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Schirren AEC, Albrecht JD, Melchers S, Weiß C, Büttner S, Dippel E, Gosmann J, Jonak C, Klemke CD, Laturnus-Chang M, Livingstone E, Mitteldorf C, Schummer P, Stadler R, Stranzenbach R, Weyer-Fahlbusch SS, Wobser M, Ziemer M, Nicolay JP. Health-related quality of life and its influencing factors in patients with primary cutaneous B-cell lymphomas: A multicentric study in 100 patients. J Eur Acad Dermatol Venereol 2024; 38:954-966. [PMID: 38279594 DOI: 10.1111/jdv.19799] [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: 12/11/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Primary cutaneous B-cell lymphomas (CBCL) are a group of rare malignant skin diseases that represent approximately 20%-30% of all primary cutaneous lymphomas (PCL). Previous studies revealed impaired health-related quality of life (HRQoL) in patients diagnosed with primary cutaneous T-cell lymphoma (CTCL). Currently, only small-sized studies investigated HRQoL in CBCL patients and lacked detailed analysis of respective subtypes. OBJECTIVES This study aims to investigate HRQoL in CBCL patients to identify independent factors of HRQoL impairment in CBCL patients. METHODS One hundred CBCL patients were recruited from eight German PCL centres in this multicentric, cross-sectional study from 2021 to 2022. The patients completed the dermatologic HRQoL questionnaire Skindex-29 and an investigator-designed 'CBCL-Questionnaire' with additional questions on HRQoL and clinical characteristics. RESULTS The Skindex-29 revealed that HRQoL in CBCL patients is impaired on a mild to moderate level. The multiple regression analysis identified parameters like worries about dying, feeling prejudiced/discriminated and impairment of daily activities to be independently associated with impairment of HRQoL. Highest scores for HRQoL impairment were found in patients with primary cutaneous follicle centre lymphoma while on rituximab treatment and in patients with primary cutaneous marginal zone lymphoma while on watchful waiting. CONCLUSIONS HRQoL is impaired in CBCL patients, even though, in the face of indolent disease course and favourable prognosis in the majority of cases. Of note, our investigator-designed tool identified worries about dying, feeling prejudiced/discriminated, and the type of treatment to have a negative impact on patients' HRQoL. Our study highlights the importance of a thorough patient-doctor communication to capture overall disease burden because generic HRQoL tools might lack of disease-specific items.
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Affiliation(s)
- A E C Schirren
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Mannheim, Germany
- Section for Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - J D Albrecht
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Mannheim, Germany
- Section for Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - S Melchers
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Mannheim, Germany
- Section for Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - C Weiß
- Department for Medical Statistics, Biomathematics and Information Processing, Medical Faculty Mannheim of the University of Heidelberg and University Medical Centre Mannheim, Mannheim, Germany
| | - S Büttner
- Department for Medical Statistics, Biomathematics and Information Processing, Medical Faculty Mannheim of the University of Heidelberg and University Medical Centre Mannheim, Mannheim, Germany
| | - E Dippel
- Department of Dermatology, Ludwigshafen Medical Centre, Ludwigshafen, Germany
| | - J Gosmann
- University Clinic for Dermatology, Johannes Wesling Medical Centre, Minden, Germany
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C-D Klemke
- Department of Dermatology and Skin Cancer Centre, Municipal Hospital Karlsruhe, Academic Educational Hospital of the University of Freiburg, Karlsruhe, Germany
| | - M Laturnus-Chang
- Department of Dermatology, Ludwigshafen Medical Centre, Ludwigshafen, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - C Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Centre Göttingen, Göttingen, Germany
| | - P Schummer
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - R Stadler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - R Stranzenbach
- Department of Dermatology, Bochum Medical Centre, Bochum, Germany
| | | | - M Wobser
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - M Ziemer
- Department of Dermatology, University Medical Centre, Leipzig, Germany
| | - J P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Mannheim, Germany
- Section for Clinical and Experimental Dermatology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Centre (DKFZ), Heidelberg, Germany
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Schirren AEC, Albrecht JD, Dippel E, Fahlbusch S, Gosmann J, Klemke CD, Chang ML, Livingstone E, Mitteldorf C, Schummer P, Stadler R, Stranzenbach R, Wobser M, Ziemer M, Nicolay JP. Quality of life and its influencing factors in patients with primary cutaneous B-cell lymphomas. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00589-5] [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: 11/25/2022]
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Nicolay JP, Albrecht JD, Assaf C, Dippel E, Stadler R, Wehkamp U, Wobser M, Burghaus I, Schneider S, Guelow K, Goerdt S, Krammer PH. Dimethyl fumarate (DMF) therapy in CTCL: final results from a clinical phase II study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00593-7] [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: 11/03/2022]
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Quaglino P, Prince H, Cowan R, Vermeer M, Papadavid L, Bagot M, Servitjie O, Berti E, Guenova E, Stadler R, Querfeld C, Busschots A, Hodak E, Patsatsi A, Sanches J, Maule M, Yoo J, Kevin M, Fava P, Ribero S, Zocchi L, Rubatto M, Fierro M, Wehkamp U, Marshalko M, Mitteldorf C, Akilov O, Ortiz-Romero P, Estrach T, Vakeva L, Enz P, Wobser M, Bayne M, Jonak C, Rubeta M, Forbes A, Bates A, Battistella M, Amel-Kashipaz R, Vydianath B, Combalia A, Georgiou E, Hauben E, Hong E, Jost M, Knobler R, Amitay-Laish I, Miyashiro D, Cury-Martins J, Martinez X, Muniesa C, Prag-Naveh H, Nikolaou V, Quint K, Ram-Wolff C, Rieger K, Stranzenbach R, Szepesi Á, Alberti-Violetti S, Felicity E, Cerroni L, Kempf W, Whittaker S, Willemze R, Kim Y, Scarisbrick J. Treatment of early-stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study. Br J Dermatol 2021; 184:722-730. [PMID: 32479678 PMCID: PMC7704558 DOI: 10.1111/bjd.19252] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. Here we examine front-line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF). OBJECTIVES To identify (i) differences in first-line approaches according to tumour-nodes-metastasis-blood (TNMB) staging; (ii) parameters related to a first-line systemic approach and (iii) response rates and QoL measures. METHODS In total, 395 newly diagnosed patients with early-stage MF (stage IA-IIA) were recruited from 41 centres in 17 countries between 1 January 2015 and 31 December 2018 following central clinicopathological review. RESULTS The most common first-line therapy was skin-directed therapy (SDT) (322 cases, 81·5%), while a smaller percentage (44 cases, 11·1%) received systemic therapy. Expectant observation was used in 7·3%. In univariate analysis, the use of systemic therapy was significantly associated with higher clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA-IB vs. IIA, P < 0·001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0·001), higher modified Severity Weighted Assessment Tool (> 10, 15%; ≤ 10, 7%; P = 0·01) and folliculotropic MF (FMF) (24% vs. 12%, P = 0·001). Multivariate analysis demonstrated significant associations with the presence of plaques (T1b/T2b vs. T1a/T2a, odds ratio 3·07) and FMF (odds ratio 2·83). The overall response rate (ORR) to first-line SDT was 73%, while the ORR to first-line systemic treatments was lower (57%) (P = 0·027). Health-related QoL improved significantly both in patients with responsive disease and in those with stable disease. CONCLUSIONS Disease characteristics such as presence of plaques and FMF influence physician treatment choices, and SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early-stage MF need to address these issues.
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Affiliation(s)
- P. Quaglino
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - H.M. Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - R. Cowan
- Christie Hospital, Manchester UK
| | - M. Vermeer
- Leiden University Medical Centre, The Netherlands
| | | | - M. Bagot
- Hospital St Louis, Paris, France
| | - O. Servitjie
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - R. Stadler
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - C. Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | | | - E. Hodak
- Rabin Medical Center, Tel Aviv University, Israel
| | - A. Patsatsi
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - J. Sanches
- University of Sao Paulo Medical School, Brazil, South America
| | - M. Maule
- Cancer Epidemiology Unit, Department Medical Sciences, University of Turin, Italy
| | - J. Yoo
- University Hospitals Birmingham, UK
| | - M. Kevin
- University Hospitals Birmingham, UK
| | - P. Fava
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - S. Ribero
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - L. Zocchi
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M. Rubatto
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M.T. Fierro
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - U. Wehkamp
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - C. Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Center Göttingen, Germany
| | - O. Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, USA
| | | | - T. Estrach
- Hospital Clinico, University of Barcelona, Spain
| | - L. Vakeva
- Helsinki University Central Hospital, Finland
| | - P.A. Enz
- Hospital Italiano De Buenos Aires, Argentina, South America
| | - M. Wobser
- University Hospital Wuerzburg, Germany
| | | | - C. Jonak
- Dept of Dermatology, Medical University of Vienna, Austria
| | - M. Rubeta
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford UK
| | | | - A. Bates
- University Hospital Southampton, Southampton, UK
| | | | | | | | - A. Combalia
- Hospital Clinico, University of Barcelona, Spain
| | - E. Georgiou
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - E. Hauben
- Belgium University Hospitals Leuven, Leuven, Belgium
| | | | - M. Jost
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R. Knobler
- Dept of Dermatology, Medical University of Vienna, Austria
| | | | - D. Miyashiro
- University of Sao Paulo Medical School, Brazil, South America
| | - J. Cury-Martins
- University of Sao Paulo Medical School, Brazil, South America
| | - X. Martinez
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | - C. Muniesa
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - K. Quint
- Leiden University Medical Centre, The Netherlands
| | | | | | - R. Stranzenbach
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - Á. Szepesi
- Semmelweis University, Budapest, Hungary
| | | | | | - L. Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | - W. Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zurich, Switzerland
| | - S. Whittaker
- Kings College London, Guys and St Thomas NHS Foundation Trust, London
| | - R. Willemze
- Leiden University Medical Centre, The Netherlands
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Hodak E, Sherman S, Papadavid E, Bagot M, Querfeld C, Quaglino P, Prince HM, Ortiz-Romero PL, Stadler R, Knobler R, Guenova E, Estrach T, Patsatsi A, Leshem YA, Prague-Naveh H, Berti E, Alberti-Violetti S, Cowan R, Jonak C, Nikolaou V, Mitteldorf C, Akilov O, Geskin L, Matin R, Beylot-Barry M, Vakeva L, Sanches JA, Servitje O, Weatherhead S, Wobser M, Yoo J, Bayne M, Bates A, Dunnill G, Marschalko M, Buschots AM, Wehkamp U, Evison F, Hong E, Amitay-Laish I, Stranzenbach R, Vermeer M, Willemze R, Kempf W, Cerroni L, Whittaker S, Kim YH, Scarisbrick JJ. Should we be imaging lymph nodes at initial diagnosis of early-stage mycosis fungoides? Results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) international study. Br J Dermatol 2021; 184:524-531. [PMID: 32574377 DOI: 10.1111/bjd.19303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Accepted: 05/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early-stage mycosis fungoides (MF) includes involvement of dermatopathic lymph nodes (LNs) or early lymphomatous LNs. There is a lack of unanimity among current guidelines regarding the indications for initial staging imaging in early-stage presentation of MF in the absence of enlarged palpable LNs. OBJECTIVES To investigate how often imaging is performed in patients with early-stage presentation of MF, to assess the yield of LN imaging, and to determine what disease characteristics promoted imaging. METHODS A review of clinicopathologically confirmed newly diagnosed patients with cutaneous patch/plaque (T1/T2) MF from PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) data. RESULTS PROCLIPI enrolled 375 patients with stage T1/T2 MF: 304 with classical MF and 71 with folliculotropic MF. Imaging was performed in 169 patients (45%): 83 with computed tomography, 18 with positron emission tomography-computed tomography and 68 with ultrasound. Only nine of these (5%) had palpable enlarged (≥ 15 mm) LNs, with an over-representation of plaques, irrespectively of the 10% body surface area cutoff that distinguishes T1 from T2. Folliculotropic MF was not more frequently imaged than classical MF. Radiologically enlarged LNs (≥ 15 mm) were detected in 30 patients (18%); only seven had clinical lymphadenopathy. On multivariate analysis, plaque presentation was the sole parameter significantly associated with radiologically enlarged LNs. Imaging of only clinically enlarged LNs upstaged 4% of patients (seven of 169) to at least IIA, whereas nonselective imaging upstaged another 14% (24 of 169). LN biopsy, performed in eight of 30 patients, identified N3 (extensive lymphomatous involvement) in two and N1 (dermatopathic changes) in six. CONCLUSIONS Physical examination was a poor determinant of LN enlargement or involvement. Presence of plaques was associated with a significant increase in identification of enlarged or involved LNs in patients with early-stage presentation of MF, which may be important when deciding who to image. Imaging increases the detection rate of stage IIA MF, and identifies rare cases of extensive lymphomatous nodes, upstaging them to advanced-stage IVA2.
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Affiliation(s)
- E Hodak
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Sherman
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Papadavid
- Athens University Medical School, Athens, Greece
| | - M Bagot
- Hospital St Louis, Paris, France
| | - C Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - P Quaglino
- Dermatologic Clinic, University of Turin Medical School, Turin, Italy
| | - H M Prince
- Sir Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - P L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain
| | - R Stadler
- Johannes Wesling University Medical Centre, Minden, Germany
| | - R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Guenova
- University Hospital Zurich, Zurich, Switzerland
| | - T Estrach
- Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - A Patsatsi
- Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Y A Leshem
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Prague-Naveh
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Berti
- University of Milan, Milan, Italy
| | | | - R Cowan
- Christie Hospital, Manchester, UK
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Nikolaou
- Athens University Medical School, Athens, Greece
| | - C Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Centre Göttingen, Göttingen, Germany
| | - O Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, PA, USA
| | - L Geskin
- University of Columbia, New York, NY, USA
| | - R Matin
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - L Vakeva
- Helsinki University Central Hospital, Helsinki, Finland
| | - J A Sanches
- University of São Paulo Medical School, São Paulo, SP, Brazil
| | - O Servitje
- Hospital Universatari de Bellvitge, Barcelona, Spain
| | | | - M Wobser
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - J Yoo
- University Hospital Birmingham, Birmingham, UK
| | | | - A Bates
- University Hospital Southampton, Southampton, UK
| | - G Dunnill
- University Hospital Bristol, Bristol, UK
| | | | | | - U Wehkamp
- University Hospital Kiel, Kiel, Germany
| | - F Evison
- University Hospital Birmingham, Birmingham, UK
| | - E Hong
- Stanford University Medical Center, Stanford, CA, USA
| | - I Amitay-Laish
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Stranzenbach
- Johannes Wesling University Medical Centre, Minden, Germany
| | - M Vermeer
- Leiden University Medical Centre, Leiden, the Netherlands
| | - R Willemze
- Leiden University Medical Centre, Leiden, the Netherlands
| | - W Kempf
- Kempf and PFlatz, Histologische Diagnostik, Zurich, Switzerland
| | - L Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | | | - Y H Kim
- Stanford University Medical Center, Stanford, CA, USA
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Wehkamp U, Mitteldorf C, Stendel S, Stranzenbach R, Nicolay JP, Wobser M, Weichenthal M, Schneiderbauer R, Klemke CD, Hillen U, Kempf W, Assaf C. Most rare subtypes of cutaneous lymphoma display variable CD30 expression: analysis of the German Cutaneous Lymphoma Network. Br J Dermatol 2021; 185:228-230. [PMID: 33480069 DOI: 10.1111/bjd.19823] [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: 10/08/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Affiliation(s)
- U Wehkamp
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Mitteldorf
- Department of Dermatology, University Medical Center Goettingen, Germany
| | - S Stendel
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R Stranzenbach
- Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of Ruhr-University Bochum, Minden, Germany
| | - J P Nicolay
- Department of Dermatology, University Hospital Mannheim, Germany
| | - M Wobser
- Department of Dermatology, University Hospital Würzburg, Germany
| | - M Weichenthal
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - C-D Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Germany
| | - U Hillen
- Department of Dermatology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - W Kempf
- Department of Dermatology, University Hospital Zurich, Switzerland.,Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | - C Assaf
- Department of Dermatology, Helios-Klinikum Krefeld, Germany
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7
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Kempf W, Mitteldorf C, Battistella M, Willemze R, Cerroni L, Santucci M, Geissinger E, Jansen P, Vermeer MH, Marschalko M, Papadavid E, Piris MA, Ortiz-Romero PL, Novelli M, Paulli M, Quaglino P, Ranki A, Rodríguez Peralto JL, Wobser M, Auschra B, Robson A. Primary cutaneous peripheral T-cell lymphoma, not otherwise specified: results of a multicentre European Organization for Research and Treatment of Cancer (EORTC) cutaneous lymphoma taskforce study on the clinico-pathological and prognostic features. J Eur Acad Dermatol Venereol 2020; 35:658-668. [PMID: 32997839 DOI: 10.1111/jdv.16969] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/10/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cutaneous peripheral T-cell lymphoma, not otherwise specified (PTL NOS) is an aggressive, but poorly characterized neoplasm. OBJECTIVES The European Organization for Research and Treatment of Cancer cutaneous lymphoma taskforce (EORTC CLTF) investigated 33 biopsies of 30 patients with primary cutaneous PTL NOS to analyse their clinical, histological, immunophenotypic features and outcome. METHODS Retrospective analysis of clinical data and histopathological features by an expert panel. RESULTS Cutaneous PTL NOS manifested clinically either with solitary or disseminated rapidly grown ulcerated tumours or disseminated papulo-nodular lesions. Histologically, a mostly diffuse or nodular infiltrate in the dermis and often extending into the subcutis was found. Epidermotropism was rarely present and only mild and focal. Unusual phenotypes were frequent, e.g. CD3+ /CD4- /CD8- and CD3+ /CD4+ /CD8+ . Moreover, 18% of the cases exhibited an aberrant expression of the B-cell marker CD20 by the tumour cells. All solitary tumours were located on the limbs and presented a high expression of GATA-3 but this did not correlate with outcome and therefore could not serve as a prognostic factor. The prognosis was shown to be generally poor with 10 of 30 patients (33%) dying of lymphoma within the follow-up of 36 months (mean value; range 3-144). The survival rates were 61% after 3 years (CI, 43-85%) and 54% after 5 years (CI, 36-81%). Small to medium-sized morphology of tumour cells was associated with a better outcome than medium to large or large tumour cells. Age, gender, clinical stage, CD4/CD8 phenotype and GATA-3 expression were not associated with prognosis. Chemotherapy was the most common treatment modality, but surgical excision and/or radiotherapy may represent an appropriate first-line treatment for solitary lesions. CONCLUSIONS Cutaneous PTL NOS shows an aggressive course in most patients independent of initial presentation, age and phenotype. Cytomorphology was identified as a prognostic factor. The data indicate a need for more effective treatment modalities in PTL NOS.
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Affiliation(s)
- W Kempf
- Histologische Diagnostik, Kempf und Pfaltz, Zürich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - C Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - M Battistella
- Department of Pathology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, INSERM U976, Paris, France
| | - R Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M Santucci
- Department of Health Sciences, University of Florence School of Human Health Sciences, Florence, Italy.,Division of Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - E Geissinger
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - P Jansen
- Department of Clinical Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - M H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Marschalko
- Department of Dermatology and Venerology, Semmelweis Medical University, Budapest, Hungary
| | - E Papadavid
- Department of Dermatology-Venereology, Attikon University Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - M A Piris
- Department of Pathology, Fundacion Jimenez Diaz, CIBERONC, Madrid, Spain
| | - P L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Medical School, Institute i+12, University Complutense, Madrid, Spain
| | - M Novelli
- Cutaneous Immunopathology Laboratory, Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Paulli
- Department of Molecular Pathology, University of Pavia, Pavia, Italy.,Department of Anatomic Pathology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - P Quaglino
- Dermatologic Clinic, Dept Medical Sciences, University of Turin Medical School, Torino, Italy
| | - A Ranki
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J L Rodríguez Peralto
- Department of Pathology, Hospital Universitario 12 de Octubre, Universidad, Complutense, Instituto de Investigación I+12, Madrid, Spain
| | - M Wobser
- Department of Dermatology, University of Würzburg, Würzburg, Germany
| | - B Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - A Robson
- Institute of Oncology, Lisbon, Portugal.,LDPath, London, UK
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8
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. A study of quality of life in people with mycosis fungoides and Sézary syndrome. Br J Dermatol 2020. [DOI: 10.1111/bjd.18827] [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: 11/30/2022]
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9
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. 样肉芽肿和 Sézary 综合征患者生活质量研究. Br J Dermatol 2020. [DOI: 10.1111/bjd.18840] [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: 11/30/2022]
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10
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Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, Servitje O, Berti E, Ortiz-Romero P, Stadler R, Patsatsi A, Knobler R, Guenova E, Child F, Whittaker S, Nikolaou V, Tomasini C, Amitay I, Prag Naveh H, Ram-Wolff C, Battistella M, Alberti-Violetti S, Stranzenbach R, Gargallo V, Muniesa C, Koletsa T, Jonak C, Porkert S, Mitteldorf C, Estrach T, Combalia A, Marschalko M, Csomor J, Szepesi A, Cozzio A, Dummer R, Pimpinelli N, Grandi V, Beylot-Barry M, Pham-Ledard A, Wobser M, Geissinger E, Wehkamp U, Weichenthal M, Cowan R, Parry E, Harris J, Wachsmuth R, Turner D, Bates A, Healy E, Trautinger F, Latzka J, Yoo J, Vydianath B, Amel-Kashipaz R, Marinos L, Oikonomidi A, Stratigos A, Vignon-Pennamen MD, Battistella M, Climent F, Gonzalez-Barca E, Georgiou E, Senetta R, Zinzani P, Vakeva L, Ranki A, Busschots AM, Hauben E, Bervoets A, Woei-A-Jin FJSH, Matin R, Collins G, Weatherhead S, Frew J, Bayne M, Dunnill G, McKay P, Arumainathan A, Azurdia R, Benstead K, Twigger R, Rieger K, Brown R, Sanches JA, Miyashiro D, Akilov O, McCann S, Sahi H, Damasco FM, Querfeld C, Folkes A, Bur C, Klemke CD, Enz P, Pujol R, Quint K, Geskin L, Hong E, Evison F, Vermeer M, Cerroni L, Kempf W, Kim Y, Willemze R. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181:350-357. [PMID: 30267549 DOI: 10.1111/bjd.17258] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [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] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survival in mycosis fungoides (MF) is varied and may be poor. The PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study is a web-based data collection system for early-stage MF with legal data-sharing agreements permitting international collaboration in a rare cancer with complex pathology. Clinicopathological data must be 100% complete and in-built intelligence in the database system ensures accurate staging. OBJECTIVES To develop a prognostic index for MF. METHODS Predefined datasets for clinical, haematological, radiological, immunohistochemical, genotypic, treatment and quality of life are collected at first diagnosis of MF and annually to test against survival. Biobanked tissue samples are recorded within a Federated Biobank for translational studies. RESULTS In total, 430 patients were enrolled from 29 centres in 15 countries spanning five continents. Altogether, 348 were confirmed as having early-stage MF at central review. The majority had classical MF (81·6%) with a CD4 phenotype (88·2%). Folliculotropic MF was diagnosed in 17·8%. Most presented with stage I (IA: 49·4%; IB: 42·8%), but 7·8% presented with enlarged lymph nodes (stage IIA). A diagnostic delay between first symptom development and initial diagnosis was frequent [85·6%; median delay 36 months (interquartile range 12-90)]. This highlights the difficulties in accurate diagnosis, which includes lack of a singular diagnostic test for MF. CONCLUSIONS This confirmed early-stage MF cohort is being followed-up to identify prognostic factors, which may allow better management and improve survival by identifying patients at risk of disease progression. This study design is a useful model for collaboration in other rare diseases, especially where pathological diagnosis can be complex.
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Affiliation(s)
- J J Scarisbrick
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - P Quaglino
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H M Prince
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Papadavid
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hodak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Bagot
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Servitje
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Berti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - P Ortiz-Romero
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Stadler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Patsatsi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Knobler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Guenova
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Child
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - S Whittaker
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - V Nikolaou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Tomasini
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - I Amitay
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Prag Naveh
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Ram-Wolff
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Alberti-Violetti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Stranzenbach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - V Gargallo
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Muniesa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Koletsa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Jonak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Porkert
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Mitteldorf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Estrach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Combalia
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Marschalko
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Csomor
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Szepesi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Cozzio
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Dummer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - N Pimpinelli
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - V Grandi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Beylot-Barry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Pham-Ledard
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Wobser
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Geissinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - U Wehkamp
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Weichenthal
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Cowan
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - E Parry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - J Harris
- Member of the UK Cutaneous Lymphoma Group
| | - R Wachsmuth
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - D Turner
- Member of the UK Cutaneous Lymphoma Group
| | - A Bates
- Member of the UK Cutaneous Lymphoma Group
| | - E Healy
- Member of the UK Cutaneous Lymphoma Group
| | - F Trautinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J Latzka
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Yoo
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - B Vydianath
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - R Amel-Kashipaz
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - L Marinos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Oikonomidi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Stratigos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M-D Vignon-Pennamen
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F Climent
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Gonzalez-Barca
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Georgiou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Senetta
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Zinzani
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Vakeva
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Ranki
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A-M Busschots
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Hauben
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Bervoets
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F J S H Woei-A-Jin
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Matin
- Member of the UK Cutaneous Lymphoma Group
| | - G Collins
- Member of the UK Cutaneous Lymphoma Group
| | | | - J Frew
- Member of the UK Cutaneous Lymphoma Group
| | - M Bayne
- Member of the UK Cutaneous Lymphoma Group
| | - G Dunnill
- Member of the UK Cutaneous Lymphoma Group
| | - P McKay
- Member of the UK Cutaneous Lymphoma Group
| | | | - R Azurdia
- Member of the UK Cutaneous Lymphoma Group
| | - K Benstead
- Member of the UK Cutaneous Lymphoma Group
| | - R Twigger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Rieger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Brown
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J A Sanches
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - D Miyashiro
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Akilov
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S McCann
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Sahi
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F M Damasco
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Querfeld
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Folkes
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Bur
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C-D Klemke
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Enz
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Pujol
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Quint
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Geskin
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hong
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Evison
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - M Vermeer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - L Cerroni
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - W Kempf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - Y Kim
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Willemze
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
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Molloy K, Jonak C, Woei‐A‐Jin F, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (
PROCLIPI
) study. Br J Dermatol 2019; 182:770-779. [DOI: 10.1111/bjd.18089] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/01/2023]
Affiliation(s)
- K. Molloy
- University Hospitals Birmingham Birmingham U.K
| | - C. Jonak
- Medical University of Vienna Vienna Austria
| | | | | | | | | | | | - R. Knobler
- Medical University of Vienna Vienna Austria
| | - S. Porkert
- Medical University of Vienna Vienna Austria
| | | | - R. Cowan
- Christie Hospital Manchester U.K
| | | | - M. Beylot‐Barry
- Centre Hospitalier Universitaire Hospital de Bordeaux Bordeaux France
| | - E. Berti
- Department of Dermatology Fondazione Ca’ Granda IRCCS OMP Milan Italy
| | | | - T. Estrach
- Hospital Clinico University of Barcelona Barcelona Spain
| | | | - O. Akilov
- University of Pittsburgh School of Medicine Pittsburgh PA U.S.A
| | - L. Vakeva
- Helsinki University Central Hospital Helsinki Finland
| | - M. Prince
- Peter MacCallum Cancer Centre Melbourne Australia
| | - A. Bates
- University Hospital Southampton Southampton U.K
| | | | | | | | | | - O. Servitje
- Hospital Universatari de Bellvitge Barcelona Spain
| | | | | | - M. Wobser
- University Hospital Würzburg Würzburg Germany
| | - J.A. Sanches
- University of São Paulo Medical School São Paulo Brazil
| | - P. McKay
- Beatson West of Scotland Cancer Centre Glasgow U.K
| | - D. Klemke
- Stadtisches Klinikum Karlsruhe Karlsruhe Germany
| | - C. Peng
- University Hospitals Birmingham Birmingham U.K
| | - A. Howles
- University Hospitals Birmingham Birmingham U.K
| | - J. Yoo
- University Hospitals Birmingham Birmingham U.K
| | - F. Evison
- University Hospitals Birmingham Birmingham U.K
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12
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Persa OD, Loquai C, Wobser M, Baltaci M, Dengler S, Kreuter A, Volz A, Laimer M, Emberger M, Doerler M, Mauch C, Helbig D. Extended surgical safety margins and ulceration are associated with an improved prognosis in pleomorphic dermal sarcomas. J Eur Acad Dermatol Venereol 2019; 33:1577-1580. [PMID: 30767327 DOI: 10.1111/jdv.15493] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/18/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pleomorphic dermal sarcomas (PDS) are frequent UV-induced sarcomas of the skin of intermediate grade malignant potential. Despite the fact that PDS have a noteworthy potential to recur (up to 28%) as well as to metastasize (up to 20%), there are no specific clinical guidelines with respect to follow-up these patients. Moreover, little is known about clinical, histological or molecular prognostic factors in PDS. OBJECTIVE The aim of the present study was to identify risk factors to predict relapse in a large multicentre sample cohort of PDS which could aid to optimize personalized treatment recommendations regarding surgical safety margins and adjuvant radiotherapy. METHODS Patients with a diagnosis of PDS were selected from nine European institutions based on the histopathologic criteria described by Fletcher. Clinicopathologic and follow-up data were collected and statistically analysed calculating univariate hazard ratios with 95% confidence intervals by use of the Cox proportional-hazards model and a significance level of P < 0.05. Patients with an incomplete excision of the tumour were excluded. RESULTS Univariate Cox regression analysis of possible prognostic factors for progression-free survival (PFS) performed in 92 patients revealed that an excision margin of <2 cm is significantly associated with relapse of PDS [hazard ratio 4.478 (95% CI 1.536-13.055), P = 0.006]. Ulceration of the tumour was associated with a significantly better prognosis [0.396 (0.174-0.904), P = 0.028] whereas adjuvant radiotherapy did not reach statistical significance to improve prognosis in patients with PDS [0.775 (0.231-2.593), P = 0.679]. Gender, age, immunosuppression, intratumoural necrosis, tumour location, vertical thickness or horizontal diameter did not significantly influence PFS in PDS. CONCLUSION We identified surgical safety margins of <2 cm and absence of ulceration as risk factors for relapse in patients with PDS. These findings may be implemented into both the primary treatment as well as the further monitoring of patients with PDS.
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Affiliation(s)
- O D Persa
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
| | - C Loquai
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
| | - M Wobser
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - M Baltaci
- Department of Dermatology, Helios Hospital Krefeld, Krefeld, Germany
| | - S Dengler
- Department of Dermatology, Dortmund Hospital, Dortmund, Germany
| | - A Kreuter
- Department of Dermatology, Venereology and Allergology, HELIOS St Elisabeth Hospital Oberhausen, University Witten/Herdecke, Oberhausen, Germany
| | - A Volz
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - M Laimer
- Department of Dermatology, University Hospital Salzburg, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - M Emberger
- Institute of Pathology, Salzburg, Austria
| | - M Doerler
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - C Mauch
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
| | - D Helbig
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
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Herz C, Wobser M, Fischer J, Hamm H. Pachyonychia congenita und Steatocystoma multiplex durch Mutation im Keratin-17-Gen. Akt Dermatol 2019. [DOI: 10.1055/a-0806-9586] [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: 10/27/2022]
Abstract
ZusammenfassungDie Pachyonychia congenita (PC) wird durch heterozygote Mutationen in den Keratin-Genen KRT6A, KRT6B, KRT6C, KRT16 oder KRT17 verursacht. Die Einteilung in PC Typ 1 und PC Typ 2 nach klinischen Kriterien wurde zugunsten einer molekulargenetischen Klassifikation auf Basis der 5 betroffenen Gene (PC-K6a, PC-K6b, PC-K6c, PC-K16, PC-K17) verlassen. Die Erkrankung wird autosomal-dominant vererbt, Spontanmutationen kommen in etwa 30 % der Fälle vor. Über 97 % der PC-Patienten weisen die 3 Hauptsymptome Verdickung der Fußnägel, Plantarkeratosen und Fußsohlenschmerzen auf. Lokalisierte Steatozystome, Vellushaarzysten oder das diffuse Steatocystoma multiplex zeichnen die PC durch Keratin-17-Mutationen aus. Konnatale oder perinatale Zähne und follikuläre Hyperkeratosen an Ellenbogen, Knien und Rumpf sind ebenfalls häufig mit einer Mutation in KRT17 vergesellschaftet. Wir berichten über eine 40-jährige Patientin mit Steatocystoma multiplex, Verdickung und distaler Dystrophie aller Nägel, schmerzhaften Plantarkeratosen und palmoplantarer Hyperhidrose. Molekulargenetisch konnte mittels Next-Generation-Sequencing eine Mutation im Exon 1 des KRT17-Gens als ursächlich nachgewiesen werden.
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Affiliation(s)
- C. Herz
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - M. Wobser
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - J. Fischer
- Institut für Humangenetik, Universitätsklinikum Freiburg
| | - H. Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
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14
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Röding K, Schrüfer P, Grän F, Olk J, Ueberschaar S, Behle V, Kneitz H, Goebeler M, Wobser M. Kutane Lymphome – ein vielgestaltiges Krankheitsbild. Akt Dermatol 2019. [DOI: 10.1055/a-0807-3938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
ZusammenfassungKutane Lymphome präsentieren sich klinisch und histologisch oftmals ungewöhnlich und stellen nicht selten eine diagnostische Herausforderung für den Dermatologen dar. In dieser Arbeit werden die vielgestaltigen Präsentationsformen der Mycosis fungoides und anderer kutaner Lymphome anhand von Fallbeispielen aus der Würzburger Spezialsprechstunde für kutane Lymphome vorgestellt und ein Überblick über die Verwechslungsmöglichkeiten mit anderen Dermatosen gegeben.
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Affiliation(s)
- K. Röding
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - P. Schrüfer
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - F. Grän
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - J. Olk
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - S. Ueberschaar
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - V. Behle
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - H. Kneitz
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - M. Goebeler
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
| | - M. Wobser
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
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Maurus K, Roth S, Appenzeller S, Goebeler M, Rosenwald A, Geissinger E, Wobser M. Genetic alterations in CD30-positive lymphoproliferations. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30549-0] [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: 11/25/2022]
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16
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Blazejak C, Stranzenbach R, Gambichler T, Stendel S, Wehkamp U, Klemke CD, Wobser M, Olk J, Nicolay J, Stadler R, Assaf C. Low-dose gemcitabine therapy in CTCL: ‘real-life” data of the German Cutaneous Lymphoma Network. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30594-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Wobser M, Roth S, Olk J, Kneitz H, Goebeler M, Rosenwald A, Geissinger E, Maurus K. Sequential comprehensive molecular work-up of treatment-resistant mycosis fungoides with systemic dissemination during a 4-year period. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30553-2] [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: 11/25/2022]
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18
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Molloy K, Jonak C, Sherida F, Woei-A-Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot-Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Antonio Sanches J, McKay P, Klemke D, Howles A, Yoo J, Evison F, Scarisbrick J. An overall response in skin is associated with improved HRQoL in patients with MF/SS enrolled in the PROCLIPI study. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30617-3] [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: 10/26/2022]
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19
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Wobser M, Maurus K, Roth S, Appenzeller S, Weyandt G, Goebeler M, Rosenwald A, Geissinger E. Myeloid differentiation primary response 88 mutations in a distinct type of cutaneous marginal-zone lymphoma with a nonclass-switched immunoglobulin M immunophenotype. Br J Dermatol 2017; 177:564-566. [DOI: 10.1111/bjd.15183] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. Wobser
- Department of Dermatology; University Hospital Würzburg; Josef-Schneider-Str. 2 97080 Würzburg Germany
| | - K. Maurus
- Institute of Pathology; Comprehensive Cancer Centre; University of Würzburg; Germany
| | - S. Roth
- Institute of Pathology; Comprehensive Cancer Centre; University of Würzburg; Germany
| | - S. Appenzeller
- Core Unit Bioinformatics; Comprehensive Cancer Centre; University Hospital Würzburg; Josef-Schneider-Str. 2 97080 Würzburg Germany
| | - G. Weyandt
- Department of Dermatology; University Hospital Würzburg; Josef-Schneider-Str. 2 97080 Würzburg Germany
| | - M. Goebeler
- Department of Dermatology; University Hospital Würzburg; Josef-Schneider-Str. 2 97080 Würzburg Germany
| | - A. Rosenwald
- Institute of Pathology; Comprehensive Cancer Centre; University of Würzburg; Germany
| | - E. Geissinger
- Institute of Pathology; Comprehensive Cancer Centre; University of Würzburg; Germany
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Brenner I, Roth S, Flossbach L, Wobser M, Rosenwald A, Geissinger E. Lack of myeloid differentiation primary response protein MyD88 L265P mutation in primary cutaneous marginal zone lymphoma. Br J Dermatol 2015; 173:1527-8. [DOI: 10.1111/bjd.13960] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- I. Brenner
- Institute of Pathology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
| | - S. Roth
- Institute of Pathology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
| | - L. Flossbach
- Institute of Pathology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
| | - M. Wobser
- Department of Dermatology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
| | - A. Rosenwald
- Institute of Pathology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
- Comprehensive Cancer Center (CCC) Mainfranken; University and University Hospital; Würzburg Germany
| | - E. Geissinger
- Institute of Pathology; University of Würzburg; Josef-Schneider-Straße 2 97080 Würzburg Germany
- Comprehensive Cancer Center (CCC) Mainfranken; University and University Hospital; Würzburg Germany
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Kneitz H, Wobser M, Stoevesandt J, Goebeler M. Therapieresistente purulente Papeln und Knoten gluteal und im Bereich beider Oberschenkel. Hautarzt 2015; 66:636-8. [DOI: 10.1007/s00105-015-3634-9] [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: 11/30/2022]
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22
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Wobser M, Roth S, Reinartz T, Rosenwald A, Goebeler M, Geissinger E. CD68 expression is a discriminative feature of indolent cutaneous CD8-positive lymphoid proliferation and distinguishes this lymphoma subtype from other CD8-positive cutaneous lymphomas. Br J Dermatol 2015; 172:1573-1580. [PMID: 25524664 DOI: 10.1111/bjd.13628] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Indolent cutaneous CD8+ lymphoid proliferation is a recently described rare entity among cutaneous T-cell lymphomas that typically presents with solitary skin lesions at acral sites. Separation from otherwise aggressive T-cell lymphomas bearing a cytotoxic CD8+ phenotype is fundamental to avoid unnecessary harmful treatment. However, up to now, no reliable discriminative marker has been identified. OBJECTIVES Motivated by these diagnostic quandaries, we have analyzed a large series of archived formalin-fixed paraffin-embedded (FFPE) specimens of atypical CD8+ cutaneous infiltrates with clear-cut diagnosis and clinical follow-up (n = 44) including five cases of indolent CD8+ lymphoid proliferation by using immunohistochemistry with the aim of obtaining markers predictive of subtype assignment. RESULTS We identified exclusive expression of CD68 by lymphoma cells within the subgroup of indolent CD8+ lymphoid proliferation (5/5 cases). Specific CD68 expression in this entity was confirmed by the application of several monoclonal antibodies (KP1, PG-M1, KiM1P) against the CD68 molecule available for FFPE tissue. In contrast, none of the infiltrates of the other CD8+ cutaneous lymphoma entities stained positive for CD68 (0/39). CONCLUSIONS Based on these observations, we suggest CD68 as a new discriminative marker which is helpful in distinguishing indolent CD8+ lymphoid proliferation from other CD8+ cutaneous lymphomas in ambiguous cases.
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Affiliation(s)
- M Wobser
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - S Roth
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - T Reinartz
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - A Rosenwald
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - M Goebeler
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - E Geissinger
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
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23
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Sbiera S, Kroiss M, Thamm T, Beyer M, Majidi F, Kuehner D, Wobser M, Becker JC, Adam P, Ronchi C, Allolio B, Fassnacht M. Survivin in adrenocortical tumors - pathophysiological implications and therapeutic potential. Horm Metab Res 2013; 45:137-46. [PMID: 23143666 DOI: 10.1055/s-0032-1327750] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Treatment options for adrenocortical carcinoma (ACC) are very limited. In other solid tumors, small vaccination trials targeting the anti-apoptotic molecule survivin suggested immunological and clinical benefit in selected patients. Therefore, we investigated whether survivin might be a suitable target for immunotherapy in ACC. Survivin mRNA and protein expression was assessed in adrenal tissue specimens [by real-time-PCR in 29 ACC, 24 adrenocortical adenomas (ACA) and 12 normal adrenal glands; by immunohistochemistry in 167 ACCs, 15 ACA, and 5 normal adrenal glands]. Expression was correlated with clinical outcome using Kaplan-Meier and Cox regression analyses. The anti-apoptotic role of survivin was investigated in the SW13 ACC cell line using survivin siRNA. The presence of spontaneous survivin specific T-cells in peripheral blood was assessed by FACS dextramere staining in 29 ACC patients in comparison to healthy controls. Survivin mRNA in ACC was significantly overexpressed when compared with ACA or normal adrenal glands. Immunohistochemistry confirmed survivin protein expression in 97% of the ACCs. In 83% of samples, staining was moderate or high and clinical outcome in this subgroup showed a trend towards poorer prognosis [hazard ratio for death 2.28 (95% CI 0.99-5.28); p=0.053]. Survivin knockdown in SW-13 cell significantly increased the rate of apoptosis. Finally, spontaneous survivin-reactive T cells were detectable in 3 of 29 ACC patients. In conclusion, our data suggest that survivin could play an important role in the anti-apoptotic mechanisms in ACC and provide first hints that targeting survivin might be an interesting new therapeutic approach in this rare disease.
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Affiliation(s)
- S Sbiera
- Department of Internal Medicine I, Endocrine and Diabetes Unit, University Hospital Würzburg, University of Würzburg, Würzburg, Germany
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Wobser M, Schmitt A, Bröcker EB, Trautmann A. Circumscribed Inflammatory Plaque at the Scalp: Follicular Impetigo or Tinea Capitis? Klin Padiatr 2010; 222:38-9. [DOI: 10.1055/s-0029-1220707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Wobser M, Seitz C, Becker J, Bröcker E. Endometriose des Bauchnabels. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-2008-1039239] [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: 10/20/2022] Open
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27
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Hofmann U, Wobser M, Kneitz H, Kleine P, Becker J, Bröcker E, Ugurel S. Major response to paclitaxel combined with irradiation as second-line therapy in metastatic angiosarcoma of the face and scalp. Br J Dermatol 2009; 160:456-8. [DOI: 10.1111/j.1365-2133.2008.08968.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Becker JC, Wobser M, Hofmeister V, Bauer B, Broecker EB, thor Straten P, Andersen MH. Safety, immunogenicity, and clinical response of a survivin-based peptide vaccine in therapy-resistant advanced cancer: Results from a phase I/II trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Abstract
Rituximab has been established as an effective and safe therapy for cutaneous B-cell lymphoma (CBCL). Different survival pathways, that is the Raf/MEK/Erk- or the p38MAPK cascade, have been suggested as downstream mediators of rituximab and may be involved in treatment failure. Biopsies from four patients, suffering from different subtypes of CBCL, which were obtained at various time points of relapse during or after therapy with 375 mg rituximab per m2 of body surface area, were analysed for the expression of CD20, CD3, Ki-67, Raf-kinase inhibitory protein (RKIP) and bcl-2 by immunohistochemistry. No CD20-loss variants, that is the suggested main tumour escape mechanism to rituximab therapy, were observed in any specimen of relapsing CBCL. Notably, the expression of proapoptotic RKIP remained increased in these tumour samples. This was concomitated by a constant to slightly reduced proliferation status as demonstrated by Ki-67 staining. However, relapsing CBCL exhibited a strong upregulation of the antiapoptotic molecule bcl-2 in comparison to pretherapeutic levels. The immunohistochemical analyses of this case series of rituximab refractory CBCL suggest that upregulation of bcl-2 may play a major role in therapy resistance.
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MESH Headings
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antigens, CD20/genetics
- Antineoplastic Agents/therapeutic use
- Drug Resistance, Neoplasm/genetics
- Female
- Gene Expression Regulation, Neoplastic
- Genes, bcl-2
- Humans
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Male
- Phosphatidylethanolamine Binding Protein/genetics
- Rituximab
- Treatment Failure
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Affiliation(s)
- M Wobser
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - H Voigt
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - A O Eggert
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - R Houben
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - C S Kauczok
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - E B Bröcker
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
| | - J C Becker
- Department of Dermatology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany
- E-mail:
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30
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Wortmann S, Sbiera S, Kuehner D, Wobser M, Adam P, Kraus L, Becker JC, Allolio B, Fassnacht M. Survivin – a promising target for immunotherapy in patients with adrenocortical carcinoma. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972203] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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