak U, Oscier DG, Passamonti F, Piazza F, Pizzolitto S, Rambaldi A, Sabattini E, Salles G, Santambrogio E, Scarfò L, Stathis A, Stüssi G, Geyer JT, Tapia G, Tarella C, Thieblemont C, Tousseyn T, Tucci A, Vanini G, Visco C, Vitolo U, Walewska R, Zaja F, Zenz T, Zinzani PL, Khiabanian H, Calcinotto A, Bertoni F, Bhagat G, Campo E, De Leval L, Dirnhofer S, Pileri SA, Piris MA, Traverse-Glehen A, Tzankov A, Paulli M, Ponzoni M, Mazzucchelli L, Cavalli F, Zucca E, Rossi D. Genetic and phenotypic attributes of splenic marginal zone lymphoma. Blood 2022; 139:732-747. [PMID: 34653238 DOI: 10.1182/blood.2021012386] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/14/2021] [Indexed: 11/20/2022] Open
Abstract
Splenic marginal zone B-cell lymphoma (SMZL) is a heterogeneous clinico-biological entity. The clinical course is variable, multiple genes are mutated with no unifying mechanism, and essential regulatory pathways and surrounding microenvironments are diverse. We sought to clarify the heterogeneity of SMZL by resolving different subgroups and their underlying genomic abnormalities, pathway signatures, and microenvironment compositions to uncover biomarkers and therapeutic vulnerabilities. We studied 303 SMZL spleen samples collected through the IELSG46 multicenter international study (NCT02945319) by using a multiplatform approach. We carried out genetic and phenotypic analyses, defined self-organized signatures, validated the findings in independent primary tumor metadata and in genetically modified mouse models, and determined correlations with outcome data. We identified 2 prominent genetic clusters in SMZL, termed NNK (58% of cases, harboring NF-κB, NOTCH, and KLF2 modules) and DMT (32% of cases, with DNA-damage response, MAPK, and TLR modules). Genetic aberrations in multiple genes as well as cytogenetic and immunogenetic features distinguished NNK- from DMT-SMZLs. These genetic clusters not only have distinct underpinning biology, as judged by differences in gene-expression signatures, but also different outcomes, with inferior survival in NNK-SMZLs. Digital cytometry and in situ profiling segregated 2 basic types of SMZL immune microenvironments termed immune-suppressive SMZL (50% of cases, associated with inflammatory cells and immune checkpoint activation) and immune-silent SMZL (50% of cases, associated with an immune-excluded phenotype) with distinct mutational and clinical connotations. In summary, we propose a nosology of SMZL that can implement its classification and also aid in the development of rationally targeted treatments.
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Affiliation(s)
- Ferdinando Bonfiglio
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Alessio Bruscaggin
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Francesca Guidetti
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | | | - Martin Faderl
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Valeria Spina
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Adalgisa Condoluci
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Luisella Bonomini
- International Extranodal Lymphoma Study Group, Bellinzona, Switzerland
| | - Gabriela Forestieri
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Ricardo Koch
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Deborah Piffaretti
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Katia Pini
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Maria Cristina Pirosa
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Micol Giulia Cittone
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Alberto Arribas
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
| | - Marco Lucioni
- Unit of Anatomic Pathology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Guido Ghilardi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Wei Wu
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Maria Joao Baptista
- Lymphoid Neoplasms Group, Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Gabriela Bastidas
- Division of Hematology, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | - Silvia Bea
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Pathology Department, Hospital Clínic, Barcelona University, Barcelona, Spain
| | - Renzo Boldorini
- Division of Pathology, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Broccoli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
| | - Marco Matteo Buehler
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Vincenzo Canzonieri
- Pathology Unit, CRO Aviano National Cancer Institute, Aviano, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luciano Cascione
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
| | - Luca Ceriani
- Clinic of Nuclear Medicine and PET-CT Centre, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Sergio Cogliatti
- Institute of Pathology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Paolo Corradini
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Enrico Derenzini
- Onco-hematology Division, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Liliana Devizzi
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Sascha Dietrich
- Division of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Angela Rita Elia
- Cancer Immunotherapy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Fabio Facchetti
- Department of Molecular and Translational Medicine, Pathology Unit, Spedali Civili, Brescia, Italy
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Bernhard Gerber
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Department of Hematology and Oncology, University of Zurich, Zurich, Switzerland
| | - Paolo Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia (CLL), IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Maria Gomes da Silva
- Division of Hematology, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Giuseppe Gritti
- Division of Hematology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Guidetti
- Division of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Felicitas Hitz
- Division of Hematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY
| | - Marco Ladetto
- Division of Hematology, Azienda Ospedaliera SS Antonio e Biagio, Alessandria, Italy
- Dipartimento di Medicina Traslazionale, University of Eastern Piedmont, Alessandria, Italy
| | | | - Elisa Lucchini
- Division of Hematology, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Antonino Maiorana
- Division of Pathology, Universitá degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Roberto Marasca
- Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Estella Matutes
- Haematopathology Unit, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | | | - Michele Merli
- Division of Hematology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Alden Moccia
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Manuela Mollejo
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Division of Pathology, Hospital Virgen de la Salud, Toledo, Spain
| | - Carlos Montalban
- Division of Hematology, MD Anderson Cancer Center, Madrid, Spain
| | - Urban Novak
- Department of Medical Oncology and University Cancer Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Graham Oscier
- Division of Hematology, University Hospitals Dorset, Bournemouth, United Kingdom
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Piazza
- Division of Hematology, Ospedale Universitario di Padova, Padova, Italy
| | - Stefano Pizzolitto
- Division of Pathology, General Hospital S Maria della Misericordia, Udine, Italy
| | - Alessandro Rambaldi
- Division of Hematology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Elena Sabattini
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Gilles Salles
- Faculté de Médecine et de Maïeutique Lyon Sud, Université de Lyon, Lyon, France
| | | | - Lydia Scarfò
- Strategic Research Program on Chronic Lymphocytic Leukemia (CLL), IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Anastasios Stathis
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Georg Stüssi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Julia T Geyer
- Division of Anatomic Pathology and Clinical Pathology, Weill Cornell Medical College, New York, NY
| | - Gustavo Tapia
- Division of Pathology, Hospital Germans Trias I Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Corrado Tarella
- Onco-hematology Division, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Catherine Thieblemont
- Assistance Publique-Hôpitaux de Paris, Hopital Saint-Louis, Hemato-Oncology Unit; Université de Paris, Paris, France
| | - Thomas Tousseyn
- Department of Haematology, University Hospitals Leuven, Leuven, Belgium
| | | | - Giorgio Vanini
- Department of Medical Oncology and University Cancer Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Italy
| | - Umberto Vitolo
- Candiolo Cancer Institute (FPO-IRCCS), Candiolo, Turin, Italy
| | - Renata Walewska
- Division of Hematology, University Hospitals Dorset, Bournemouth, United Kingdom
| | - Francesco Zaja
- Division of Hematology, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Thorsten Zenz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Hossein Khiabanian
- Center for Systems and Computational Biology, Rutgers University, New Brunswick, NJ
| | - Arianna Calcinotto
- Cancer Immunotherapy, Institute of Oncology Research, Bellinzona, Switzerland
| | - Francesco Bertoni
- Lymphoma Genomics, Institute of Oncology Research, Bellinzona, Switzerland
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Govind Bhagat
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS)
- Pathology Department, Hospital Clínic, Barcelona University, Barcelona, Spain
| | - Laurence De Leval
- Division of Pathology, Institut Universitaire de Pathologie, Lausanne, Switzerland
| | - Stefan Dirnhofer
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Stefano A Pileri
- Haematopathology Division, European Institute of Oncology IRCCS, Milan, Italy
| | - Miguel A Piris
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) 28029, Madrid, Spain
- Pathology Service, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Alexander Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, Basel, Switzerland
| | - Marco Paulli
- Unit of Anatomic Pathology, Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo and Università degli Studi di Pavia, Pavia, Italy
| | - Maurilio Ponzoni
- Ateneo Vita-Salute San Raffaele University and Pathology Unit San Raffaele Scientific Institute, Milan, Italy
| | - Luca Mazzucchelli
- Division of Pathology, Cantonal Institute of Pathology, Locarno, Switzerland
| | - Franco Cavalli
- Institute of Oncology Research, Bellinzona, Switzerland; and
| | - Emanuele Zucca
- International Extranodal Lymphoma Study Group, Bellinzona, Switzerland
- Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
- Department of Medical Oncology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Davide Rossi
- Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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Albitar M, Zhang H, Goy A, Xu-Monette ZY, Bhagat G, Visco C, Tzankov A, Fang X, Zhu F, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Hagemeister FB, Huh J, Ponzoni M, Ferreri AJM, Møller MB, Parsons BM, van Krieken JH, Piris MA, Winter JN, Li Y, Xu B, Young KH. Determining clinical course of diffuse large B-cell lymphoma using targeted transcriptome and machine learning algorithms. Blood Cancer J 2022; 12:25. [PMID: 35105854 PMCID: PMC8807629 DOI: 10.1038/s41408-022-00617-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 12/20/2022] Open
Abstract
Multiple studies have demonstrated that diffuse large B-cell lymphoma (DLBCL) can be divided into subgroups based on their biology; however, these biological subgroups overlap clinically. Using machine learning, we developed an approach to stratify patients with DLBCL into four subgroups based on survival characteristics. This approach uses data from the targeted transcriptome to predict these survival subgroups. Using the expression levels of 180 genes, our model reliably predicted the four survival subgroups and was validated using independent groups of patients. Multivariate analysis showed that this patient stratification strategy encompasses various biological characteristics of DLBCL, and only TP53 mutations remained an independent prognostic biomarker. This novel approach for stratifying patients with DLBCL, based on the clinical outcome of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, can be used to identify patients who may not respond well to these types of therapy, but would otherwise benefit from alternative therapy and clinical trials.
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Affiliation(s)
- Maher Albitar
- Genomic Testing Cooperative, LCA, Irvine, CA, 92618, USA.
| | - Hong Zhang
- Genomic Testing Cooperative, LCA, Irvine, CA, 92618, USA
| | - Andre Goy
- John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, 07601, USA
| | | | - Govind Bhagat
- Columbia University Medical Center, New York, NY, 10027, USA
| | | | - Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, 4054, Basel, Switzerland
| | | | - Feng Zhu
- Duke University Medical Center, Durham, NC, 27710, USA
| | - Karen Dybkaer
- Aalborg University Hospital, Aalborg, 5000-5270, Denmark
| | | | - Wayne Tam
- Weill Medical College of Cornell University, New York, NY, 10065, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, 77030, USA
| | - Eric D Hsi
- Wake Forest University Medical Center, Winston-Salem, NC, 77055, USA
| | | | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | | | | | | | | | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, 6500, Nijmegen, Netherlands
| | - Miguel A Piris
- Hospital Universitario Marqués de Valdecilla, 39008, Santander, Spain
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Yong Li
- Baylor College of Medicine, Houston, TX, 77030, USA
| | - Bing Xu
- The First Affiliated Hospital of Xiamen University, 361004, Xiamen, Fujian, China.
| | - Ken H Young
- Duke University Medical Center, Durham, NC, 27710, USA. .,Duke Cancer Institute, Durham, NC, 27710, USA.
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Ferrarini I, Rigo A, Visco C. The mitochondrial anti-apoptotic dependencies of hematological malignancies: from disease biology to advances in precision medicine. Haematologica 2022; 107:790-802. [PMID: 35045693 PMCID: PMC8968907 DOI: 10.3324/haematol.2021.280201] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Mitochondria are critical organelles in the regulation of intrinsic apoptosis. As a general feature of blood cancers, different antiapoptotic members of the BCL-2 protein family localize at the outer mitochondrial membrane to sequester variable amounts of proapoptotic activators, and hence protect cancer cells from death induction. However, the impact of distinct anti-apoptotic members on apoptosis prevention, a concept termed anti-apoptotic dependence, differs remarkably across disease entities. Over the last two decades, several genetic and functional methodologies have been established to uncover the anti-apoptotic dependencies of the majority of blood cancers, inspiring the development of a new class of small molecules called BH3 mimetics. In this review, we highlight the rationale of targeting mitochondrial apoptosis in hematology, and provide a comprehensive map of the anti-apoptotic dependencies that are currently guiding novel therapeutic strategies. Cell-extrinsic and -intrinsic mechanisms conferring resistance to BH3 mimetics are also examined, with insights on potential strategies to overcome them. Finally, we discuss how the field of mitochondrial apoptosis might be complemented with other dimensions of precision medicine for more successful treatment of ‘highly complex’ hematologic malignancies.
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Affiliation(s)
- Isacco Ferrarini
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
| | - Antonella Rigo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
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32
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Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertù L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv 2022; 6:327-338. [PMID: 34644385 PMCID: PMC8516438 DOI: 10.1182/bloodadvances.2021005691] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022] Open
Abstract
Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30- and 100-days mortality was 13% (95% confidence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to significantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate- and high-risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Roberto Mina
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Marianna Sassone
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Anna Guidetti
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Domenico Penna
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Cattaneo
- Hematology, Azienda Socio-Sanitaria Territoriale-Spedali Civili, Brescia, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Alessandro Busca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria Citta’della Salute e della Scienza, Turin, Italy
| | - Andrés José María Ferreri
- Lymphoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Bruna
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
| | - Luigi Petrucci
- Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy
| | - Roberto Cairoli
- Hematology, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Salvini
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Lorenza Bertù
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Marco Ladetto
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Sofia Pilerci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Antonello Pinto
- Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico “Fondazione G Pascale,” Naples, Italy
| | - Safaa Ramadan
- Division of Onco-Hematology, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, Istituto di Ricovero e Cura a Carattere Scientifico Regina Elena National Cancer Institute, Rome, Italy
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo & Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Elisa Coviello
- Hematology and bone marrow transplant, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genova, Italy
| | - Alessandra Romano
- Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation, Aldo Moro” University School of Medicine and Unit of Hematology and Stem Cell Transplantation, Azienda Ospedaliera Universitaria Consorziale Policlinico, Bari, Italy
| | | | - Nicola Fracchiolla
- Oncoematologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milano, Italy
| | - Monia Marchetti
- Hematology, Azienda Ospedaliera Santissimi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Antonio Cuneo
- Hematology, Azienda Ospedaliero Universitaria Sant’Anna, Ferrara, Italy
| | - Matteo Della Porta
- Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | | | | | - Agostino Tafuri
- Hematology, University Hospital Sant’Andrea, Sapienza, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Hematology Unit, University of Siena, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | | | - Daniela Cilloni
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Turin, Italy
| | | | - Daniele Armiento
- Unit of Hematology, Stem Cell Transplantation, University Campus Bio-Medico, Rome, Italy
| | | | - Elettra Ortu La Barbera
- Unità Operativa Complessa Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy
| | | | - Giuseppe Visani
- Dipartimento di OncoEmatologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Carmine Selleri
- Department of Medicine, Hematology, University of Salerno, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Patrizia Tosi
- Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy
| | | | - Anna Candoni
- Hematology and Stem Cell Transplant Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Corradini
- Hematology and Bone Marrow Transplantation, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milano, Milano, Italy
| | - Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria and Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy
| | - Francesco Merli
- Hematology, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico Reggio Emilia, Reggio Emilia, Italy
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33
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Xu-Monette ZY, Wei L, Fang X, Au Q, Nunns H, Nagy M, Tzankov A, Zhu F, Visco C, Bhagat G, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Hagemeister FB, Sun X, Han X, Go H, Ponzoni M, Ferreri AJM, Møller MB, Parsons BM, van Krieken JH, Piris MA, Winter JN, Li Y, Xu B, Albitar M, You H, Young KH. Genetic Subtyping and Phenotypic Characterization of the Immune Microenvironment and MYC/BCL2 Double Expression Reveal Heterogeneity in Diffuse Large B-cell Lymphoma. Clin Cancer Res 2022; 28:972-983. [PMID: 34980601 DOI: 10.1158/1078-0432.ccr-21-2949] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/25/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) is molecularly and clinically heterogeneous, and can be subtyped according to genetic alterations, cell-of-origin, or microenvironmental signatures using high-throughput genomic data at the DNA or RNA level. Although high-throughput proteomic profiling has not been available for DLBCL subtyping, MYC/BCL2 protein double expression (DE) is an established prognostic biomarker in DLBCL. The purpose of this study is to reveal the relative prognostic roles of DLBCL genetic, phenotypic, and microenvironmental biomarkers. EXPERIMENTAL DESIGN We performed targeted next-generation sequencing; IHC for MYC, BCL2, and FN1; and fluorescent multiplex IHC for microenvironmental markers in a large cohort of DLBCL. We performed correlative and prognostic analyses within and across DLBCL genetic subtypes and MYC/BCL2 double expressors. RESULTS We found that MYC/BCL2 double-high-expression (DhE) had significant adverse prognostic impact within the EZB genetic subtype and LymphGen-unclassified DLBCL cases but not within MCD and ST2 genetic subtypes. Conversely, KMT2D mutations significantly stratified DhE but not non-DhE DLBCL. T-cell infiltration showed favorable prognostic effects within BN2, MCD, and DhE but unfavorable effects within ST2 and LymphGen-unclassified cases. FN1 and PD-1-high expression had significant adverse prognostic effects within multiple DLBCL genetic/phenotypic subgroups. The prognostic effects of DhE and immune biomarkers within DLBCL genetic subtypes were independent although DhE and high Ki-67 were significantly associated with lower T-cell infiltration in LymphGen-unclassified cases. CONCLUSIONS Together, these results demonstrated independent and additive prognostic effects of phenotypic MYC/BCL2 and microenvironment biomarkers and genetic subtyping in DLBCL prognostication, important for improving DLBCL classification and identifying prognostic determinants and therapeutic targets.
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Affiliation(s)
- Zijun Y Xu-Monette
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carolina.
| | - Li Wei
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carolina.,Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qingyan Au
- NeoGenomics Laboratories, Aliso Viejo, California
| | - Harry Nunns
- NeoGenomics Laboratories, Aliso Viejo, California
| | - Máté Nagy
- NeoGenomics Laboratories, Aliso Viejo, California
| | - Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Feng Zhu
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | | | - Govind Bhagat
- Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York
| | | | | | - Wayne Tam
- Weill Medical College of Cornell University, New York, New York
| | - Youli Zu
- The Methodist Hospital, Houston, Texas
| | | | - Fredrick B Hagemeister
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiaoping Sun
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xin Han
- Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Heounjeong Go
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of South Korea
| | | | | | | | | | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Miguel A Piris
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Yong Li
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Bing Xu
- The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
| | - Maher Albitar
- Genomic Testing Cooperative, LCA, Irvine, California
| | - Hua You
- Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Ken H Young
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carolina. .,Duke Cancer Institute, Durham, North Carolina
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Bega G, Olivieri J, Riva M, Scapinello G, Paolini R, Finotto S, Sartori R, Lucchini E, Guandalini G, Facchinelli D, Tisi MC, Basso M, Ballotta L, Piazza F, Ferrarini I, Visco C. Rituximab and Bendamustine (BR) Compared with Rituximab, Bendamustine, and Cytarabine (R-BAC) in Previously Untreated Elderly Patients with Mantle Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13236089. [PMID: 34885198 PMCID: PMC8657015 DOI: 10.3390/cancers13236089] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Both BR, and R-BAC are suitable induction therapies in elderly patients with mantle cell lymphoma (MCL). However, the two regimens have not been compared before. We retrospectively analysed the outcome and the safety features of elderly patients with newly diagnosed MCL, treated with BR or R-BAC between 2008 and 2019 at eight institutions. We used propensity scores to reduce selection bias, thus analysing 156 patients (53 BR, 103 R-BAC). Patients treated with R-BAC achieved higher CR rate than BR (91% vs. 60%, p < 0.0001). The 2-year PFS was 87 ± 3% and 64 ± 7% for R-BAC and BR, respectively (p = 0.001). Median overall survival (OS) was 121 months for R-BAC and 78 months for BR (p = 0.08). R-BAC was associated with significantly more pronounced grade 3–4 thrombocytopenia than BR (50% vs. 17%). This study indicates that R-BAC is associated with significantly prolonged 2-year PFS than BR in elderly patients with MCL. Abstract Background: Rituximab plus bendamustine (BR), and rituximab, bendamustine, and cytarabine (R-BAC) are well-known induction therapies in elderly patients with mantle cell lymphoma (MCL), according to clinical guidelines. However, a direct comparison between the two regimens has never been performed. Methods: In this multicentre retrospective study, we compared the outcome of patients with newly diagnosed MCL, treated with BR or R-BAC. Primary endpoint was 2-year progression-free survival (PFS). Inclusion bias was assessed using a propensity score stratified by gender, age, MCL morphology, and MIPI score. Results: After adjusting by propensity score, we identified 156 patients (53 BR, 103 R-BAC) with median age of 72 (53–90). Median follow-up was 46 months (range 12–133). R-BAC was administered in a 2-day schedule or with attenuated dose in 51% of patients. Patients treated with R-BAC achieved CR in 91% of cases, as compared with 60% for BR (p < 0.0001). The 2-year PFS was 87 ± 3% and 64 ± 7% for R-BAC and BR, respectively (p = 0.001). In terms of toxicity, R-BAC was associated with significantly more pronounced grade 3–4 thrombocytopenia than BR (50% vs. 17%). Conclusions: This study indicates that R-BAC, even when administered with judiciously attenuated doses, is associated with significantly prolonged 2-year PFS than BR in elderly patients with previously untreated MCL.
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Affiliation(s)
- Giulia Bega
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Jacopo Olivieri
- Hematology and SCT Unit, Azienda Sanitaria Universitaria Integrata Santa Maria della Misericordia, 33100 Udine, Italy;
| | - Marcello Riva
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Greta Scapinello
- Department of Medicine, Section of Hematology, University of Padova, 35122 Padova, Italy; (G.S.); (F.P.)
| | - Rossella Paolini
- Oncohematology, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy;
| | - Silvia Finotto
- Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV-IRCSS, 35128 Padova, Italy;
| | - Roberto Sartori
- Onco Hematology Unit, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy; (R.S.); (M.B.)
| | - Elisa Lucchini
- Hematology Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, 34148 Trieste, Italy; (E.L.); (L.B.)
| | - Gianmarco Guandalini
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Davide Facchinelli
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Maria Chiara Tisi
- Cell Therapy and Hematology, San Bortolo Hospital, 36100 Vicenza, Italy; (M.R.); (D.F.); (M.C.T.)
| | - Marco Basso
- Onco Hematology Unit, Istituto Oncologico Veneto IOV-IRCSS, 31033 Castelfranco Veneto, Italy; (R.S.); (M.B.)
| | - Laura Ballotta
- Hematology Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, 34148 Trieste, Italy; (E.L.); (L.B.)
| | - Francesco Piazza
- Department of Medicine, Section of Hematology, University of Padova, 35122 Padova, Italy; (G.S.); (F.P.)
| | - Isacco Ferrarini
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, 37129 Verona, Italy; (G.B.); (G.G.); (I.F.)
- Correspondence: ; Tel.: +39-045-8124797; Fax: +39-045-8124660
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Bonuomo V, Ferrarini I, Dell'Eva M, Sbisà E, Krampera M, Visco C. COVID-19 (SARS-CoV-2 infection) in lymphoma patients: A review. World J Virol 2021; 10:312-325. [PMID: 34909405 PMCID: PMC8641038 DOI: 10.5501/wjv.v10.i6.312] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/16/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection now has a global resonance and represents a major threat for several patient populations. Observations from initial case series suggested that cancer patients in general might have an unfavorable outcome following coronavirus disease 2019 (COVID-19), due to their underlying conditions and cytotoxic treatments. More recently, data regarding the incidence and clinical evolution of COVID-19 in lymphomas have been reported with the aim to identify those more frequently associated with severe complications and death. Patients with lymphoma appear particularly vulnerable to SARS-CoV-2 infection, only partly because of the detrimental effects of the anti-neoplastic regimens (chemotherapy, pathway inhibitors, monoclonal antibodies) on the immune system. Here, we systematically reviewed the current literature on COVID-19 in adult patients with lymphoma, with particular emphasis on disease course and prognostic factors. We also highlighted the potential differences in COVID-19 clinical picture according to lymphoma subtype, delivered treatment for the hematological disease and its relationship on how these patients have been managed thus far.
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Affiliation(s)
- Valentina Bonuomo
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
| | - Isacco Ferrarini
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
| | - Michele Dell'Eva
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
| | - Eugenio Sbisà
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
| | - Mauro Krampera
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
| | - Carlo Visco
- Section of Haematology, Department of Medicine, University of Verona, Verona 37134, Italy
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36
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Arcari A, Morello L, Vallisa D, Marcheselli L, Tecchio C, Quaglia FM, Tisi MC, Zilioli VR, Di Rocco A, Perrone T, Gini G, Dogliotti I, Bianchetti N, Bozzoli V, De Philippis C, Alvarez De Celis MI, Chiappella A, Fabbri A, Pelosini M, Merli M, Molinari AL, Sciarra R, Volpetti S, Hohaus S, Nassi L, Visco C. Allogeneic stem cell transplantation in patients with mantle cell lymphoma: results from the MANTLE-FIRST study on behalf of Fondazione Italiana Linfomi. Leuk Lymphoma 2021; 62:3474-3483. [PMID: 34625013 DOI: 10.1080/10428194.2021.1961238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The role of allogeneic stem cell transplantation (allo-SCT) in mantle cell lymphoma (MCL) is uncertain, even more in the era of bruton's tyrosine kinase inhibitors (BTKi) and chimeric antigen receptor T-cells. We retrospectively analyzed 55 patients who underwent allo-SCT for MCL relapsed or refractory (r/r) after rituximab and high-dose cytarabine within the MANTLE-FIRST project. With a median follow-up of 3.7 years, non-relapse mortality (NRM), progression-free survival, and overall survival were 23%, 53%, and 56%, respectively. NRM was significantly higher in the case of acute graft-versus-host disease, > 2 prior lines of therapy, age > 60 years. The outcome was similar for patients with early (≤24 months) and late progression of disease. The use of BTKi as a bridge to allo-SCT did not increase the toxicity and allowed a good control of disease. Our real-life experience confirms that allo-SCT still represents an option in MCL patients, especially if young and early-relapsed.
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Affiliation(s)
- Annalisa Arcari
- Unit of Hematology and Bone Marrow Transplantation, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Lucia Morello
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy
| | - Daniele Vallisa
- Unit of Hematology and Bone Marrow Transplantation, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Cristina Tecchio
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | | | | | - Alice Di Rocco
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Guido Gini
- Hematology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Irene Dogliotti
- Stem Cell Transplant Unit, A.O.U. "Città della Salute e della Scienza di Torino", Turin, Italy
| | | | | | - Chiara De Philippis
- Department of Medical Oncology and Hematology, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy
| | | | - Annalisa Chiappella
- Hematology and Bone Marrow Transplantation, IRCCS Istituto Nazionale Tumori, Milan, Italy.,Hematology, "Città della Salute e della Scienza di Torino" University Hospital, Turin, Italy
| | - Alberto Fabbri
- Hematology, Azienda Ospedaliero-Universitaria Senese and University of Siena, Siena, Italy
| | | | - Michele Merli
- Hematology, University Hospital Ospedale di Circolo e Fondazione Macchi-ASST Sette Laghi, University of Insubria, Varese, Italy
| | | | - Roberta Sciarra
- Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Volpetti
- Department of Hematology, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Stefan Hohaus
- Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Nassi
- Hematology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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37
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You H, Xu-Monette ZY, Wei L, Nunns H, Nagy ML, Bhagat G, Fang X, Zhu F, Visco C, Tzankov A, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Hagemeister FB, Huh J, Ponzoni M, Ferreri AJM, Møller MB, Parsons BM, Van Krieken JH, Piris MA, Winter JN, Li Y, Au Q, Xu B, Albitar M, Young KH. Genomic complexity is associated with epigenetic regulator mutations and poor prognosis in diffuse large B-cell lymphoma. Oncoimmunology 2021; 10:1928365. [PMID: 34350060 PMCID: PMC8293967 DOI: 10.1080/2162402x.2021.1928365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma with high mutation burdens but a low response rate to immune checkpoint inhibitors. In this study, we performed targeted next-generation sequencing and fluorescent multiplex immunohistochemistry, and investigated the clinical significance and immunological effect of mutation numbers in 424 DLBCL patients treated with standard immunochemotherapy. We found that KMT2D and TP53 nonsynonymous mutations (MUT) were significantly associated with increased nonsynonymous mutation numbers, and that high mutation numbers (MUThigh) were associated with significantly poorer clinical outcome in germinal center B-cell-like DLBCL with wild-type TP53. To understand the underlying mechanisms, we identified a gene-expression profiling signature and the association of MUThigh with decreased T cells in DLBCL patients with wild-type TP53. On the other hand, in overall cohort, MUThigh was associated with lower PD-1 expression in T cells and PD-L1 expression in macrophages, suggesting a positive role of MUThigh in immune responses. Analysis in a whole-exome sequencing dataset of 304 patients deposited by Chapuy et al. validated the correlation of MUT-KMT2D with genomic complexity and the significantly poorer survival associated with higher numbers of genomic single nucleotide variants in activated B-cell-like DLBCL with wild-type TP53. Together, these results suggest that KMT2D inactivation or epigenetic dysregulation has a role in driving DLBCL genomic instability, and that genomic complexity has adverse impact on clinical outcome in DLBCL patients with wild-type TP53 treated with standard immunochemotherapy. The oncoimmune data in this study have important implications for biomarker and therapeutic studies in DLBCL.
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Affiliation(s)
- Hua You
- Department of Hematology and Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.,Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carollina, USA
| | - Zijun Y Xu-Monette
- Department of Hematology and Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
| | - Li Wei
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carollina, USA.,Duke Cancer Institute, Durham, North Caronlina, USA
| | - Harry Nunns
- Duke Cancer Institute, Durham, North Caronlina, USA
| | - Máté L Nagy
- Duke Cancer Institute, Durham, North Caronlina, USA
| | - Govind Bhagat
- NeoGenomics Laboratories, Aliso Viejo, California, USA
| | - Xiaosheng Fang
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carollina, USA
| | - Feng Zhu
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, North Carollina, USA
| | - Carlo Visco
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York, New York, USA
| | - Alexandar Tzankov
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Karen Dybkaer
- Department of Pathology, Institute of Pathology,University Hospital Basel, Switzerland
| | - April Chiu
- Clinical Department, Aalborg University Hospital, Aalborg, Denmark
| | - Wayne Tam
- Hematopathology Department, Mayo Clinic, Rochester, Minnesota, USA
| | - Youli Zu
- Department of Pathology, Weill Medical College of Cornell University, New York, New York, USA
| | - Eric D Hsi
- Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas, USA
| | | | - Jooryung Huh
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maurilio Ponzoni
- Department of Pathology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Andrés J M Ferreri
- Department of Pathology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Michael B Møller
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - J Han Van Krieken
- Hematology & Oncology, Gundersen Lutheran Health System, La Crosse, Wisconsin, USA
| | - Miguel A Piris
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Jane N Winter
- Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Yong Li
- Department of Medicine (Hematology and Oncology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois,USA
| | - Qingyan Au
- Duke Cancer Institute, Durham, North Caronlina, USA
| | - Bing Xu
- Department of Medicine, Baylor College of Medicine, Houston, Texas,USA
| | - Maher Albitar
- Department of Hematology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian,China
| | - Ken H Young
- Department of Hematology and Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.,Genomic Testing Cooperative, LCA, Irvine, California,USA
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38
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Dalla Pietà A, Cappuzzello E, Palmerini P, Ventura A, Visentin A, Astori G, Chieregato K, Mozzo V, Perbellini O, Tisi MC, Trentin L, Visco C, Ruggeri M, Sommaggio R, Rosato A. Innovative therapeutic strategy for B-cell malignancies that combines obinutuzumab and cytokine-induced killer cells. J Immunother Cancer 2021; 9:jitc-2021-002475. [PMID: 34272306 PMCID: PMC8287629 DOI: 10.1136/jitc-2021-002475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 12/24/2022] Open
Abstract
Background Patients affected by aggressive B-cell malignancies who are resistant to primary or salvage chemoimmunotherapy have an extremely poor prognosis and limited therapeutic options. Promising therapeutic success has been achieved with the infusion of CD19 chimeric antigen receptor-T cells, but several limits still restrain the administration to a limited proportion of patients. This unmet clinical need might be fulfilled by an adoptive immunotherapy approach that combines cytokine-induced killer (CIK) cells and monoclonal antibodies (mAb) to the CD20 antigen. Indeed, CIK cells are an effector population endowed with antitumor activity, which can be further improved and antigen-specifically redirected by clinical-grade mAb triggering antibody-dependent cell-mediated cytotoxicity. Methods CIK cells were generated from peripheral blood of patients affected by different B-cell malignancies using a blinatumomab-based cell culture protocol. Effector cells were combined with the anti-CD20 mAb obinutuzumab and their therapeutic activity was assessed both in vitro and in vivo. Results CIK cells were successfully expanded in clinically relevant numbers, starting from small volumes of peripheral blood with extremely low CD3+ counts and high tumor burden. This relied on the addition of blinatumumab in culture, which leads to the simultaneous expansion of effector cells and the complete elimination of the neoplastic component. Moreover, CIK cells were highly cytotoxic in vitro against both B-cell tumor cell lines and autologous neoplastic targets, and had a significant therapeutic efficacy against a B-cell malignancy patient-derived xenograft on in vivo transfer. Conclusions The combination of an easily expandable CIK cell effector population with a mAb already in clinical use establishes a tumor antigen-specific redirection strategy that can be rapidly translated into clinical practice, providing an effective therapeutic alternative for B-cell malignancies without any need for genetic modifications. Additionally, the approach can be potentially applied to an extremely vast array of different tumors by simply substituting the targeting mAb.
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Affiliation(s)
- Anna Dalla Pietà
- Department of Surgery, Oncology and Gastroenterology, Immunology and Oncology Section, University of Padua, Padova, Italy
| | - Elisa Cappuzzello
- Department of Surgery, Oncology and Gastroenterology, Immunology and Oncology Section, University of Padua, Padova, Italy
| | - Pierangela Palmerini
- Department of Surgery, Oncology and Gastroenterology, Immunology and Oncology Section, University of Padua, Padova, Italy
| | - Annavera Ventura
- Department of Surgery, Oncology and Gastroenterology, Immunology and Oncology Section, University of Padua, Padova, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padova, Italy
| | - Giuseppe Astori
- Advanced Cellular Therapy Laboratory, Department of Hematology, San Bortolo Hospital of Vicenza, Vicenza, Italy
| | - Katia Chieregato
- Advanced Cellular Therapy Laboratory, Department of Hematology, San Bortolo Hospital of Vicenza, Vicenza, Italy.,Consorzio per la Ricerca Sanitaria (CORIS) of Veneto Region, Padova, Italy
| | | | - Omar Perbellini
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | | | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padova, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Marco Ruggeri
- Cell Therapy and Hematology, San Bortolo Hospital, Vicenza, Italy
| | | | - Antonio Rosato
- Department of Surgery, Oncology and Gastroenterology, Immunology and Oncology Section, University of Padua, Padova, Italy .,Veneto Institute of Oncology IOV - IRCCS, Padova, Italy
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39
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Merli M, Rattotti S, Spina M, Re F, Motta M, Piazza F, Orsucci L, Ferreri AJ, Perbellini O, Dodero A, Vallisa D, Pulsoni A, Santoro A, Zuccaro V, Chimienti E, Russo F, Visco C, Zignego AL, Marcheselli L, Luminari S, Paulli M, Bruno R, Arcaini L. DIRECT‐ACTING ANTIVIRALS AS PRIMARY TREATMENT FOR HCV‐ASSOCIATED INDOLENT NON‐HODGKIN LYMPHOMAS: THE PROSPECTIVE BART STUDY OF THE
FONDAZIONE ITALIANA LINFOMI. Hematol Oncol 2021. [DOI: 10.1002/hon.77_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Merli
- University Hospital "Ospedale di Circolo e Fondazione Macchi" ‐ ASST Sette Laghi University of Insubria Hematology Varese Italy
| | - S. Rattotti
- Fondazione IRCCS Policlinico San Matteo Hematology Pavia Italy
| | - M. Spina
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Re
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - M. Motta
- ASST Spedali Civili Brescia Hematology Brescia Italy
| | - F. Piazza
- Azienda Ospedaliera‐Universitaria University of Padova Medicine, Hematology Padova Italy
| | - L. Orsucci
- Città della Salute e della Scienza di Torino Hematology Torino Italy
| | | | | | - A. Dodero
- Fondazione IRCCS Istituto Nazionale dei Tumori Hematology Milano Italy
| | - D. Vallisa
- Ospedale Guglielmo da Saliceto Hematology Piacenza Italy
| | - A. Pulsoni
- Sapienza University of Rome Translational and Precision Medicine Roma Italy
| | - A. Santoro
- Humanitas Research Hospital Medical Oncology and Hematology Unit Rozzano Milan Italy
| | - V. Zuccaro
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - E. Chimienti
- Centro di Riferimento Oncologico IRCCS Medical Oncology and Immune‐related Tumors Aviano (PN) Italy
| | - F. Russo
- Azienda Ospedaliera Universitaria Hematology and BMT Center Parma Italy
| | - C. Visco
- University of Verona Medicine, Section of Hematology Verona Italy
| | - A. L. Zignego
- University of Florence Clinical and Experimental Medicine Interdepartmental Hepatology Center MASVE Florence Italy
| | | | - S. Luminari
- AUSL ‐ IRCCS Reggio Emilia University of Modena and Reggio Emilia Hematology Reggo Emilia Italy
| | - M. Paulli
- Fondazione IRCCS Policlinico San Matteo University of Pavia Anatomic Pathology Unit Pavia Italy
| | - R. Bruno
- Fondazione IRCCS Policlinico San Matteo University of Pavia Infectious and Tropical Diseases Pavia Italy
| | - L. Arcaini
- University of Pavia Molecular Medicine Pavia Italy
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Orgueira AM, López MC, Raindo AP, Díaz Arias JÁ, Pérez MSG, Rodríguez BA, Pérez LB, Ferro RF, Santos CA, Encinas MMP, Rodríguez MFF, Xu‐Monette Z, Visco C, Young K, López JLB. LYMFOREST‐25
: PERSONALLY‐TAILORED SURVIVAL PREDICTION OF PATIENTS WITH DIFFUSE LARGE B‐CELL LYMPHOMA USING CLINICO‐GENOMIC PROGNOSTIC MODELS. Hematol Oncol 2021. [DOI: 10.1002/hon.79_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. Mosquera Orgueira
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - M. Cid López
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - A. Peleteiro Raindo
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - J. Án. Díaz Arias
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - M. S. González Pérez
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - B. Antelo Rodríguez
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - L. Bao Pérez
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - R. Ferreiro Ferro
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - C. Aliste Santos
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - M. M. Pérez Encinas
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | - M. F. Fraga Rodríguez
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
| | | | - C. Visco
- University of Verona Medicine Verona Italy
| | - K. Young
- Duke University Medical Center Pathology Durham USA
| | - J. L. Bello López
- University Hospital of Santiago de Compostela Hematology SANTIAGO DE COMPOSTELA Spain
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Bonfiglio F, Bruscaggin A, Guidetti F, Terzi di Bergamo L, Faderl M, Spina V, Condoluci A, Bonomini L, Forestieri G, Koch R, Piffaretti D, Pini K, Pirosa MC, Cittone MG, Arribas A, Lucioni M, Ghilardi G, Wu W, Arcaini L, Baptista MJ, Bastidas G, Bea S, Boldorini R, Broccoli A, Canzonieri V, Cascione L, Ceriani L, Cogliatti S, Derenzini E, Devizzi L, Dietrich S, Elia AR, Facchetti F, Gaidano G, Garcia JF, Gerber B, Ghia P, Silva MG, Gritti G, Guidetti A, Hitz F, Inghirami G, Ladetto M, Lopez‐Guillermo A, Lucchini E, Maiorana A, Marasca R, Matutes E, Meignin V, Merli M, Moccia A, Mollejo M, Montalban C, Novak U, Oscier DG, Passamonti F, Piazza F, Pizzolitto S, Sabattini E, Salles G, Santambrogio E, Scarfó L, Stathis A, Stüssi G, Geyer JT, Tapia G, Thieblemont C, Tousseyn T, Tucci A, Visco C, Vitolo U, Zenz T, Zinzani PL, Khiabanian H, Calcinotto A, Bertoni F, Bhagat G, Campo E, Leval L, Dirnhofer S, Pileri SA, Piris MÁ, Traverse‐Glehen A, Tzankov A, Paulli M, Ponzoni M, Mazzucchelli L, Cavalli F, Zucca E, Rossi D. GENETIC AND PHENOTYPIC ATTRIBUTES OF SPLENIC MARGINAL ZONE LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.43_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Villa D, Jiang A, Crosbie N, Rule S, McCulloch R, Visco C, Buege MJ, Kumar A, Bond D, Paludo J, Maurer MJ, Thanarajasingam G, Baech J, El‐Galaly T, Kugathasan L, Gerrie AS, Lewis D. TIME TO SECOND LINE BRUTON TYROSINE KINASE THERAPY AND AGE AT ITS INITIATION ARE STRONGLY ASSOCIATED WITH SUBSEQUENT OVERALL SURVIVAL IN PATIENTS WITH FIRST RELAPSE OF MANTLE CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.59_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- D. Villa
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - A. Jiang
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - N. Crosbie
- University Hospitals Plymouth NHS Trust Haematology Plymouth UK
| | - S. Rule
- University Hospitals Plymouth NHS Trust Haematology Plymouth UK
| | - R. McCulloch
- University Hospitals Plymouth NHS Trust Haematology Plymouth UK
| | - C. Visco
- University of Verona Hematology Verona Italy
| | - M. J. Buege
- Memorial Sloan Kettering Cancer Center Clinical Pharmacy, Lymphoma New York USA
| | - A. Kumar
- Memorial Sloan Kettering Cancer Center Division of Hematologic Malignancies New York USA
| | - D. Bond
- The Ohio State University Hematology Columbus USA
| | - J. Paludo
- Mayo Clinic Hematology Rochester USA
| | - M. J. Maurer
- Mayo Clinic Division of Clinical Trials and Biostatistics Rochester USA
| | | | - J. Baech
- Aalborg University Hospital Haematology Aalborg Denmark
| | - T. El‐Galaly
- Aalborg University Hospital Haematology Aalborg Denmark
| | - L. Kugathasan
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - A. S. Gerrie
- BC Cancer, Centre for Lymphoid Cancer Vancouver Canada
| | - D. Lewis
- University Hospitals Plymouth NHS Trust Haematology Plymouth UK
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Visco C, Pregnolato F, Ferrarini I, De Marco B, Bonuomo V, Sbisà E, Fraenza C, Bernardelli A, Tanasi I, Quaglia FM, Krampera M. Efficacy of R-COMP in comparison to R-CHOP in patients with DLBCL: A systematic review and single-arm metanalysis. Crit Rev Oncol Hematol 2021; 163:103377. [PMID: 34087342 DOI: 10.1016/j.critrevonc.2021.103377] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 11/29/2022] Open
Abstract
Doxorubicin represents the mainstay in the upfront treatment of diffuse large B-cell lymphoma (DLBCL) patients. However, its administration is sometimes hampered by the coexistence of former comorbidities/cardiac issues, especially in the elderly population. Liposome encapsulated drug delivery systems have been adopted to reduce the exposure of normal tissues to the drug, both in solid cancers and lymphomas. Despite claims for lower toxicity, the efficacy of non-pegylated liposome doxorubicin (NPLD) in DLBCL, as compared to standard doxorubicin, has never been established. We systematically reviewed relevant literature of NPLD in lymphoma treatment. Adjusting for age/comorbidities, our metanalysis revealed that the use of combinations including NPLD (R-COMP) were non-inferior in terms of response, overall and progression-free survival to the standard of care (R-CHOP) in overlapping series of DLBCL patients. R-COMP may represent a safe and active option for elderly patients with DLBCL, or for those with some extent of cardiac impairment at baseline.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
| | - Francesca Pregnolato
- Experimental Laboratory of Immuno-rheumatology, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan, Italy
| | - Isacco Ferrarini
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Beatrice De Marco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Eugenio Sbisà
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Costanza Fraenza
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Andrea Bernardelli
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Ilaria Tanasi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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Conconi A, Vannata B, Janikova A, Ramirez A, Bodoni CL, Nowakowski G, Mian M, Ferreri AJ, Ryan G, Pangalis GA, Cabrera ME, Luminari S, Montoto S, Tsang R, Aurer I, Visco C, Mazzucchelli L, Trneny M, Gaidano G, Federico M, Lopez‐Guillermo A, Pro B, Zucca E. PRIMARY EXTRANODAL FOLLICULAR LYMPHOMA IN A LARGE RETROSPECTIVE SURVEY OF THE INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP (IELSG31). Hematol Oncol 2021. [DOI: 10.1002/hon.78_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Conconi
- Azienda sanitaria locale Biella Ospedale degli Infermi ‐ Ematologia Biella Italy
| | - B. Vannata
- Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - A. Janikova
- University Hospital Brno Department of Hematology and Oncology Brno Czech Republic
| | - A. Ramirez
- Instituto Nacional de Cancerologia Hematology Department Mexico City Mexico
| | - C. Lobetti Bodoni
- Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
| | - G. Nowakowski
- Mayo Clinic Division of Hematology Rochester Minnesota USA
| | - M. Mian
- Ospedale di Bolzano Ematologia e Centro Trapianto Midollo Osseo Bolzano Italy
| | - Andrés J.M. Ferreri
- IRCCS San Raffaele Scientific Institute Unità Operativa di Oncologia Medica Milano Italy
| | - G. Ryan
- Peter MacCallum Cancer Institute Deptment of Radiation Oncology Melbourne Australia
| | - G. A. Pangalis
- Athens Medical Center‐Psychikon Branch Hematology Department Athens Greece
| | - M. E. Cabrera
- Hospital del Salvador Facultad de Medicina Santiago Chile
| | - S. Luminari
- Arcispedale Santa Maria Nuova Servizio di Ematologia Reggio Emilia Italy
| | - S. Montoto
- St. Bartholomew’s Hospital Department of Medical Oncology London UK
| | - R. Tsang
- University Health Network Princess Margaret Hospital Toronto Canada
| | - I. Aurer
- University Hospital Centre Zagreb Division of Hematology Zagreb Croatia
| | - C. Visco
- University of Verona Departmento of Medicine ‐ Section of Hematology Verona Italy
| | | | - M. Trneny
- Charles University General Hospital Prague First Faculty of Medicine Prague Czech Republic
| | - G. Gaidano
- Azienda Ospedaliera "Maggiore della Carità" Ematologia Novara Italy
| | - M. Federico
- Università degli Studi di Modena e Reggio Emilia Centro Oncologico Modenese Modena Italy
| | | | - B. Pro
- Northwestern Medicine Hematology and Medical Oncology Chicago Illinois USA
| | - E. Zucca
- Foundation for the Institute of Oncology Research (IOR) International Extranodal Lymphoma Study Group Oncology Institute of Southern Switzerland Medical Oncology Clinic Bellinzona Switzerland
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Facchinelli D, Boninsegna E, Visco C, Tecchio C. Primary Pancreatic Lymphoma: Recommendations for Diagnosis and Management. J Blood Med 2021; 12:257-267. [PMID: 33981170 PMCID: PMC8107008 DOI: 10.2147/jbm.s273095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Primary pancreatic lymphoma (PPL) is a rare disease representing 0.1% of all malignant lymphomas, which lacks well-defined diagnostic and therapeutic protocols. We conducted a systematic review to analyze demographic, diagnostic and therapeutic features of PPL. METHODS This review identified small series and single case reports. Sources were MEDLINE, PubMed, and the Cochrane library from January 2001 to December 2020. Data were screened, extracted and the risk of bias analyzed by three independent reviewers. RESULTS A total of 107 eligible papers (17 small series, 90 single case reports) describing 266 patients were identified. Patients had a median age of 53.1 (range 3-86) years and were males in 64.6% of cases. Abdominal pain and jaundice were the most common presenting symptoms, affecting 75.3% and 41.8% of patients, respectively. PPL had a median size of 60.6 mm (range 16-200) and it was localized in the pancreatic head in 63.7% of cases. At diagnosis most patients underwent ultrasonography followed by computed tomography. PPL typically showed low echogenicity, and lower contrast enhancement than solid tumors. Histopathological specimens were obtained by percutaneous or endoscopic biopsies in 47.7% of patients; abdominal surgery was performed in 33.5% of cases. Overall, diffuse large B-cell lymphoma was the most frequent histological diagnosis (53.6%). However, patients aged <18 years were affected by Burkitt lymphoma in 52.4% of cases. Most patients (53.6%) received immunochemotherapy (IC) or IC plus radiotherapy (14%). Demolitive surgery appeared to be associated with impaired survival. Central nervous system (CNS) relapse or progression was observed in 20% of patients. CONCLUSION PPL is a rare entity, with some peculiar features at modern imaging. For diagnostic purposes percutaneous or endoscopic biopsies might be preferable, as opposed to surgery. No definite data is available about the optimal treatment, which should be tailored on the histological type and associated with CNS prophylaxis.
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Affiliation(s)
| | - Enrico Boninsegna
- Department of Radiology, Azienda Socio Sanitaria Territoriale, Mantova, Italy
| | - Carlo Visco
- Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Cristina Tecchio
- Hematology and Bone Marrow Transplant Unit, Department of Medicine, University of Verona, Verona, Italy
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Garcia-Reyero J, Martinez Magunacelaya N, Gonzalez de Villambrosia S, Loghavi S, Gomez Mediavilla A, Tonda R, Beltran S, Gut M, Pereña Gonzalez A, d'Ámore E, Visco C, Khoury JD, Montes-Moreno S. Genetic lesions in MYC and STAT3 drive oncogenic transcription factor overexpression in plasmablastic lymphoma. Haematologica 2021; 106:1120-1128. [PMID: 32273478 PMCID: PMC8018103 DOI: 10.3324/haematol.2020.251579] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Indexed: 12/22/2022] Open
Abstract
The mutational profile of plasmablastic lymphoma has not been described. We performed a targeted, exonic next-generation sequencing analysis of 30 plasmablastic lymphoma cases with a Bcell lymphoma-dedicated panel and fluorescence in situ hybridization for the detection of MYC rearrangements. Complete phenotyping of the neoplastic and microenvironmental cell populations was also performed. We identified an enrichment in recurrent genetic events in MYC (69% with MYC translocation or amplification and three cases with missense point mutations), PRDM1/Blimp1 and STAT3 mutations. These gene mutations were more frequent in Epstein-Barr virus (EBV)-positive disease. Other genetic events included mutations in BRAF, EP300, BCR (CD79A and CD79B), NOTCH pathway (NOTCH2, NOTCH1 and SGK1) and MYD88pL265P. Immunohistochemical analysis showed consistent MYC expression, which was higher in cases with MYC rearrangements, together with phospho-STAT3 (Tyr705) overexpression in cases with STAT3 SH2 domain mutations. Microenvironmental cell populations were heterogeneous and unrelated to EBV, with enrichment of tumor-associated macrophages (TAM) and PD1-positive T cells. PD-L1 was expressed in all cases in the TAM population but only in the neoplastic cells in five cases (4 of 14 EBV-positive cases). HLA expression was absent in the majority of cases of plasmablastic lymphoma. In summary, the mutational profile of plasmablastic lymphoma is heterogeneous and related to EBV infection. Genetic events in MYC, STAT3 and PRDM1/Blimp1 are more frequent in EBV-positive disease. An enrichment in TAM and PD1 reactive T lymphocytes is found in the microenvironment of plasmablastic lymphoma and a fraction of the neoplastic cells express PD-L1.
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Affiliation(s)
- Julia Garcia-Reyero
- Anatomic Pathology Service, Hospital Universitario Marqués de Valdecilla/IDIVAL, Santander, Spain
| | | | | | - Sanam Loghavi
- Hematopathology Department, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Raul Tonda
- CNAG-CRG, Barcelona Institute of Science and Technology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Sergi Beltran
- CNAG-CRG, Barcelona Institute of Science and Technology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Marta Gut
- CNAG-CRG, Barcelona Institute of Science and Technology, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Emanuele d'Ámore
- Departments of Pathology and Hematology, San Bortolo Hospital, Vicenza, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, San Bortolo Hospital, Italy
| | - Joseph D Khoury
- Hematopathology Department, MD Anderson Cancer Center, Houston, TX, USA
| | - Santiago Montes-Moreno
- Anatomic Pathology Service, Hospital Universitario Marqués de Valdecilla/IDIVAL, Santander, Spain
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Marangon M, Visco C, Barbui AM, Chiappella A, Fabbri A, Ferrero S, Galimberti S, Luminari S, Musuraca G, Re A, Zilioli VR, Ladetto M. Allogeneic Stem Cell Transplantation in Mantle Cell Lymphoma in the Era of New Drugs and CAR-T Cell Therapy. Cancers (Basel) 2021; 13:cancers13020291. [PMID: 33466784 PMCID: PMC7830938 DOI: 10.3390/cancers13020291] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
MCL is an uncommon lymphoproliferative disorder that has been regarded as incurable since its identification as a distinct entity. Allogeneic transplantation for two decades has represented the only option capable of ensuring prolonged remissions and possibly cure. Despite its efficacy, its application has been limited by feasibility limitations and substantial toxicity, particularly in elderly patients. Nevertheless, the experience accumulated over time has been wide though often scattered among retrospective and small prospective studies. In this review, we aimed at critically revise and discuss available evidence on allogeneic transplantation in MCL, trying to put available evidence into the 2020 perspective, characterized by unprecedented development of novel promising therapeutic agents and regimens.
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Affiliation(s)
- Miriam Marangon
- Department of Hematology, Azienda Sanitaria Universitaria Giuliano Isontina, 34129 Trieste, Italy;
| | - Carlo Visco
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy;
| | | | - Annalisa Chiappella
- Division of Hematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Alberto Fabbri
- Hematology Division, Department of Oncology, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
| | - Simone Ferrero
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, Università di Torino, 10126 Torino, Italy;
- Hematology 1, AOU Città della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Sara Galimberti
- Hematology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, 42123 Modena, Italy;
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 42123 Modena, Italy
| | - Gerardo Musuraca
- Department of Hematology, IRCCS—Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), 47014 Meldola, Italy;
| | - Alessandro Re
- Hematology Unit, ASST Spedali Civili, 25123 Brescia, Italy;
| | | | - Marco Ladetto
- SC Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, 15121 Alessandria, Italy
- Correspondence:
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Ferrarini I, Rigo A, Visco C, Krampera M, Vinante F. The Evolving Knowledge on T and NK Cells in Classic Hodgkin Lymphoma: Insights into Novel Subsets Populating the Immune Microenvironment. Cancers (Basel) 2020; 12:cancers12123757. [PMID: 33327433 PMCID: PMC7764890 DOI: 10.3390/cancers12123757] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/03/2020] [Accepted: 12/11/2020] [Indexed: 12/24/2022] Open
Abstract
Simple Summary In classic Hodgkin lymphoma, T and NK cells constitute a significant fraction of the reactive microenvironment established by malignant Hodgkin Reed–Sternberg cells. Despite their abundance, T and NK cells remain largely ineffective because of two coordinated levels of immune evasion. The first is based on the acquisition of regulatory properties or exhausted phenotypes that cripple their antitumor activity. The second is represented by their peculiar spatial distribution, with the most immunosuppressive subpopulations lying in close proximity of neoplastic cells. Recent discoveries about the functional role and the spatial orientation of T and NK cells in classic Hodgkin lymphoma are the focus of this review. Abstract Classic Hodgkin lymphoma (cHL) is a unique lymphoid neoplasm characterized by extensive immune infiltrates surrounding rare malignant Hodgkin Reed–Sternberg (HRS) cells. Different subsets of T and NK cells have long been recognized in the cHL microenvironment, yet their distinct contribution to disease pathogenesis has remained enigmatic. Very recently, novel platforms for high dimensional analysis of immune cells, such as single-cell RNA sequencing and mass cytometry, have revealed unanticipated insights into the composition of T- and NK-cell compartments in cHL. Advances in imaging techniques have better defined specific T-helper subpopulations physically interacting with neoplastic cells. In addition, the identification of novel cytotoxic subsets with an exhausted phenotype, typically enriched in cHL milieu, is shedding light on previously unrecognized immune evasion mechanisms. This review examines the immunological features and the functional properties of T and NK subsets recently identified in the cHL microenvironment, highlighting their pathological interplay with HRS cells. We also discuss how this knowledge can be exploited to predict response to immunotherapy and to design novel strategies to improve PD-1 blockade efficacy.
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Affiliation(s)
- Isacco Ferrarini
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy; (A.R.); (C.V.); (M.K.); (F.V.)
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, 37134 Verona, Italy
- Correspondence: ; Tel.: +39-045-812-8411
| | - Antonella Rigo
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy; (A.R.); (C.V.); (M.K.); (F.V.)
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Carlo Visco
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy; (A.R.); (C.V.); (M.K.); (F.V.)
| | - Mauro Krampera
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy; (A.R.); (C.V.); (M.K.); (F.V.)
| | - Fabrizio Vinante
- Section of Hematology, Department of Medicine, University of Verona, 37134 Verona, Italy; (A.R.); (C.V.); (M.K.); (F.V.)
- Cancer Research and Cell Biology Laboratory, Department of Medicine, University of Verona, 37134 Verona, Italy
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Varettoni M, Ferrari A, Frustaci AM, Ferretti VV, Rizzi R, Motta M, Piazza F, Merli M, Benevolo G, Visco C, Laurenti L, Ferrero S, Gentile M, Del Fabro V, Abbadessa A, Klersy C, Musto P, Fabbri N, Deodato M, Dogliotti I, Greco C, Corbingi A, Luminari S, Arcaini L. Younger patients with Waldenström Macroglobulinemia exhibit low risk profile and excellent outcomes in the era of immunotherapy and targeted therapies. Am J Hematol 2020; 95:1473-1478. [PMID: 32780514 DOI: 10.1002/ajh.25961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022]
Abstract
We analyzed 160 young Waldenström Macroglobulinemia (WM) patients with a median age of 49 years (range 23-55 years), diagnosed between January 2000 and January 2019 in 14 Italian centers. At diagnosis, 70% of patients were asymptomatic. With a median follow-up of 5.6 years, 57% have been treated. As initial therapy 79% of patients received chemo-immunotherapy, 13% a chemo-free induction and 8% chemotherapy only. At relapse or progression, 6% underwent an autologous stem cell transplantation. Overall, 19% of patients received ibrutinib during the course of the disease. According to IPSSWM, 63% were classified as low risk, 27% as intermediate risk and 10% as high risk. Five-year OS was shorter in high-risk as compared with low or intermediate risk patients (92.9% vs 100% P = .002). According to revised IPSSWM, 92% were classified as very low or low risk and 8% as intermediate risk, with a shorter 5-year OS in the latter group (87.5% vs 100%, P = .028). The OS of young WM patients was not significantly reduced as compared with age-matched, sex-matched and calendar year-matched general population. Early diagnosis, absence of high-risk features in symptomatic patients and high efficacy of modern treatments are the main determinants of the excellent outcome of young WM patients.
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Affiliation(s)
- Marzia Varettoni
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Angela Ferrari
- Hematology Unit Azienda USL IRCCS di Reggio Emilia Reggio Emilia Italy
| | - Anna M. Frustaci
- Department of Hematology Niguarda Cancer Center, Niguarda Hospital Milan Italy
| | - Virginia V. Ferretti
- Service of Biometry and Clinical Epidemiology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Rita Rizzi
- Department of Emergency and Organ Transplantation "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOU Consorziale Policlinico Bari Italy
| | - Marina Motta
- Department of Hematology ASST‐Spedali Civili Brescia Italy
| | - Francesco Piazza
- Department of Medicine (DIMED), Haematology and Clinical Immunology Section Padua University School of Medicine Padua Italy
| | - Michele Merli
- Division of Hematology Ospedale di Circolo e Fondazione Macchi ‐ ASST Sette Laghi Varese Italy
| | - Giulia Benevolo
- Department of Hematology Cittaʼ della Salute e della Scienza Torino Italy
| | - Carlo Visco
- Medicine, Section of Hematology University of Verona Verona Italy
| | - Luca Laurenti
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Roma Italy
| | - Simone Ferrero
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences University of Torino, Italy/AOU “Città della Salute e della Scienza di Torino” Torino Italy
| | | | - Vittorio Del Fabro
- Division of Hematology Azienda Policlinico‐OVE, University of Catania Catania Italy
| | | | - Catherine Klersy
- Service of Biometry and Clinical Epidemiology Fondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Pellegrino Musto
- Department of Emergency and Organ Transplantation "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOU Consorziale Policlinico Bari Italy
| | - Nicole Fabbri
- Department of Molecular Medicine University of Pavia Pavia Italy
| | - Marina Deodato
- Department of Hematology Niguarda Cancer Center, Niguarda Hospital Milan Italy
| | - Irene Dogliotti
- Division of Hematology, Department of Molecular Biotechnologies and Health Sciences University of Torino, Italy/AOU “Città della Salute e della Scienza di Torino” Torino Italy
| | | | - Andrea Corbingi
- Dipartimento Universitario di Scienze Radiologiche ed Ematologiche Fondazione Policlinico Universitario Agostino Gemelli, IRCCS Roma Italy
| | - Stefano Luminari
- Hematology Unit Azienda USL IRCCS di Reggio Emilia Reggio Emilia Italy
- Department CHIMOMO University of Modena and Reggio Emilia Reggio Emilia Italy
| | - Luca Arcaini
- Division of Hematology Fondazione IRCCS Policlinico San Matteo Pavia Italy
- Department of Molecular Medicine University of Pavia Pavia Italy
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Merli M, Marino D, Cencini E, Rattotti S, Fraenza C, Grossi P, Bianchi B, Mora B, Sciarra R, Finotto S, Mecacci B, Passamonti F, Visco C, Arcaini L. Direct-acting antivirals in hepatitis C virus-positive mantle cell lymphomas. Hematol Oncol 2020; 39:263-266. [PMID: 33150988 DOI: 10.1002/hon.2825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Michele Merli
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Dario Marino
- Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Italy
| | - Emanuele Cencini
- Hematology, Azienda Ospedaliera Senese, University of Siena, Siena, Italy
| | - Sara Rattotti
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Costanza Fraenza
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Paolo Grossi
- Infectious and Tropical Diseases, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Benedetta Bianchi
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Barbara Mora
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Roberta Sciarra
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvia Finotto
- Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IOV IRCCS, Padova, Italy
| | - Bianca Mecacci
- Hematology, Azienda Ospedaliera Senese, University of Siena, Siena, Italy
| | - Francesco Passamonti
- Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi"-ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Luca Arcaini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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