1
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Godfrey JK, Gao L, Shouse G, Song JY, Pak S, Lee B, Chen BT, Kallam A, Baird JH, Marcucci G, Ghoda LY, Vauleon S, Danilov AV, Herrera AF, Kwak LW, Budde LE. Glofitamab stimulates immune cell infiltration of CNS tumors and induces clinical responses in secondary CNS lymphoma. Blood 2024:blood.2024024168. [PMID: 38484137 DOI: 10.1182/blood.2024024168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
Although CD20xCD3 bispecific antibodies are effective against systemic B-cell lymphomas, their efficacy in CNS lymphoma is unknown. Here, we report the CD20xCD3 bispecific, glofitamab, penetrates the blood-brain barrier, stimulates immune-cell infiltration of CNS tumors, and induces responses in CNS lymphoma.
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Affiliation(s)
| | - Lei Gao
- City of Hope, Duarte, California, United States
| | - Geoffrey Shouse
- City of Hope National Medical Center, Duarte, California, United States
| | - Joo Y Song
- City of Hope Medical Center, Duarte, California, United States
| | - Stacy Pak
- City of Hope National Medical Center, Duarte, California, United States
| | - Brian Lee
- City of Hope, Duarte, California, United States
| | | | | | | | - Guido Marcucci
- Hematologic Malignancies Translational Science, Gehr Family Center for Leukemia Research, City of Hope Medical Center and Beckman Research Institute, Duarte, California, United States
| | - Lucy Y Ghoda
- Beckman Research Institute, City of Hope, Duarte, California, United States
| | | | | | | | | | - Lihua E Budde
- City of Hope National Medical Center, Duarte, California, United States
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2
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Cooper A, Tumuluru S, Kissick K, Venkataraman G, Song JY, Lytle A, Duns G, Yu J, Kotlov N, Bagaev A, Hodkinson B, Srinivasan S, Smith SM, Scott DW, Steidl C, Godfrey JK, Kline J. CD5 Gene Signature Identifies Diffuse Large B-Cell Lymphomas Sensitive to Bruton's Tyrosine Kinase Inhibition. J Clin Oncol 2024; 42:467-480. [PMID: 38079587 DOI: 10.1200/jco.23.01574] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/24/2023] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 01/31/2024] Open
Abstract
PURPOSE A genetic classifier termed LymphGen accurately identifies diffuse large B-cell lymphoma (DLBCL) subtypes vulnerable to Bruton's tyrosine kinase inhibitors (BTKis), but is challenging to implement in the clinic and fails to capture all DLBCLs that benefit from BTKi-based therapy. Here, we developed a novel CD5 gene expression signature as a biomarker of response to BTKi-based therapy in DLBCL. METHODS CD5 immunohistochemistry (IHC) was performed on 404 DLBCLs to identify CD5 IHC+ and CD5 IHC- cases, which were subsequently characterized at the molecular level through mutational and transcriptional analyses. A 60-gene CD5 gene expression signature (CD5sig) was constructed using genes differentially expressed between CD5 IHC+ and CD5 IHC- non-germinal center B-cell-like (non-GCB DLBCL) DLBCLs. This CD5sig was applied to external DLBCL data sets, including pretreatment biopsies from patients enrolled in the PHOENIX study (n = 584) to define the extent to which the CD5sig could identify non-GCB DLBCLs that benefited from the addition of ibrutinib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). RESULTS CD5 expression was observed in 12% of non-GCB DLBCLs. CD5+ DLBCLs displayed transcriptional features of B-cell receptor (BCR) activation and were enriched for BCR-activating mutations known to correlate with BTKi sensitivity. However, most CD5+ DLBCLs lacked canonical BCR-activating mutations or were LymphGen-unclassifiable (LymphGen-Other). The CD5sig recapitulated these findings in multiple independent data sets, indicating its utility in identifying DLBCLs with genetic and nongenetic bases for BCR dependence. Supporting this notion, CD5sig+ DLBCLs derived a selective survival advantage from the addition of ibrutinib to R-CHOP in the PHOENIX study, independent of LymphGen classification. CONCLUSION CD5sig is a useful biomarker to identify DLBCLs vulnerable to BTKi-based therapies and complements current biomarker approaches by identifying DLBCLs with genetic and nongenetic bases for BTKi sensitivity.
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Affiliation(s)
- Alan Cooper
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Sravya Tumuluru
- Committee on Cancer Biology, University of Chicago, Chicago, IL
| | - Kyle Kissick
- Department of Pathology, University of Chicago, Chicago, IL
| | | | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | - Andrew Lytle
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC
| | - Gerben Duns
- Lymphoid Cancer Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Jovian Yu
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | | | | | - Brendan Hodkinson
- Oncology Translational Research, Janssen Research & Development, Spring House, PA
| | - Srimathi Srinivasan
- Oncology Translational Research, Janssen Research & Development, Lower Gwynedd Township, PA
| | - Sonali M Smith
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - David W Scott
- Lymphoid Cancer Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Christian Steidl
- Lymphoid Cancer Research, BC Cancer Agency, Vancouver, BC, Canada
| | - James K Godfrey
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Justin Kline
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
- Committee on Cancer Biology, University of Chicago, Chicago, IL
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3
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Godfrey J, Mei M, Chen L, Song JY, Bedell V, Budde E, Armenian S, Puverel S, Nikolaenko L, Chen R, Daniels S, Kennedy N, Peters L, Rosen ST, Forman SJ, Popplewell LL, Kwak LW, Herrera AF. Results from a phase I trial of pembrolizumab plus vorinostat in relapsed/refractory B-cell non-Hodgkin lymphoma. Haematologica 2024; 109:533-542. [PMID: 37470137 PMCID: PMC10828763 DOI: 10.3324/haematol.2023.283002] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/03/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
Outcomes after programmed death-1 (PD-1) blockade in B-cell lymphomas are disappointing with few durable responses. Histone deacetylase inhibitors exhibit favorable immunomodulatory effects and demonstrate synergistic anti-tumor immune responses with anti-PD-1 therapy in preclinical models. We, therefore, developed a phase I study to evaluate the safety and preliminary efficacy of pembrolizumab with vorinostat in relapsed/refractory B-cell lymphomas. Patients were treated in a dose-escalation cohort using a Rolling 6 design followed by an expansion cohort at the recommended phase II dose (R2PD). Fifty-two patients were enrolled (32 Hodgkin and 20 non-Hodgkin lymphoma [NHL]). Here, we report safety data from the dose escalation cohort, and the toxicity and efficacy within NHL patients. Vorinostat was administered twice daily on days 1-5 and 8-12 (dose-level [DL]1: 100 mg; DL2: 200 mg) and pembrolizumab (200 mg) was administered on day 1 of each 3-week cycle. Of six patients treated at DL1, one had a dose-limiting toxicity (DLT) (Stevens-Johnson syndrome [SJS]), and one of six had a DLT at DL2 (thromboembolism); therefore, DL2 was the RP2D. The patient developing SJS was treated with corticosteroids, infliximab, and cyclosporine but ultimately died of invasive fungal infection from the extensive immunosuppression used to treat the SJS. The most common adverse events were hypertension, diarrhea, and cytopenias. Of 20 NHL patients, nine had follicular lymphoma (FL) and 11 had diffuse large B-cell lymphoma (DLBCL). Five DLBCL patients had primary mediastinal B-cell lymphoma (PMBL). The complete and overall response rates (CR and ORR) were 11% and 22% for FL and 45% and 55% for all DLBCL. Amongst DLBCL, the CR and ORR was 80% and 80% for PMBL and 17% and 33% for non-PMBL. In conclusion, pembrolizumab with vorinostat was tolerable and produced responses in relapsed/refractory B-cell NHL, with particularly notable efficacy in PMBL (clinicaltrials gov. Identifier: NCT03150329).
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Affiliation(s)
- James Godfrey
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Matthew Mei
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Lu Chen
- Department of Information Sciences, City of Hope, Duarte, CA
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | | | - Elizabeth Budde
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | | | - Sandrine Puverel
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Liana Nikolaenko
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Robert Chen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Shari Daniels
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Neena Kennedy
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Lacolle Peters
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Steven T Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Leslie L Popplewell
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Larry W Kwak
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA.
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4
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Aldoss I, Tizro P, Bedi D, Mangan JK, Clark MC, Spencer D, Song JY, Cherian S, Pillai R, Kim Y, Mahajan N, Gendzekhadze K, James M, Jacobs K, Davidson-Moncada J, Forman SJ, Wang HY, Afkhami M. Myeloid lineage switch following CD7-targeted chimeric antigen receptor T-cell therapy in relapsed/refractory T-cell acute lymphoblastic leukemia. Haematologica 2023; 108:3511-3516. [PMID: 37470155 PMCID: PMC10690902 DOI: 10.3324/haematol.2023.283566] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/22/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
Not available.
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Affiliation(s)
- Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA.
| | | | - Davsheen Bedi
- Department of Pathology, University of California San Diego, La Jolla, CA
| | - James K Mangan
- Department of Medicine, Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Mary C Clark
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA
| | - David Spencer
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | - Sindhu Cherian
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Raju Pillai
- Department of Pathology, City of Hope, Duarte, CA
| | - Young Kim
- Department of Pathology, City of Hope, Duarte, CA
| | | | | | | | | | | | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Family Center for Leukemia Research, City of Hope, Duarte, CA
| | - Huan-You Wang
- Department of Pathology, University of California San Diego, La Jolla, CA
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5
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Zhao YX, Song JY, Bao XW, Zhang JL, Wu JC, Wang LY, He C, Shao W, Bai XL, Liang TB, Sheng JP. Single-cell RNA sequencing-guided fate-mapping toolkit delineates the contribution of yolk sac erythro-myeloid progenitors. Cell Rep 2023; 42:113364. [PMID: 37922312 DOI: 10.1016/j.celrep.2023.113364] [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: 01/17/2023] [Revised: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 11/05/2023] Open
Abstract
Erythro-myeloid progenitors of the yolk sac that originates during early embryo development has been suggested to generate tissue-resident macrophage, mast cell, and even endothelial cell populations from fetal to adult stages. However, the heterogeneity of erythro-myeloid progenitors (EMPs) is not well characterized. Here, we adapt single-cell RNA sequencing to dissect the heterogeneity of EMPs and establish several fate-mapping tools for each EMP subset to trace the contributions of different EMP subsets. We identify two primitive and one definitive EMP subsets from the yolk sac. In addition, we find that primitive EMPs are decoupled from definitive EMPs. Furthermore, we confirm that primitive and definitive EMPs give rise to microglia and other tissue-resident macrophages, respectively. In contrast, only Kit+ Csf1r- primitive EMPs generate endothelial cells transiently during early embryo development. Overall, our results delineate the contribution of yolk sac EMPs more clearly based on the single-cell RNA sequencing (scRNA-seq)-guided fate-mapping toolkit.
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Affiliation(s)
- Y X Zhao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - J Y Song
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - X W Bao
- Department of Medical Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China
| | - J L Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - J C Wu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China
| | - L Y Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang, China
| | - C He
- Infinity Scope Biotechnology Co., Ltd., Hangzhou 311200, China
| | - W Shao
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210000, China.
| | - X L Bai
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
| | - T B Liang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
| | - J P Sheng
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310002, China; Zhejiang University Cancer Center, Zhejiang University, Hangzhou 310002, China.
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6
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Song JY, Kim BH, Kang MK, Jeong JU, Kim JH, Moon SH, Suh YG, Kim JH, Kim HJ, Kim YS, Park WY, Kim HJ. Definitive Radiotherapy in Patients with Clinical T1N0M0 Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e340. [PMID: 37785190 DOI: 10.1016/j.ijrobp.2023.06.2400] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In this study, we aimed to assess the failure pattern and survival outcomes and to analyze the optimal treatment field of definitive RT for T1N0M0 esophageal squamous cell carcinoma (ESCC). MATERIALS/METHODS We performed a retrospective analysis in a multi-institutional cohort of patients with histologically confirmed T1N0M0 ESCC. We included patients who underwent RT with definitive aim from 2010 to 2019. Patterns of failure were demonstrated as in-field locoregional, out-field locoregional and distant metastasis. In the survival analysis, freedom from locoregional recurrence and their association with clinicopathologic risk factors were analyzed. We performed a propensity score matching in the cT1b patients to adjust for the heterogeneity of radiation technique, radiation dose and the use of concurrent chemotherapy. RESULTS A total of 168 patients were included with a median follow-up of 34.0 months, and there were 20 cT1a, 94 cT1b and 24 cT1x, (cT1, not otherwise specified) patients. The rates of all and locoregional failure were 26.9% and 23.1% for cT1a and 25.0% and 22.4% for cT1b patients. 10 (10.6%) patients experienced grade ≥ 3 adverse events. Among 116 cT1b patients, 69 patients received elective nodal irradiation (ENI) and 47 patients received involved field irradiation (IFI). After propensity score matching, the 3-year FFLRR rate was 84.5% (95% Confidence Interval, 71.0 - 92.1%). There was no significant difference between the ENI and IFI patients in FFLRR (Log-rank P = 0.831). In the multivariate analysis, the use of concurrent chemotherapy was the only factor marginally associated with FFLRR (Hazard ratio, 0.17; 95% CI, 0.02 - 1.13; P = 0.067). CONCLUSION cT1a patients who cannot receive endoscopic resection, showed similar rates of failure compared with cT1b patients, which questioned the accuracy of the staging and raised the need for through treatment such as chemoradiotherapy. In cT1b patients, IFI using dose of 50 to 60 Gy with concurrent chemotherapy could be a reasonable treatment option.
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Affiliation(s)
- J Y Song
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
| | - B H Kim
- Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea, Republic of (South) Korea
| | - M K Kang
- Department of Radiation Oncology, Kyungpook National University Medical Center, Daegu, Korea, Republic of (South) Korea
| | - J U Jeong
- Jeonnam National University Hwasun Hospital, Jeollanam-do, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Asan Medical Center, Seoul, Korea, Republic of (South) Korea
| | - S H Moon
- Proton Therapy Center, National Cancer Center, Goyang-si, Korea, Republic of (South) Korea
| | - Y G Suh
- Proton Therapy Center, National Cancer Center, Goyang-si, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea
| | - H J Kim
- Inha University Hospital, Inchon, Korea, Republic of (South) Korea
| | - Y S Kim
- Department of Radiation Oncology, Jeju National University School of Medicine, Jeju, Korea, Republic of (South) Korea
| | - W Y Park
- Chungbuk National University and Chungbuk National University Hospital, Cheongju, Korea, Republic of (South) Korea
| | - H J Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
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7
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Song JY, Lee JH, Wu HG, Eom KY, Wee CW, Kim JH. Prognostic Value of Depth of Invasion in Squamous Cell Carcinoma of the Oral Cavity of Size 4 cm or Less. Int J Radiat Oncol Biol Phys 2023; 117:e626. [PMID: 37785873 DOI: 10.1016/j.ijrobp.2023.06.2016] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We aimed to evaluate the role of the depth of invasion (DOI) as an independent prognostic factor in the absence of other adverse features in squamous cell carcinoma (SqCC) of the oral cavity with a size of 4 cm or less. MATERIALS/METHODS We performed a retrospective analysis in a multi-institutional cohort of patients with oral cavity SqCC, size of 4 cm or less. We included those who were treated with upfront surgery with negative resection margins from 2010 to 2021 and those with one or no nodal metastasis. Those who were treated with postoperative radiotherapy were excluded. The DOI and other adverse features, such as close resection margins, lymphovascular invasion, perineural invasion, and nodal metastasis, were evaluated in univariate and multivariate analyses for their association with locoregional recurrence (LRR). RESULTS A total of 155 patients were included with a median follow-up of 23.7 months. 56 patients (36.1%) had DOI greater than 5 mm. 26 patients (16.8%) experienced LRR and one experienced distant metastasis. Multivariate analysis showed that DOI was the only prognostic factor associated with a higher rate of LRF (p = 0.004). The 2-year LRF rates of those with DOI ≤ 5 mm and DOI > 5mm were 4.7% and 30.3%, respectively. CONCLUSION This study implies that DOI greater than 5 mm may be an independent prognostic factor of the SqCC of the OCC and may be indicated for adjuvant radiotherapy.
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Affiliation(s)
- J Y Song
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
| | - J H Lee
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - H G Wu
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - K Y Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea, Republic of (South) Korea
| | - C W Wee
- Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea; Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
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8
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Yuan Q, Song JY, Ye LQ, Zhang YM. Serum human epidermal growth factor receptor-2 extracellular domain, carcinoma embryonic antigen and carbohydrate antigen 15-3 combined detection in early diagnosis of breast cancer. J Physiol Pharmacol 2023; 74. [PMID: 38085516 DOI: 10.26402/jpp.2023.5.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023]
Abstract
The multi-markers combined detection can make up for the deficiency of single marker detection and significantly increase the positive detection rates of tumors. This study aimed to assess the performance of serum HER-2 extracellular domain (HER-2/neu ECD), carcinoembryonic antigen (CEA), and cancer antigen 15-3 (CA15-3) in early screening and auxiliary diagnosis of breast cancer. The HER-2, CEA, and CA15-3 serum levels were measured in 164 healthy volunteers, 111 patients with benign nodules (BN), 123 with early breast cancer (EBC), and 25 with advanced breast cancer. In distinguishing health and EBC, the sensitivity and specificity of joint detection of HER-2, CEA, and CA15-3 were 96.75% and 96.95%, respectively; the accuracy was up to 96.19%, and the AUC was 0.994. In the cohort for distinguishing BN from EBC, serum HER-2, CEA, and CA15-3 sensitivities were 77.03%, 75.27%, and 48.65%, respectively. Combined with three markers, the sensitivity was increased to 84.46%, the AUC was 0.834. All in all, through the combined detection of serum HER-2, CEA and CA15-3 levels in healthy volunteers, BN and EBC, our study found that this method can significantly improve the diagnosis level of breast cancer, suggesting that the three markers panel can be used as an effective tool to improve the early screening level, early diagnosis, and clinical intervention of breast cancer.
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Affiliation(s)
- Q Yuan
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - J Y Song
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - L Q Ye
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Y M Zhang
- Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China.
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9
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Boyer DF, Perry A, Wey E, Hsueh J, Li A, Jackson R, Soma L, Zhang W, Song JY. Fibrin-associated large B-cell lymphoma shows frequent mutations related to immune surveillance and PTEN. Blood 2023; 142:1022-1025. [PMID: 37433264 PMCID: PMC10517201 DOI: 10.1182/blood.2023020349] [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] [Received: 03/22/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Affiliation(s)
- Daniel F. Boyer
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Anamarija Perry
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Elizabeth Wey
- Department of Pathology, Beaumont Health System, Royal Oak, MI
| | - Julia Hsueh
- Department of Pathology, City of Hope, Duarte, CA
| | - Aimin Li
- Department of Pathology, City of Hope, Duarte, CA
| | - Ryan Jackson
- Department of Pathology, City of Hope, Duarte, CA
| | - Lorinda Soma
- Department of Pathology, City of Hope, Duarte, CA
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Joo Y. Song
- Department of Pathology, Beaumont Health System, Royal Oak, MI
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10
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Zhang PP, Song JY, Wang HJ, Wang H. [Combined effect of PNPLA3 rs738409 and UGT1A1 rs10929303 gene polymorphisms on nonalcoholic fatty liver disease in children]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:723-728. [PMID: 37580255 DOI: 10.3760/cma.j.cn501113-20220222-00084] [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] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Objective: To investigate the combined effects of patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 (C > G) and uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) rs10929303 (C > T) on nonalcoholic fatty liver disease (NAFLD) in children and adolescents so as to provide scientific evidence for NAFLD genetic research. Methods: 1 027 children and adolescents aged 7-18 were selected as the research subjects. The general situation, past medical history, height and body weight measurements, and B- mode ultrasound test of the liver were investigated by dedicated full-time personnel. In addition, the morning fasting venous blood was collected to measure the blood biochemical indicators. DNA was extracted and genotyped for PNPLA3 rs738409 and UGT1A1 rs10929303. Logistic regression analysis was used to analyze the association and combined effect of the two gene polymorphisms and NAFLD. Statistical analysis was performed by t-test, Mann-Whitney U test, or c2 test according to different data. Results: The GG genotype of PNPLA3 rs738409 and the CC genotype of UGT1A1 rs10929303 were associated with an increased risk of developing NAFLD in children by 89% (OR = 1.89, 95% CI: 1.11-3.23, P = 0.019) and 96% (OR = 1.96, 95% CI: 1.21-3.17, P = 0.006), respectively, while the concurrent risk of NAFLD in those who carried the above two genotypes increased by 306% compared with those who did not carry both genotypes (OR = 4.06, 95% CI: 1.90 ~ 8.66, P < 0.001). Conclusion: The combined effect of PNPLA3 and UGT1A1 gene polymorphisms can significantly increase the risk of NAFLD in children, providing new evidence for elucidating the genetic susceptibility to NAFLD.
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Affiliation(s)
- P P Zhang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - J Y Song
- Institute of Child and Adolescent Health, Peking University, Beijing 100191, China
| | - H J Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - H Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
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Chen J, Xiao WC, Shan R, Song JY, Liu Z. [Influence of rs2587552 polymorphism of DRD2 gene on the effect of a childhood obesity intervention: A prospective, parallel-group controlled trial]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:436-441. [PMID: 37291918] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the association between rs2587552 polymorphism (has a strong lin-kage disequilibrium with rs1800497 which had been found in many studies to be related to obesity, r2=0.85) of DRD2 gene and the effect of a childhood obesity intervention in Chinese population, and provide a scientific basis for future personalized childhood obesity intervention based on genetic background. METHODS From a multi-center cluster randomized controlled trial studying the effect of a childhood obesity intervention, we enrolled 382 children from 8 primary schools (192 and 190 children from intervention and control groups, respectively) in Beijing as study subjects. Saliva was collected and DNA was extracted to detect the rs2587552 polymorphism of DRD2 gene, and the interactions between the gene and study arms on childhood obesity indicators [including body weight, body mass index (BMI), BMI Z-score, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, and body fat percentage] were analyzed. RESULTS No association was found between rs2587552 polymorphism and the changes in hip circumference or body fat percentage in the intervention group (P>0.05). However, in the control group, children carrying the A allele at DRD2 rs2587552 locus showed a greater increase in hip circumference and body fat percentage compared with those not carrying A allele (P < 0.001). There were interactions between rs2587552 polymorphism of DRD2 gene and study arms on the changes in hip circumference and body fat percentage (P=0.007 and 0.015, respectively). Compared with the control group, children in the intervention group carrying the A allele at DRD2 rs2587552 locus showed decrease in hip circumference by (-1.30 cm, 95%CI: -2.25 to -0.35, P=0.007) and decrease in body fat percentage by (-1.34%, 95%CI: -2.42 to -0.27, P=0.015) compared with those not carrying A allele. The results were consistent between the dominant model and the additive model (hip circumfe-rence: -0.66 cm, 95%CI: -1.28 to -0.03, P=0.041; body fat percentage: -0.69%, 95%CI: -1.40 to 0.02, P=0.056). No interaction was found between rs2587552 polymorphism and study arms on the changes in other childhood obesity-related indicators (P>0.05). CONCLUSION Children carrying the A allele at rs2587552 polymorphism of DRD2 gene are more sensitive to intervention and showed more improvement in hip circumference and body fat percentage after the intervention, suggesting that future personalized childhood obesity lifestyle intervention can be carried out based on the rs2587552 polymorphism of DRD2 gene.
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Affiliation(s)
- J Chen
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China
| | - W C Xiao
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China
| | - R Shan
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China
| | - J Y Song
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
| | - Z Liu
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China
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12
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Schroers-Martin JG, Soo J, Brisou G, Scherer F, Kurtz DM, Sworder BJ, Khodadoust MS, Jin MC, Bru A, Liu CL, Stehr H, Vineis P, Natkunam Y, Teras LR, Song JY, Nadel B, Diehn M, Roulland S, Alizadeh AA. Tracing Founder Mutations in Circulating and Tissue-Resident Follicular Lymphoma Precursors. Cancer Discov 2023; 13:1310-1323. [PMID: 36939219 PMCID: PMC10239329 DOI: 10.1158/2159-8290.cd-23-0111] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 01/24/2023] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 03/21/2023]
Abstract
Follicular lymphomas (FL) are characterized by BCL2 translocations, often detectable in blood years before FL diagnosis, but also observed in aging healthy individuals, suggesting additional lesions are required for lymphomagenesis. We directly characterized early cooperating mutations by ultradeep sequencing of prediagnostic blood and tissue specimens from 48 subjects who ultimately developed FL. Strikingly, CREBBP lysine acetyltransferase (KAT) domain mutations were the most commonly observed precursor lesions, and largely distinguished patients developing FL (14/48, 29%) from healthy adults with or without detected BCL2 rearrangements (0/13, P = 0.03 and 0/20, P = 0.007, respectively). CREBBP variants were detectable a median of 5.8 years before FL diagnosis, were clonally selected in FL tumors, and appeared restricted to the committed B-cell lineage. These results suggest that mutations affecting the CREBBP KAT domain are common lesions in FL cancer precursor cells (CPC), with the potential for discriminating subjects at risk of developing FL or monitoring residual disease. SIGNIFICANCE Our study provides direct evidence for recurrent genetic aberrations preceding FL diagnosis, revealing the combination of BCL2 translocation with CREBBP KAT domain mutations as characteristic committed lesions of FL CPCs. Such prediagnostic mutations are detectable years before clinical diagnosis and may help discriminate individuals at risk for lymphoma development. This article is highlighted in the In This Issue feature, p. 1275.
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Affiliation(s)
- Joseph G. Schroers-Martin
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Joanne Soo
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Gabriel Brisou
- Aix-Marseille University, CNRS, INSERM, Centre d’Immunologie de Marseille-Luminy, Marseille, France
| | - Florian Scherer
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - David M. Kurtz
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Brian J. Sworder
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Michael S. Khodadoust
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Michael C. Jin
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Agnès Bru
- Aix-Marseille University, CNRS, INSERM, Centre d’Immunologie de Marseille-Luminy, Marseille, France
| | - Chih Long Liu
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Henning Stehr
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Yasodha Natkunam
- Department of Pathology, Stanford University Medical Center, Stanford, CA
| | | | - Joo Y. Song
- City of Hope Cancer Research Hospital, Duarte, CA
| | - Bertrand Nadel
- Aix-Marseille University, CNRS, INSERM, Centre d’Immunologie de Marseille-Luminy, Marseille, France
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California, USA
- Stanford Cancer Institute, Stanford University, Stanford, California, USA
| | - Sandrine Roulland
- Aix-Marseille University, CNRS, INSERM, Centre d’Immunologie de Marseille-Luminy, Marseille, France
| | - Ash A. Alizadeh
- Department of Medicine, Divisions of Hematology & Oncology, Stanford University Medical Center, Stanford, CA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California, USA
- Stanford Cancer Institute, Stanford University, Stanford, California, USA
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13
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Dong Z, Song JY, Thieme E, Anderson A, Oh E, Cheng WA, Kuang BZ, Lee V, Zhang T, Wang Z, Szymura S, Smith DL, Zhang J, Nian W, Zheng X, He F, Zhou Q, Cha SC, Danilov AV, Qin H, Kwak LW. Generation of a humanized afucosylated BAFF-R antibody with broad activity against human B-cell malignancies. Blood Adv 2023; 7:918-932. [PMID: 36469551 PMCID: PMC10027513 DOI: 10.1182/bloodadvances.2022008560] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/14/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
B-cell activating factor receptor (BAFF-R) is a mature B-cell survival receptor, which is highly expressed in a wide variety of B-cell malignancies but with minimal expression in immature B cells. These properties make BAFF-R an attractive target for therapy of B-cell lymphomas. We generated a novel humanized anti BAFF-R monoclonal antibody (mAb) with high specificity and potent in vitro and in vivo activity against B-cell lymphomas and leukemias. The humanized variants of an original chimeric BAFF-R mAb retained BAFF-R binding affinity and antibody-dependent cellular cytotoxicity (ADCC) against a panel of human cell lines and primary lymphoma samples. Furthermore, 1 humanized BAFF-R mAb clone and its afucosylated version, glycoengineered to optimize the primary mechanism of action, prolonged survival of immunodeficient mice bearing human tumor cell lines or patient-derived lymphoma xenografts in 3 separate models, compared with controls. Finally, the tissue specificity of this humanized mAb was confirmed against a broad panel of normal human tissues. Taken together, we have identified a robust lead-candidate BAFF-R mAb for clinical development.
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Affiliation(s)
- Zhenyuan Dong
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Joo Y Song
- Department of Pathology, City of Hope Medical Center, Duarte, CA
| | - Elana Thieme
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Aaron Anderson
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Elizabeth Oh
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Wesley A Cheng
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Benjamin Z Kuang
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Vincent Lee
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Tiantian Zhang
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Zhe Wang
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Szymon Szymura
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - D Lynne Smith
- Clinical and Translational Project Development, City of Hope Medical Center, Duarte, CA
| | | | - Weihong Nian
- Shanghai Escugen Biotechnology Co, Ltd, Shanghai, China
| | - Xintong Zheng
- Shanghai Escugen Biotechnology Co, Ltd, Shanghai, China
| | - Feng He
- Shanghai Escugen Biotechnology Co, Ltd, Shanghai, China
| | - Qing Zhou
- Shanghai Escugen Biotechnology Co, Ltd, Shanghai, China
| | - Soung-Chul Cha
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Alexey V Danilov
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Hong Qin
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
| | - Larry W Kwak
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA
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Shestakova A, Shao L, Smith LB, Ryan R, Bedell V, Murata-Collins J, Zhang W, Perry AM, Song JY. High-grade B-cell lymphoma with concurrent MYC rearrangement and 11q aberrations: Clinicopathologic, cytogenetic and molecular characterization of 4 cases. Hum Pathol 2023; 136:34-43. [PMID: 36997031 DOI: 10.1016/j.humpath.2023.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
High-grade B-cell lymphoma with 11q aberrations (LBL-11q) resembles Burkitt lymphoma (BL), is negative for MYC rearrangement, and harbors chromosome 11q aberrations. Rare cases of high-grade B-cell lymphoma with concurrent MYC rearrangement and 11q aberrations (HGBCL-MYC-11q) have been described. In this study we report the clinicopathologic, cytogenetic, and molecular findings in 4 such cases. Diagnoses were made on tissue or bone marrow biopsies. Karyotype, fluorescence in situ hybridization, genomic microarray analyses, and next-generation sequencing were performed. All patients were male (median age 39 years). Three cases were diagnosed as BL, while one was diagnosed as diffuse large B-cell lymphoma. Karyotypes (available in 2 patients) were complex. In one patient, copy number analysis showed gains at 1q21.1-q44 and 13q31.3, and loss of 13q34, abnormalities typically seen in BL. All of our cases showed two or more mutations that are recurrent in BL, including ID3, TP53, DDX3X, CCND3, FBXO1, and MYC. Two cases showed a GNA13 mutation, commonly seen in LBL-11q. Cases of HGBCL-MYC-11q display overlapping morphologic and immunophenotypic, as well as cytogenetic and molecular features between BL and LBL-11q, with a mutational landscape enriched for mutations recurrent in BL. Concurrent MYC rearrangement with 11q abnormalities is important to recognize especially since it has implications for their classification.
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Melani C, Dowdell K, Pittaluga S, Dunleavy K, Roschewski M, Song JY, Calattini S, Kawada JI, Price DA, Chattopadhyay PK, Roederer M, Lucas AN, Steinberg SM, Jaffe ES, Cohen JI, Wilson WH. Interferon alfa-2b in patients with low-grade lymphomatoid granulomatosis and chemotherapy with DA-EPOCH-R in patients with high-grade lymphomatoid granulomatosis: an open-label, single-centre, phase 2 trial. The Lancet Haematology 2023; 10:e346-e358. [PMID: 37011643 DOI: 10.1016/s2352-3026(23)00029-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Lymphomatoid granulomatosis is a rare Epstein-Barr virus-associated B-cell lymphoproliferative disorder with a median overall survival of less than 2 years. In this study, we hypothesised that low-grade lymphomatoid granulomatosis is immune-dependent and high-grade lymphomatoid granulomatosis is immune-independent. On the basis of this hypothesis, we investigated the activity and safety of new treatment with immunotherapy in patients with low-grade disease and standard chemotherapy in patients with high-grade disease. METHODS In this open-label, single-centre, phase 2 trial, we enrolled patients aged 12 years or older with untreated, or relapsed or refractory lymphomatoid granulomatosis at the National Cancer Institute (National Institutes of Health, Bethesda, MD, USA). Patients with low-grade disease received dose-escalated interferon alfa-2b, starting at 7·5 million international units subcutaneously three times per week for up to 1 year past best response, and patients with high-grade disease received six cycles every 3 weeks of intravenous, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH-R). Starting doses were 50 mg/m2 per day as a continuous intravenous infusion from day 1 to day 4 (96 h) for etoposide; 60 mg/m2 twice daily by mouth from day 1 to day 5 for prednisone; 0·4 mg/m2 per day as a continuous intravenous infusion from day 1 to day 4 (96 h) for vincristine; 750 mg/m2 intravenous on day 5 for cyclophosphamide; 10 mg/m2 per day as a continuous intravenous infusion from day 1 to day 4 (96 h) for doxorubicin; and 375 mg/m2 intravenous on day 1 for rituximab. The doses of doxorubicin, etoposide, and cyclophosphamide were adjusted up or down on the basis of neutrophil and platelet nadirs. Patients with residual or progressive disease after initial therapy crossed over to alternative therapy. The primary endpoint was the proportion of patients who had an overall response and the 5-year progression-free survival after initial or cross-over treatment. Analysis of response included all participants who underwent restaging imaging; safety analysis included all patients who received any dose of study drugs. The trial is open for enrolment and is registered at ClinicalTrials.gov, NCT00001379. FINDINGS 67 patients were enrolled between Jan 10, 1991, and Sept 5, 2019 (42 [63%] were male). 45 patients received initial treatment with interferon alfa-2b (16 of whom crossed over to DA-EPOCH-R) and 18 received initial treatment with DA-EPOCH-R (eight of whom crossed over to interferon alfa-2b); four underwent surveillance only. After initial treatment with interferon alfa-2b, the overall response was 64% (28 of 44 evaluable patients) with 61% (27 of 44) having a complete response, whereas, after cross-over treatment with interferon alfa-2b, the overall response was 63% (five of eight evaluable patients) with 50% (four of eight) having a complete response. After initial treatment with DA-EPOCH-R, the overall response was 76% (13 of 17 evaluable patients) with 47% (eight of 17) having a complete response, whereas, after cross-over treatment with DA-EPOCH-R, the overall response was 67% (ten of 15 evaluable patients) with 47% (seven of 15) having a complete response. 5-year progression-free survival was 48·5% (95% CI 33·2-62·1) after initial treatment with interferon alfa-2b, 50·0% (15·2-77·5) after cross-over treatment with interferon alfa-2b, 25·4% (8·2-47·2) after initial treatment with DA-EPOCH-R, and 62·5% (34·9-81·1) after cross-over treatment with DA-EPOCH-R. The most common grade 3 or worse adverse events in patients treated with interferon alfa-2b included neutropenia (27 [53%] of 51 patients), lymphopenia (24 [47%]), and leukopenia (24 [47%]). The four most common grade 3 or worse adverse events in patients treated with DA-EPOCH-R included neutropenia (29 [88%] of 33 patients), leukopenia (28 [85%]), infection (18 [55%]), and lymphopenia (17 [52%]). Serious adverse events occurred in 13 (25%) of 51 patients receiving treatment with interferon alfa-2b and 21 (64%) of 33 patients receiving DA-EPOCH-R, with five treatment-related deaths: one thromboembolic, one infection, and one haemophagocytic syndrome with interferon alfa-2b, and one infection and one haemophagocytic syndrome with DA-EPOCH-R. INTERPRETATION Interferon alfa-2b is efficacious for treating low-grade lymphomatoid granulomatosis and hence reducing progression to high-grade disease, whereas patients with high-grade lymphomatoid granulomatosis showed expected responses to chemotherapy. Uncontrolled immune regulation of Epstein-Barr virus is hypothesised to result in the emergence of low-grade disease after chemotherapy, for which treatment with interferon alfa-2b is efficacious. FUNDING Intramural Research Programs of the National Cancer Institute and National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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Kim N, Song JY, Yang H, Kim MJ, Lee K, Shin YH, Rhee SY, Hwang J, Kim MS, Fond G, Boyer L, Kim SY, Shin JI, Lee SW, Yon DK. National trends in suicide-related behaviors among youths between 2005-2020, including COVID-19: a Korean representative survey of one million adolescents. Eur Rev Med Pharmacol Sci 2023; 27:1192-1202. [PMID: 36808368 DOI: 10.26355/eurrev_202302_31226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE It is difficult to conclude that COVID-19 is associated with a decrease in the suicide attempts rate by comparing only a short-term period. Therefore, it is necessary to examine attempted suicide rates through a trend analysis over a longer period. This study aimed to investigate an estimated long-term trend regarding the prevalence of suicide-related behaviors among adolescents in South Korea from 2005 to 2020, including COVID-19. SUBJECTS AND METHODS We sourced data from a national representative survey (Korea Youth Risk Behavior Survey) and analyzed one million Korean adolescents aged 13 to 18 years (n=1,057,885) from 2005 to 2020. The 16-year trends regarding the prevalence of sadness or despair and suicidal ideation and attempt and the trend changes before and during COVID-19. RESULTS Data of 1,057,885 Korean adolescents was analyzed (weighted mean age, 15.03 years; males, 52.5%; females, 47.5%). Although the 16-year trend in the prevalence of sadness or despair and suicide ideation and attempt consistently decreased (prevalence of sadness or despair between 2005-2008, 38.0% with 95% confidence interval [CI], 37.7 to 38.4 vs. prevalence in 2020, 25.0% [24.5 to 25.6]; suicide ideation between 2005-2008, 21.9% [21.6 to 22.1] vs. prevalence in 2020, 10.7% [10.3 to 11.1]; and suicide attempt between 2005-2008, 5.0% [4.9 to 5.2] vs. prevalence in 2020, 1.9% [1.8 to 2.0]), the downward slope decreased during COVID-19 (βdiff in sadness, 0.215 with 95% CI 0.206 to 0.224; βdiff in suicidal ideation, 0.245 [0.234 to 0.256]; and βdiff in suicide attempt, 0.219 [0.201 to 0.237]) compared with pre-pandemic period. CONCLUSIONS This study found that the observed risk of suicide-related behaviors during the pandemic was higher than expected through long-term trend analysis of the prevalence of sadness/despair and suicidal ideation and attempts among South Korean adolescents. We need a profound epidemiologic study of the change in mental health due to the pandemic's impact and the establishment of prevention strategies for suicide ideation and attempt.
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Affiliation(s)
- N Kim
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, South Korea.
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Song JY, Nwangwu M, He TF, Zhang W, Meawad H, Bedell V, Murata-Collins J, Skrabek P, Nasr MR, Scott D, Godfrey J, Lee P, Chan WC, Weisenburger DD, Perry AM, Herrera AF. Low T-cell proportion in the tumor microenvironment is associated with immune escape and poor survival in diffuse large B-cell lymphoma. Haematologica 2023. [PMID: 36632739 PMCID: PMC10388272 DOI: 10.3324/haematol.2022.282265] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Indexed: 01/13/2023] Open
Abstract
The tumor microenvironment (TME) is important in the pathogenesis and prognosis of lymphoma. Previous studies have demonstrated that features of the diffuse large B-cell lymphoma (DLBCL) TME can be associated with prognosis, but questions remain about the mechanisms underlying these TME features and the interplay between tumor cells and the local TME. Therefore, we performed multispectral immunofluorescence (mIF) using two 6-color panels to interrogate the cellular proportions of T-cell subsets, macrophages, and NK-cells in 57 cases of de novo DLBCL treated with R-CHOP chemotherapy. We found that very low CD3+ T-cell proportion and low CD4+PD1+ and CD8+PD1+ T-cells have poor survival compared to those with a high T-cell proportion. Also, cases with concurrently low TIM3 and PD1 have a poor prognosis. This poor prognosis with low T-cell proportion was validated using immune deconvolution of gene expression profiling data from 351 cases of DLBCL and an additional cohort of 53 cases of DLBCL using routine immunohistochemistry. In addition, cases with loss of B2M, HLA I and/or HLA II protein expression on the tumor cells also had a low T-cell proportion, providing evidence that lack of these proteins allows for immune evasion. Overall, our results show that patients with DLBCL with a low T-cell proportion in the TME have a poor survival when treated with R-CHOP and exhibit mechanisms of immune escape.
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Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA.
| | - Mary Nwangwu
- Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA
| | - Ting-Fang He
- Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Hany Meawad
- Department of Pathology, City of Hope, Duarte, CA
| | | | | | | | - Michel R Nasr
- Department of Pathology, SUNY Upstate Medical University, Syracuse
| | - David Scott
- British Columbia Research Center, Vancouver, BC
| | - James Godfrey
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Peter Lee
- Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA
| | - Wing C Chan
- Department of Pathology, City of Hope, Duarte, CA
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope, Duarte, CA; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | | | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
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Song JY, Dirnhofer S, Piris MA, Quintanilla-Martínez L, Pileri S, Campo E. Diffuse large B-cell lymphomas, not otherwise specified, and emerging entities. Virchows Arch 2023; 482:179-192. [PMID: 36459219 DOI: 10.1007/s00428-022-03466-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 09/09/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive and heterogenous group of diseases and the most common subtype of non-Hodgkin lymphoma. In the past decade, there has been an explosion in molecular profiling that has helped to identify subgroups and shared oncogenic driving mechanisms. Since the 2017 World Health Organization (WHO) classification, additional studies investigating these genomic abnormalities and phenotypic findings have been reported. Here we review these findings in DLBCL and address the proposed changes by the 2022 International Consensus Classification.
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Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
| | - Stefan Dirnhofer
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Miguel A Piris
- Servicio de Anatomia Patologica, Fundacion Jimenez Diaz, CIBERONC, Madrid, Spain
| | - Leticia Quintanilla-Martínez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany.,Cluster of Excellence iFIT, Image-Guided and Functionally Instructed Tumor Therapy, Tübingen, Germany
| | - Stefano Pileri
- Division of Hematopathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Elias Campo
- Hematopathology Unit, Hospital Clinic of Barcelona, Institute for Biomedical Research August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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19
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Abraham RS, Afzali B, Águeda A, Akin C, Albanesi C, Antiochos B, Aranow C, Atkinson JP, Aune TM, Babu S, Balko J, Ballow M, Bean R, Belavgeni A, Berek C, Beukelman T, Beziat V, Bimler L, Andrew Bird J, Blutt SE, Boguniewicz M, Boisson B, Boisson-Dupuis S, Borzova E, Bottazzi M, Boyaka PN, Bridges J, Browne SK, Burks AW, Bustamante J, Casanova JL, Chan A, Chan ES, Chatham WW, Chinen J, Christopher-Stine L, Coates E, Cope AP, Corry DB, Cosme J, Cron RQ, Dalakas MC, Dann SM, Das S, Daughety MM, Diamond B, Dispenzieri A, Durham SR, Eagar TN, Al-Hosni M, Elitzur S, Elmets CA, Erkan D, Fleisher TA, Fonacier L, Fontenot AP, Fragoulis G, Francischetti IM, Freiwald T, Frew AJ, Fujihashi K, Gadina M, Gapin L, Gatt ME, Gershwin ME, Gillespie SL, Gordon LK, Goronzy JJ, Grattan CE, Greenspan NS, Gschwend A, Gustafson CE, Hackett TL, Hamilton RG, Happe M, Harrison LC, Helbling A, Heckmann E, Hogquist K, Hohl TM, Holland SM, Hotez PJ, Houser K, Huntingdon ND, Hwangpo T, Izraeli S, Jaffe ES, Jalkanen S, Java A, Johnson DB, Johnson T, Jordan MB, Joshi SR, Jouanguy E, Kaminski HJ, Kaufmann SH, Khan DA, Kheradmand F, Khokar DS, Khoury P, Klein BS, Klion AD, Kohn DB, Kono M, Korngold R, Koulouri V, Kuhns DB, Kulkarni HS, Kuo CY, Kusner LL, Lahouti A, Lane LC, Laurence A, Lee JS, Lee ST, Leung DY, Levy O, Lewis DE, Li E, Libby P, Lichtman AH, Linkermann A, Lionakis MS, Liszewski MK, Lockshin MD, Priel DL, Lorenz AZ, Ludwig RJ, Luong A, Luqmani RA, Mackay M, Mahr A, Malley T, Mannon EC, Mannon PJ, Mannon RB, Manns MP, Maresso A, Matson SM, Mavragani CP, Maynard CL, McDonald D, Meylan F, Miller SD, Mitchell AL, Monos DS, Mueller SN, Mulders-Manders CM, Munshi PN, Murphy PM, Noel P, Notarangelo LD, Nunes-Santos CJ, Nussbaum RL, Nutman TB, Nutt SL, O'Neill L, O'Shea JJ, Ortel TL, Pai SY, Paul ME, Pearce S, Peterson EJ, Pittaluga S, Polverino F, Puck JM, Puel A, Radbruch A, Rajalingam R, Reece ST, Reveille JD, Rich RR, Ridley LK, Romeo AR, Rooney CM, Rosen A, Rosenzweig S, Rouse BT, Rowley SD, Sahiner UM, Sakaguchi S, Salinas W, Salmi M, Satola S, Schechter M, Schmidt E, Schroeder HW, Schwartzberg PL, Sciumè G, Segal BM, Selmi C, Sharabi A, Shimano KA, Sikorski PM, Simon A, Smith GP, Song JY, Stephens DS, Stephens R, Sun MM, Beretta-Piccoli BT, Tonnus W, Torgerson TR, Torres RM, Treat JD, Tsokos GC, Uzel G, Uzonna JE, van der Hilst JC, van der Meer JW, Varga J, Waldman M, Weatherhead J, Weiser P, Weyand CM, Wigley FM, Wing JB, Wood KJ, Wilde S, Xu H, Yusuf N, Zerbe CS, Zhang Q, Ben-Yehuda D, Zhang SY, Zieske AW. List Of Contributors. Clin Immunol 2023. [DOI: 10.1016/b978-0-7020-8165-1.00102-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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20
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Lim JE, Sargur Madabushi S, Vishwasrao P, Song JY, Abdelhamid AMH, Ghimire H, Vanishree VL, Lamba JK, Dandapani S, Salhotra A, Lemecha M, Pierini A, Zhao D, Storme G, Holtan S, Aristei C, Schaue D, Al Malki M, Hui SK. Total marrow irradiation reduces organ damage and enhances tissue repair with the potential to increase the targeted dose of bone marrow in both young and old mice. Front Oncol 2022; 12:1045016. [PMID: 36439420 PMCID: PMC9686437 DOI: 10.3389/fonc.2022.1045016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
Total body irradiation (TBI) is a commonly used conditioning regimen for hematopoietic stem cell transplant (HCT), but dose heterogeneity and long-term organ toxicity pose significant challenges. Total marrow irradiation (TMI), an evolving radiation conditioning regimen for HCT can overcome the limitations of TBI by delivering the prescribed dose targeted to the bone marrow (BM) while sparing organs at risk. Recently, our group demonstrated that TMI up to 20 Gy in relapsed/refractory AML patients was feasible and efficacious, significantly improving 2-year overall survival compared to the standard treatment. Whether such dose escalation is feasible in elderly patients, and how the organ toxicity profile changes when switching to TMI in patients of all ages are critical questions that need to be addressed. We used our recently developed 3D image-guided preclinical TMI model and evaluated the radiation damage and its repair in key dose-limiting organs in young (~8 weeks) and old (~90 weeks) mice undergoing congenic bone marrow transplant (BMT). Engraftment was similar in both TMI and TBI-treated young and old mice. Dose escalation using TMI (12 to 16 Gy in two fractions) was well tolerated in mice of both age groups (90% survival ~12 Weeks post-BMT). In contrast, TBI at the higher dose of 16 Gy was particularly lethal in younger mice (0% survival ~2 weeks post-BMT) while old mice showed much more tolerance (75% survival ~13 weeks post-BMT) suggesting higher radio-resistance in aged organs. Histopathology confirmed worse acute and chronic organ damage in mice treated with TBI than TMI. As the damage was alleviated, the repair processes were augmented in the TMI-treated mice over TBI as measured by average villus height and a reduced ratio of relative mRNA levels of amphiregulin/epidermal growth factor (areg/egf). These findings suggest that organ sparing using TMI does not limit donor engraftment but significantly reduces normal tissue damage and preserves repair capacity with the potential for dose escalation in elderly patients.
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Affiliation(s)
- Ji Eun Lim
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | | | - Paresh Vishwasrao
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Joo Y. Song
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Amr M. H. Abdelhamid
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
- Radiation Oncology Section, Department of Medicine and Surgery, Perugia University and General Hospital, Perugia, Italy
- Department of Oncology and Nuclear Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hemendra Ghimire
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - V. L. Vanishree
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Jatinder K. Lamba
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gianesville, FL, United States
| | - Savita Dandapani
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Amandeep Salhotra
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, United States
| | - Mengistu Lemecha
- Department of Molecular and Cellular Biology, Beckman Research Institute, Duarte, CA, United States
| | - Antonio Pierini
- Division of Hematology and Bone Marrow Transplantation, Perugia General Hospital, Perugia, Italy
| | - Daohong Zhao
- Department of Biochemistry and Structural Biology, Univeristy of Texas (UT) Health San Antonio, San Antonio, TX, United States
| | - Guy Storme
- Department of Radiotherapy Universitair Ziekenhuis (UZ) Brussels, Brussels, Belgium
| | - Shernan Holtan
- Blood and Marrow Transplant Program, Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Cynthia Aristei
- Radiation Oncology Section, Department of Medicine and Surgery, Perugia University and General Hospital, Perugia, Italy
| | - Dorthe Schaue
- Department of Radiation Oncology, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Monzr Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, United States
| | - Susanta K. Hui
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, United States
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21
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Stephens DM, Li H, Constine LS, Fitzgerald TJ, Leonard JP, Kahl BS, Song JY, LeBlanc ML, Smith SM, Persky DO, Friedberg JW. Extranodal presentation in limited-stage diffuse large Bcell lymphoma as a prognostic marker in three SWOG trials S0014, S0313 and S1001. Haematologica 2022; 107:2732-2736. [PMID: 35833300 PMCID: PMC9614528 DOI: 10.3324/haematol.2022.281004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/07/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Hongli Li
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester, Rochester
| | | | - John P Leonard
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York
| | - Brad S Kahl
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | - Michael L LeBlanc
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Research Center, Seattle
| | - Sonali M Smith
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Daniel O Persky
- Division of Hematology/Oncology, University of Arizona, Tucson, AZ
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22
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Dong G, Liu X, Wang L, Yin W, Bouska A, Gong Q, Shetty K, Chen L, Sharma S, Zhang J, Lome-Maldonado C, Quintanilla-Martinez L, Li Y, Song JY, Zhang W, Shi Y, Wang J, Kong L, Wu X, Wang J, Liu HG, Kong L, Sun W, Liu W, Wang L, McKeithan TW, Iqbal J, Chan WC. Genomic profiling identifies distinct genetic subtypes in extra-nodal natural killer/T-cell lymphoma. Leukemia 2022; 36:2064-2075. [PMID: 35697790 PMCID: PMC10499270 DOI: 10.1038/s41375-022-01623-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 01/17/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023]
Abstract
Extra-nodal NK/T-cell lymphoma, nasal type (ENKTCL) is a highly aggressive Epstein-Barr virus associated lymphoma, typically presenting in the nasal and paranasal areas. We assembled a large series of ENKTCL (n = 209) for comprehensive genomic analysis and correlative clinical study. The International Lymphoma Prognostic Index (IPI), site of disease, stage, lymphadenopathy, and hepatomegaly were associated with overall survival. Genetic analysis revealed frequent oncogenic activation of the JAK/STAT3 pathway and alterations in tumor suppressor genes (TSGs) and genes associated with epigenomic regulation. Integrated genomic analysis including recurrent mutations and genomic copy number alterations using consensus clustering identified seven distinct genetic clusters that were associated with different clinical outcomes, thus constituting previously unrecognized risk groups. The genetic profiles of ENTKCLs from Asian and Hispanic ethnic groups showed striking similarity, indicating shared pathogenetic mechanism and tumor evolution. Interestingly, we discovered a novel functional cooperation between activating STAT3 mutations and loss of the TSG, PRDM1, in promoting NK-cell growth and survival. This study provides a genetic roadmap for further analysis and facilitates investigation of actionable therapeutic opportunities in this aggressive lymphoma.
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Affiliation(s)
- Gehong Dong
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
| | - Xuxiang Liu
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Lifu Wang
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Wenjuan Yin
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310018, China
| | - Alyssa Bouska
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Qiang Gong
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Kunal Shetty
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Lu Chen
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, 91010, USA
| | - Sunandini Sharma
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Jibin Zhang
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Carmen Lome-Maldonado
- Departamento de Patologia, Instituto Nacional de Cancerologia, 14080, Ciudad de México, Mexico
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, 72076, Tübingen, Germany
| | - Yuping Li
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Wenyan Zhang
- Department of Pathology, West China Hospital, Chengdu, 610041, China
| | - Yunfei Shi
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
- Department of Pathology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 100142, Beijing, China
| | - Jinhui Wang
- Integrative Genomics Core, City of Hope, Duarte, CA, 91010, USA
| | - Lingbo Kong
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope, Duarte, CA, 91010, USA
| | - Jingwen Wang
- Department of Hematology, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China
| | - Hong-Gang Liu
- Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, 100070, Beijing, China
| | - Lingfei Kong
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Wenyong Sun
- Department of Pathology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, China
- Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, 310018, China
| | - Weiping Liu
- Department of Pathology, West China Hospital, Chengdu, 610041, China
| | - Lili Wang
- Department of Systems Biology, Beckman Research Institute, City of Hope, Monrovia, CA, 91016, USA
| | - Timothy W McKeithan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Javeed Iqbal
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA.
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23
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Kim MJ, Lee KH, Lee JS, Kim N, Song JY, Shin YH, Yang JM, Lee SW, Hwang J, Rhee SY, Yon DK, Shin JI, Choi YJ. Trends in body mass index changes among Korean adolescents between 2005-2020, including the COVID-19 pandemic period: a national representative survey of one million adolescents. Eur Rev Med Pharmacol Sci 2022; 26:4082-4091. [PMID: 35731079 DOI: 10.26355/eurrev_202206_28978] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE The impact of the coronavirus disease 2019 (COVID-19) pandemic on weight gain in children and adolescents remains unknown. We aimed to identify an estimated 15-year trend in mean body mass index (BMI) changes and prevalence of obesity and overweight among Korean adolescents from 2005 to 2020, including the period of the COVID-19 pandemic. PATIENTS AND METHODS We analyzed data taken from a nationwide survey (Korea Youth Risk Behavior Survey), between 2005 and 2020. Representative samples of one million Korean adolescents aged 13-18 years (n=1,057,885) were examined. The 15-year trends in mean BMI and proportion of obesity or overweight, and the changes due to the COVID-19 pandemic were analyzed. RESULTS The data of 1,057,885 Korean adolescents were analyzed (mean age: 14.98 years; females, 48.4%). The estimated weighted mean BMI was 20.5 kg/m2 [95% confidence interval (CI), 20.4-20.5] from 2005 to 2008 and 21.5 kg/m2 (95% CI, 21.4-21.6) in 2020 (during the COVID-19 pandemic). Although the 15-year trend of mean BMI gradually increased, the change in mean BMI before and during the pandemic significantly lessened (βdiff, -0.027; 95% CI, -0.028 to -0.026). The 15-year (2005-2020) trend changes in the prevalence of obesity and overweight were similar (obesity prevalence from 2005-2008, 3.2%; 95% CI, 3.1-3.3 vs. obesity prevalence in 2020, 8.6%; 95% CI, 8.2-9.0; βdiff, -0.309; 95% CI, -0.330 to -0.288). CONCLUSIONS The 15-year trend of overall mean BMI and obesity and overweight prevalence demonstrated a significant increase; however, its slope decreased during the pandemic. These landmark results suggest the need for the development of precise strategies to prevent pediatric obesity and overweight during the COVID-19 pandemic.
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Affiliation(s)
- M J Kim
- Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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Ladbury C, Somlo G, Dagis A, Yang D, Armenian S, Song JY, Sahebi F, Spielberger R, Popplewell L, Parker P, Forman S, Snyder D, Rincon A, Liu A, Frankel P, Wong J. Long-Term Follow-Up of Multiple Myeloma Patients Treated with Tandem Autologous Transplantation Following Melphalan and Upon Recovery, Total Marrow Irradiation. Transplant Cell Ther 2022; 28:367.e1-367.e9. [PMID: 35534000 DOI: 10.1016/j.jtct.2022.04.022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Total body irradiation in combination with melphalan for multiple myeloma (MM), was shown to be prohibitively toxic. To ameliorate toxicity, total marrow irradiation (TMI), was given as the sole ablative modality during the second cycle of tandem autologous stem cell transplant (TASCT) for MM patients on a phase I-II trial. STUDY DESIGN Patients with MM in response or with stable disease and ≤ 18 months from diagnosis received melphalan (MEL) 200 mg/m2 and ASCT (Cycle 1), and, after recovery, TMI and ASCT (Cycle 2) followed by maintenance with an IMiD and dexamethasone for up to 12 months. TMI doses were escalated from 1,000 cGy to 1,800 cGy by 200 cGy increments. RESULTS Fifty-four patients were to receive TASCT between 2004 and 2011; 8 patients received single ASCT due to patient or physician preference. The median time between melphalan and TMI was 65 days (range 47-125). Thirty patients (55•6%) received TASCT at the maximum tolerated dose of 1600 cGy. The complete and very good partial response rates were 48•1% and 22•2% following ASCT and maintenance. Median follow-up among survivors was 12.3 years (range: 9•2-15•5+). Progression free survival and overall survival at 10 years was 20•4% (95% CI 10•9-31•9) and 38•8% (95% CI: 25•9-51•5). Secondary neoplasms included (1 each) acute myeloid leukemia, papillary thyroid and prostate carcinoma, and melanoma, and we observed 1 case of ductal carcinoma in situ and 4 patients with non-melanoma skin cancers. CONCLUSION TMI as part of TASCT was well-tolerated and TASCT lead to a 20.4% PFS plateau. The inclusion of TMI as a conditioning regiment for MM prior to ASCT warrants further study in the context of modern induction and maintenance therapies.
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Affiliation(s)
- Colton Ladbury
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - George Somlo
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA.
| | - Andy Dagis
- Division of Biostatistics, City of Hope National Medical Center, Duarte, CA
| | - Dongyun Yang
- Division of Biostatistics, City of Hope National Medical Center, Duarte, CA
| | - Saro Armenian
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA
| | - Firoozeh Sahebi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ricardo Spielberger
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Leslie Popplewell
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Pablo Parker
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Stephen Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - David Snyder
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Amalia Rincon
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - An Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - Paul Frankel
- Division of Biostatistics, City of Hope National Medical Center, Duarte, CA
| | - Jeffrey Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA.
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25
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Ali SF, Cloe A, Siaghani PJ, Himchak E, Cantu D, Gaal K, Kim YS, Afkhami M, Pillai R, Chan W, Quirk E, Weisenburger DD, Aoun P, Song JY. Bone Marrow Collection: Comparison of Unassisted vs Assisted Bedside Collections by a Laboratory Technologist. Am J Clin Pathol 2022; 157:573-577. [PMID: 34788366 DOI: 10.1093/ajcp/aqab165] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Bone marrow collections are often difficult, and creating quality smears and touch preparations at the bedside can prove challenging. The objective of this study is to compare the quality of bone marrow specimens between unassisted and assisted bone marrow collections by a bone marrow technologist. METHODS Data for this study were collected from 422 hematopathology reports over 14 months. We recorded the bone marrow quality of the different parts (aspirate smears, touch imprints, core biopsy, and clot/particle sections) as adequate, suboptimal, or inadequate. Student t test statistical analysis was performed between the corresponding parts in the two groups. RESULTS Our results demonstrate that the quality of assisted bone marrow specimens is significantly better compared with unassisted specimens, particularly for the aspirate smears (P < .0001) and touch imprints (P < .0001). Notably, the quality of aspirate smears was improved, which is important for cytologic evaluation. CONCLUSIONS We conclude that assistance by a bone marrow technologist resulted in a significant improvement in the quality of bone marrow collection.
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Affiliation(s)
- Saba F Ali
- Department of Pathology, Roswell Park, Buffalo, NY, USA
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Adam Cloe
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Quest Diagnostics, Woodland Hills, CA, USA
| | - Parwiz J Siaghani
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Evan Himchak
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Department of Pathology, Texas Health Presbyterian Hospital, Dallas, TX, USA
| | - David Cantu
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Department of Pathology, Creighton University School of Medicine, Omaha, NE, USA
| | - Karl Gaal
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Young S Kim
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Michelle Afkhami
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Wanda Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Elizabeth Quirk
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Patricia Aoun
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
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Brooks J, Zuro D, Song JY, Madabushi SS, Sanchez JF, Guha C, Kortylewski M, Chen BT, Gupta K, Storme G, Froelich J, Hui SK. Longitudinal Preclinical Imaging Characterizes Extracellular Drug Accumulation After Radiation Therapy in the Healthy and Leukemic Bone Marrow Vascular Microenvironment. Int J Radiat Oncol Biol Phys 2022; 112:951-963. [PMID: 34767936 PMCID: PMC9038217 DOI: 10.1016/j.ijrobp.2021.10.146] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/24/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Recent initial findings suggest that radiation therapy improves blood perfusion and cellular chemotherapy uptake in mice with leukemia. However, the ability of radiation therapy to influence drug accumulation in the extracellular bone marrow tissue is unknown, due in part to a lack of methodology. This study developed longitudinal quantitative multiphoton microscopy (L-QMPM) to characterize the bone marrow vasculature (BMV) and drug accumulation in the extracellular bone marrow tissue before and after radiation therapy in mice bearing leukemia. METHODS AND MATERIALS We developed a longitudinal window implant for L-QMPM imaging of the calvarium BMV before, 2 days after, and 5 days after total body irradiation (TBI). Live time-lapsed images of a fluorescent drug surrogate were used to obtain measurements, including tissue wash-in slope (WIStissue) to measure extracellular drug accumulation. We performed L-QMPM imaging on healthy C57BL/6 (WT) mice, as well as mice bearing acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). RESULTS Implants had no effects on calvarium dose, and parameters for wild-type untreated mice were stable during imaging. We observed decreased vessel diameter, vessel blood flow, and WIStissue with the onset of AML and ALL. Two to 10 Gy TBI increased WIStissue and vessel diameter 2 days after radiation therapy in all 3 groups of mice and increased single-vessel blood flow in mice bearing ALL and AML. Increased WIStissue was observed 5 days after 10 Gy TBI or 4 Gy split-dose TBI (2 treatments of 2 Gy spaced 3 days apart). CONCLUSIONS L-QMPM provides stable functional assessments of the BMV. Nonmyeloablative and myeloablative TBI increases extracellular drug accumulation in the leukemic bone marrow 2 to 5 days posttreatment, likely through improved blood perfusion and drug exchange from the BMV to the extravascular tissue. Our data show that neo-adjuvant TBI at doses from 2 Gy to 10 Gy conditions the BMV to improve drug transport to the bone marrow.
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Affiliation(s)
- Jamison Brooks
- Department of Radiation Oncology, City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Darren Zuro
- Department of Radiation Oncology, City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, California
| | | | - James F Sanchez
- Beckman Research Institute of City of Hope, Duarte, California
| | - Chandan Guha
- Department of Radiation Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Marcin Kortylewski
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, California
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope Medical Center, Duarte, California
| | - Kalpna Gupta
- Hematology/Oncology, Department of Medicine, University of California, Irvine and Southern California Institute for Research and Education, VA Medical Center, North Hills, California; Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Guy Storme
- Department of Radiotherapy, UZ Brussel, Jette, Belgium
| | - Jerry Froelich
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Susanta K Hui
- Department of Radiation Oncology, City of Hope, Duarte, California; Beckman Research Institute of City of Hope, Duarte, California.
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Kang S, Chae YJ, Bae SY, Song JY, Joe HB. Remifentanil requirement for acceptable intubation conditions with two different doses of ketamine without a neuromuscular blocking agent in pediatric patients. Eur Rev Med Pharmacol Sci 2022; 26:1632-1639. [PMID: 35302210 DOI: 10.26355/eurrev_202203_28231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The optimal remifentanil concentration for improving intubation conditions when intubation is performed without neuromuscular blocking agents (NMBAs) but with ketamine as an induction agent remains unknown. Here, we aimed to identify the effective bolus doses of remifentanil required to achieve acceptable intubation conditions upon anesthesia induction with 1 or 2 mg/kg ketamine without NMBAs. PATIENTS AND METHODS In this prospective, double-blinded, randomized up-down sequential allocation study, we enrolled pediatric patients aged 3-12 years undergoing general anesthesia for inguinal hernia surgery. The patients were randomly allocated to one of two groups to receive either ketamine 1.0 mg/kg (K1 group) or 2.0 mg/kg (K2 group) intravenously until seven success-failure pairs were achieved. The remifentanil dose for each patient was determined using the modified Dixon's up-and-down method with an initial dose of 2.5 μg/kg and a step size of 0.5 μg/kg. RESULTS In total, 51 patients (22 in the K1 group and 29 in the K2 group) were enrolled. The effective dose (ED)50s of remifentanil for obtaining clinically acceptable intubation conditions under anesthesia induction with ketamine but without NMBAs was 3.2 μg/kg in the K1 group and 1.6 μg/kg in the K2 group. High-dose remifentanil with 1 mg/kg ketamine was associated with more severe chest wall rigidity and lower mean blood pressure and heart rate than was low-dose remifentanil with 2 mg/kg ketamine. CONCLUSIONS The ED50 of remifentanil required for clinically acceptable intubation conditions with anesthesia induction using 1 mg/kg ketamine without NMBAs in pediatric patients was twice that when using 2 mg/kg ketamine. The combination of 2 mg/kg ketamine and remifentanil was better at preventing chest wall rigidity.
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Affiliation(s)
- S Kang
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea.
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28
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Di Raimondo C, Rubio-Gonzalez B, Palmer J, Weisenburger DD, Zain J, Wu X, Han Z, Rosen ST, Song JY, Querfeld C. Expression of Immune Checkpoint Molecules PD1, PD-L1 and ICOS in Mycosis Fungoides and Sézary Syndrome: Association with Disease Stage and Clinical Outcome. Br J Dermatol 2022; 187:234-243. [PMID: 35194801 PMCID: PMC9357001 DOI: 10.1111/bjd.21063] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/11/2022] [Accepted: 02/18/2022] [Indexed: 12/01/2022]
Abstract
Background The relationship between immune checkpoint status and disease outcome is a major focus of research in cutaneous T‐cell lymphoma (CTCL), a disfiguring neoplastic dermatological disorder. Mycosis fungoides (MF) and Sézary syndrome (SS) are the two most common types of CTCL. Objectives The aim was to evaluate the immune checkpoint markers programmed death protein 1 (PD1), inducible T‐cell co‐stimulator (ICOS) and programmed death‐ligand 1 (PD‐L1) in skin biopsies from patients with CTCL relative to disease stage and overall survival. Methods This consecutive case series enrolled 47 patients: 57% had stage IA–IIA disease and 43% had stage IIB–IVA2 disease (including seven with SS). Results PD1, PD‐L1 and ICOS expression was seen in all biopsies. Notably, PD‐L1 was predominantly expressed on histiocytes/macrophages, but focal expression on CTCL cells was seen. High expression of either ICOS or PD‐L1 was associated with advanced‐stage disease (P = 0·007 for both) and with the appearance of large‐cell transformation (LCT), a histopathological feature associated with a poor prognosis (ICOS: P = 0·02; PD‐L1: P = 0·002). PD1 expression was not significantly associated with disease stage (P = 0·12) or LCT (P = 0·49), but expression was high in SS biopsies. A high combined checkpoint marker score (PD1, PD‐L1 and ICOS) was associated with advanced‐stage disease (P = 0·001), LCT (P = 0·021) and lower overall survival (P = 0·014). Conclusions These findings demonstrate the existence of a complex immunoregulatory microenvironment in CTCL and support the development of immunotherapies targeting ICOS and PD‐L1 in advanced disease.
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Affiliation(s)
| | | | - Joycelynne Palmer
- Department of Computational and Quantitative Medicine, Division of Biostatistics
| | | | - Jasmine Zain
- Department of Hematology/Hematopoietic Cell Transplantation
| | - Xiwei Wu
- Integrative and Genomics Core.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Zhen Han
- Division of Dermatology.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Steve T Rosen
- Department of Hematology/Hematopoietic Cell Transplantation.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | | | - Christiane Querfeld
- Division of Dermatology.,Department of Pathology.,Department of Hematology/Hematopoietic Cell Transplantation.,Beckman Research Institute, City of Hope, Duarte, CA, USA
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29
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Song JY. To be, or not 3B. Haematologica 2022; 107:2014-2015. [PMID: 35021609 PMCID: PMC9425320 DOI: 10.3324/haematol.2021.280263] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA.
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Abdulla FR, Zhang W, Wu X, Honda K, Qin H, Cho H, Querfeld C, Zain J, Rosen ST, Chan WC, Parekh V, Song JY. Genomic Analysis of Cutaneous CD30-Positive Lymphoproliferative Disorders. JID Innov 2022; 2:100068. [PMID: 34977845 PMCID: PMC8688881 DOI: 10.1016/j.xjidi.2021.100068] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022] Open
Abstract
Primary cutaneous CD30+ T-cell lymphoproliferative disorders are the second most common cutaneous lymphomas. According to the World Health Organization, CD30+ T-cell lymphoproliferative disorders include primary cutaneous anaplastic large cell lymphoma (C-ALCL) and lymphomatoid papulosis (LyP) as well as borderline lesions. C-ALCL and LyP are thought to represent two ends of a spectrum of diseases that have different clinical presentations, clinical courses, and prognoses in their classic forms but share the same histology of medium to large CD30+ atypical lymphoid cell infiltrates. Because the behavior of these entities is different clinically and prognostically, we aim to search for oncogenic genomic variants using whole-exome sequencing that drive the development of LyP and C-ALCL. Clinical information, pathology, immunohistochemistry, and T-cell rearrangements on six cases of LyP and five cases of C-ALCL were reviewed to confirm the rendered diagnosis before whole-exome sequencing of all specimens. Both LyP and C-ALCL had recurrent alterations in epigenetic modifying genes affecting histone methylation and acetylation (SETD2, KMT2A, KMT2D, and CREBBP). However, they also harbor unique differences with mutations in signal transducer and activator of transcription gene STAT3 of the Jak/signal transducer and activator of transcription pathway and EOMES, a transcription factor involved in lymphocyte development, only noted in C-ALCL specimens. Genomic characterization of LyP and C-ALCL in this series confirms the role of multiple pathways involved in the biology and development of these lymphomatous processes. The identification of similar aberrations within the epigenetic modifying genes emphasizes common potential development mechanisms of lymphomagenesis within lymphoproliferative disorders being shared between LyP and C-ALCL; however, the presence of differences may account for the differences in clinical course.
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Key Words
- BI-ALCL, breast implant‒associated anaplastic large cell lymphoma
- C-ALCL, cutaneous anaplastic large cell lymphoma
- CD30+LPD, CD30+ lymphoproliferative disorder
- CN, copy number
- CTCL, cutaneous T-cell lymphoma
- FFPE, formalin-fixed, paraffin-embedded
- IHC, immunohistochemistry
- LyP, lymphomatoid papulosis
- MF, mycosis fungoides
- STAT, signal transducer and activator of transcription
- sALCL, systemic anaplastic large cell lymphoma
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Affiliation(s)
- Farah R Abdulla
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California, USA
| | - Kord Honda
- Department of Pathology, University Hospitals of Cleveland, Cleveland, Ohio, USA
| | - Hanjun Qin
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California, USA
| | - Hyejin Cho
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California, USA
| | - Christiane Querfeld
- Department of Surgery, City of Hope National Medical Center, Duarte, California, USA
| | - Jasmine Zain
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Steven Terry Rosen
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Vishwas Parekh
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
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31
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Mahale P, Nomburg J, Song JY, Steinberg M, Starrett G, Boland J, Lynch CF, Chadburn A, Rubinstein PG, Hernandez BY, Weisenburger DD, Bullman S, Engels EA. Metagenomic analysis to identify novel infectious agents in systemic anaplastic large cell lymphoma. Infect Agent Cancer 2021; 16:65. [PMID: 34775986 PMCID: PMC8591940 DOI: 10.1186/s13027-021-00404-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/03/2021] [Indexed: 12/03/2022] Open
Abstract
Systemic anaplastic large cell lymphoma (ALCL) is a rare CD30-expressing T-cell non-Hodgkin lymphoma. Risk of systemic ALCL is highly increased among immunosuppressed individuals. Because risk of cancers associated with viruses is increased with immunosuppression, we conducted a metagenomic analysis of systemic ALCL to determine whether a known or novel pathogen is associated with this malignancy. Total RNA was extracted and sequenced from formalin-fixed paraffin-embedded tumor specimens from 19 systemic ALCL cases (including one case from an immunosuppressed individual with human immunodeficiency virus infection), 3 Epstein-Barr virus positive diffuse large B-cell lymphomas (DLBCLs) occurring in solid organ transplant recipients (positive controls), and 3 breast cancers (negative controls). We used a pipeline based on the Genome Analysis Toolkit (GATK)-PathSeq algorithm to subtract out human RNA reads and map the remaining RNA reads to microbes. No microbial association with ALCL was identified, but we found Epstein-Barr virus in the DLBCL positive controls and determined the breast cancers to be negative. In conclusion, we did not find a pathogen associated with systemic ALCL, but because we analyzed only one ALCL tumor from an immunosuppressed person, we cannot exclude the possibility that a pathogen is associated with some cases that arise in the setting of immunosuppression.
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Affiliation(s)
- Parag Mahale
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Jason Nomburg
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Mia Steinberg
- Cancer Genomics Research Laboratory, National Cancer Institute, Rockville, MD, USA
| | - Gabriel Starrett
- Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Joseph Boland
- Cancer Genomics Research Laboratory, National Cancer Institute, Rockville, MD, USA
| | - Charles F Lynch
- Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Amy Chadburn
- Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Paul G Rubinstein
- Stroger Hospital of Cook County, Ruth M. Rothstein Core Center, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Susan Bullman
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eric A Engels
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
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Otoukesh S, Song JY, Mojtahedzadeh M, Mokhtari S, Marcucci G, Pullarkat V, Ali H. Refractory primary autoimmune myelofibrosis treated with ruxolitinib. Am J Hematol 2021; 96:E283-E285. [PMID: 33909922 DOI: 10.1002/ajh.26208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Salman Otoukesh
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Center for Leukemia Research City of Hope National Medical Center California Duarte USA
| | - Joo Y. Song
- Department of Pathology City of Hope National Medical Center California Duarte USA
| | - Mona Mojtahedzadeh
- Division of Psychiatry, Department of Supportive Care Medicine City of Hope National Medical Center California Duarte USA
| | - Sally Mokhtari
- Department of Clinical Translational Project Development City of Hope National Medical Center California Duarte USA
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Center for Leukemia Research City of Hope National Medical Center California Duarte USA
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Center for Leukemia Research City of Hope National Medical Center California Duarte USA
| | - Haris Ali
- Department of Hematology and Hematopoietic Cell Transplantation, Gehr Center for Leukemia Research City of Hope National Medical Center California Duarte USA
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Chapman JR, Bouska AC, Zhang W, Alderuccio JP, Lossos IS, Rimsza LM, Maguire A, Yi S, Chan WC, Vega F, Song JY. EBV-positive HIV-associated diffuse large B cell lymphomas are characterized by JAK/STAT (STAT3) pathway mutations and unique clinicopathologic features. Br J Haematol 2021; 194:870-878. [PMID: 34272731 DOI: 10.1111/bjh.17708] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 05/03/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022]
Abstract
Even in the era of highly active combination antiretroviral therapy (cART), patients with HIV have a disproportionate risk of developing aggressive lymphomas that are frequently Epstein-Barr virus (EBV)-related. Here, we investigate HIV-associated diffuse large B-cell lymphoma (HIV-DLBCL) and compare EBV-positive and EBV-negative cases. HIV-DLBCL were identified from two academic medical centres and characterised by immunohistochemistry, EBV status, fluorescence in situ hybridisation, cell of origin determination by gene expression profiling, and targeted deep sequencing using a custom mutation panel of 334 genes. We also applied the Lymphgen tool to determine the genetic subtype of each case. Thirty HIV-DLBCL were identified, with a median patient age of 46 years and male predominance (5:1). Thirteen cases (48%) were EBV-positive and 14 (52%) EBV-negative. Nine of the 16 tested cases (56%) had MYC rearrangement, three (19%) had BCL6 (two of which were double hit MYC/BCL6) and none had BCL2 rearrangements. Using the Lymphgen tool, half of the cases (15) were classified as other. All HIV-DLBCL showed mutational abnormalities, the most frequent being TP53 (37%), MYC (30%), STAT3 (27%), HIST1H1E (23%), EP300 (20%), TET2 (20%), SOCS1 (17%) and SGK1 (17%). EBV-negative cases were mostly of germinal centre B-cell (GCB) origin (62%), showed more frequent mutations per case (a median of 13·5/case) and significant enrichment of TP53 (57% vs. 15%; P = 0·046), SGK1 (36% vs. 0%; P = 0·04), EP300 (43% vs. 0%; P = 0·02) and histone-modifying gene (e.g. HIST1H1E, HIST1H1D, 79% vs. 31%; P = 0·02) mutations. EBV-positive cases were mostly of non-GCB origin (70%), with fewer mutations per case (median 8/case; P = 0·007), and these tumours were enriched for STAT3 mutations (P = 0·10). EBV-positive cases had a higher frequency of MYC mutations but the difference was not significant (36% vs. 15%; P = 0·38). EBV-association was more frequent in HIV-DLBCLs, arising in patients with lower CD4 counts at diagnosis (median 46·5 vs. 101, P = 0·018). In the era of cART, approximately half of HIV-DLBCL are EBV-related. HIV-DLBCL are enriched for MYC rearrangements, MYC mutations and generally lack BCL2 rearrangements, regardless of EBV status. Among HIV-DLBCL, tumours that are EBV-negative and EBV-positive appear to have important differences, the latter arising in context of lower CD4 count, showing frequent non-GCB origin, lower mutation burden and recurrent STAT3 mutations.
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Affiliation(s)
- Jennifer R Chapman
- Division of Hematopathology, Department of Pathology, University of Miami and Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Alyssa C Bouska
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Juan Pablo Alderuccio
- Division of Hematology, Department of Medicine, University of Miami and Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami and Sylvester Comprehensive Cancer Center, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami, Miami, FL, USA
| | - Lisa M Rimsza
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Alanna Maguire
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, AZ, USA
| | - Shuhua Yi
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Francisco Vega
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
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Zuro D, Madabushi SS, Brooks J, Chen BT, Goud J, Salhotra A, Song JY, Parra LE, Pierini A, Sanchez JF, Stein A, Malki MA, Kortylewski M, Wong JYC, Alaei P, Froelich J, Storme G, Hui SK. First Multimodal, Three-Dimensional, Image-Guided Total Marrow Irradiation Model for Preclinical Bone Marrow Transplantation Studies. Int J Radiat Oncol Biol Phys 2021; 111:671-683. [PMID: 34119592 DOI: 10.1016/j.ijrobp.2021.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Total marrow irradiation (TMI) has significantly advanced radiation conditioning for hematopoietic cell transplantation in hematologic malignancies by reducing conditioning-induced toxicities and improving survival outcomes in relapsed/refractory patients. However, the relapse rate remains high, and the lack of a preclinical TMI model has hindered scientific advancements. To accelerate TMI translation to the clinic, we developed a TMI delivery system in preclinical models. METHODS AND MATERIALS A Precision X-RAD SmART irradiator was used for TMI model development. Images acquired with whole-body contrast-enhanced computed tomography (CT) were used to reconstruct and delineate targets and vital organs for each mouse. Multiple beam and CT-guided Monte Carlo-based plans were performed to optimize doses to the targets and to vary doses to the vital organs. Long-term engraftment and reconstitution potential were evaluated by a congenic bone marrow transplantation (BMT) model and serial secondary BMT, respectively. Donor cell engraftment was measured using noninvasive bioluminescence imaging and flow cytometry. RESULTS Multimodal imaging enabled identification of targets (skeleton and spleen) and vital organs (eg, lungs, gut, liver). In contrast to total body irradiation (TBI), TMI treatment allowed variation of radiation dose exposure to organs relative to the target dose. Dose reduction mirrored that in clinical TMI studies. Similar to TBI, mice treated with different TMI regimens showed full long-term donor engraftment in primary BMT and second serial BMT. The TBI-treated mice showed acute gut damage, which was minimized in mice treated with TMI. CONCLUSIONS A novel multimodal image guided preclinical TMI model is reported here. TMI conditioning maintained long-term engraftment with reconstitution potential and reduced organ damage. Therefore, this TMI model provides a unique opportunity to study the therapeutic benefit of reduced organ damage and BM dose escalation to optimize treatment regimens in BMT and hematologic malignancies.
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Affiliation(s)
- Darren Zuro
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | | | - Jamison Brooks
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope Medical Center, Duarte, California
| | - Janagama Goud
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Amandeep Salhotra
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Joo Y Song
- Department of Pathology, City of Hope Medical Center, Duarte, California
| | | | - Antonio Pierini
- Division of Hematology and Clinical Immunology, Department of Medicine, University of Perugia, Perugia, Italy
| | - James F Sanchez
- Beckman Research Institute of City of Hope, Duarte, California
| | - Anthony Stein
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Monzr Al Malki
- Department of Hematology and HCT, City of Hope Medical Center, Duarte, California
| | - Marcin Kortylewski
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, California
| | - Jeffrey Y C Wong
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California
| | - Parham Alaei
- Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
| | - Jerry Froelich
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Guy Storme
- Department of Radiotherapy UZ Brussels, Brussels, Belgium
| | - Susanta K Hui
- Department of Radiation Oncology, City of Hope Medical Center, Duarte, California; Beckman Research Institute of City of Hope, Duarte, California; Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota.
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35
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Zhang LY, Zheng D, Jing SS, Zhang XK, Chang PC, Yang J, Pei JQ, Du HG, Song JY, Qin MX, Dang ZJ, Wang ZA, Chai KQ. [A comparative study of transperitoneal transmesenteric approach versus paracolic sulci approach laparoscopic adrenal tumorectomy for treatment of primary hyperaldosteronism on left side]. Zhonghua Yi Xue Za Zhi 2021; 101:1513-1517. [PMID: 34044519 DOI: 10.3760/cma.j.cn112137-20210208-00385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the therapeutic effect of transperitoneal transmesenteric approach versus paracolic sulci approach laparoscopic adrenal tumorectomy for treatment of left-sided primary hyperaldosteronism. Methods: From January 2017 to July 2019, the clinical data of 70 patients with left-sided primary hyperaldosteronism (PHA) who underwent surgery in the First Hospital of Lanzhou University and five other hospitals in Gansu Province were retrospectively analyzed. There are 43 male and 27 female patients. Among them,28 patients were performed transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy and 42 patients were performed transperitoneal paracolic sulci approach laparoscopic adrenal tumorectomy. The general information and perioperative data of the two groups were compared. Results: All 70 cases of surgery were successfully completed. As compared with the paracolic sulci approach group, the operation time was significantly shorter in the transmesenteric approach group[(26.7±8.8)vs (38.9±7.1)min,P<0.001)], and the estimated blood loss was less in the transmesenteric approach group[45(30,50) vs 50(40,60)ml,P=0.042]. There was no statistically significant difference in the postoperative hospitalization days between the two groups[(4.4±1.0)vs(4.5±1.0)d, P=0.669)]. The electrolytes and aldosterone to renin ratio returned to a healthy level in the postoperative one month, and the blood pressure also returned to a healthy level in 53 (75.7%) patients. Conclusion: Transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy is safe and feasible, with a short operation time and relatively less estimated blood loss.
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Affiliation(s)
- L Y Zhang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - D Zheng
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - S S Jing
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - X K Zhang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - P C Chang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - J Yang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - J Q Pei
- Department of Urology, Jiu Gang Hospital, Jiayuguan 735100, China
| | - H G Du
- Department of Urology, Jiu Gang Hospital, Jiayuguan 735100, China
| | - J Y Song
- Department of Urology, Jinchuan Group Staff Hospital, Jinchang 737100, China
| | - M X Qin
- Department of Urology, Jinchuan Group Staff Hospital, Jinchang 737100, China
| | - Z J Dang
- Department of Urology, Yumen First People's Hospital, Yumen 735211, China
| | - Z A Wang
- Department of Urology, Jiuquan Second People's Hospital, Jiuquan 735000, China
| | - K Q Chai
- Department of Urology, Baiyin First People's Hospital, Baiyin 730900, China
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Ramis-Zaldivar JE, Gonzalez-Farre B, Nicolae A, Pack S, Clot G, Nadeu F, Mottok A, Horn H, Song JY, Fu K, Wright G, Gascoyne RD, Chan WC, Scott DW, Feldman AL, Valera A, Enjuanes A, Braziel RM, Smeland EB, Staudt LM, Rosenwald A, Rimsza LM, Ott G, Jaffe ES, Salaverria I, Campo E. MAP-kinase and JAK-STAT pathways dysregulation in plasmablastic lymphoma. Haematologica 2021; 106:2682-2693. [PMID: 33951889 PMCID: PMC8485662 DOI: 10.3324/haematol.2020.271957] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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: 09/24/2020] [Indexed: 11/09/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is an aggressive B-cell lymphoma with an immunoblastic/large cell morphology and plasmacytic differentiation. The differential diagnosis with Burkitt lymphoma (BL), plasma cell myeloma (PCM) and some variants of diffuse large B-cell lymphoma (DLBCL) may be challenging due to the overlapping morphological, genetic and immunophenotypic features. Furthermore, the genomic landscape in PBL is not well known. To characterize the genetic and molecular heterogeneity of these tumors, we investigated thirty-four PBL using an integrated approach, including fluorescence in situ hybridization, targeted sequencing of 94 B-cell lymphoma related genes, and copy-number arrays. PBL were characterized by high genetic complexity including MYC translocations (87%), gains of 1q21.1-q44, trisomy 7, 8q23.2-q24.21, 11p13-p11.2, 11q14.2-q25, 12p and 19p13.3-p13.13, losses of 1p33, 1p31.1-p22.3, 13q and 17p13.3-p11.2, and recurrent mutations of STAT3 (37%), NRAS and TP53 (33%), MYC and EP300 (19%) and CARD11, SOCS1 and TET2 (11%). Pathway enrichment analysis suggested a cooperative action between MYC alterations and MAPK (49%) and JAK-STAT (40%) signaling pathways. Of note, EBVnegative PBL cases had higher mutational and copy-number load and more frequent TP53, CARD11 and MYC mutations, whereas EBV-positive PBL tended to have more mutations affecting the JAK-STAT pathway. In conclusion, these findings further unravel the distinctive molecular heterogeneity of PBL identifying novel molecular targets and the different genetic profile of these tumors related to EBV infection.
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Affiliation(s)
- Joan Enric Ramis-Zaldivar
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Blanca Gonzalez-Farre
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Alina Nicolae
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Svetlana Pack
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Guillem Clot
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Ferran Nadeu
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Anja Mottok
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - Heike Horn
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte
| | - Kai Fu
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
| | - George Wright
- Biometric Research Branch, Division of Cancer Diagnosis and Treatment, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Randy D Gascoyne
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte
| | - David W Scott
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver
| | - Andrew L Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Alexandra Valera
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona
| | - Anna Enjuanes
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Rita M Braziel
- Department of Clinical Pathology, Oregon Health and Science University, Oregon
| | - Erlend B Smeland
- Department of Immunology and Centre for Cancer Biomedicine, University of Oslo and Oslo University Hospital, Oslo
| | - Louis M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Institutes of Health, Bethesda
| | | | - Lisa M Rimsza
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen
| | - Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Itziar Salaverria
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Elias Campo
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.
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Chaudhary S, Brown N, Song JY, Yang L, Skrabek P, Nasr MR, Wong JT, Bedell V, Murata-Collins J, Kochan L, Li J, Zhang W, Chan WC, Weisenburger DD, Perry AM. Relative frequency and clinicopathologic characteristics of MYC-rearranged follicular lymphoma. Hum Pathol 2021; 114:19-27. [PMID: 33964277 DOI: 10.1016/j.humpath.2021.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022]
Abstract
MYC rearrangement is a relatively rare genetic abnormality in follicular lymphoma (FL). In this study, we evaluated the relative frequency of MYC rearrangement in 522 cases of FL and studied their clinicopathologic, cytogenetic, and molecular characteristics. Fluorescence in situ hybridization studies for MYC (break-apart probe), MYC/IGH, IGH/BCL2, and BCL6 rearrangements were performed on tissue microarrays. Immunohistochemical stains for CD10, BCL2, BCL6, and MYC were performed and scored on MYC-rearranged cases. On 4 FL cases, a custom targeted panel of 356 genes was used for mutation analysis. Ten cases (1.9%) were positive for MYC rearrangement. Histologically, 6 of 10 cases were grade 1-2, and 4 cases were grade 3A. By immunohistochemistry, 9 of 9 tested cases were CD10+, all cases were BCL6+, and 9/10 cases were BCL2+. MYC protein staining was low in all cases tested. IGH/BCL2 rearrangement was detected in 5 of 9 cases, whereas BCL6 rearrangement was detected in 3 of 7 tested cases and 4 of 10 cases showed MYC/IGH rearrangement. The most commonly detected mutations in the MYC-positive cases included HLA-B, TNFRSF14, and KMT2D. MYC and/or B2M abnormalities were detected in 2 cases. In conclusion, MYC rearrangement is uncommon in FL and these cases do not appear to have specific histologic characteristics. Molecular analysis showed abnormalities in genes associated with transformation, namely MYC and B2M. Larger studies are needed to evaluate if MYC-rearrangement in FL has prognostic significance.
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Affiliation(s)
- Shweta Chaudhary
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Noah Brown
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Lin Yang
- Section of Hematology/Oncology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, R3E 0W2, Canada; Cancer Care Manitoba, Winnipeg, Manitoba, R3E 0V9, Canada
| | - Pamela Skrabek
- Section of Hematology/Oncology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, R3E 0W2, Canada; Cancer Care Manitoba, Winnipeg, Manitoba, R3E 0V9, Canada
| | - Michel R Nasr
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| | - Jerry T Wong
- Department of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Joyce Murata-Collins
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Lindsay Kochan
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jie Li
- Department of Pathology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, R3E 0W2, Canada; Shared Health Manitoba, Winnipeg, Manitoba, R3C 3H8, Canada
| | - Weiwei Zhang
- Department of Pathology and Microbiology, University of Nebraska, Omaha, NE 68198, USA
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Anamarija M Perry
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA.
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38
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Baugh L, Brown N, Song JY, Pandya S, Montoya V, Perry AM. Fibrin-Associated, EBV-Negative Diffuse Large B-Cell Lymphoma Arising in Atrial Myxoma: Expanding the Spectrum of the Entity. Int J Surg Pathol 2021; 30:39-45. [PMID: 33913371 DOI: 10.1177/10668969211014959] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is a provisional entity in the 2017 Revision of the World Health Organization Classification. This indolent entity, which is frequently discovered incidentally, is currently classified under the category of diffuse large B-cell lymphoma associated with chronic inflammation (DLBCL-CI), an aggressive lymphoma with poor survival. Several authors have proposed that it be classified separately since, in contrast to DLBCL-CI, transformation to aggressive lymphoma has rarely been reported and this entity has distinct clinical and histological features. We describe a rare case of a 62-year-old male with FA-DLBCL associated with atrial myxoma, which was incidentally discovered. In contrast to typically described immunophenotypic features of this entity, that is, activated B-cell phenotype (ABC) and Epstein-Barr virus (EBV) positivity, our case showed germinal center B-cell (GCB) phenotype and was EBV negative. Clinical staging revealed no evidence of lymphoma elsewhere in the body, and the patient did not receive adjuvant chemotherapy after surgical excision and remains in remission. This case illustrates that occasionally FA-DLBCL can show GCB phenotype, as opposed to the typical ABC phenotype. Moreover, we propose that the definition of the entity be expanded to include EBV-negative cases.
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Affiliation(s)
| | - Noah Brown
- University of Michigan, Ann Arbor, MI, USA
| | - Joo Y Song
- 20220City of Hope National Medical Center, Duarte, CA, USA
| | - Shreyash Pandya
- Northside Hospital, Hospital Corporation of America, St. Petersburg, FL, USA
| | - Vernon Montoya
- Cancer Care and Urology of North Florida, Lake City, FL, USA
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Sadras T, Martin M, Kume K, Robinson ME, Saravanakumar S, Lenz G, Chen Z, Song JY, Siddiqi T, Oksa L, Knapp AM, Cutler J, Cosgun KN, Klemm L, Ecker V, Winchester J, Ghergus D, Soulas-Sprauel P, Kiefer F, Heisterkamp N, Pandey A, Ngo V, Wang L, Jumaa H, Buchner M, Ruland J, Chan WC, Meffre E, Martin T, Müschen M. Developmental partitioning of SYK and ZAP70 prevents autoimmunity and cancer. Mol Cell 2021; 81:2094-2111.e9. [PMID: 33878293 DOI: 10.1016/j.molcel.2021.03.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/01/2020] [Accepted: 03/26/2021] [Indexed: 12/11/2022]
Abstract
Even though SYK and ZAP70 kinases share high sequence homology and serve analogous functions, their expression in B and T cells is strictly segregated throughout evolution. Here, we identified aberrant ZAP70 expression as a common feature in a broad range of B cell malignancies. We validated SYK as the kinase that sets the thresholds for negative selection of autoreactive and premalignant clones. When aberrantly expressed in B cells, ZAP70 competes with SYK at the BCR signalosome and redirects SYK from negative selection to tonic PI3K signaling, thereby promoting B cell survival. In genetic mouse models for B-ALL and B-CLL, conditional expression of Zap70 accelerated disease onset, while genetic deletion impaired malignant transformation. Inducible activation of Zap70 during B cell development compromised negative selection of autoreactive B cells, resulting in pervasive autoantibody production. Strict segregation of the two kinases is critical for normal B cell selection and represents a central safeguard against the development of autoimmune disease and B cell malignancies.
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Affiliation(s)
- Teresa Sadras
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA; Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Mickaël Martin
- CNRS UPR 3572 "Immunopathology and Therapeutic Chemistry," Institute of Molecular and Cellular Biology (IBMC), Strasbourg, France; Department of Clinical Immunology, Strasbourg University Hospital, Strasbourg, France
| | - Kohei Kume
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Mark E Robinson
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Supraja Saravanakumar
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Gal Lenz
- Department of Cancer Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Zhengshan Chen
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Tanya Siddiqi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Laura Oksa
- Tampere Center for Child Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anne Marie Knapp
- CNRS UPR 3572 "Immunopathology and Therapeutic Chemistry," Institute of Molecular and Cellular Biology (IBMC), Strasbourg, France
| | - Jevon Cutler
- Department of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kadriye Nehir Cosgun
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Lars Klemm
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Veronika Ecker
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA; Institute of Clinical Chemistry and Pathobiochemistry, Technical University of Munich, Klinikum rechts der Isar, 81675 Munich, Germany
| | - Janet Winchester
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Dana Ghergus
- Department of Clinical Hematology, Hospices Civils de Lyon, Lyon, France
| | - Pauline Soulas-Sprauel
- CNRS UPR 3572 "Immunopathology and Therapeutic Chemistry," Institute of Molecular and Cellular Biology (IBMC), Strasbourg, France; Department of Clinical Immunology, Strasbourg University Hospital, Strasbourg, France
| | - Friedemann Kiefer
- Mammalian Cell Signaling Laboratory, Department of Vascular Cell Biology, Max Planck Institute for Molecular Biomedicine, Münster, Germany
| | - Nora Heisterkamp
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Akhilesh Pandey
- Department of Biological Chemistry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vu Ngo
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Lili Wang
- Department of Systems Biology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Hassan Jumaa
- Department of Immunology, University of Ulm, Ulm, Germany
| | - Maike Buchner
- Institute of Clinical Chemistry and Pathobiochemistry, Technical University of Munich, Klinikum rechts der Isar, 81675 Munich, Germany
| | - Jürgen Ruland
- Institute of Clinical Chemistry and Pathobiochemistry, Technical University of Munich, Klinikum rechts der Isar, 81675 Munich, Germany
| | - Wing-Chung Chan
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Eric Meffre
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.
| | - Thierry Martin
- CNRS UPR 3572 "Immunopathology and Therapeutic Chemistry," Institute of Molecular and Cellular Biology (IBMC), Strasbourg, France; Department of Clinical Immunology, Strasbourg University Hospital, Strasbourg, France.
| | - Markus Müschen
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA; Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.
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40
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Jeyakumar N, Aldoss I, Yang D, Mokhtari S, Gendzekhadze K, Khaled S, O'Donnell M, Palmer J, Song JY, Marcucci G, Stein AS, Forman SJ, Pullarkat VA, Chen W, Wu X, Nakamura R. Cytokine gene polymorphisms are associated with response to blinatumomab in B-cell acute lymphoblastic leukemia. Eur J Haematol 2021; 106:851-858. [PMID: 33721333 DOI: 10.1111/ejh.13622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/16/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/28/2022]
Abstract
Blinatumomab is a bispecific T cell-engaging antibody approved for treatment of relapsed/refractory (r/r) ALL, with 40%-50% complete response (CR)/CR with incomplete count recovery (CRi). Cytokine release syndrome (CRS) as a major adverse effect after blinatumomab therapy. Here, we evaluated the possible association between single-nucleotide polymorphisms (SNPs) in cytokine genes, disease response, and CRS in r/r ALL patients who received blinatumomab between 2012 and 2017 at our center (n = 66), using patients' archived DNA samples. With a median duration of 9.5 months (range: 1-37), 37 patients (56.1%) achieved CR/CRi, 54 (81.8%) experienced CRS (G1: n = 35, G2: n = 14, G3: n = 5), and 9 (13.6%) developed neurotoxicity. By multivariable analysis, after adjusting for high disease burden, one SNP on IL2 (rs2069762), odds ratio (OR) = 0.074 (95% CI: NE-0.43, P = .01) and one SNP on IL17A (rs4711998), OR = 0.28 (95% CI: 0.078-0.92, P = .034) were independently associated with CR/CRi. None of the analyzed SNPs were associated with CRS. To our knowledge, this is the first study demonstrating a possible association between treatment response to blinatumomab and SNPs. Our hypothesis-generated data suggest a potential role for IL-17 and IL-2 in blinatumomab response and justify a larger confirmatory study, which may lead to personalized blinatumomab immunotherapy for B-ALL.
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Affiliation(s)
- Nikeshan Jeyakumar
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Ibrahim Aldoss
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Dongyun Yang
- Department of Computational Quantitative Medicine, City of Hope National Medical Center, Duarte, CA, USA
| | - Sally Mokhtari
- Department of Clinical Translational Project Development, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Samer Khaled
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Margaret O'Donnell
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Joycelynne Palmer
- Department of Computational Quantitative Medicine, City of Hope National Medical Center, Duarte, CA, USA
| | - Joo Y Song
- Department of Molecular and Cellular Biology/Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, USA
| | - Guido Marcucci
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Anthony S Stein
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Stephen J Forman
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Vinod A Pullarkat
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Wei Chen
- Department of Molecular and Cellular Biology/Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, USA
| | - Xiwei Wu
- Department of Molecular and Cellular Biology/Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, USA
| | - Ryotaro Nakamura
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
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41
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Nguyen H, Perry A, Skrabek P, Nasr M, Herrera AF, Bedell V, Murata-Collins J, Pillai R, Xu M, Chen L, Chan WC, Weisenburger DD, Scott DW, Song JY. Validation of the Double-Hit Gene Expression Signature (DLBCL90) in an Independent Cohort of Patients with Diffuse Large B-Cell Lymphoma of Germinal Center Origin. J Mol Diagn 2021; 23:658-664. [PMID: 33636392 DOI: 10.1016/j.jmoldx.2021.02.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 10/22/2022] Open
Abstract
The prognosis of diffuse large B-cell lymphoma (DLBCL) has been associated with clinical parameters, cell of origin, and various genetic aberrations. Recently, a NanoString gene expression assay (DLBCL90) was developed, which identifies DLBCL cases with an outcome similar to those with double- or triple-hit DLBCL with both MYC and BCL2 rearrangements. This study validates the predictive ability of the DLBCL90 assay in an independent cohort of patients with the germinal center B-cell subtype DLBCL. A customized targeted sequencing panel was used to analyze the mutational profile in these patients. Cases with a double or triple hit by conventional fluorescence in situ hybridization cytogenetic analysis are known to have a poor prognosis, and the DLBCL90 gene expression signature identified these cases, as well as additional cases that would have otherwise been missed by fluorescence in situ hybridization analysis. Our findings validate use of the DLBCL90 assay for identifying high-risk patients for new and innovative therapies.
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Affiliation(s)
- Ha Nguyen
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Anamarija Perry
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | | | - Michel Nasr
- Department of Pathology, Upstate Medical University, Syracuse, New York
| | - Alex F Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Joyce Murata-Collins
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Minlin Xu
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Lu Chen
- Information Sciences, City of Hope National Medical Center, Duarte, California
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | | | - David W Scott
- BC Cancer Centre for Lymphoid Cancer, Vancouver, British Columbia, Canada
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, California.
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42
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Song JY, Perry AM, Herrera AF, Chen L, Skrabek P, Nasr MR, Ottesen RA, Nikowitz J, Bedell V, Murata-Collins J, Li Y, McCarthy C, Pillai R, Wang J, Wu X, Zain J, Popplewell L, Kwak LW, Nademanee AP, Niland JC, Scott DW, Gong Q, Chan WC, Weisenburger DD. Double-hit Signature with TP53 Abnormalities Predicts Poor Survival in Patients with Germinal Center Type Diffuse Large B-cell Lymphoma Treated with R-CHOP. Clin Cancer Res 2021; 27:1671-1680. [PMID: 33414134 DOI: 10.1158/1078-0432.ccr-20-2378] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/28/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We performed detailed genomic analysis on 87 cases of de novo diffuse large B-cell lymphoma of germinal center type (GCB DLBCL) to identify characteristics that are associated with survival in those treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). EXPERIMENTAL DESIGN The cases were extensively characterized by combining the results of IHC, cell-of-origin gene expression profiling (GEP; NanoString), double-hit GEP (DLBCL90), FISH cytogenetic analysis for double/triple-hit lymphoma, copy-number analysis, and targeted deep sequencing using a custom mutation panel of 334 genes. RESULTS We identified four distinct biologic subgroups with different survivals, and with similarities to the genomic classifications from two large retrospective studies of DLBCL. Patients with the double-hit signature, but no abnormalities of TP53, and those lacking EZH2 mutation and/or BCL2 translocation, had an excellent prognosis. However, patients with an EZB-like profile had an intermediate prognosis, whereas those with TP53 inactivation combined with the double-hit signature had an extremely poor prognosis. This latter finding was validated using two independent cohorts. CONCLUSIONS We propose a practical schema to use genomic variables to risk-stratify patients with GCB DLBCL. This schema provides a promising new approach to identify high-risk patients for new and innovative therapies.
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Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, California. .,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Anamarija M Perry
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Alex F Herrera
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Lu Chen
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Information Sciences, City of Hope National Medical Center, Duarte, California
| | - Pamela Skrabek
- Department of Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Michel R Nasr
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
| | - Rebecca A Ottesen
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Janet Nikowitz
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Joyce Murata-Collins
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Yuping Li
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Christine McCarthy
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - Raju Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Jinhui Wang
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope National Medical Center, Duarte, California
| | - Jasmine Zain
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Leslie Popplewell
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Larry W Kwak
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Auayporn P Nademanee
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California.,Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Joyce C Niland
- Department of Diabetes & Cancer Discovery Science, City of Hope National Medical Center, Duarte, California
| | - David W Scott
- British Columbia Research Center, Vancouver, British Columbia, Canada
| | - Qiang Gong
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, California.,Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, California
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43
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Kambhampati S, Song JY, Herrera AF, Chan WC. Barriers to achieving a cure in lymphoma. CDR 2021; 4:965-983. [PMID: 35582375 PMCID: PMC8992454 DOI: 10.20517/cdr.2021.66] [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] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/08/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Abstract
Lymphoma is a diverse disease with a variety of different subtypes, each characterized by unique pathophysiology, tumor microenvironment, and underlying signaling pathways leading to oncogenesis. With our increasing understanding of the molecular biology of lymphoma, there have been a number of novel targeted therapies and immunotherapy approaches that have been developed for the treatment of this complex disease. Despite rapid progress in the field, however, many patients still relapse largely due to the development of drug resistance to these therapies. A better understanding of the mechanisms underlying resistance is needed to develop more novel treatment strategies that circumvent these mechanisms and design better treatment algorithms that personalize therapies to patients and sequence these therapies in the most optimal manner. This review focuses on the recent advances in therapies in lymphoma, including targeted therapies, monoclonal antibodies, antibody-drug conjugates, cellular therapy, bispecific antibodies, and checkpoint inhibitors. We discuss the genetic and cellular principles of drug resistance that span across all the therapies, as well as some of the unique mechanisms of resistance that are specific to these individual classes of therapies and the strategies that have been developed to address these modes of resistance.
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Affiliation(s)
- Swetha Kambhampati
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Joo Y. Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Alex F. Herrera
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Wing C. Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA
- Correspondence to: Dr. Wing C. Chan, MD, Department of Pathology, City of Hope National Medical Center, 1500 E. Duarte Rd, Duarte, CA 91010, USA. E-mail:
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44
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Qin H, Dong Z, Wang X, Cheng WA, Wen F, Xue W, Sun H, Walter M, Wei G, Smith DL, Sun X, Fei F, Xie J, Panagopoulou TI, Chen CW, Song JY, Aldoss I, Kayembe C, Sarno L, Müschen M, Inghirami GG, Forman SJ, Kwak LW. CAR T cells targeting BAFF-R can overcome CD19 antigen loss in B cell malignancies. Sci Transl Med 2020; 11:11/511/eaaw9414. [PMID: 31554741 DOI: 10.1126/scitranslmed.aaw9414] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/03/2019] [Accepted: 07/31/2019] [Indexed: 02/05/2023]
Abstract
CAR T cells targeting CD19 provide promising options for treatment of B cell malignancies. However, tumor relapse from antigen loss can limit efficacy. We developed humanized, second-generation CAR T cells against another B cell-specific marker, B cell activating factor receptor (BAFF-R), which demonstrated cytotoxicity against human lymphoma and acute lymphoblastic leukemia (ALL) lines. Adoptively transferred BAFF-R-CAR T cells eradicated 10-day preestablished tumor xenografts after a single treatment and retained efficacy against xenografts deficient in CD19 expression, including CD19-negative variants within a background of CD19-positive lymphoma cells. Four relapsed, primary ALLs with CD19 antigen loss obtained after CD19-directed therapy retained BAFF-R expression and activated BAFF-R-CAR, but not CD19-CAR, T cells. BAFF-R-CAR, but not CD19-CAR, T cells also demonstrated antitumor effects against an additional CD19 antigen loss primary patient-derived xenograft (PDX) in vivo. BAFF-R is amenable to CAR T cell therapy, and its targeting may prevent emergence of CD19 antigen loss variants.
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Affiliation(s)
- Hong Qin
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Zhenyuan Dong
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Xiuli Wang
- Center for CAR T Cell Therapy, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Wesley A Cheng
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Feng Wen
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA.,Department of Medical Oncology Cancer Center, West China Hospital, Sichuan University, Sichuan 910041, China
| | - Weili Xue
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA.,The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China
| | - Han Sun
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Miriam Walter
- Center for CAR T Cell Therapy, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Guowei Wei
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - D Lynne Smith
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Xiuhua Sun
- The Second Affiliated Hospital of Dalian Medical University, Dalian 116044, China
| | - Fan Fei
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, CA 90007, USA
| | - Jianming Xie
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, CA 90007, USA
| | - Theano I Panagopoulou
- Department of Systems Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Chun-Wei Chen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Ibrahim Aldoss
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Clarisse Kayembe
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Luisa Sarno
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Markus Müschen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Giorgio G Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Stephen J Forman
- Center for CAR T Cell Therapy, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Larry W Kwak
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA.
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Abstract
In recent years, both benign and malignant thyroid tumors have grown rapidly in the world, and have become one of the most common tumors in the endocrine system. At present, the pathogenesis of thyroid tumor is still unclear, but more and more studies have found that certain factors are related to the occurrence and development of thyroid tumors. It is of great significance to summarize and analyze these risk factors. This article reviews the research progress of its risk factors reported in recent years, so as to provide a basis for the accuracy and scientific prevention and control of thyroid tumors.
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Affiliation(s)
- S Liu
- Department of Nutritional Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - J Y Song
- Persistent Organic Pollutants Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - J Q Zhang
- Persistent Organic Pollutants Laboratory, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
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46
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Song JY, Egan C, Bouska AC, Zhang W, Gong Q, Venkataraman G, Herrera AF, Chen L, Ottesen R, Niland JC, Bedell V, Valle-Catuna M, Murata-Collins J, Weisenburger DD, Iqbal J, Jaffe ES, Chan WC. Genomic characterization of diffuse large B-cell lymphoma transformation of nodular lymphocyte-predominant Hodgkin lymphoma. Leukemia 2020; 34:2238-2242. [PMID: 32054999 PMCID: PMC8499090 DOI: 10.1038/s41375-020-0739-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/11/2019] [Accepted: 01/30/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA.
| | - Caoimhe Egan
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Alyssa C Bouska
- Department of Pathology, University of Nebraska, Omaha, NE, USA
| | - Weiwei Zhang
- Department of Pathology, University of Nebraska, Omaha, NE, USA
| | - Qiang Gong
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Alex F Herrera
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Lu Chen
- Department of Information Sciences, City of Hope National Medical Center, Duarte, CA, USA
| | - Rebecca Ottesen
- Department of Diabetes and Cancer Discovery Science, City of Hope National Medical Center, Duarte, CA, USA
| | - Joyce C Niland
- Department of Diabetes and Cancer Discovery Science, City of Hope National Medical Center, Duarte, CA, USA
| | - Victoria Bedell
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Maria Valle-Catuna
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | | | | | - Javeed Iqbal
- Department of Pathology, University of Nebraska, Omaha, NE, USA
| | - Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
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47
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Abstract
The IL-3 alpha chain receptor (CD123) is a cell surface protein that is widely expressed by various subtypes of acute leukemia, including acute myeloid leukemia (AML), acute lymphoblastic leukemia and blastic plasmacytoid dendritic cell neoplasm. Notably, CD123 is preferentially overexpressed in leukemia stem cells (LSC) in contrast to normal hematopoietic stem cells, and this differential expression allows for the selective eradication of LSC and leukemic blasts through therapeutic targeting of CD123, with less impact on hematopoietic cells. The level of CD123 expression in AML correlates with both treatment response and outcomes. Therefore, targeting CD123 represents a promising universal therapeutic target in advanced acute leukemias irrespective of the individual leukemia phenotype. There are currently 31 ongoing clinical trials examining the utility of CD123-based targeted therapies. Here we focus our review on current efforts to target CD123 in acute leukemia through various therapeutic constructs.
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Affiliation(s)
- Ibrahim Aldoss
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center , Duarte, CA, USA
| | - Mary Clark
- Department of Clinical and Translational Project Development, City of Hope National Medical Center , Duarte, CA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center , Duarte, CA, USA
| | - Vinod Pullarkat
- Gehr Family Center for Leukemia Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center , Duarte, CA, USA
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48
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Persky DO, Li H, Stephens DM, Park SI, Bartlett NL, Swinnen LJ, Barr PM, Winegarden JD, Constine LS, Fitzgerald TJ, Leonard JP, Kahl BS, LeBlanc ML, Song JY, Fisher RI, Rimsza LM, Smith SM, Miller TP, Friedberg JW. Positron Emission Tomography-Directed Therapy for Patients With Limited-Stage Diffuse Large B-Cell Lymphoma: Results of Intergroup National Clinical Trials Network Study S1001. J Clin Oncol 2020; 38:3003-3011. [PMID: 32658627 DOI: 10.1200/jco.20.00999] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) presents as a limited-stage disease in 25% to 30% of patients, with better overall survival (OS) than that for advanced-stage disease but with continuous relapse regardless of treatment approach. The preferred treatment is abbreviated rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and radiation therapy. On the basis of promising results of positron emission tomography (PET)-directed treatment approaches, we designed a National Clinical Trials Network (NCTN) study to improve outcomes and decrease toxicity. METHODS Patients with nonbulky (< 10 cm) stage I/II untreated DLBCL received 3 cycles of standard R-CHOP therapy and underwent a centrally reviewed interim PET/computed tomography scan (iPET). Those with a negative iPET proceeded with 1 additional cycle of R-CHOP, whereas those with a positive iPET received involved field radiation therapy followed by ibritumomab tiuxetan radioimmunotherapy. RESULTS Of 158 patients enrolled, 132 were eligible and 128 underwent iPET, which was positive in 14 (11%) of the patients. With a median follow-up of 4.92 years (range, 1.1-7.7 years), only 6 patients progressed and 3 died as a result of lymphoma. Eleven patients died as a result of nonlymphoma causes at a median age of 80 years. The 5-year progression-free survival estimate was 87% (95% CI, 79% to 92%) and the OS estimate was 89% (95% CI, 82% to 94%), with iPET-positive and iPET-negative patients having similar outcomes. CONCLUSION To our knowledge, S1001 is the largest prospective study in the United States of limited-stage DLBCL in the rituximab era, with the best NCTN results in this disease subset. With PET-directed therapy, 89% of the patients with a negative iPET received R-CHOP × 4, and only 11% had a positive iPET and required radiation, with both groups having excellent outcomes. The trial establishes R-CHOP × 4 alone as the new standard approach to limited-stage disease for the absolute majority of patients.
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Affiliation(s)
- Daniel O Persky
- Division of Hematology/Oncology, University of Arizona, Tucson, AZ
| | - Hongli Li
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Steven I Park
- Department of Medicine, Levine Cancer Institute/Atrium Health, Charlotte, NC.,University of North Carolina, Chapel Hill, NC
| | - Nancy L Bartlett
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Lode J Swinnen
- Division of Medical Oncology, Johns Hopkins Cancer Center, Baltimore, MD
| | - Paul M Barr
- Division of Hematology/Oncology, Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | | | - Louis S Constine
- Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | | | - John P Leonard
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, NY
| | - Brad S Kahl
- Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Michael L LeBlanc
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA
| | - Richard I Fisher
- Department of Hematology/Oncology, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, PA
| | - Lisa M Rimsza
- Department of Pathology, Mayo Clinic, Scottsdale, AZ
| | - Sonali M Smith
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Thomas P Miller
- Division of Hematology/Oncology, University of Arizona, Tucson, AZ
| | - Jonathan W Friedberg
- Division of Hematology/Oncology, Wilmot Cancer Institute, University of Rochester, Rochester, NY
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49
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Malki MMA, Song JY, Yang D, Cao T, Aldoss I, Mokhtari S, Dadwal S, Marcucci G, Karanes C, Snyder D, Nademanee A, Forman SJ, Nakamura R, Pullarkat V. Iron Overload Is Associated with Delayed Engraftment and Increased Nonrelapse Mortality in Recipients of Umbilical Cord Blood Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:1697-1703. [PMID: 32534103 DOI: 10.1016/j.bbmt.2020.06.002] [Citation(s) in RCA: 4] [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: 04/01/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 11/16/2022]
Abstract
The negative impact of iron overload (IO) on outcomes of allogeneic hematopoietic cell transplantation (HCT) is well recognized, but its impact on umbilical cord blood (UCB) transplant outcome is unknown. We retrospectively analyzed outcomes of 150 patients who received UCB-HCT at our institution, stratified by pre-HCT serum ferritin (SF) level of 2000 ng/mL. Two-year overall survival rate among patients with SF >2000 and ≤2000 ng/mL was 26.1% (95% CI, 10.6% to 44.7%) and 52.1% (95% CI, 40.1% to 62.8%), respectively; hazard ratio (HR) = 2.26 (95% CI, 1.28 to 4.00, P = .005). Two-year nonrelapse mortality rate was higher among patients with SF >2000 ng/mL (56.5%; 95% CI, 33.3% to 74.4%) compared to SF ≤2000 ng/mL (30.1%; 95% CI, 20.0% to 40.9%); HR = 2.18 (95% CI, 1.10 to 4.31, P = .025). Neutrophil engraftment at 42 days was 78.3% (95% CI, 53.5% to 90.8%) in patients with SF >2000 ng/mL versus 91.8% (95% CI, 82.1% to 96.4%) in patients with SF ≤2000 ng/mL; HR = 0.58 (95% CI, 0.35 to 0.96, P = .034). A significant difference in platelet engraftment at 3 months was also observed: 52.2% (95% CI, 29.4% to 70.8%) for SF >2000 ng/mL versus 80.8% (95% CI, 69.5% to 88.3%) for SF ≤2000 ng/mL; HR = 0.48 (95% CI, 0.23 to 0.98, P = .044). In conclusion, IO defined by SF of 2000 ng/mL is a strong adverse prognostic factor for UCB-HCT and should be considered when UCB is chosen as the graft source for patients without a fully matched donor.
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Affiliation(s)
- Monzr M Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California.
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, California
| | - Dongyun Yang
- Department of Computational and Quantitative Medicine, Division of Biostatistics, City of Hope, Duarte, California
| | - Thai Cao
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Sally Mokhtari
- Department of Clinical Translational Program Development, City of Hope, Duarte, California
| | - Sanjeet Dadwal
- Department of Infectious Disease, City of Hope, Duarte, California
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Chatchada Karanes
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - David Snyder
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Auayporn Nademanee
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California
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50
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Abstract
There are multiple entities that involve the lung that have radiographic, clinical, and morphologic overlaps with pulmonary lymphoma. In this review, we will discuss these entities in detail and provide relevant updates.
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Affiliation(s)
- Ha Nguyen
- Department of Pathology, City of Hope, Duarte, CA, USA
| | - Joo Y Song
- Department of Pathology, City of Hope, Duarte, CA, USA.
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