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Gómez-Caverzaschi V, Yagüe J, Espinosa G, Mayordomo-Bofill I, Bedón-Galarza R, Araújo O, Pelegrín L, Arbelo E, Morales X, Balagué O, Figueras-Nart I, Mascaró JM, Fuertes I, Giavedoni P, Muxí A, Alobid I, Vilaseca I, Cervera R, Aróstegui JI, Mensa-Vilaró A, Hernández-Rodríguez J. Disease phenotypes in adult patients with suspected undifferentiated autoinflammatory diseases and PFAPA syndrome: Clinical and therapeutic implications. Autoimmun Rev 2024:103520. [PMID: 38561135 DOI: 10.1016/j.autrev.2024.103520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Undifferentiated autoinflammatory diseases are characterized by recurrent or persistent fever, usually combined with other inflammatory manifestations, and negative or inconclusive genetic studies for monogenic autoinflammatory disorders. AIMS To define and characterize disease phenotypes in adult patients diagnosed in an adult reference center with undifferentiated autoinflammatory diseases, and to analyze the efficacy of the drugs used in order to provide practical diagnostic and therapeutic recommendations. METHODS Retrospective study (2015-2022) of patients with undifferentiated autoinflammatory diseases among all patients visited in our reference center. Demographic, clinical, laboratory features and detailed therapeutic information was collected. RESULTS Of the 334 patients with a suspected autoinflammatory disease, 134 (40%) patients (61% women) were initially diagnosed with undifferentiated autoinflammatory diseases. Mean age at disease onset and at diagnosis was 28.7 and 37.7 years, respectively. In 90 (67.2%) patients, symptoms started during adulthood. Forty-four (32.8%) patients met diagnostic/classification criteria for adult PFAPA syndrome. In the remaining patients, four additional phenotypes were differentiated according to the predominant manifestations: a) Predominantly fever phenotype (n = 18; 13.4%); b) Predominantly abdominal/pleuritic pain phenotype (n = 9; 6.7%); c) Predominantly pericarditis phenotype (n = 18; 13.4%), and d) Complex syndrome phenotype (n = 45; 33.6%). Prednisone (mainly on demand), colchicine and anakinra were the drugs commonly used. Overall, complete responses were achieved with prednisone in 41.3%, colchicine in 40.2%, and anakinra in 58.3% of patients in whom they were used. By phenotypes, prednisone on demand was more effective in adult PFAPA syndrome and colchicine in patients with the abdominal/pleuritic pain pattern and PFAPA syndrome. Patients with complex syndrome achieved complete responses with prednisone (21.9%), colchicine (25.7%) and anakinra (44.4%), and were the group more often requiring additional immunosuppressive drugs. CONCLUSIONS The analysis of the largest single-center series of adult patients with undifferentiated autoinflammatory diseases identified and characterized different disease phenotypes and their therapeutic approaches. This study is expected to contribute to increase the awareness of physicians for an early identification of these conditions, and to provide the best known therapeutic options.
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Affiliation(s)
- Verónica Gómez-Caverzaschi
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain
| | - Jordi Yagüe
- Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain; Department of Immunology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gerard Espinosa
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain
| | - Isabet Mayordomo-Bofill
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ricardo Bedón-Galarza
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olga Araújo
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain
| | - Laura Pelegrín
- Department of Ophthalmology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Arbelo
- Arrhythmia Section, Department of Cardiology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain
| | - Xavier Morales
- Gastrointestinal Surgery Section, Department of General and Digestive Surgery, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Olga Balagué
- Department of Anatomic Pathology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Ignasi Figueras-Nart
- Department of Dermatology, Hospital Universitari de Bellvitge, University of Barcelona, Spain
| | - José M Mascaró
- Department of Dermatology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Irene Fuertes
- Department of Dermatology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Priscila Giavedoni
- Department of Dermatology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Africa Muxí
- Department of Nuclear Medicine, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Isam Alobid
- Department of Otorhinolaryngology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Isabel Vilaseca
- Department of Otorhinolaryngology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ricard Cervera
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain
| | - Juan I Aróstegui
- Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain; Department of Immunology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Mensa-Vilaró
- Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain; Department of Immunology, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Hernández-Rodríguez
- Autoinflammatory Diseases Clinical Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Center of the European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA), Spanish Center of the Centros, Servicios y Unidades de Referencia (CSUR) and Catalan Center of the Xarxa d'Unitats d'Expertesa Clínica (XUEC) for Autoinflammatory Diseases, Barcelona, Spain.
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Huibers M, Abla O, Andrés M, Balagué O, Beishuizen A, Carraro E, Chiang A, Csóka M, David BA, de Ville de Goyet M, Gilad G, Hori D, Kotecha RS, Kabickova E, Klapper W, Miakova N, Minard-Colin V, Nakazawa A, Pillon M, Rigaud C, Salaverria I, Tölle I, Verdú-Amorós J, von Mersi H, Wössmann W, Burkhardt B, Attarbaschi A. Large B-cell lymphoma-IRF4+ in children and young people: time to reduce chemotherapy in a rare malignant mature B-cell neoplasm? Blood Adv 2024; 8:1509-1514. [PMID: 38290136 DOI: 10.1182/bloodadvances.2023012109] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024] Open
Affiliation(s)
- Minke Huibers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Oussama Abla
- Division of Hematology and Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, Canada
| | - Mara Andrés
- Department of Pediatric Hematology and Oncology, University Hospital La Fe of Valencia, Valencia, Spain
| | - Olga Balagué
- Hematopathology section, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Elisa Carraro
- Maternal and Child Health Department, Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padova, Padova, Italy
| | - Alan Chiang
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Monika Csóka
- Pediatric Clinic (Tűzoltó Street Department), Semmelweis University, Budapest, Hungary
| | - Bianca-Andreea David
- Department of Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital Liège, Liège, Belgium
| | - Maëlle de Ville de Goyet
- Department of Pediatric Hematology and Oncology, Cliniques universitaires Saint-Luc, UC Louvain, Brussels, Belgium
| | - Gil Gilad
- Department of Pediatric Hematology and Oncology, Schneider Children's Medical Center, Petah Tikva, and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daiki Hori
- Department of Hematology and Oncology for children and adolescents, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Rishi S Kotecha
- Department of Clinical Haematology, Oncology, Blood and Marrow Transplantation, Perth Children's Hospital, Perth, Australia
- Leukaemia Translational Research Laboratory, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
- Curtin Medical School, Curtin University, Perth, Australia
| | - Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Wolfram Klapper
- Hematopathology Section, Department of Pathology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Natasha Miakova
- Department of Pediatric Hematology and Oncology, Federal Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy Cancer Campus, Paris-Sacaly University, Villejuif, France
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Marta Pillon
- Hematopathology section, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Charlotte Rigaud
- Department of Pediatric and Adolescent Oncology, Gustave-Roussy Cancer Campus, Paris-Sacaly University, Villejuif, France
| | - Itziar Salaverria
- Department of Pathology, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Ida Tölle
- Pediatric Hematology and Oncology and NHL-BFM Study Center, University Hospital Münster, Münster, Germany
| | - Jaime Verdú-Amorós
- Department of Pediatric Hematology and Oncology, University Hospital La Fe of Valencia, Valencia, Spain
- Department of Pediatric Hematology and Oncology, Hospital Clínico Universitario, Biomedical Research Institute, INCLIVA, Valencia, Spain
| | - Hannah von Mersi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Wilhelm Wössmann
- Pediatric Hematology and Oncology and NHL-BFM Study Center, Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Burkhardt
- Pediatric Hematology and Oncology and NHL-BFM Study Center, University Hospital Münster, Münster, Germany
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
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Mozas P, López C, Grau M, Nadeu F, Clot G, Valle S, Kulis M, Navarro A, Ramis-Zaldivar JE, González-Farré B, Rivas-Delgado A, Rivero A, Frigola G, Balagué O, Giné E, Delgado J, Villamor N, Matutes E, Magnano L, García-Sanz R, Huet S, Russell RB, Campo E, López-Guillermo A, Beà S. Genomic landscape of follicular lymphoma across a wide spectrum of clinical behaviors. Hematol Oncol 2023; 41:631-643. [PMID: 36994552 DOI: 10.1002/hon.3132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/31/2023]
Abstract
While some follicular lymphoma (FL) patients do not require treatment or experience prolonged responses, others relapse early, and little is known about genetic alterations specific to patients with a particular clinical behavior. We selected 56 grade 1-3A FL patients according to their need of treatment or timing of relapse: never treated (n = 7), non-relapsed (19), late relapse (14), early relapse or POD24 (11), and primary refractory (5). We analyzed 56 diagnostic and 12 paired relapse lymphoid tissue biopsies and performed copy number alteration (CNA) analysis and next generation sequencing (NGS). We identified six focal driver losses (1p36.32, 6p21.32, 6q14.1, 6q23.3, 9p21.3, 10q23.33) and 1p36.33 copy-neutral loss of heterozygosity (CN-LOH). By integrating CNA and NGS results, the most frequently altered genes/regions were KMT2D (79%), CREBBP (67%), TNFRSF14 (46%) and BCL2 (40%). Although we found that mutations in PIM1, FOXO1 and TMEM30A were associated with an adverse clinical behavior, definitive conclusions cannot be drawn, due to the small sample size. We identified common precursor cells harboring early oncogenic alterations of the KMT2D, CREBBP, TNFRSF14 and EP300 genes and 16p13.3-p13.2 CN-LOH. Finally, we established the functional consequences of mutations by means of protein modeling (CD79B, PLCG2, PIM1, MCL1 and IRF8). These data expand the knowledge on the genomics behind the heterogeneous FL population and, upon replication in larger cohorts, could contribute to risk stratification and the development of targeted therapies.
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Affiliation(s)
- Pablo Mozas
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Cristina López
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Marta Grau
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Ferran Nadeu
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Guillem Clot
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Sara Valle
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Marta Kulis
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | - Alba Navarro
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Joan Enric Ramis-Zaldivar
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Blanca González-Farré
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Andrea Rivero
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gerard Frigola
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Olga Balagué
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Neus Villamor
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Estella Matutes
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Ramón García-Sanz
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Department of Haematology, University Hospital of Salamanca (HUS/IBSAL) and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Sarah Huet
- Team LIB, ISEM 1111 International Center for Research in Infectiology, Université Claude Bernard Lyon I, Pierre-Bénite, France
- France and Department of Biological Haematology, Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Robert B Russell
- Biochemie Zentrum Heidelberg (BZH) and Cell Networks, Bioquant, Ruprecht-Karl University of Heidelberg, Heidelberg, Germany
| | - Elías Campo
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Sílvia Beà
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Department of Pathology, Haematopathology Section, Hospital Clínic de Barcelona, Barcelona, Spain
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4
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Salmerón-Villalobos J, Castrejón-de-Anta N, Guerra-García P, Ramis-Zaldivar JE, López-Guerra M, Mato S, Colomer D, Diaz-Crespo F, Menarguez J, Garrido-Pontnou M, Andrés M, García-Fernández E, Llavador M, Frigola G, García N, González-Farré B, Martín-Guerrero I, Garrido-Colino C, Astigarraga I, Fernández A, Verdú-Amorós J, González-Muñíz S, González B, Celis V, Campo E, Balagué O, Salaverria I. Decoding the molecular heterogeneity of pediatric monomorphic post-solid organ transplant lymphoproliferative disorders. Blood 2023; 142:434-445. [PMID: 37053555 DOI: 10.1182/blood.2022019543] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/28/2023] [Accepted: 03/31/2023] [Indexed: 04/15/2023] Open
Abstract
Posttransplant lymphoproliferative disorders (PTLDs) represent a broad spectrum of lymphoid proliferations, frequently associated with Epstein-Barr virus (EBV) infection. The molecular profile of pediatric monomorphic PTLDs (mPTLDs) has not been elucidated, and it is unknown whether they display similar genetic features as their counterpart in adult and immunocompetent (IMC) pediatric patients. In this study, we investigated 31 cases of pediatric mPTLD after solid organ transplantation, including 24 diffuse large B-cell lymphomas (DLBCLs), mostly classified as activated B cell, and 7 cases of Burkitt lymphoma (BL), 93% of which were EBV positive. We performed an integrated molecular approach, including fluorescence in situ hybridization, targeted gene sequencing, and copy number (CN) arrays. Overall, PTLD-BL carried mutations in MYC, ID3, DDX3X, ARID1A, or CCND3 resembling IMC-BL, higher mutational burden than PTLD-DLBCL, and lesser CN alterations than IMC-BL. PTLD-DLBCL showed a very heterogeneous genomic profile with fewer mutations and CN alterations than IMC-DLBCL. Epigenetic modifiers and genes of the Notch pathway were the most recurrently mutated in PTLD-DLBCL (both 28%). Mutations in cell cycle and Notch pathways correlated with a worse outcome. All 7 patients with PTLD-BL were alive after treatment with pediatric B-cell non-Hodgkin lymphoma protocols, whereas 54% of patients with DLBCL were cured with immunosuppression reduction, rituximab, and/or low-dose chemotherapy. These findings highlight the low complexity of pediatric PTLD-DLBCL, their good response to low-intensity treatment, and the shared pathogenesis between PTLD-BL and EBV-positive IMC-BL. We also suggest new potential parameters that could help in the diagnosis and the design of better therapeutic strategies for these patients.
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Affiliation(s)
- Julia Salmerón-Villalobos
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
| | - Natalia Castrejón-de-Anta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pilar Guerra-García
- Pediatric Hematology and Oncology Department, Hospital Universitario La Paz, Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Joan Enric Ramis-Zaldivar
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
| | - Mónica López-Guerra
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Sara Mato
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
| | - Dolors Colomer
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Francisco Diaz-Crespo
- Pathology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Menarguez
- Pathology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Mara Andrés
- Pediatric Hematology and Oncology Department, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain
| | | | - Margarita Llavador
- Pathology Department, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain
| | - Gerard Frigola
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Noelia García
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Blanca González-Farré
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Idoia Martín-Guerrero
- Department of Genetics, Physics Anthropology and Animal Physiology, Faculty of Science and Technology, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Leioa, Spain
- Department of Pediatrics, Osakidetza, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain
- Departament of Pediatrics, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Leioa, Spain
| | - Carmen Garrido-Colino
- Pediatric Oncology and Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Itziar Astigarraga
- Department of Pediatrics, Osakidetza, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain
- Departament of Pediatrics, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Leioa, Spain
| | - Alba Fernández
- Pediatric Oncology and Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jaime Verdú-Amorós
- Pediatric Oncology and Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Soledad González-Muñíz
- Pediatric Oncology and Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Berta González
- Pediatric Hematology and Oncology Department, Hospital Universitario La Paz, Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
| | - Verónica Celis
- Pediatric Oncology and Hematology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Elías Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Olga Balagué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
- Hematopathology Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red-Oncología, Madrid, Spain
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5
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Frigola G, Bühler M, Marginet M, Enjuanes A, Nadeu F, Papaleo N, Salido M, Haralambieva E, Alamo J, Garcia-Bragado F, Álvarez R, Ramos R, Aldecoa I, Campo E, Colomo L, Balagué O. MYC and TP53 Alterations but Not MAPK Pathway Mutations Are Common Oncogenic Mechanisms in Follicular Dendritic Cell Sarcomas. Arch Pathol Lab Med 2023; 147:896-906. [PMID: 36355424 DOI: 10.5858/arpa.2021-0517-oa] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 07/28/2023]
Abstract
CONTEXT.— Despite their stromal origin, follicular dendritic cells (FDCs) share many functions with hematopoietic system cells. FDC neoplasms are currently classified by the World Health Organization along with those of a histiocytic nature. However, the molecular alterations driving oncogenesis in FDC sarcomas (FDCSs) are beginning to be unveiled and do not seem to concur with those described in histiocytic neoplasms, namely MAPK pathway activation. OBJECTIVE.— To identify molecular alterations driving tumorigenesis in FDCS. DESIGN.— We investigated the role of MYC and TP53 in FDC-derived tumor oncogenesis and assessed comprehensively the status of the MAPK pathway in 16 FDCSs, 6 inflammatory pseudotumor (IPT)-like FDCSs, and 8 IPTs. RESULTS.— MYC structural alterations (both amplifications and rearrangements) were identified in 5 of 14 FDCSs (35.7%), all associated with MYC overexpression. TP53 mutations were identified in 4 of 14 FDCSs (28.6%), all of which displayed intense and diffuse p53 expression. None of these alterations were identified in any IPT-like FDCSs or in IPT cases. No MAPK pathway gene alterations were identified in any of the cases studied. CONCLUSIONS.— The presence of MYC and TP53 alterations and the lack of association with Epstein-Barr virus segregate classical FDCS from IPT-like FDCS, pointing at different oncogenic mechanisms in both entities. Our results suggest a possible oncogenic role of MYC and TP53 alterations in FDCS. The absence of MAPK pathway alterations confirms the lack of a significant role of this pathway in the oncogenesis of FDC-derived neoplasms.
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Affiliation(s)
- Gerard Frigola
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
| | - Marco Bühler
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Department of Pathology, University Hospital Zürich, Zürich, Switzerland (Bühler, Haralambieva)
| | - Marta Marginet
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Anna Enjuanes
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
| | - Ferran Nadeu
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
| | - Natalia Papaleo
- The Department of Pathology, Parc Taulí Hospital Universitari, Sabadell, Spain (Papaleo)
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
- The Department of Diagnostic Fundamentals, University Pompeu Fabra, Barcelona, Spain (Papaleo, Colomo)
| | - Marta Salido
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
| | - Eugenia Haralambieva
- The Department of Pathology, University Hospital Zürich, Zürich, Switzerland (Bühler, Haralambieva)
| | - José Alamo
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Federico Garcia-Bragado
- The Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain (Garcia-Bragado)
| | - Ramiro Álvarez
- The Department of Pathology, Hospital Universitario Miguel Servet, Zaragoza, Spain (Álvarez)
| | - Rafael Ramos
- The Department of Pathology, Hospital Universitari Son Espases, Palma de Mallorca, Spain (Ramos)
| | - Iban Aldecoa
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Elías Campo
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
- The Department of Clinical Fundamentals, University of Barcelona, Barcelona, Spain (Campo, Balagué)
| | - Lluis Colomo
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
- The Department of Diagnostic Fundamentals, University Pompeu Fabra, Barcelona, Spain (Papaleo, Colomo)
| | - Olga Balagué
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
- The Department of Clinical Fundamentals, University of Barcelona, Barcelona, Spain (Campo, Balagué)
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6
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Salmerón-Villalobos J, Ramis-Zaldivar JE, Balagué O, Verdú-Amorós J, Celis V, Sábado C, Garrido M, Mato S, Uriz J, Ortega MJ, Gutierrez-Camino A, Sinnett D, Illarregi U, Carron M, Regueiro A, Galera A, Gonzalez-Farré B, Campo E, Garcia N, Colomer D, Astigarraga I, Andrés M, Llavador M, Martin-Guerrero I, Salaverria I. Diverse mutations and structural variations contribute to Notch signaling deregulation in paediatric T-cell lymphoblastic lymphoma. Pediatr Blood Cancer 2022; 69:e29926. [PMID: 36000950 DOI: 10.1002/pbc.29926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND T-cell lymphoblastic lymphoma (T-LBL) is an aggressive neoplasm closely related to T-cell acute lymphoblastic leukaemia (T-ALL). Despite their similarities, and contrary to T-ALL, studies on paediatric T-LBL are scarce and, therefore, its molecular landscape has not yet been fully elucidated. Thus, the aims of this study were to characterize the genetic and molecular heterogeneity of paediatric T-LBL and to evaluate novel molecular markers differentiating this entity from T-ALL. PROCEDURE Thirty-three paediatric T-LBL patients were analyzed using an integrated approach, including targeted next-generation sequencing, RNA-sequencing transcriptome analysis and copy-number arrays. RESULTS Copy number and mutational analyses allowed the detection of recurrent homozygous deletions of 9p/CDKN2A (78%), trisomy 20 (19%) and gains of 17q24-q25 (16%), as well as frequent mutations of NOTCH1 (62%), followed by the BCL11B (23%), WT1 (19%) and FBXW7, PHF6 and RPL10 genes (15%, respectively). This genetic profile did not differ from that described in T-ALL in terms of mutation incidence and global genomic complexity level, but unveiled virtually exclusive 17q25 gains and trisomy 20 in T-LBL. Additionally, we identified novel gene fusions in paediatric T-LBL, including NOTCH1-IKZF2, RNGTT-SNAP91 and DDX3X-MLLT10, the last being the only one previously described in T-ALL. Moreover, clinical correlations highlighted the presence of Notch pathway alterations as a factor related to favourable outcome. CONCLUSIONS In summary, the genomic landscape of paediatric T-LBL is similar to that observed in T-ALL, and Notch signaling pathway deregulation remains the cornerstone in its pathogenesis, including not only mutations but fusion genes targeting NOTCH1.
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Affiliation(s)
- Julia Salmerón-Villalobos
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Joan Enric Ramis-Zaldivar
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Olga Balagué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain.,Haematopathology Unit, Hospital Clínic, Barcelona, Spain
| | | | - Verónica Celis
- Paediatric Oncology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Constantino Sábado
- Paediatric Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Marta Garrido
- Anatomic Pathology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Sara Mato
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Javier Uriz
- Paediatric Oncohaematology Department, Donostia University Hospital, Biodonostia Health Research Institute, San Sebastian, Spain
| | - M José Ortega
- Paediatric Oncology Department, Hospital Universitario Virgen de la Nieves, Granada, Spain
| | | | - Daniel Sinnett
- Division of Haematology-Oncology, CHU Sainte-Justine Research Center, Montreal, Canada.,Department of Paediatrics, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Unai Illarregi
- Genetics, Physics Anthropology and Animal Physiology, Faculty of Science and Technology, UPV/EHU, Leioa, Spain
| | - Máxime Carron
- Division of Haematology-Oncology, CHU Sainte-Justine Research Center, Montreal, Canada
| | - Alexandra Regueiro
- Paediatric Haematology and Oncology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Galera
- Paediatric Oncohaematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Blanca Gonzalez-Farré
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain.,Haematopathology Unit, Hospital Clínic, Barcelona, Spain
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain.,Haematopathology Unit, Hospital Clínic, Barcelona, Spain
| | - Noelia Garcia
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Dolors Colomer
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain.,Haematopathology Unit, Hospital Clínic, Barcelona, Spain
| | - Itziar Astigarraga
- Paediatric Department, Osakidetza, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Barakaldo, Spain.,Paediatric Department, Universidad del Pais Vasco UPV/EHU, Leioa, Spain
| | - Mara Andrés
- Paediatric Oncology Department, Hospital La Fe, Valencia, Spain
| | | | - Idoia Martin-Guerrero
- Biocruces Bizkaia Health Research Institute, Department of Genetics, Physical Anthropology & Animal Physiology, Science and Technology Faculty, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
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7
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Mato S, Salmerón-Villalobos J, de Anta NC, Ramis-Zaldivar J, Garcia N, Wang L, Colmenero A, Verdú J, Andrés M, Celis V, Ortega M, Campo E, Balagué O, Salaverria I. REFINING THE GENETIC LANDSCAPE OF AGGRESSIVE B-CELL LYMPHOMA BY INTEGRATIVE MOLECULAR ANALYSIS. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00268-5] [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: 11/05/2022]
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8
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Salmeron J, Castrejón-de-Anta N, Guerra-Garcia P, Ramis-Zaldivar JE, López-Guerra M, Colomer D, Diaz-Crespo F, Garrido M, Menarguez J, del Mar Andrés M, Garcia-Fernandez E, Llavador M, Garcia N, Gonzalez-Farré B, Martin-Guerrero I, Garrido C, Astigarraga I, Fernández A, Verdú-Amorós J, González-Muñíz S, Gonzalez B, Celis V, Campo E, Balagué O, Salaverria I. Abstract 2502: Unravelling the heterogenous molecular landscape of pediatric post-transplant lymphoproliferative disorders. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2502] [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: 11/16/2022]
Abstract
Abstract
The genetic landscape of post-transplant lymphoproliferative disorders (PTLD) in pediatric population has not been fully elucidated. This absence of information raises the question whether therapeutic strategies should be the same as for their counterparts in immunocompetent (IC) patients. The aim of this study was to characterize genetically and immunophenotypically pediatric monomorphic PTLD.
Thirty-nine monomorphic PTLD ≤19 years-old (mean 10y, gender 25 male/14 female) were recruited and analyzed for germinal center markers, IRF4 and EBER expression. Presence of MYC, PAX5, IRF4, BCL2, BCL6 and 11q alterations was investigated by FISH. Additional molecular studies included clonality, copy number (CN) arrays, cell of origin-COO (Nanostring) and mutational analyses (Custom 167 lymphoma related genes panel, SureSelectXT, Agilent).
Twenty-nine patients received solid organ transplantation and eight were hematopoietic stem cell transplant recipients. The mean time from transplant to PTLD diagnosis was 34 months (range 2-170) and the estimated 5-year overall survival (5y-OS) rate was 67%. Patients that received a solid organ had a better prognosis than hematopoietic stem cell transplant recipients (5y-OS 83% vs. 38%, p=0.03).
Thirty-three cases were classified as diffuse large B-cell lymphoma (DLBCL) and six as Burkitt lymphoma (BL). Thirty-two cases had extranodal localization, 21 of which in the gastrointestinal tract. Among the DLBCL, 24/28 cases had an ABC/non-GC COO phenotype and the six BL were GCB. EBER was positive in 33/37 cases. Five out of six BL and one DLBCL had MYC rearrangements, while no 11q alterations or other rearrangements were observed.
Ten out of the 23 pediatric monomorphic PTLD studied displayed CN alterations (mean 1.6 alt/case; range 0-12). Comparative analyses showed that pediatric PTLD had lower genetic complexity than BL (Scholtysik, 2010) and DLBCL (Ramis-Zaldivar, 2020) in IC patients and adult-PTLD (Ferreiro, 2016; Rinaldi, 2010) and lacked characteristic CN alterations of those groups. Regarding the mutational profile, all 6 PTLD-BL carried MYC mutations in addition to ID3 (4 cases), ARID1A (2 cases) or CCND3 (1 case) and a higher mutational burden than PTLD-DLBCL (12.3 vs 6.2, p=0.01). PTLD-DLBCL showed a very heterogeneous profile characterized by a lower number of mutations than their counterparts in IC patients (2.4 vs 6.5, p=0.01). Pathway enrichment analysis revealed that epigenetic modifiers and NOTCH pathway (4 cases each) were the most recurrently affected. Two out of 20 cases were classified as N1 according to LymphGen (Wright, 2020) algorithm while the rest remained undetermined.
The mutational profile of pediatric PTLD-BL is similar to that observed in IC patients whereas PTLD-DLBCL are less complex than their counterpart in IC children and present a very heterogeneous mutational landscape with enrichment in NOTCH pathway mutations.
Citation Format: Julia Salmeron, Natalia Castrejón-de-Anta, Pilar Guerra-Garcia, Joan Enric Ramis-Zaldivar, Mónica López-Guerra, Dolors Colomer, Francisco Diaz-Crespo, Marta Garrido, Javier Menarguez, Maria del Mar Andrés, Eugenia Garcia-Fernandez, Margarita Llavador, Noelia Garcia, Blanca Gonzalez-Farré, Idoia Martin-Guerrero, Carmen Garrido, Itziar Astigarraga, Alba Fernández, Jaime Verdú-Amorós, Soledad González-Muñíz, Berta Gonzalez, Verónica Celis, Elias Campo, Olga Balagué, Itziar Salaverria. Unravelling the heterogenous molecular landscape of pediatric post-transplant lymphoproliferative disorders [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2502.
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Affiliation(s)
- Julia Salmeron
- 1Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Barcelona; Madrid, Spain
| | | | | | - Joan Enric Ramis-Zaldivar
- 1Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Barcelona; Madrid, Spain
| | - Mónica López-Guerra
- 4Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC); Hospital Clínic de Barcelona, Barcelona; Madrid, Spain
| | | | | | - Marta Garrido
- 6Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Margarita Llavador
- 7Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain
| | - Noelia Garcia
- 8Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Blanca Gonzalez-Farré
- 4Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC); Hospital Clínic de Barcelona, Barcelona; Madrid, Spain
| | | | - Carmen Garrido
- 5Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | | | | | | | - Elias Campo
- 14Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC); Hospital Clínic de Barcelona, Barcelona, Madrid, Spain
| | - Olga Balagué
- 14Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC); Hospital Clínic de Barcelona, Barcelona, Madrid, Spain
| | - Itziar Salaverria
- 15Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Barcelona, Madrid, Spain
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9
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Ortiz-Maldonado V, Frigola G, Español-Rego M, Balagué O, Martínez-Cibrián N, Magnano L, Giné E, Pascal M, Correa JG, Martínez-Roca A, Cid J, Lozano M, Villamor N, Benítez-Ribas D, Esteve J, López-Guillermo A, Campo E, Urbano-Ispizua Á, Juan M, Delgado J. Results of ARI-0001 CART19 Cells in Patients With Chronic Lymphocytic Leukemia and Richter’s Transformation. Front Oncol 2022; 12:828471. [PMID: 35174095 PMCID: PMC8841853 DOI: 10.3389/fonc.2022.828471] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 12/11/2022] Open
Abstract
CART19 cells are emerging as an alternative therapy for patients with chronic lymphocytic leukemia (CLL). Here we report the outcome of nine consecutive patients with CLL treated with ARI-0001 CART19 cells, six of them with Richter’s transformation (RT). One patient with RT never received therapy. The cytokine release syndrome rate was 87.5% (12.5% grade ≥3). Neurotoxicity was not observed in any patient. All patients experienced absolute B-cell aplasia, and seven (87.5%) responded to therapy. With a median follow-up of 5.6 months, two patients with RT experienced a CD19-negative relapse. In conclusion, ARI-0001 cell therapy was feasible, safe, and effective in patients with high-risk CLL or RT.
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Affiliation(s)
- Valentín Ortiz-Maldonado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gerard Frigola
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Español-Rego
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Olga Balagué
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Mariona Pascal
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Juan G. Correa
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Joan Cid
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis & Cell Therapy Unit, Department of Hemotherapy and Hemostasis, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Apheresis & Cell Therapy Unit, Department of Hemotherapy and Hemostasis, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Neus Villamor
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniel Benítez-Ribas
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Stem Cell Transplant and Cell Immunotherapy Group, Institute of Research Josep Carreras, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Elías Campo
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Hematopathology Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Álvaro Urbano-Ispizua
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Stem Cell Transplant and Cell Immunotherapy Group, Institute of Research Josep Carreras, Barcelona, Spain
| | - Manel Juan
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Immunology, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
- Oncology and Hematology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- *Correspondence: Julio Delgado,
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10
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Vidal-Robau N, Caballero G, Archilla I, Ladino A, Fernández S, Ortiz-Maldonado V, Rovira M, Gómez-Hernando M, Delgado J, Suárez-Lledó M, Fernández de Larrea C, Balagué O, Frigola G, Muñoz A, Ortiz E, Ribalta T, Martinez MJ, Angeles-Marcos M, Español-Rego M, González A, Benitez-Ribas D, Martinez-Hernandez E, Castro P, Aldecoa I. Post-mortem neuropathologic examination of a 6-case series of CAR T-cell treated patients. Free Neuropathol 2022; 3:3-23. [PMID: 37284165 PMCID: PMC10210002 DOI: 10.17879/freeneuropathology-2022-4365] [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] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 06/08/2023]
Abstract
Introduction: Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapy for the treatment of refractory hematopoietic malignancies. Adverse events are common, and neurotoxicity is one of the most important. However, the physiopathology is unknown and neuropathologic information is scarce. Materials and methods: Post-mortem examination of 6 brains from patients that underwent CAR T-cell therapy from 2017 to 2022. In all cases, polymerase chain reaction (PCR) in paraffin blocks for the detection of CAR T cells was performed. Results: Two patients died of hematologic progression, while the others died of cytokine release syndrome, lung infection, encephalomyelitis, and acute liver failure. Two out of 6 presented neurological symptoms, one with extracranial malignancy progression and the other with encephalomyelitis. The neuropathology of the latter showed severe perivascular and interstitial lymphocytic infiltration, predominantly CD8+, together with a diffuse interstitial histiocytic infiltration, affecting mainly the spinal cord, midbrain, and hippocampus, and a diffuse gliosis of basal ganglia, hippocampus, and brainstem. Microbiological studies were negative for neurotropic viruses, and PCR failed to detect CAR T -cells. Another case without detectable neurological signs showed cortical and subcortical gliosis due to acute hypoxic-ischemic damage. The remaining 4 cases only showed a mild patchy gliosis and microglial activation, and CAR T cells were detected by PCR only in one of them. Conclusions: In this series of patients that died after CAR T-cell therapy, we predominantly found non-specific or minimal neuropathological changes. CAR T-cell related toxicity may not be the only cause of neurological symptoms, and the autopsy could detect additional pathological findings.
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Affiliation(s)
- Nuria Vidal-Robau
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Gabriela Caballero
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Ivan Archilla
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Andrea Ladino
- Medical Intensive Care Unit, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Sara Fernández
- Medical Intensive Care Unit, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Valentín Ortiz-Maldonado
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Marta Gómez-Hernando
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - María Suárez-Lledó
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Carlos Fernández de Larrea
- Haematology Department, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
- August Pi Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Olga Balagué
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Gerard Frigola
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Abel Muñoz
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Estrella Ortiz
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Teresa Ribalta
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Miguel J Martinez
- Microbiology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Maria Angeles-Marcos
- Microbiology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Marta Español-Rego
- Immunology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Azucena González
- Immunology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | - Daniel Benitez-Ribas
- Immunology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
| | | | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
- August Pi Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Iban Aldecoa
- Pathology Department, Biomedical Diagnostic Centre (CDB), Hospital Clinic of Barcelona - University of Barcelona, Barcelona, Spain
- Neurological Tissue Bank, Biobank of Hospital Clinic of Barcelona - IDIBAPS, Barcelona, Spain
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11
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Au-Yeung RKH, Richter J, Iaccarino I, Abramov D, Bacon CM, Balagué O, d'Amore ESG, Simonitsch-Klupp I, Hebeda K, Nakazawa A, Oschlies I, Kontny U, Woessmann W, Burkhardt B, Klapper W. Molecular features of non-anaplastic peripheral T-cell lymphoma in children and adolescents. Pediatr Blood Cancer 2021; 68:e29285. [PMID: 34390161 DOI: 10.1002/pbc.29285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 04/27/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022]
Abstract
Non-anaplasticperipheral T-cell lymphomas (PTCL) are rare tumors in children, adolescents, and young adults (CAYA) with poor prognosis and scarce genetic data. We analyzed lymphoma tissue from 36 patients up to 18 years old with PTCL, not otherwise specified (PTCL-NOS), hepatosplenic T-cell lymphoma, Epstein-Barr virus (EBV)-positive T-lymphoproliferative diseases, subcutaneous panniculitis-like T-cell lymphoma, and other PTCL types. Twenty-three patients (64%) had at least one genetic variant detectable, including TET2, KMT2C, PIK3D, and DMNT3A. TP53 and RHOA variants, commonly found in adults, were not identified. Eight of 20 (40%) CAYA PTCL-NOS had no detectable mutations. The genetic findings suggest that CAYA PTCL differ from adult cases.
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Affiliation(s)
- Rex K H Au-Yeung
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Pathology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Julia Richter
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ingram Iaccarino
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, Kiel, Germany
| | - Dmitriy Abramov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Chris M Bacon
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust and Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Olga Balagué
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | | | - Konnie Hebeda
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Ilske Oschlies
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, Kiel, Germany
| | - Udo Kontny
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, University Medical Center Aachen, Aachen, Germany
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Burkhardt
- Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry, University of Kiel/University Hospital Schleswig-Holstein, Kiel, Germany
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12
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Dlouhy I, Karube K, Enjuanes A, Salaverria I, Nadeu F, Ramis-Zaldivar JE, Valero JG, Rivas-Delgado A, Magnano L, Martin-García D, Pérez-Galán P, Clot G, Rovira J, Jares P, Balagué O, Giné E, Mozas P, Briones J, Sancho JM, Salar A, Mercadal S, Alcoceba M, Valera A, Campo E, López-Guillermo A. Revised International Prognostic Index and genetic alterations are associated with early failure to R-CHOP in patients with diffuse large B-cell lymphoma. Br J Haematol 2021; 196:589-598. [PMID: 34632572 DOI: 10.1111/bjh.17858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/26/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
Relapsed or refractory diffuse large B-cell lymphoma (DLBCL) cases have a poor outcome. Here we analysed clinico-biological features in 373 DLBCL patients homogeneously treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP), in order to identify variables associated with early failure to treatment (EF), defined as primary refractoriness or relapse within 12 months from diagnosis. In addition to clinical features, mutational status of 106 genes was studied by targeted next-generation sequencing in 111 cases, copy number alterations in 87, and gene expression profile (GEP) in 39. Ninety-seven cases (26%) were identified as EF and showed significantly shorter overall survival (OS). Patients with B symptoms, advanced stage, high levels of serum lactate dehydrogenase (LDH) or β2-microglobulin, low lymphocyte/monocyte ratio and higher Revised International Prognostic Index (R-IPI) scores, as well as those with BCL2 rearrangements more frequently showed EF, with R-IPI being the most important in logistic regression. Mutations in NOTCH2, gains in 5p15·33 (TERT), 12q13 (CDK2), 12q14·1 (CDK4) and 12q15 (MDM2) showed predictive importance for EF independently from R-IPI. GEP studies showed that EF cases were significantly enriched in sets related to cell cycle regulation and inflammatory response, while cases in response showed over-representation of gene sets related to extra-cellular matrix and tumour microenvironment.
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Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Kennosuke Karube
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Cell Biology & Pathology Department, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
| | - Anna Enjuanes
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Itziar Salaverria
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ferran Nadeu
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Enric Ramis-Zaldivar
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan G Valero
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - David Martin-García
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Patricia Pérez-Galán
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Guillem Clot
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Jordina Rovira
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Pedro Jares
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olga Balagué
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain
| | - Pablo Mozas
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | - Miguel Alcoceba
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Hospital Clínico Universitario, Salamanca, Spain
| | - Alexandra Valera
- Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elías Campo
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,Institut d`Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Tumores Hematológicos, Madrid, Spain.,University of Barcelona, Barcelona, Spain
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13
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Bastidas-Mora G, Beà S, Navarro A, Gine E, Costa D, Delgado J, Baumann T, Magnano L, Rivas-Delgado A, Villamor N, Colomer D, Lopez-Guerra M, Rozman M, Balagué O, Martínez D, Baptista MJ, Escoda L, Alcoceba M, Blanes M, Climent F, Campo E, Wotherspoon A, López-Guillermo A, Matutes E. Clinico-biological features and outcome of patients with splenic marginal zone lymphoma with histological transformation. Br J Haematol 2021; 196:146-155. [PMID: 34519021 PMCID: PMC9292151 DOI: 10.1111/bjh.17815] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 12/04/2022]
Abstract
We describe 36 patients with splenic marginal zone lymphoma (SMZL) with transformation (SMZL‐T), including 15 from a series of 84 patients with SMZL diagnosed at the Hospital Clinic of Barcelona (HCB) and 21 diagnosed with SMZL‐T in other centres. In the HCB cohort, the cumulative incidence of transformation at 5 years was 15%. Predictors for transformation were cytopenias, hypoalbuminaemia, complex karyotype (CK) and both the Intergruppo Italiano Linfomi (ILL) and simplified Haemoglobin, Platelet count, lactate dehydrogenase (LDH) and extrahilar Lymphadenopathy (HPLL)/ABC scores (P < 0·05). The only independent predictor for transformation in multivariate analysis was CK [hazard ratio (HR) 4·025, P = 0·05]. Patients with SMZL‐T had a significantly higher risk of death than the remainder (HR 3·89, P < 0·001). Of the 36 patients with SMZL‐T, one developed Hodgkin lymphoma and 35 a diffuse large B‐cell lymphoma, 71% with a non‐germinal centre phenotype. The main features were B symptoms, lymphadenopathy, and high serum LDH. CK was observed in 12/22 (55%) SMZL‐T and fluorescence in situ hybridisation detected abnormalities of MYC proto‐oncogene, basic helix‐loop‐helix transcription factor (MYC), B‐cell leukaemia/lymphoma 2 (BCL2) and/or BCL6 in six of 14 (43%). In all, 21 patients received immunochemotherapy, six chemotherapy, one radiotherapy and three splenectomy. The complete response (CR) rate was 61% and the median survival from transformation was 4·92 years. Predictors for a worse survival in multivariate analysis were high‐risk International Prognostic Index (HR 5·294, P = 0·016) and lack of CR (HR 2·67, P < 0·001).
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Affiliation(s)
- Gabriela Bastidas-Mora
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Sílvia Beà
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Alba Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Eva Gine
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Dolors Costa
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Julio Delgado
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Tycho Baumann
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Servicio de Hematología, Hospital 12 de Octubre, Madrid, Spain
| | - Laura Magnano
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Neus Villamor
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Dolors Colomer
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Mónica Lopez-Guerra
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - María Rozman
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olga Balagué
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Daniel Martínez
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Maria Joao Baptista
- ICO-Hospital Germans Trias I Pujol- Josep Carreras Leukaemia Research Institute (IJC), Barcelona, Spain
| | | | - Miguel Alcoceba
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Department of Hematology, Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), University Hospital of Salamanca (HUS/IBSAL), Salamanca, Spain
| | | | - Fina Climent
- Department of Pathology, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Elías Campo
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Armando López-Guillermo
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Estella Matutes
- Hematology Department and Hematopathology Section, Pathology Department, Hospital Clínic of Barcelona, Barcelona, Spain
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14
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Frauenfeld L, Castrejon‐de‐Anta N, Ramis‐Zaldivar JE, Otto F, Streich S, Salmerón‐Villalobos J, Mayer A, Steinhilber J, Pinyol M, Mankel B, Bonzheim I, Fend F, Rimza L, Salaverria I, Campo E, Balagué O, Quintanilla‐Martinez L. TRIPLE POSITIVE (CD10+BCL6+MUM1+) DIFFUSE LARGE B‐CELL LYMPHOMAS IN ADULTS ARE A HETEROGENEOUS GROUP ENRICHED IN LARGE B‐CELL LYMPHOMAS WITH
IRF4
REARRANGEMENT. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- L. Frauenfeld
- University of Tübingen Institute for Pathology Tübingen Germany
| | | | - J. E. Ramis‐Zaldivar
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) Barcelona Spain
| | - F. Otto
- University of Tübingen Institute for Pathology Tübingen Germany
| | - S. Streich
- University of Tübingen Institute for Pathology Tübingen Germany
| | - J. Salmerón‐Villalobos
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) Barcelona Spain
| | - A. Mayer
- University of Tübingen Institute for Pathology Tübingen Germany
| | - J. Steinhilber
- University of Tübingen Institute for Pathology Tübingen Germany
| | - M. Pinyol
- Hospital Clínic de Barcelona Hematopathology Unit Barcelona Spain
| | - B. Mankel
- University of Tübingen Institute for Pathology Tübingen Germany
| | - I. Bonzheim
- University of Tübingen Institute for Pathology Tübingen Germany
| | - F. Fend
- University of Tübingen Institute for Pathology Tübingen Germany
| | - L. Rimza
- Mayo Clinic Division of Hematopathology Phoenix AZ USA
| | - I. Salaverria
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) Barcelona Spain
| | - E. Campo
- Hospital Clínic de Barcelona Hematopathology Unit Barcelona Spain
| | - O. Balagué
- Hospital Clínic de Barcelona Hematopathology Unit Barcelona Spain
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15
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Valero JG, Matas-Céspedes A, Arenas F, Rodriguez V, Carreras J, Serrat N, Guerrero-Hernández M, Yahiaoui A, Balagué O, Martin S, Capdevila C, Hernández L, Magnano L, Rivas-Delgado A, Tannheimer S, Cid MC, Campo E, López-Guillermo A, Colomer D, Pérez-Galán P. The receptor of the colony-stimulating factor-1 (CSF-1R) is a novel prognostic factor and therapeutic target in follicular lymphoma. Leukemia 2021; 35:2635-2649. [PMID: 33731849 PMCID: PMC8410584 DOI: 10.1038/s41375-021-01201-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 08/18/2020] [Revised: 02/03/2021] [Accepted: 02/18/2021] [Indexed: 01/31/2023]
Abstract
Microenvironment contributes to follicular lymphoma (FL) pathogenesis and impacts survival with macrophages playing a controversial role. In the present study, using FL primary samples and HK follicular dendritic cells (FDC) to mimic the germinal center, together with mouse models, we have analyzed the three-way crosstalk of FL-FDC-macrophages and derived therapeutic opportunities. Ex vivo primary FL-FDC co-cultures (n = 19) and in vivo mouse co-xenografts demonstrated that FL-FDC crosstalk favors tumor growth and, via the secretion of CCL2 and CSF-1, promotes monocyte recruitment, differentiation, and polarization towards an M2-like protumoral phenotype. Moreover, FL-M2 co-cultures displayed enhanced angiogenesis, dissemination, and immunosuppression. Analysis of the CSF-1/CSF-1R pathway uncovered that CSF-1 was significantly higher in serum from grade 3A FL patients, and that high CSF-1R expression in FL biopsies correlated with grade 3A, reduced overall survival and risk of transformation. Furthermore, CSF-1R inhibition with pexidartinib (PLX3397) preferentially affected M2-macrophage viability and polarization program disrupting FL-M2 positive crosstalk. In vivo CSF1-R inhibition caused M2 reduction and repolarization towards M1 macrophages and antitumor effect cooperating with anti-CD20 rituximab. In summary, these results support the role of macrophages in FL pathogenesis and indicate that CSF-1R may be a relevant prognostic factor and a novel therapeutic target cooperating with anti-CD20 immunotherapy.
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Affiliation(s)
- Juan Garcia Valero
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Alba Matas-Céspedes
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain ,grid.417815.e0000 0004 5929 4381Present Address: Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Fabián Arenas
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Vanina Rodriguez
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.415306.50000 0000 9983 6924Present Address: Garvan Institute of Medical Research, Sydney, Australia
| | - Joaquim Carreras
- grid.265061.60000 0001 1516 6626Department of Pathology, Tokai University, School of Medicine, Isehara, Kanagawa Japan
| | - Neus Serrat
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain
| | - Martina Guerrero-Hernández
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.11478.3bPresent Address: Department of Gene Regulation, Stem Cells and Cancer Center for Genomic Regulation (CRG-PRBB), Barcelona, Spain
| | - Anella Yahiaoui
- grid.418227.a0000 0004 0402 1634Gilead Sciences, Inc, Foster City, USA
| | - Olga Balagué
- grid.410458.c0000 0000 9635 9413Hematopathology Unit, Pathology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Silvia Martin
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Cristina Capdevila
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain
| | - Lluis Hernández
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
| | - Laura Magnano
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Department of Hematology, Hospital Clinic -IDIBAPS, Barcelona, Spain
| | - Alfredo Rivas-Delgado
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Department of Hematology, Hospital Clinic -IDIBAPS, Barcelona, Spain
| | - Stacey Tannheimer
- grid.418227.a0000 0004 0402 1634Gilead Sciences, Inc, Foster City, USA
| | - Maria C. Cid
- Department of Autoimmune Diseases, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Elías Campo
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hematopathology Unit, Pathology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain ,grid.5841.80000 0004 1937 0247University of Barcelona, Medical School, Barcelona, Spain
| | - Armando López-Guillermo
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Department of Hematology, Hospital Clinic -IDIBAPS, Barcelona, Spain ,grid.5841.80000 0004 1937 0247University of Barcelona, Medical School, Barcelona, Spain
| | - Dolors Colomer
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hematopathology Unit, Pathology Department, Hospital Clínic-IDIBAPS, Barcelona, Spain ,grid.5841.80000 0004 1937 0247University of Barcelona, Medical School, Barcelona, Spain
| | - Patricia Pérez-Galán
- grid.10403.36Department of Hematology-Oncology, IDIBAPS, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Madrid, Spain
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16
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Rivas-Delgado A, Nadeu F, Enjuanes A, Casanueva-Eliceiry S, Mozas P, Magnano L, Castrejón de Anta N, Rovira J, Dlouhy I, Martín S, Osuna M, Rodríguez S, Simó M, Pinyol M, Baumann T, Beà S, Balagué O, Delgado J, Villamor N, Setoain X, Campo E, Giné E, López-Guillermo A. Mutational Landscape and Tumor Burden Assessed by Cell-free DNA in Diffuse Large B-Cell Lymphoma in a Population-Based Study. Clin Cancer Res 2020; 27:513-521. [PMID: 33122345 DOI: 10.1158/1078-0432.ccr-20-2558] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/29/2020] [Accepted: 10/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We analyzed the utility of cell-free DNA (cfDNA) in a prospective population-based cohort to determine the mutational profile, assess tumor burden, and estimate its impact in response rate and outcome in patients with diffuse large B-cell lymphoma (DLBCL). EXPERIMENTAL DESIGN A total of 100 patients were diagnosed with DLBCL during the study period. Mutational status of 112 genes was studied in cfDNA by targeted next-generation sequencing. Paired formalin-fixed, paraffin-embedded samples and volumetric PET/CT were assessed when available. RESULTS Appropriate cfDNA to perform the analyses was obtained in 79 of 100 cases. At least one mutation could be detected in 69 of 79 cases (87%). The sensitivity of cfDNA to detect the mutations was 68% (95% confidence interval, 56.2-78.7). The mutational landscape found in cfDNA samples was highly consistent with that shown in the tissue and allowed genetic classification in 43% of the cases. A higher amount of circulating tumor DNA (ctDNA) significantly correlated with clinical parameters related to tumor burden (elevated lactate dehydrogenase and β2-microglobulin serum levels, advanced stage, and high-risk International Prognostic Index) and total metabolic tumor volume assessed by PET/CT. In patients treated with curative intent, high ctDNA levels (>2.5 log hGE/mL) were associated with lower complete response (65% vs. 96%; P < 0.004), shorter progression-free survival (65% vs. 85%; P = 0.038), and overall survival (73% vs. 100%; P = 0.007) at 2 years, although it did not maintain prognostic value in multivariate analyses. CONCLUSIONS In a population-based prospective DLBCL series, cfDNA resulted as an alternative source to estimate tumor burden and to determine the tumor mutational profile and genetic classification, which have prognostic implications and may contribute to a future tailored treatment.
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Affiliation(s)
- Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Anna Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | | | - Pablo Mozas
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Jordina Rovira
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ivan Dlouhy
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Martín
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain
| | - Miguel Osuna
- Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sonia Rodríguez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marc Simó
- Department of Nuclear Medicine, Instituto Universitario Dexeus, Grupo Quiron Salud, Barcelona, Spain
| | - Magda Pinyol
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Silvia Beà
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Olga Balagué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Neus Villamor
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Xavier Setoain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nuclear Medicine, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain
| | - Elías Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
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17
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Mozas P, Nadeu F, Rivas-Delgado A, Rivero A, Garrote M, Balagué O, González-Farré B, Veloza L, Baumann T, Giné E, Delgado J, Villamor N, Campo E, Magnano L, López-Guillermo A. Patterns of change in treatment, response, and outcome in patients with follicular lymphoma over the last four decades: a single-center experience. Blood Cancer J 2020; 10:31. [PMID: 32139690 PMCID: PMC7058022 DOI: 10.1038/s41408-020-0299-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/10/2020] [Accepted: 02/18/2020] [Indexed: 11/13/2022] Open
Abstract
Although the introduction of immunotherapy has improved outcomes for follicular lymphoma (FL) patients, histological transformation (HT) and early relapse still confer a poor prognosis. We sought to describe the patterns of change in treatment, response, and outcome of FL patients at our institution over the last four decades. Seven hundred and twenty-seven patients (389 F/338 M; median age, 57 years) consecutively diagnosed with grade 1-3a FL between 1980 and 2017, categorized into four decades according to the time of diagnosis, constituted the study population. Clinical characteristics, treatment, response, absolute and relative survival, HT, second malignancies (SM), and causes of death were assessed. Median OS for the entire cohort was 17.6 years. From decade 1 to 4, there was an increase in the complete response rate (48 to 70%), progression-free survival (40 to 56% at 5 years), OS (77 to 86% at 5 years), and relative survival ratio (0.83 to 0.94 at 5 years), with no significant differences in the risk of HT or SM. Lymphoma remained the most common cause of death in all four decades. These findings illustrate the overall improvement in outcome for FL patients, but support the need for further research into risk stratification and management.
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Affiliation(s)
- Pablo Mozas
- Department of Hematology, Hospital Clínic, Barcelona, Spain.
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | | | - Andrea Rivero
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Marta Garrote
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Olga Balagué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Blanca González-Farré
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Luis Veloza
- Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clínic, Barcelona, Spain
| | - Eva Giné
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain
| | - Neus Villamor
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Elías Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Laura Magnano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,Hematopathology Unit, Department of Pathology, Hospital Clínic, Barcelona, Spain
| | - Armando López-Guillermo
- Department of Hematology, Hospital Clínic, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.,University of Barcelona, Barcelona, Spain
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18
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Fuster C, Martín-Garcia D, Balagué O, Navarro A, Nadeu F, Costa D, Prieto M, Salaverria I, Espinet B, Rivas-Delgado A, Terol MJ, Giné E, Forcada P, Ashton-Key M, Puente XS, Swerdlow SH, Beà S, Campo E. Cryptic insertions of the immunoglobulin light chain enhancer region near CCND1 in t(11;14)-negative mantle cell lymphoma. Haematologica 2019; 105:e408-e411. [PMID: 31753927 DOI: 10.3324/haematol.2019.237073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Carla Fuster
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - David Martín-Garcia
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Olga Balagué
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | - Alba Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Dolors Costa
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Miriam Prieto
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Blanca Espinet
- Laboratori de Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain Grup de Recerca Translacional en Neoplàsies Hematològiques, Cancer Research Programme, IMIM-Hospital del Mar, Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Hematology Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria José Terol
- Department of Hematology, Hospital Clínico, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
| | - Eva Giné
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Department of Hematology Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pilar Forcada
- Department of Pathology, Hospital Mutua Terrassa, Terrassa, Spain
| | - Margaret Ashton-Key
- Department of Cellular Pathology, Southampton University Hospitals National Health Service Trust, UK
| | - Xose S Puente
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,Departamento de Bioquímica y Biología Molecular, IUOPA, Universidad de Oviedo, Oviedo, Spain
| | - Steven H Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sílvia Beà
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,University of Barcelona, Barcelona, Spain
| | - Elias Campo
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain .,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.,University of Barcelona, Barcelona, Spain
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19
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Rodríguez-Pinilla SM, García FJS, Balagué O, Rodríguez-Justo M, Piris MÁ. Breast implant-associated Epstein-Barr virus-positive large B-cell lymphomas: a report of three cases. Haematologica 2019; 105:e412-e414. [PMID: 31753922 DOI: 10.3324/haematol.2019.232355] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
| | | | - Olga Balagué
- Hospital Clinic of Barcelona, Pathology Department, Barcelona, Spain
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20
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Veloza L, Teixido C, Castrejon N, Climent F, Carrió A, Marginet M, Soldini D, González-Farré B, Ribera-Cortada I, Lopez-Guillermo A, González-Barca E, Sierra A, Herrera M, Gómez C, Garcia A, Balagué O, Campo E, Martinez A. Clinicopathological evaluation of the programmed cell death 1 (PD1)/programmed cell death-ligand 1 (PD-L1) axis in post-transplant lymphoproliferative disorders: association with Epstein-Barr virus, PD-L1 copy number alterations, and outcome. Histopathology 2019; 75:799-812. [PMID: 30861172 DOI: 10.1111/his.13857] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 10/17/2018] [Revised: 02/04/2019] [Accepted: 03/07/2019] [Indexed: 12/25/2022]
Abstract
AIMS The clinical implications of the programmed cell death 1 (PD1)/programmed cell death-ligand 1 (PD-L1) axis in patients with post-transplant lymphoproliferative disorders are largely unknown, and its association with Epstein-Barr virus (EBV) status and PD-L1 copy number alterations (CNAs) has not been thoroughly studied. METHODS AND RESULTS PD1/PD-L1 expression was studied in 50 adult post-transplant lymphoproliferative disorders, and the correlations with PD-L1 CNAs, EBV, clinicopathological features and outcome were evaluated. Thirty-seven (74%) cases were classified as diffuse large B-cell lymphoma (DLBCL), nine (18%) cases were classified as polymorphic, and four (8%) cases were classified as classic Hodgkin lymphoma. Thirty-four cases were EBV-positive, with 29 of 34 (85%) having latency II or III, and 15 of 34 (44%) having viral replication. PD-L1 expression in tumour cells and tumour-associated macrophages was observed in 30 (60%) and 37 (74%) cases, respectively. PD1 positivity was seen in 16 (32%) cases. PD-L1 expression was associated with EBV with latency II or III (P = 0.001) and organ rejection (P = 0.04), and, in DLBCL, with non-germinal centre type DLBCL (P < 0.001). Cases with PD-L1-positive tumour cells showed a higher number of PD-L1 CNAs than PD-L1-negative cases (P = 0.001). Patients with EBV/latency III/replication and simultaneous PD-L1 expression showed the worst overall survival (P < 0.001). CONCLUSIONS The PD1/PD-L1 axis is deregulated in post-transplant lymphoproliferative disorders, with frequent PD-L1 expression and PD1 negativity. PD-L1 expression is associated with EBV latency II or III and PD-L1 CNAs, and probably reflects a proinflammatory tumour microenvironment. The combined analysis of EBV status and PD-L1 expression may help to identify deeply immunosuppressed patients who can benefit from immune reconstitution approaches.
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Affiliation(s)
- Luis Veloza
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Cristina Teixido
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Natalia Castrejon
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fina Climent
- Department of Pathology, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Ana Carrió
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Marta Marginet
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Davide Soldini
- Institut für klinische Pathologie medica, Zürich, Switzerland
| | - Blanca González-Farré
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Inmaculada Ribera-Cortada
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.,Department of Pathology, Hospital Nostra Senyora de Meritxell, Escaldes-Engordany, Principat d'Andorra
| | - Armando Lopez-Guillermo
- Department of Haematology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Eva González-Barca
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Adriana Sierra
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Mileyka Herrera
- Fachbereich Pathologie, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Cándida Gómez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Adriana Garcia
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Olga Balagué
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Elias Campo
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Antonio Martinez
- Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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21
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Sangiorgio V, Veloza L, Galvis K, López M, Frigola G, Campo E, Balagué O. Kikuchi-Fujimoto disease and breast implants: is there a relationship? Haematologica 2019; 104:e581-e584. [PMID: 31582552 DOI: 10.3324/haematol.2019.229831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Luis Veloza
- Haematopathology Unit, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel, Barcelona, Spain and
| | - Karen Galvis
- Department of Pathology and Laboratory Medicine, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Mónica López
- Haematopathology Unit, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel, Barcelona, Spain and
| | - Gerard Frigola
- Haematopathology Unit, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel, Barcelona, Spain and
| | - Elias Campo
- Haematopathology Unit, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel, Barcelona, Spain and
| | - Olga Balagué
- Haematopathology Unit, Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Villarroel, Barcelona, Spain and
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22
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Rivas-Delgado A, Nadeu F, Enjuanes A, Magnano L, Castrejón de Anta N, Mozas P, Baumann T, Delgado J, Balagué O, Villamor N, Campo E, Giné E, López-Guillermo A. MUTATIONAL LANDSCAPE OF DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL) AT DIAGNOSIS AND AT PROGRESSION ASSESSED BY CIRCULATING TUMOR DNA ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.1_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- A. Rivas-Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - A. Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | | | - P. Mozas
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - T. Baumann
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - O. Balagué
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
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23
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Rivas-Delgado A, Nadeu F, Enjuanes A, Magnano L, Mozas P, Osuna M, Martín S, Baumann T, Castrejón de Anta N, Balagué O, Delgado J, Villamor N, Campo E, Giné E, López-Guillermo A. GENOTYPING PRIMARY MEDIASTINAL B-CELL LYMPHOMA (PMBCL) BY MEANS OF CIRCULATING TUMOR DNA ANALYSIS. Hematol Oncol 2019. [DOI: 10.1002/hon.9_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A. Rivas-Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - A. Enjuanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - P. Mozas
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - M. Osuna
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - S. Martín
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - T. Baumann
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | | | - O. Balagué
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Department of Pathology, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Department of Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology Department; Hospital Clínic de Barcelona; Barcelona Spain
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24
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Mozas P, Magnano L, Rivas-Delgado A, Rivero A, Nadeu F, Veloza L, González-Farré B, Baumann T, Balagué O, Giné E, Delgado J, Villamor N, Campo E, López-Guillermo A. PATTERNS OF CHANGE IN TREATMENT, SURVIVAL, HISTOLOGICAL TRANSFORMATION, AND SECONDARY MALIGNANCIES OF FOLLICULAR LYMPHOMA OVER THE LAST 4 DECADES: A SINGLE CENTER EXPERIENCE. Hematol Oncol 2019. [DOI: 10.1002/hon.66_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P. Mozas
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - L. Magnano
- Hematopathology Unit; Pathology Department, Hospital Clínic de Barcelona; Barcelona Spain
| | | | - A. Rivero
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - F. Nadeu
- Lymphoid Malignancies; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona Spain
| | - L. Veloza
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | | | - T. Baumann
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - O. Balagué
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Giné
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - J. Delgado
- Hematology; Hospital Clínic de Barcelona; Barcelona Spain
| | - N. Villamor
- Hematopathology Unit; Pathology Department, Hospital Clínic de Barcelona; Barcelona Spain
| | - E. Campo
- Pathology; Hospital Clínic de Barcelona; Barcelona Spain
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25
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Laurent C, Marçal AL, Prieto-González S, Balagué O, Morales X, Darnell A, Ripoll E, Cid MC, Hernández-Rodríguez J. HIV-associated vasculitis. Part II: histologic and angiographic diagnostic reconfirmation after an uncontrolled HIV infection and fatal outcome. Clin Exp Rheumatol 2019; 37 Suppl 117:151-152. [PMID: 31074723] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Charlotte Laurent
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Ana L Marçal
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Sergio Prieto-González
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Olga Balagué
- Department of Anatomic Pathology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Xavier Morales
- Department of Gastrointestinal Surgery, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Anna Darnell
- Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Enric Ripoll
- Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Maria C Cid
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - José Hernández-Rodríguez
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
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26
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Gonzalez-Farre B, Ramis-Zaldivar JE, Salmeron-Villalobos J, Balagué O, Celis V, Verdu-Amoros J, Nadeu F, Sábado C, Ferrández A, Garrido M, García-Bragado F, de la Maya MD, Vagace JM, Panizo CM, Astigarraga I, Andrés M, Jaffe ES, Campo E, Salaverria I. Burkitt-like lymphoma with 11q aberration: a germinal center-derived lymphoma genetically unrelated to Burkitt lymphoma. Haematologica 2019; 104:1822-1829. [PMID: 30733272 PMCID: PMC6717587 DOI: 10.3324/haematol.2018.207928] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/07/2019] [Indexed: 12/29/2022] Open
Abstract
Burkitt-like lymphoma with 11q aberration is characterized by pathological features and gene expression profile resembling those of Burkitt lymphoma but lacks the MYC rearrangement and carries an 11q-arm aberration with proximal gains and telomeric losses. Whether this lymphoma is a distinct category or a particular variant of other recognized entities is controversial. To improve the understanding of Burkitt-like lymphoma with 11q aberration we performed an analysis of copy number alterations and targeted sequencing of a large panel of B-cell lymphoma-related genes in 11 cases. Most patients had localized nodal disease and a favorable outcome after therapy. Histologically, they were high grade B-cell lymphoma, not otherwise specified (8 cases), diffuse large B-cell lymphoma (2 cases) and only one was considered as atypical Burkitt lymphoma. All cases had a germinal center B-cell signature and phenotype with frequent LMO2 expression. The patients with Burkitt-like lymphoma with 11q aberration had frequent gains of 12q12-q21.1 and losses of 6q12.1-q21, and lacked common Burkitt lymphoma or diffuse large B-cell lymphoma alterations. Potential driver mutations were found in 27 genes, particularly involving BTG2, DDX3X, ETS1, EP300, and GNA13. However, ID3, TCF3, or CCND3 mutations were absent in all cases. These results suggest that Burkitt-like lymphoma with 11q aberration is a germinal center-derived lymphoma closer to high-grade B-cell lymphoma or diffuse large B-cell lymphoma than to Burkitt lymphoma.
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Affiliation(s)
- Blanca Gonzalez-Farre
- Hematopathology Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Joan Enric Ramis-Zaldivar
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Olga Balagué
- Hematopathology Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Verónica Celis
- Pediatric Oncology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Jaime Verdu-Amoros
- Pediatric Oncology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Constantino Sábado
- Pediatric Oncology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Marta Garrido
- Pathology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - José Manuel Vagace
- Pediatric Hematology Department, Hospital Materno Infantil de Badajoz, Badajoz, Spain
| | - Carlos Manuel Panizo
- Department of Hematology, Clínica Universidad de Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Itziar Astigarraga
- Pediatrics Department, Hospital Universitario Cruces, IIS Biocruces Bizkaia, UPV/EHU, Barakaldo, Spain
| | - Mara Andrés
- Pediatric Oncology Department, Hospital La Fe, Valencia, Spain
| | - Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elias Campo
- Hematopathology Unit, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain .,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
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27
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van der Kaaij RT, van Kessel JP, van Dieren JM, Snaebjornsson P, Balagué O, van Coevorden F, van der Kolk LE, Sikorska K, Cats A, van Sandick JW. Outcomes after prophylactic gastrectomy for hereditary diffuse gastric cancer. Br J Surg 2018; 105:e176-e182. [PMID: 29341148 DOI: 10.1002/bjs.10754] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/25/2017] [Accepted: 10/17/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients with hereditary diffuse gastric cancer and a CDH1 mutation have a 60-80 per cent lifetime risk of developing diffuse gastric cancer. Total prophylactic gastrectomy eliminates this risk, but is associated with considerable morbidity. The effectiveness (removal of all gastric mucosa) and outcomes of this procedure were evaluated retrospectively. METHODS All consecutive individuals undergoing a prophylactic gastrectomy for a CDH1 mutation or gastric signet ring cell foci at the authors' institute between 2005 and 2017 were included. RESULTS In 25 of 26 patients, intraoperative frozen-section examination (proximal resection margin) was used to verify complete removal of gastric mucosa. All definitive resection margins were free of gastric mucosa, but only after the proximal margin had been reresected in nine patients. In the first year after surgery, five of the 26 patients underwent a relaparotomy for adhesiolysis (2 patients) or jejunostomy-related complications (3 patients). Six patients were readmitted to the hospital within 1 year for nutritional and/or psychosocial support (4 patients) or surgical reintervention (2 patients). Mean weight loss after 1 year was 15 (95 per cent c.i. 12 to 18) per cent. For the 25 patients with a follow-up at 1 year or more, functional complaints were reported more frequently at 1 year than at 3 months after the operation: bile reflux (15 versus 11 patients respectively) and dumping (11 versus 7 patients). The majority of patients who worked or studied before surgery (15 of 19) had returned fully to these activities within 1 year. CONCLUSION The considerable morbidity and functional consequences of gastrectomy should be considered when counselling individuals with an inherited predisposition to diffuse gastric cancer. Intraoperative frozen-section examination is recommended to remove all risk-bearing gastric mucosa.
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Affiliation(s)
- R T van der Kaaij
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J P van Kessel
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J M van Dieren
- Department of Gastroenterology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - P Snaebjornsson
- Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - O Balagué
- Department of Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - F van Coevorden
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L E van der Kolk
- Department of Clinical Genetics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - K Sikorska
- Department of Biometrics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Cats
- Department of Gastroenterology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - J W van Sandick
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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28
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Magnano L, Balagué O, Dlouhy I, Rovira J, Karube K, Pinyol M, Rivas-Delgado A, Costa D, Martínez-Trillos A, González-Farre B, Martínez-Pozo A, Giné E, Colomer D, Delgado J, Villamor N, Campo E, López-Guillermo A. Clinicobiological features and prognostic impact of diffuse large B-cell lymphoma component in the outcome of patients with previously untreated follicular lymphoma. Ann Oncol 2017; 28:2799-2805. [PMID: 29045517 DOI: 10.1093/annonc/mdx407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The co-existence at diagnosis of follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) components (FL/DLBCL) has been considered a transformed lymphoma and accordingly treated although clinicobiological information on these patients is scarce. The aim of this study was to analyze the initial features and outcome of FL/DLBCL patients in the rituximab era. PATIENTS AND METHODS All patients consecutively diagnosed at a single institution with FL/DLBCL (n = 40), as well as those with pure FL (n = 328) or de novo DLBCL (n = 510) as controls. RESULTS The proportion of the DLBCL component was highly variable (median 50%). In 29 FL/DLBCL cases analyzed, the cell of origin was GCB in 86%, ABC in 10% and unclassifiable in 4%. NOTCH1-2 was mutated in 10% of these cases. The proportion of DLBCL component did not impact on overall survival (OS). Regarding initial characteristics, patients with FL/DLBCL were closer to FL in terms of primary nodal origin, good performance status and advanced stage, whereas the other features were intermediate between FL and DLBCL. FL/DLBCL patients were treated as DLBCL with no further intensification. Complete response and primary refractory rates were 65% and 20%, respectively, with these figures being similar to DLBCL and worse than FL. Progression-free survival and OS were intermediate between FL and DLBCL (5-year OS: 85%, 73% and 63% for FL, FL/DLBCL and DLBCL, respectively). FL/DLBCL histology did not reach independent prognostic value for OS in the multivariate analyses. CONCLUSIONS The outcome of FL/DLBCL patients is not worse than that of de novo DLBCL. These cases should be treated with immunochemotherapy as DLBCL, but intensification with ASCT may not be necessary. The biological insights of FL/DLBCL warrants further genetic and molecular studies.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Case-Control Studies
- Female
- Follow-Up Studies
- Humans
- Lymphoma, Follicular/complications
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasm Recurrence, Local/complications
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Survival Rate
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Affiliation(s)
- L Magnano
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - O Balagué
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - I Dlouhy
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - J Rovira
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - K Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus;; Faculty of Medicine, University of the Ryukyus, Japan
| | - M Pinyol
- CIBERONC, Barcelona;; Genomics Unit, IDIBAPS, Barcelona, Spain
| | - A Rivas-Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Costa
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A Martínez-Trillos
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - B González-Farre
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Martínez-Pozo
- CIBERONC, Barcelona;; Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E Giné
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - D Colomer
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - J Delgado
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona
| | - N Villamor
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - E Campo
- Hematopathology Unit, Department of Pathology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona;; CIBERONC, Barcelona
| | - A López-Guillermo
- Department of Hematology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona;; CIBERONC, Barcelona;.
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Dlouhy I, Filella X, Rovira J, Magnano L, Rivas-Delgado A, Baumann T, Martínez-Trillos A, Balagué O, Martínez A, González-Farre B, Karube K, Gine E, Delgado J, Campo E, López-Guillermo A. High serum levels of soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF) are associated with adverse clinical features and predict poor outcome in diffuse large B-cell lymphoma. Leuk Res 2017; 59:20-25. [PMID: 28544905 DOI: 10.1016/j.leukres.2017.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/11/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with heterogeneous outcomes. To improve accuracy of the international prognostic index score, new biological variables are being investigated. The aim of this study was to determine the prognostic significance of serum levels of different cytokines, namely soluble interleukin-2 receptor (sIL2-R), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF). We analyzed 197 de novo DLBCL patients (91 M/106 F; median age 66 years) treated with immunochemotherapy in a single institution. Serum cytokine determination was performed with ELISA, using the upper normal values as cut-offs. sIL-2R, IL-6 and TNF were elevated in 133, 130 and 144 cases, respectively. Elevation of each of these cytokines correlated with worse performance status, presence of B symptoms, advanced stage, elevated LDH and β2-microglobulin (P<0.03) and lower complete remission rate (P<0.001). Elevated levels of serum sIL-2R and TNF were significantly associated with shorter progression-free (PFS) and overall survival (OS), while elevated IL-6 only with shorter PFS. Early death (<4months from diagnosis) strongly correlated with elevated cytokines. Determination of serum cytokines levels is simple and adds information regarding risk of early death, response to therapy, and outcome.
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Affiliation(s)
- Ivan Dlouhy
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain.
| | - Xavier Filella
- Department of Biochemistry and Molecular Genetics, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Jordina Rovira
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Laura Magnano
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Alfredo Rivas-Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Tycho Baumann
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | | | - Olga Balagué
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Antonio Martínez
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Blanca González-Farre
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
| | - Kennosuke Karube
- Cell Biology & Pathology Department, University of the Ryukyus Graduate School of Medicine, 207 Uehara, Nishihara, Okinawa, Japan
| | - Eva Gine
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Julio Delgado
- Department of Hematology, Hospital Clinic, Villarroel St. 170, 08036 Barcelona, Spain
| | - Elías Campo
- Hematopathology Unit, Hospital Clínic, August Pi and Sunyer Biomedical Investigation Center (IDIBAPS), Villarroel St. 170, 08036 Barcelona, Spain
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31
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Ripoll E, Prieto-González S, Balagué O, Marco-Hernández J, Miró JM, Darnell A, Cid MC, Hernández-Rodríguez J. Occlusive vasculopathy in human immunodeficiency virus (HIV)-associated vasculitis: unusual clinical and imaging course. Clin Exp Rheumatol 2017; 35 Suppl 103:185-188. [PMID: 27974095] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
Human immunodeficiency virus (HIV)-associated vasculitis is a rare secondary systemic vasculitis involving small and medium arteries. We report a 42-year-old man with uncontrolled HIV infection presenting with long-lasting abdominal pain. An abdominal CT angiography revealed multiple microaneurysms and stenoses in intrarenal arteries, with involvement of mesenteric and hepatic arteries. HIV-associated vasculitis was diagnosed and glucocorticoids and raltegravir-based antiretroviral therapy were administered with good initial clinical and virological response. Several episodes of acute intestinal ischaemia were later developed requiring bowel resections of which histological examination showed vascular occlusive fibrotic changes without active vasculitic lesions. Vasculitis persisted in remission and intrarenal microaneurysms disappeared.
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Affiliation(s)
- Enric Ripoll
- Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Sergio Prieto-González
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Olga Balagué
- Department of Anatomic Pathology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Javier Marco-Hernández
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Josep M Miró
- Infectious Diseases Service; Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Anna Darnell
- Department of Radiology, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - Maria C Cid
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain
| | - José Hernández-Rodríguez
- Vasculitis Research Unit, Department of Autoimmune Diseases, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
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32
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Magnano L, Martínez A, Carreras J, Martínez-Trillos A, Giné E, Rovira J, Dlouhy I, Baumann T, Balagué O, Campo E, López-Guillermo A, Villamor N. T-cell subsets in lymph nodes identify a subgroup of follicular lymphoma patients with favorable outcome. Leuk Lymphoma 2016; 58:842-850. [DOI: 10.1080/10428194.2016.1217525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sander B, de Jong D, Rosenwald A, Xie W, Balagué O, Calaminici M, Carreras J, Gaulard P, Gribben J, Hagenbeek A, Kersten MJ, Molina TJ, Lee A, Montes-Moreno S, Ott G, Raemaekers J, Salles G, Sehn L, Thorns C, Wahlin BE, Gascoyne RD, Weller E. The reliability of immunohistochemical analysis of the tumor microenvironment in follicular lymphoma: a validation study from the Lunenburg Lymphoma Biomarker Consortium. Haematologica 2014; 99:715-25. [PMID: 24510338 DOI: 10.3324/haematol.2013.095257] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The cellular microenvironment in follicular lymphoma is of biological and clinical importance. Studies on the clinical significance of non-malignant cell populations have generated conflicting results, which may partly be influenced by poor reproducibility in immunohistochemical marker quantification. In this study, the reproducibility of manual scoring and automated microscopy based on a tissue microarray of 25 follicular lymphomas as compared to flow cytometry is evaluated. The agreement between manual scoring and flow cytometry was moderate for CD3, low for CD4, and moderate to high for CD8, with some laboratories scoring closer to the flow cytometry results. Agreement in manual quantification across the 7 laboratories was low to moderate for CD3, CD4, CD8 and FOXP3 frequencies, moderate for CD21, low for MIB1 and CD68, and high for CD10. Manual scoring of the architectural distribution resulted in moderate agreement for CD3, CD4 and CD8, and low agreement for FOXP3 and CD68. Comparing manual scoring to automated microscopy demonstrated that manual scoring increased the variability in the low and high frequency interval with some laboratories showing a better agreement with automated scores. Manual scoring reliably identified rare architectural patterns of T-cell infiltrates. Automated microscopy analyses for T-cell markers by two different instruments were highly reproducible and provided acceptable agreement with flow cytometry. These validation results provide explanations for the heterogeneous findings on the prognostic value of the microenvironment in follicular lymphoma. We recommend a more objective measurement, such as computer-assisted scoring, in future studies of the prognostic impact of microenvironment in follicular lymphoma patients.
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Espinet B, Salaverria I, Beà S, Ruiz-Xivillé N, Balagué O, Salido M, Costa D, Carreras J, Rodríguez-Vicente AE, Luís García J, Hernández-Rivas JM, Calasanz MJ, Siebert R, Ferrer A, Salar A, Carrió A, Polo N, García-Marco JA, Domingo A, González-Barca E, Romagosa V, Marugán I, López-Guillermo A, Millá F, Luís Mate J, Luño E, Sanzo C, Collado R, Oliver I, Monzó S, Palacín A, González T, Sant F, Salinas R, Ardanaz MT, Font L, Escoda L, Florensa L, Serrano S, Campo E, Solé F. Incidence and prognostic impact of secondary cytogenetic aberrations in a series of 145 patients with mantle cell lymphoma. Genes Chromosomes Cancer 2010; 49:439-51. [PMID: 20143418 DOI: 10.1002/gcc.20754] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a mature B-cell neoplasm with an aggressive behavior, characterized by the t(11;14)(q13;q32). Several secondary genetic abnormalities with a potential role in the oncogenic process have been described. Studies of large MCL series using conventional cytogenetics, and correlating with proliferation and survival, are scarce. We selected 145 MCL cases at diagnosis, displaying an aberrant karyotype, from centers belonging to the Spanish Cooperative Group for Hematological Cytogenetics. Histological subtype, proliferative index and survival data were ascertained. Combined cytogenetic and molecular analyses detected CCND1 translocations in all cases, mostly t(11;14)(q13;q32). Secondary aberrations were present in 58% of patients, the most frequent being deletions of 1p, 13q and 17p, 10p alterations and 3q gains. The most recurrent breakpoints were identified at 1p31-32, 1p21-22, 17p13, and 1p36. Aggressive blastoid/pleomorphic variants displayed a higher karyotypic complexity, a higher frequency of 1p and 17p deletions and 10p alterations, a higher proliferation index and poor survival. Gains of 3q and 13q and 17p13 losses were associated with reduced survival times. Interestingly, gains of 3q and 17p losses added prognostic significance to the morphology in a multivariate analysis. Our findings confirm previous observations indicating that proliferation index, morphology and several secondary genetic alterations (3q gains and 13q and 17p losses) have prognostic value in patients with MCL. Additionally, we observed that 3q gains and 17p losses detected by conventional cytogenetics are proliferation-independent prognostic markers indicating poor outcome.
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Affiliation(s)
- Blanca Espinet
- Laboratori de Citogenètica Molecular, Laboratori de Citologia Hematològica, Servei de Patologia, Servei d'Hematologia Clínica, GRETNHE, IMIM-Hospital del Mar, Barcelona, Spain.
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Balagué O, Martínez A, Colomo L, Roselló E, Garcia A, Martínez-Bernal M, Palacín A, Fu K, Weisenburger D, Colomer D, Burke JS, Warnke RA, Campo E. Epstein-Barr Virus Negative Clonal Plasma Cell Proliferations and Lymphomas in Peripheral T-cell Lymphomas. Am J Surg Pathol 2007; 31:1310-22. [PMID: 17721185 DOI: 10.1097/pas.0b013e3180339f18] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Clonal B-cell populations have been described in peripheral T-cell lymphomas (PTCL) as secondary Epstein-Barr virus (EBV) driven B-cell expansions that may evolve to an overt B-cell lymphoma. EBV-negative B-cell proliferations associated with T-cell lymphomas are uncommon and not well characterized. We studied 15 patients who developed an EBV-negative B-cell proliferation or malignant lymphoma associated with PTCL. The T-cell tumors were 8 PTCL, not otherwise specified, 4 angioimmunoblastic T-cell lymphomas, and 3 cutaneous PTCL. The B-cell component was intermingled with the PTCL in all patients and it was classified as clonal/monotypic plasma cell proliferation in 8 lesions, clonal/monotypic large B-cell proliferation in 4 patients, and B-cell lymphoma with plasmacytic/plasmablastic differentiation in 3 patients. Two patients had 2 clonally unrelated plasma cell proliferations associated with the same PTCL. All cases showed cytoplasmic Ig light chain restriction. Clonal IgH and T-cell receptor rearrangements were detected in 11/12 and 11/13 cases examined, respectively. EBV, cytomegalovirus, and HHV-8 were not observed in any of the examined cases. Sequential samples in 7 patients showed persistence of the PTCL and the B-cell component in 4, the PTCL without the B-cell lymphoma in 2, and progression of the B-cell neoplasm in 1. Patients followed an aggressive clinical course similar to conventional PTCL. In conclusion, EBV-negative clonal or mononotypic B-cell proliferations in patients with PTCL present with a spectrum of lesions ranging from plasma cell proliferations to overt lymphomas with plasmacytic/plasmablastic features. The distinctive features of these patients suggest that these lesions represent a specific phenomenon in PTCL.
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MESH Headings
- Adolescent
- Aged
- Aged, 80 and over
- Cell Differentiation
- Cell Proliferation
- Clone Cells/pathology
- Clone Cells/virology
- Cytomegalovirus
- Female
- Gene Expression Regulation, Neoplastic
- Gene Rearrangement, B-Lymphocyte
- Gene Rearrangement, T-Lymphocyte
- Herpesvirus 4, Human
- Herpesvirus 8, Human
- Humans
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/virology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/virology
- Male
- Middle Aged
- Plasma Cells/pathology
- Plasma Cells/virology
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Affiliation(s)
- Olga Balagué
- Hematopathology Section, Laboratory of Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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Marcé S, Balagué O, Colomo L, Martinez A, Höller S, Villamor N, Bosch F, Ott G, Rosenwald A, Leoni L, Esteller M, Fraga MF, Montserrat E, Colomer D, Campo E. Lack of methylthioadenosine phosphorylase expression in mantle cell lymphoma is associated with shorter survival: implications for a potential targeted therapy. Clin Cancer Res 2006; 12:3754-61. [PMID: 16778103 DOI: 10.1158/1078-0432.ccr-05-2780] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the methylthioadenosine phosphorylase (MTAP) gene alterations in mantle cell lymphoma (MCL) and to investigate whether the targeted inactivation of the alternative de novo AMP synthesis pathway may be a useful therapeutic strategy in tumors with inactivation of this enzyme. EXPERIMENTAL DESIGN MTAP gene deletion and protein expression were studied in 64 and 52 primary MCL, respectively, and the results were correlated with clinical behavior. Five MCL cell lines were analyzed for MTAP expression and for the in vitro sensitivity to L-alanosine, an inhibitor of adenylosuccinate synthetase, and hence de novo AMP synthesis. RESULTS No protein expression was detected in 8 of 52 (15%) tumors and one cell line (Granta 519). Six of these MTAP negative tumors and Granta 519 cell line had a codeletion of MTAP and p16 genes; one case showed a deletion of MTAP, but not p16, and one tumor had no deletions in neither of these genes. Patients with MTAP deletions had a significant shorter overall survival (mean, 16.1 months) than patients with wild-type MTAP (mean, 63.6 months; P < 0.0001). L-Alanosine induced cytotoxicity and activation of the intrinsic mitochondrial-dependent apoptotic pathway in MCL cells. 9-beta-D-Erythrofuranosyladenine, an analogue of 5'-methylthioadenosine, selectively rescued MTAP-positive cells from L-alanosine toxicity. CONCLUSIONS MTAP gene deletion and lack of protein expression are associated with poor prognosis in MCL and might identify patients who might benefit from treatment with de novo AMP synthesis pathway-targeted therapies.
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MESH Headings
- Base Sequence
- Cell Line, Tumor
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 14
- DNA Primers
- Gene Expression Regulation, Enzymologic
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, Mantle-Cell/enzymology
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/mortality
- Lymphoma, Mantle-Cell/pathology
- Purine-Nucleoside Phosphorylase/deficiency
- Purine-Nucleoside Phosphorylase/genetics
- Retrospective Studies
- Survival Analysis
- Time Factors
- Translocation, Genetic
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Affiliation(s)
- Silvia Marcé
- Pathology Department, Hematopathology Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
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