1
|
Qin Y, Meng FL. Taming AID mutator activity in somatic hypermutation. Trends Biochem Sci 2024:S0968-0004(24)00077-X. [PMID: 38614818 DOI: 10.1016/j.tibs.2024.03.011] [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: 10/15/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
Activation-induced cytidine deaminase (AID) initiates somatic hypermutation (SHM) by introducing base substitutions into antibody genes, a process enabling antibody affinity maturation in immune response. How a mutator is tamed to precisely and safely generate programmed DNA lesions in a physiological process remains unsettled, as its dysregulation drives lymphomagenesis. Recent research has revealed several hidden features of AID-initiated mutagenesis: preferential activity on flexible DNA substrates, restrained activity within chromatin loop domains, unique DNA repair factors to differentially decode AID-caused lesions, and diverse consequences of aberrant deamination. Here, we depict the multifaceted regulation of AID activity with a focus on emerging concepts/factors and discuss their implications for the design of base editors (BEs) that install somatic mutations to correct deleterious genomic variants.
Collapse
Affiliation(s)
- Yining Qin
- Key Laboratory of RNA Science and Engineering, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences; Shanghai 200031, China
| | - Fei-Long Meng
- Key Laboratory of RNA Science and Engineering, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences; Shanghai 200031, China.
| |
Collapse
|
2
|
Milrod CJ, Kim KW, Raker C, Ollila TA, Olszewski AJ, Pelcovits A. Progression-free survival is a weakly predictive surrogate end-point for overall survival in follicular lymphoma: A systematic review and meta-analysis. Br J Haematol 2024. [PMID: 38571449 DOI: 10.1111/bjh.19449] [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: 02/23/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
Although progression-free survival (PFS) is a commonly used surrogate end-point for clinical trials of follicular lymphoma (FL), no analyses have evaluated the strength of surrogacy for PFS with overall survival (OS). A systematic review was performed and 20 studies (total participants, 10 724) met final inclusion criteria. PFS was weakly associated with OS (correlation coefficient; 0.383, p < 0.001). The coefficient of determination was 0.15 (95% CI: 0.002-0.35) suggesting 15% of OS variance could be explained by changes in PFS. This challenges the role for PFS as a surrogate end-point for clinical trials and drug approvals.
Collapse
Affiliation(s)
- Charles J Milrod
- Department of Hematology/Oncology, Brown University, Providence, Rhode Island, USA
| | - Kang Woo Kim
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Christina Raker
- Lifespan Biostatistics, Epidemiology, Research Design, and Informatics, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Thomas A Ollila
- Department of Hematology/Oncology, Brown University, Providence, Rhode Island, USA
| | - Adam J Olszewski
- Department of Hematology/Oncology, Brown University, Providence, Rhode Island, USA
| | - Ari Pelcovits
- Department of Hematology/Oncology, Brown University, Providence, Rhode Island, USA
| |
Collapse
|
3
|
Abeyakoon C, Gregory GP. New standards of care for treatment of diffuse large B-cell lymphoma. Br J Haematol 2024; 204:1132-1134. [PMID: 38251726 DOI: 10.1111/bjh.19295] [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: 12/26/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024]
Abstract
Treatment of newly diagnosed diffuse large B-cell lymphoma with rituximab and CHOP (R-CHOP) has been largely unchanged for the last two decades. The Guideline by Fox et al. provides new evidence-based therapeutic strategies informed by positive results of randomised clinical trials. Commentary on: Fox et al. The management of newly diagnosed large B-cell lymphoma: A British Society for Haematology Guideline. Br J Haematol 2024; 204:1178-1192.
Collapse
Affiliation(s)
- Chathuri Abeyakoon
- Lymphoma Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
- Department of Medical Oncology and Haematology, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Gareth P Gregory
- Lymphoma Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Monash Haematology, Monash Health, Clayton, Victoria, Australia
| |
Collapse
|
4
|
Brannock K, Kahwash SB. Interfollicular Classic Hodgkin Lymphoma: Report of a Case and a Brief Review of Literature. Pediatr Dev Pathol 2024:10935266241236874. [PMID: 38468389 DOI: 10.1177/10935266241236874] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Interfollicular Hodgkin lymphoma (IHL) has been rarely reported in the literature and is recognized by the WHO Classification as a morphologic pattern sometimes seen in mixed cellularity classic Hodgkin lymphoma (CHL). The changes may be subtle due to preservation of architecture. We report a case of a 9-year-old male with IHL showing preserved follicular architecture but with the presence of interfollicular infiltrates consisting of eosinophils, plasma cells, and Hodgkin-Reed-Sternberg (HRS) cells. Immunophenotyping confirmed the morphologic suspicion for IHL. A discussion and review of the literature are offered. We conclude that IHL is a variant that requires a high index of suspicion, as it may be easily missed due to the subtle morphologic features and preserved architecture seen in most cases. We further emphasize that unexplained interfollicular infiltrates of eosinophils may be clues that should prompt a search of HRS cells and consideration of immunohistochemical staining if needed.
Collapse
Affiliation(s)
- Kristina Brannock
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Samir B Kahwash
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
5
|
Wang Y, Meng FL, Yeap LS. DNA flexibility can shape the preferential hypermutation of antibody genes. Trends Immunol 2024; 45:167-176. [PMID: 38402044 DOI: 10.1016/j.it.2024.01.005] [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: 12/28/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024]
Abstract
Antibody-coding genes accumulate somatic mutations to achieve antibody affinity maturation. Genetic dissection using various mouse models has shown that intrinsic hypermutations occur preferentially and are predisposed in the DNA region encoding antigen-contacting residues. The molecular basis of nonrandom/preferential mutations is a long-sought question in the field. Here, we summarize recent findings on how single-strand (ss)DNA flexibility facilitates activation-induced cytidine deaminase (AID) activity and fine-tunes the mutation rates at a mesoscale within the antibody variable domain exon. We propose that antibody coding sequences are selected based on mutability during the evolution of adaptive immunity and that DNA mechanics play a noncoding role in the genome. The mechanics code may also determine other cellular DNA metabolism processes, which awaits future investigation.
Collapse
Affiliation(s)
- Yanyan Wang
- Shanghai Institute of Immunology, State Key Laboratory of Oncogenes and Related Genes, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fei-Long Meng
- Key Laboratory of RNA Science and Engineering, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai 200031, China.
| | - Leng-Siew Yeap
- Shanghai Institute of Immunology, State Key Laboratory of Oncogenes and Related Genes, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| |
Collapse
|
6
|
Al-Mashhadi AL, Jakobsen LH, Brown P, Gang AO, Thorsteinsson AL, Rasoul K, Haissman JM, Tøstesen MB, Christoffersen MN, Jelicic J, Jørgensen JB, Thomsen T, Dessau-Arp A, Andersen APH, Frederiksen M, Pedersen PT, Clausen MR, Jørgensen JM, Poulsen CB, El-Galaly TC, Larsen TS. Real-world outcomes following third or subsequent lines of therapy: A Danish population-based study on 189 patients with relapsed/refractory large B-cell lymphomas. Br J Haematol 2024; 204:839-848. [PMID: 38009548 DOI: 10.1111/bjh.19201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
Outcome data of patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) beyond the second line are scarce outside of clinical trials. Novel therapies in the R/R setting have been approved based on single-arm trials, but results need to be contextualized by real-world outcomes. Medical records from 3753 Danish adults diagnosed with DLBCL were reviewed. Patients previously treated with rituximab and anthracycline-based chemotherapy who received the third or later line (3 L+) of treatment after 1 January 2015, were included. Only 189 patients with a median age of 71 years were eligible. The median time since the last line of therapy was 6 months. Patients were treated with either best supportive care (22%), platinum-based salvage therapy (13%), low-intensity chemotherapy (22%), in clinical trial (14%) or various combination treatments (32%). The 2-year OS-/PFS estimates were 25% and 12% for all patients and 49% and 17% for those treated with platinum-based salvage therapy. Age ≥70, CNS involvement, elevated LDH and ECOG ≥2 predicted poor outcomes, and patients with 0-1 of these risk factors had a 2-year OS estimate of 65%. Only a very small fraction of DLBCL patients received third-line treatment and were eligible for inclusion. Outcomes were generally poor, but better in intensively treated, fit young patients with limited disease.
Collapse
Affiliation(s)
- Ahmed Ludvigsen Al-Mashhadi
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | - Lasse Hjort Jakobsen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark
| | - Peter Brown
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Ortved Gang
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Luise Thorsteinsson
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kaziwa Rasoul
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Judith Melchior Haissman
- Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | | | - Mette Niemann Christoffersen
- Department of Haematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jelena Jelicic
- Department of Haematology, Vejle Hospital, Vejle, Denmark
| | | | - Troels Thomsen
- Department of Internal Medicine, Haematology Section, Goedstrup Hospital, Herning, Denmark
| | | | | | - Mikael Frederiksen
- Department of Hematology, Hospital of Southern Jutland, Sønderborg, Denmark
| | | | | | | | - Christian Bjørn Poulsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Haematology, Zealand University Hospital, Roskilde, Denmark
| | - Tarec Christoffer El-Galaly
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Stauffer Larsen
- Department of Haematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
7
|
Gong IY, Prica A, Ante Z, Calzavara A, Krzyzanowska MK, Singh S, Suleman A, Cheung MC, Crump M. Indolent lymphoma care delivery and outcomes during the COVID-19 pandemic in Ontario, Canada. Br J Haematol 2024; 204:805-814. [PMID: 37886835 DOI: 10.1111/bjh.19166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
The treatment pattern and outcomes in patients with indolent B-cell lymphoma treated during the coronavirus disease 2019 (COVID-19) pandemic period compared to the prepandemic period are unclear. This was a retrospective population-based study using administrative databases in Ontario, Canada (follow-up to 31 March 2022). The primary outcome was treatment pattern; secondary outcomes were death, toxicities, healthcare utilization (emergency department [ED] visit, hospitalization) and SARS-CoV-2 outcomes. Adjusted hazard ratios (aHR) from Cox proportional hazards models were used to estimate associations. We identified 4143 patients (1079 pandemic, 3064 prepandemic), with a median age of 69 years. In both time periods, bendamustine (B) + rituximab (BR) was the most frequently prescribed regimen. During the pandemic, fewer patients received R maintenance or completed the full 2-year course (aHR 0.81, 95% CI 0.71-0.92, p = 0.001). Patients treated during the pandemic had less healthcare utilization (ED visit aHR 0.77, 95% CI 0.68, 0.88, p < 0.0001; hospitalization aHR 0.81, 95% CI 0.70-0.94, p = 0.0067) and complications (infection aHR 0.69, 95% CI 0.57-0.82, p < 0.0001; febrile neutropenia aHR 0.66, 95% CI 0.47-0.94, p = 0.020), with no difference in death. Independent of vaccination, active rituximab use was associated with a higher risk of COVID-19 complications. Despite similar front-line regimen use, healthcare utilization and admissions for infection were less in the pandemic cohort.
Collapse
Affiliation(s)
- Inna Y Gong
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anca Prica
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Zharmaine Ante
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Andrew Calzavara
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Monika K Krzyzanowska
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Simron Singh
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Adam Suleman
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Matthew C Cheung
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Michael Crump
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| |
Collapse
|
8
|
Al-Maghrabi JA. Primary pancreatic lymphoma: Histopathological pattern of 8 cases. Saudi Med J 2024; 45:307-312. [PMID: 38438200 DOI: 10.15537/smj.2024.45.3.20230930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES To report the histopathological pattern of primary pancreatic lymphoma (PPL) in 2 tertiary hospitals. METHODS The pathology slides and reports of all the cases diagnosed in pathology departments in 2 referral hospitals were reviewed. An additional immunohistochemistry study was done to reclassify lymphomas according to the current system. RESULTS Eight patients with PPL have been identified. The ages ranged from 36 to 71 years. Clinical presentation includes abdominal pain, weight loss, jaundice, abdominal mass, nausea, and vomiting. Pathological evaluation revealed 5 diffuse large B-cell lymphomas, one high-grade B-cell lymphoma, one MALT lymphoma, and one follicular lymphoma. CONCLUSION Primary pancreatic lymphoma is a very rare tumor without specific clinical, laboratory tests, or radiological findings. Abdominal pain is the most common clinical presentation. Diffuse large b-cell lymphoma is the most common pathological subtype. Primary pancreatic lymphoma should be taken into consideration when evaluating pancreatic mass to avoid unnecessary surgical resection.
Collapse
Affiliation(s)
- Jaudah A Al-Maghrabi
- From the Department of Pathology, Faculty of Medicine, King Abdulaziz University; and from the Department of Pathology, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| |
Collapse
|
9
|
Minson A, Hamad N, Di Ciaccio P, Talaulikar D, Ku M, Ratnasingam S, Cheah C, Yannakou CK, Bishton M, Ng ZY, Agrawal S, McQuillan A, Johnston A, Choong E, Wong K, McQuillan J, Beekman A, Hawkes E, Dickinson M. Death from mantle cell lymphoma limits sequential therapy, particularly after first relapse: Patterns of care and outcomes in a series from Australia and the United Kingdom. Br J Haematol 2024; 204:548-554. [PMID: 37904342 DOI: 10.1111/bjh.19179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023]
Abstract
Mantle cell lymphoma (MCL) is a B-cell non-Hodgkin lymphoma characterised by a heterogeneous clinical course. Patients can often receive sequential treatments, yet these typically yield diminishing periods of disease control, raising questions about optimal therapy sequencing. Novel agents, such as chimeric antigen receptor T-cell therapies and bispecific antibodies, show promise in relapsed MCL, but are often reserved for later treatment lines, which may underserve patients with aggressive disease phenotypes who die early in the treatment journey. To assess the problem of patient attrition from lymphoma-related death limiting sequential treatment, we performed a multicentre retrospective cohort analysis of 389 patients treated at Australian and UK centres over a 10-year period. Deaths from MCL increased after each treatment line, with 7%, 23% and 26% of patients dying from uncontrolled MCL after first, second and third lines respectively. Patients with older age at diagnosis and early relapse after induction therapy were at particular risk of death after second-line treatment. This limitation of sequential treatment by lymphoma-related death provides support for the trial of novel therapies in earlier treatment lines, particularly in high-risk patient populations.
Collapse
Affiliation(s)
- Adrian Minson
- Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Nada Hamad
- St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Pietro Di Ciaccio
- Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Dipti Talaulikar
- Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Matthew Ku
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | | | - Chan Cheah
- Sir Charles Gairdner Hospital & Linear Health, Perth, Western Australia, Australia
| | | | | | - Zi Yun Ng
- Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia
| | - Shivam Agrawal
- Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia
| | | | | | - Emily Choong
- Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Kimberly Wong
- Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia
| | - James McQuillan
- Hollywood Private Hospital, Perth, Western Australia, Australia
| | | | - Eliza Hawkes
- Olivia Newton-John Cancer Research Institute at Austin Health, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Dickinson
- Peter MacCallum Cancer Centre & Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
10
|
Antony F, Dubey A, Skrabek P, Tsang LF, Lambert P, Bybel B, Ahmed N. Hypofractionated Radiotherapy for Hematologic Malignancies during the COVID-19 Pandemic and Beyond. Curr Oncol 2024; 31:383-393. [PMID: 38248110 PMCID: PMC10814841 DOI: 10.3390/curroncol31010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE Radiotherapy is integral in the management of hematological malignancies (HM). Standard radiotherapy dose fractionation regimens range between 20 and 50 Gy in 10-25 fractions over 2-5 weeks. This study presents the outcomes of patients with HM treated with hypofractionation radiotherapy (HFRT) during the COVID-19 pandemic. METHODS Patients (n = 36) were treated with HFRT between January 2020 and September 2022. The outcomes measured were the overall response rate (ORR), freedom from local progression (FFLP), and overall survival (OS). RESULTS The median follow-up was 13.2 months. Thirty-three patients (92%) had non-Hodgkin (NHL) or Hodgkin lymphoma (HL). Eighteen patients (50%) had aggressive and nine (25%) had indolent NHL. Nineteen patients (53%) presented with stage I/II and fifteen (42%) with stage III/IV disease. Twenty-five (69.4%) and eleven (30%) received consolidative and definitive RT, respectively. Twenty patients (56%) received treatment to the neck and/or thorax and nine (25%) to the abdomen or pelvis. The total dose ranged from 18 to 42.5 Gy in 6-17 fractions/2.67-5 Gy per fraction. The median dose in 2 Gy fractions for an alpha/beta (α/β) ratio of 10 amounted to 39 Gy (SD ± 13.86) and 43.6 Gy (SD ± 12) for an α/β of 3. The most commonly used fractionation scheme was 39 Gy in 13 fractions. ORR was 94.4% for the entire cohort, and 100, 94.4, and 83.3% for indolent NHL, aggressive NHL, and HL patients. The two-year FFLP was 76% (95% CI: 34-93%) for the entire cohort and 100, 87 (95% CI: 56.4-96.5%), and 42% (95% CI: 1.1-84.3%) for the indolent NHL, aggressive NHL, and HL patients. Two-year OS for the entire cohort was 80% (95% CI: 59.9-90.5%) and 100, 66.1 (95% CI: 36.4-84.4%), and 100% for the indolent NHL, aggressive NHL, and HL patients. Only one patient presented with grade two pulmonary toxicity. CONCLUSIONS HFRT in HM provides excellent local control to be validated in a larger prospective study.
Collapse
Affiliation(s)
- Febin Antony
- Section of Radiation Oncology, Department of Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (F.A.)
| | - Arbind Dubey
- Section of Radiation Oncology, Department of Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (F.A.)
| | - Pamela Skrabek
- Section of Medical Oncology/Hematology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3A TR9, Canada;
| | - Lung Fung Tsang
- Department of Epidemiology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada; (L.F.T.)
| | - Pascal Lambert
- Department of Epidemiology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada; (L.F.T.)
| | - Bohdan Bybel
- Section of Nuclear Medicine, Department of Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Naseer Ahmed
- Section of Radiation Oncology, Department of Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (F.A.)
- CancerCare Manitoba Research Institute, Winnipeg, MB R3E 0V9, Canada
| |
Collapse
|
11
|
Eyre TA, Bishton MJ, McCulloch R, O'Reilly M, Sanderson R, Menon G, Iyengar S, Lewis D, Lambert J, Linton KM, McKay P. Diagnosis and management of mantle cell lymphoma: A British Society for Haematology Guideline. Br J Haematol 2024; 204:108-126. [PMID: 37880821 DOI: 10.1111/bjh.19131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Toby A Eyre
- Department of Haematology, Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mark J Bishton
- Department of Haematology, Nottingham University Hospitals NHS Foundation Trust, Oxford, UK
- Translational Medical Sciences, University of Nottingham, Nottingham, UK
| | - Rory McCulloch
- Department of Haematology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - Maeve O'Reilly
- Department of Haematology, University College London Hospitals, London, UK
| | - Robin Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | - Geetha Menon
- Department of Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Sunil Iyengar
- Department of Haematology, The Royal Marsden Hospital, London, UK
| | - David Lewis
- Department of Haematology, Derriford Hospital, Plymouth, UK
| | - Jonathan Lambert
- Department of Haematology, University College London Hospitals, London, UK
| | - Kim M Linton
- Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK
| | - Pamela McKay
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| |
Collapse
|
12
|
Chandrashekhar H, Arman S, Khan J, Kalladka M. Lymphoma masquerading as jaw pain, headache, and syncope: A case report. J Am Dent Assoc 2024; 155:79-88. [PMID: 37389534 DOI: 10.1016/j.adaj.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/04/2023] [Accepted: 03/22/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Lymphomas of parapharyngeal space often have complex manifestations, posing a diagnostic dilemma for clinicians. CASE DESCRIPTION A 64-year-old man sought treatment for a 4-month history of unresolving right-sided headache and jaw pain associated with syncope, all of which started with a toothache. Since the onset of pain, the patient had undergone multiple diagnostic tests with various specialists, with no pain relief. A detailed clinical and radiologic examination by an orofacial pain specialist revealed diffuse large B-cell lymphoma in the parapharynx. PRACTICAL IMPLICATIONS A thorough knowledge of the head and neck anatomy helps in identifying the pathophysiology of complex orofacial pain manifestations, which assists in early diagnosis and treatment.
Collapse
|
13
|
Li Z, Guo W, Bai O. Mechanism of action and therapeutic targeting of CD30 molecule in lymphomas. Front Oncol 2023; 13:1301437. [PMID: 38188299 PMCID: PMC10767573 DOI: 10.3389/fonc.2023.1301437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
At present, the treatment of lymphoma has entered the era of precision medicine, and CD30, as a transmembrane protein, has become an important marker to help the diagnosis and formulation of treatment plans for lymphomas. This protein is widely expressed in various types of lymphomas and can play a role through nuclear factor-κB (NF-κB), mitogen-activated protein kinase (MAPK), and other pathways, and ultimately lead to the up-regulation of CD30 expression to give tumor cells a survival advantage. Brentuximab vedotin (BV), as an antibody-drug conjugate (ADC) targeting CD30, is one of the first new drugs to significantly improve survival in patients with CD30+lymphomas. However, the biological function of CD30 has not been fully elucidated. Therefore, this review highlights the CD30-mediated tumor-promoting mechanisms and the molecular factors that regulate CD30 expression. We hope that a better understanding of CD30 biology will provide new insights into clinical treatment and improve the survival and quality of life of lymphoma patients.
Collapse
Affiliation(s)
| | | | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
14
|
Tomacinschii V, Mosquera Orgueira A, Santos CA, Robu M, Buruiana S, Fraga Rodriguez MF. The implication of next-generation sequencing in the diagnosis and clinical management of non-Hodgkin lymphomas. Front Oncol 2023; 13:1275327. [PMID: 38023160 PMCID: PMC10663367 DOI: 10.3389/fonc.2023.1275327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Next generation sequencing (NGS) is a technology that broadens the horizon of knowledge of several somatic pathologies, especially in oncological and oncohematological pathology. In the case of NHL, the understanding of the mechanisms of tumorigenesis, tumor proliferation and the identification of genetic markers specific to different lymphoma subtypes led to more accurate classification and diagnosis. Similarly, the data obtained through NGS allowed the identification of recurrent somatic mutations that can serve as therapeutic targets that can be inhibited and thus reducing the rate of resistant cases. The article's purpose is to offer a comprehensive overview of the best ways of integrating of next-generation sequencing technologies for diagnosis, prognosis, classification, and selection of optimal therapy from the perspective of tailor-made medicine.
Collapse
Affiliation(s)
- Victor Tomacinschii
- Department of Hematology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
- Department of Hematology, Public Medical Sanitary Institution (PMSI) Institute of Oncology, Chisinau, Moldova
| | - Adrian Mosquera Orgueira
- University Hospital of Santiago de Compostela, Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Aliste Santos
- University Hospital of Santiago de Compostela, Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain
| | - Maria Robu
- Department of Hematology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Sanda Buruiana
- Department of Hematology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Maximo Francisco Fraga Rodriguez
- University Hospital of Santiago de Compostela, Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Forensic Sciences, Pathology, Ginecology and Obstetrics and Pediatrics, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
15
|
Toner K, Allen CE, Jain S, Kahl B, Leonard J, Wasserstrom H, Friedberg JW, Seibel NL, Kelly K. Overcoming barriers to drug development and enrollment in clinical trials for adolescents and young adults with lymphoma. EJHaem 2023; 4:921-926. [PMID: 38024612 PMCID: PMC10660108 DOI: 10.1002/jha2.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 12/01/2023]
Abstract
Lymphoma is one of the most common cancers in adolescents and young adults, but historically, this population has had lower clinical trial enrollment and improvements in overall survival as compared to other age populations. There are multiple challenges that are unique to this population that have affected drug development and clinical trial enrollment. Our panel of experts have identified barriers, and in this review, we discuss current methods to address these barriers as well as potential solutions moving forward.
Collapse
Affiliation(s)
- Keri Toner
- Center for Cancer and Blood DisordersChildren's National HospitalWashingtonDistrict of ColumbiaUSA
| | - Carl E. Allen
- Baylor College of MedicineTexas Children's HospitalHoustonTexasUSA
| | - Shweta Jain
- Clinical DevelopmentSeagen Inc.BothellWashingtonUSA
| | - Brad Kahl
- Department of MedicineDivision of OncologyWashington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - John Leonard
- Weill Department of MedicineDivision of Hematology and Medical OncologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Heather Wasserstrom
- Clinical Development Team PediatricsHematology and Cellular Therapy at Bristol Myers SquibbNew YorkNew YorkUSA
| | | | - Nita L. Seibel
- Division of Cancer Treatment and DiagnosisNational Cancer InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Kara Kelly
- Roswell Park Comprehensive Cancer CenterUniversity at Buffalo Jacobs School of Medicine and Biomedical SciencesBuffaloNew YorkUSA
| |
Collapse
|
16
|
Watanabe M, Kanda J, Fukuda T, Uchida N, Ikegame K, Kataoka K, Kobayashi H, Ara T, Ishikawa J, Matsuoka KI, Sugio Y, Nakazawa H, Ikeda T, Atsuta Y, Kondo E, Suzuki R. Impact of GVHD on lymphoma progression: Nationwide study from Japanese Society for Transplantation and Cellular Therapy. Br J Haematol 2023; 203:446-459. [PMID: 37614023 DOI: 10.1111/bjh.19041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/23/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
The graft-versus-lymphoma (GVL) effect and its association with acute and chronic GVHD (aGVHD, cGVHD) has not been comprehensively elucidated. We retrospectively analysed 2204 Japanese patients with non-Hodgkin lymphomas (NHLs; indolent B-NHLs, n = 689; aggressive B-NHLs, n = 720; mature T/NK-NHLs, n = 795) receiving a first allo-HSCT in 2003-2017. Pre-transplant lymphoma control showed complete response (CR) in 759 and non-CR in 1445. We assessed the impact of aGVHD/cGVHD on lymphoma progression and other outcomes. Although aGVHD/cGVHD showed no statistical impact on lymphoma progression in the overall cohort, their impact was clear in certain groups: Grade I-II aGVHD in CR patients (HR, 0.63; 95% CI, 0.43-0.91), especially in mature T/NK-NHL (HR, 0.46; 95% CI, 0.26-0.83) and extensive cGVHD in patients with mature aggressive B-NHLs (HR, 0.55; 95% CI, 0.31-0.97). In total, limited cGVHD was associated with superior survivals (progression-free survival: HR, 0.71; 95% CI, 0.56-0.90), whereas severe GVHDs showed negative impacts on them. Our results support the presence of GVL effects differentially associated with GVHD in different lymphoma subtypes/controls. Meanwhile, it was also suggested that we should manage GVHDs within a limited activity, considering the negative impact of severe GVHDs. As pre-transplant lymphoma control remains a strong factor influencing transplant outcomes, improving its management is an important issue to be addressed.
Collapse
Affiliation(s)
- Mizuki Watanabe
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo College of Medicine Hospital, Tokyo, Japan
| | - Keisuke Kataoka
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Hikaru Kobayashi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Takahide Ara
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yasuhiro Sugio
- Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Hideyuki Nakazawa
- Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Eisei Kondo
- Department of Hematology, Kawasaki Medical School, Izumo, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan
| |
Collapse
|
17
|
Pophali PA, Morton LM, Parsons SK, Hodgson D, Thanarajasingam G, Thompson C, Habermann TM, Savage KJ. Critical gaps in understanding treatment outcomes in adolescents and young adults with lymphoma: A review of current data. EJHaem 2023; 4:927-933. [PMID: 38024619 PMCID: PMC10660371 DOI: 10.1002/jha2.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 12/01/2023]
Abstract
Adolescents and young adults (AYA) with lymphoma experience treatment-related effects in the short and long term that impact their quality of life and survivorship experience. The effort to improve outcomes for AYA lymphoma survivors requires understanding the available literature, identifying current knowledge deficits, designing better clinical trials incorporating the patient perspective, using novel tools to bridge data gaps and building survivorship guidelines that translate research to clinical practice. This review article summarizes the current state of lymphoma treatment-related outcomes in AYAs and provides future direction.
Collapse
Affiliation(s)
- Priyanka A. Pophali
- Division of HematologyMedical Oncology and Palliative CareUniversity of Wisconsin, Carbone Cancer CenterMadisonWisconsinUSA
| | - Lindsay M. Morton
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Susan K. Parsons
- Department of MedicineDivision of Hematology/OncologyTufts Medical Centerand the Tufts University School of MedicineBostonMassachusettsUSA
| | - David Hodgson
- Department of Radiation OncologyPrincess Margaret HospitalTorontoOntarioCanada
| | | | | | | | - Kerry J. Savage
- Centre for Lymphoid CancerBritish Columbia CancerVancouverBritish ColumbiaCanada
| |
Collapse
|
18
|
Saliot M, Murzot L. [CAR-T cells, an innovative therapy]. Rev Infirm 2023; 72:42-44. [PMID: 37838372 DOI: 10.1016/j.revinf.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
CAR-T cell therapy for patients with hematological malignancies has been practiced at the Basse-Normandie Hematology Institute since November 2022. This treatment requires the care pathway to be coordinated by the nurse coordinator. Nurses play a key role in the early diagnosis of side effects induced by this drug. Interdisciplinary collaboration and the value of teamwork are also emphasized.
Collapse
Affiliation(s)
- Marine Saliot
- Institut d'hématologie de Basse-Normandie (IHBN), Centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Laëtitia Murzot
- Institut d'hématologie de Basse-Normandie (IHBN), Centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
| |
Collapse
|
19
|
Yang S, Wahab S, Almoyad MAA, Chen Y, Kalam N, Khalid M. Discovery of promising B lymphocyte kinase inhibitors using structure-guided virtual screening. J Biomol Struct Dyn 2023:1-11. [PMID: 37688373 DOI: 10.1080/07391102.2023.2256397] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Tyrosine-protein kinase BLK, also known as B-cell lymphocyte kinase (BLK), is a non-receptor tyrosine kinase that is primarily expressed in B-cells. BLK plays a key role in B-cell signaling, particularly in B-cell development and maturation. The increased expression of BLK has been linked to various complex diseases, including autoimmune disorders, and specific malignancies of B cells, such as lymphomas and leukemias. Due to its significant involvement in B-cell signaling, BLK has emerged as a promising target for drug development, offering the potential for developing novel therapeutics to combat these diseases. Small molecule inhibitors of BLK hold great potential for therapeutic intervention; however, discovering potent and selective inhibitors remains challenging. Within this context, natural compounds hold significant potential as a valuable resource for discovering novel inhibitors of BLK. In the current study, a structure-based virtual screening of the IMPPAT 2 library was employed to identify promising candidates with potential as inhibitors of BLK. The control molecule for this study was the known BLK inhibitor, Dasatinib. After a multi-step filtering process, two molecules (Withanolide I and Mexogenin) demonstrated potential against BLK based on their superior binding affinity, ligand efficiency, and specific interaction. Interaction analysis of these compounds revealed several significant interactions with the active site residues of BLK. Both proposed molecules remained bound to the binding pocket of BLK, as indicated by the molecular dynamics (MD) simulation study. Taken together, these findings provide valuable insights for guiding future research endeavors and translational efforts in developing therapeutics for different complex diseases, such as autoimmune disorders, lymphomas, and leukemias.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Song Yang
- Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture & Life Sciences, Lincoln University, Christchurch, New Zealand
| | - Shadma Wahab
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Ali Abdullah Almoyad
- Department of Basic Medical Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Yanxin Chen
- Department of Anaesthesiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Nida Kalam
- School of Pharmaceutical Education and Research (SPER), New Delhi, India
| | - Mohammad Khalid
- Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| |
Collapse
|
20
|
吕 佳, 于 婷, 尹 万. [Diffuse large B-cell lymphoma of thyroid invading the superior mediastinum with hashimoto's thyroiditis: a case report and literature review]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:755-758. [PMID: 37640999 PMCID: PMC10722120 DOI: 10.13201/j.issn.2096-7993.2023.09.012] [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] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/27/2022] [Indexed: 08/31/2023]
Abstract
This article reports a case of primary thyroid diffuse large B-cell lymphoma involving the superior mediastinum with Hashimoto's thyroiditis admitted to the Department of Otolaryngology and Head and Neck Surgery, First Hospital of Jilin University. This patient underwent right thyroid lobectomy and was transferred to the Department of Hematology of the Oncology Center for 6 courses of chemotherapy with R-CHOP protocol. The postoperative recovery was good, and the patient was regularly followed up for 12 months after the operation. The patient's condition was stable, and CT showed no abnormally high metabolism in the operation area indicating the inhibition of tumor activity, superficial lymph nodes and peripheral blood cells were normal. The case encountered many difficulties in the diagnosis process, and the diagnosis was not confirmed after puncture in two Grade III Class A hospitals in China. There are few patients with primary thyroid diffuse large B-cell lymphoma complicated with Hashimoto's thyroiditis, and it is particularly rare to invade the mediastinum. There is no report in China and abroad in the literature we reviewed. Therefore, this article reports the case and retrospectively analyzes the etiology, clinical symptoms, diagnosis and treatment of primary thyroid lymphoma.
Collapse
Affiliation(s)
- 佳牧 吕
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130021)Department of Otolaryngology Head and Neck Surgery, the First Hospital of Jilin University, Changchun, 130021, China
- 深圳大学总医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, Shenzhen University General Hospital
| | - 婷婷 于
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130021)Department of Otolaryngology Head and Neck Surgery, the First Hospital of Jilin University, Changchun, 130021, China
| | - 万忠 尹
- 吉林大学第一医院耳鼻咽喉头颈外科(长春,130021)Department of Otolaryngology Head and Neck Surgery, the First Hospital of Jilin University, Changchun, 130021, China
| |
Collapse
|
21
|
Mondal D, Shinde S, Paul S, Thakur S, Velu GSK, Tiwari AK, Dixit V, Amit A, Vishvakarma NK, Shukla D. Diagnostic significance of dysregulated miRNAs in T-cell malignancies and their metabolic roles. Front Oncol 2023; 13:1230273. [PMID: 37637043 PMCID: PMC10448964 DOI: 10.3389/fonc.2023.1230273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023] Open
Abstract
T-cell malignancy is a broad term used for a diverse group of disease subtypes representing dysfunctional malignant T cells transformed at various stages of their clonal evolution. Despite having similar clinical manifestations, these disease groups have different disease progressions and diagnostic parameters. The effective diagnosis and prognosis of such a diverse disease group demands testing of molecular entities that capture footprints of the disease physiology in its entirety. MicroRNAs (miRNAs) are a group of noncoding RNA molecules that regulate the expression of genes and, while doing so, leave behind specific miRNA signatures corresponding to cellular expression status in an altered stage of a disease. Using miRNAs as a diagnostic tool is justified, as they can effectively distinguish expressional diversity between various tumors and within subtypes of T-cell malignancies. As global attention for cancer diagnosis shifts toward liquid biopsy, diagnosis using miRNAs is more relevant in blood cancers than in solid tumors. We also lay forward the diagnostic significance of miRNAs that are indicative of subtype, progression, severity, therapy response, and relapse. This review discusses the potential use and the role of miRNAs, miRNA signatures, or classifiers in the diagnosis of major groups of T-cell malignancies like T-cell acute lymphoblastic lymphoma (T-ALL), peripheral T-cell lymphoma (PTCL), extranodal NK/T-cell lymphoma (ENKTCL), and cutaneous T-cell lymphoma (CTCL). The review also briefly discusses major diagnostic miRNAs having prominent metabolic roles in these malignancies to highlight their importance among other dysregulated miRNAs.
Collapse
Affiliation(s)
- Deepankar Mondal
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | - Sapnita Shinde
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | - Souvik Paul
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Suresh Thakur
- Centre for Excellence in Genomics, Trivitron Healthcare Pvt. Ltd., Chennai, India
| | - GSK Velu
- Centre for Excellence in Genomics, Trivitron Healthcare Pvt. Ltd., Chennai, India
| | - Atul Kumar Tiwari
- Department of Zoology, Dr. Bhawan Singh Porte Government College, Pendra, Chhattisgarh, India
| | - Vineeta Dixit
- Department of Botany, Sri Satguru Jagjit Singh Namdhari College, Gharwa, Jharkhand, India
| | - Ajay Amit
- Department of Forensic Sciences, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | | | - Dhananjay Shukla
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| |
Collapse
|
22
|
Al-Maghrabi J. Histopathological Experience of Primary Adrenal Lymphoma From Two Tertiary Hospitals. Cureus 2023; 15:e42940. [PMID: 37667690 PMCID: PMC10475321 DOI: 10.7759/cureus.42940] [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] [Accepted: 08/03/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Primary adrenal lymphoma (PAL) is a rare tumor. The aim of this study was to demonstrate the histopathological features of PAL at two tertiary hospitals. MATERIALS AND METHODS All PALs diagnosed between January 2003 and February 2023 were retrieved. Pathology and immunohistochemistry slides were reviewed. Additional immunohistochemical markers were done in selected cases. Follow-up data were obtained. RESULTS There were 7 cases of PAL. The age range of the patients was 52 to 73 years (median 64 years; mean 63.3 years). There were 4 males (57.1%) and 3 females (42.9%). The clinical manifestations included abdominal pain nausea, vomiting, and loss of weight. There were 4 cases of diffuse large B-cell lymphoma (DLBCL), 2 cases of high-grade B-cell lymphomas, and 1 case of follicular lymphoma. There were 5 cases that were unilateral and 2 cases that were bilateral, and both were high-grade B-cell lymphoma. During follow-up, the 1-year and 2-year overall survival rates were 50% and 33%, respectively. CONCLUSION PAL is a disease of the elderly, and DLBCL is the most common pathological type. The prognosis is generally poor. Further reporting of PAL cases might help in understanding this disease and could lead to improvement in its management.
Collapse
Affiliation(s)
- Jaudah Al-Maghrabi
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, SAU
| |
Collapse
|
23
|
Rovsing AB, Thomsen EA, Nielsen I, Skov TW, Luo Y, Dybkaer K, Mikkelsen JG. Resistance to vincristine in DLBCL by disruption of p53-induced cell cycle arrest and apoptosis mediated by KIF18B and USP28. Br J Haematol 2023; 202:825-839. [PMID: 37190875 DOI: 10.1111/bjh.18872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/21/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023]
Abstract
The frontline therapy R-CHOP for patients with diffuse large B-cell lymphoma (DLBCL) has remained unchanged for two decades despite numerous Phase III clinical trials investigating new alternatives. Multiple large studies have uncovered genetic subtypes of DLBCL enabling a targeted approach. To further pave the way for precision oncology, we perform genome-wide CRISPR screening to uncover the cellular response to one of the components of R-CHOP, vincristine, in the DLBCL cell line SU-DHL-5. We discover important pathways and subnetworks using gene-set enrichment analysis and protein-protein interaction networks and identify genes related to mitotic spindle organization that are essential during vincristine treatment. The inhibition of KIF18A, a mediator of chromosome alignment, using the small molecule inhibitor BTB-1 causes complete cell death in a synergistic manner when administered together with vincristine. We also identify the genes KIF18B and USP28 of which CRISPR/Cas9-directed knockout induces vincristine resistance across two DLBCL cell lines. Mechanistic studies show that lack of KIF18B or USP28 counteracts a vincristine-induced p53 response suggesting that resistance to vincristine has origin in the mitotic surveillance pathway (USP28-53BP1-p53). Collectively, our CRISPR screening data uncover potential drug targets and mechanisms behind vincristine resistance, which may support the development of future drug regimens.
Collapse
Affiliation(s)
| | | | - Ian Nielsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Yonglun Luo
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Lars Bolund Institute of Regenerative Medicine, BGI-Qingdao, BGI-Shenzhen, Shenzhen, China
| | - Karen Dybkaer
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | | |
Collapse
|
24
|
Ribatti D, Tamma R, Annese T, d'Amati A, Ingravallo G, Specchia G. Vascular Growth in Lymphomas: Angiogenesis and Alternative Ways. Cancers (Basel) 2023; 15:3262. [PMID: 37370872 DOI: 10.3390/cancers15123262] [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: 05/29/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
The formation of new blood vessels is a critical process for tumor growth and may be achieved through different mechanisms. Angiogenesis represents the first described and most studied mode of vessel formation, but tumors may also use alternative ways to secure blood supply and eventually acquire resistance to anti-angiogenic treatments. These non-angiogenic mechanisms have been described more recently, including intussusceptive microvascular growth (IMG), vascular co-option, and vasculogenic mimicry. Like solid tumors, angiogenic and non-angiogenic pathways in lymphomas play a fundamental role in tumor growth and progression. In view of the relevant prognostic and therapeutic implications, a comprehensive understanding of these mechanisms is of paramount importance for improving the efficacy of treatment in patients with lymphoma. In this review, we summarize the current knowledge on angiogenic and non-angiogenic mechanisms involved in the formation of new blood vessels in Hodgkin's and non-Hodgkin's lymphomas.
Collapse
Affiliation(s)
- Domenico Ribatti
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberto Tamma
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Tiziana Annese
- Department of Medicine and Surgery, Libera Università del Mediterraneo (LUM) "Giuseppe Degennaro", 70124 Bari, Italy
| | - Antonio d'Amati
- Department of Translational Biomedicine and Neurosciences, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
- Section of Anatomical and Molecular Pathology, Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Anatomical and Molecular Pathology, Department of Precision and Regenerative Medicine and Jonian Area, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giorgina Specchia
- School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| |
Collapse
|
25
|
Stuver R, Horwitz SM, Advani RH, Vose JM, Lee HJ, Mehta-Shah N, Zain JM, Haverkos B, Lechowicz MJ, Moskowitz AJ, Pham LQ, Leyden E, Ansell SM, Lunning MA. Final results of a phase II study of CHOEP plus lenalidomide as initial therapy for patients with stage II-IV peripheral T-cell lymphoma. Br J Haematol 2023. [PMID: 37217196 DOI: 10.1111/bjh.18885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
There remains no one standard induction for nodal-based peripheral T-cell lymphoma (PTCL). We conducted a phase II study of lenalidomide plus CHOEP as a novel induction strategy. Patients received CHOEP at standard doses in combination with 10 mg of lenalidomide on days 1-10 of a 21-day cycle for six cycles of therapy followed by observation, high-dose therapy with autologous stem cell rescue, or maintenance lenalidomide per provider preference. Among 39 patients evaluable for efficacy, the objective response rate after six cycles was 69%, with complete response in 49%, partial response in 21%, stable disease in 0% and progressive disease in 13%. Thirty-two patients (82%) completed full induction, and seven patients (18%) discontinued for toxicity, primarily hematologic. Any grade hematologic toxicity occurred in over 50% of patients, with grade 3 or 4 febrile neutropenia occurring in 35% of patients despite mandated growth factors. With a median followup of surviving patients of 21.3 months, the estimated 2-year progression-free and overall survival were 55% (95% CI 37%-70%) and 78% (95% CI 59%-89%), respectively. In sum, six cycles of lenalidomide plus CHOEP resulted in a modest response rate primarily due to hematologic toxicity, which prevented all patients from completing planned induction.
Collapse
Affiliation(s)
- Robert Stuver
- Memorial Sloan Kettering Cancer Center, Manhattan, New York, USA
| | - Steven M Horwitz
- Memorial Sloan Kettering Cancer Center, Manhattan, New York, USA
| | | | - Julie M Vose
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Hun Ju Lee
- MD Anderson Cancer Center, Houston, Texas, USA
| | - Neha Mehta-Shah
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | | | | | | | - Luu Q Pham
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | | | | | | |
Collapse
|
26
|
McKenna M, Epperla N, Ghobadi A, Liu J, Lazaryan A, Ibrahim U, Jacobson CA, Naik SG, Nastoupil L, Chowdhury SM, Voorhees TJ, Jacobs MT, Farooq U, Osman K, Olszewski AJ, Ahmed S, Evens AM. Real-world evidence of the safety and survival with CD19 CAR-T cell therapy for relapsed/refractory solid organ transplant-related PTLD. Br J Haematol 2023. [PMID: 37129856 DOI: 10.1111/bjh.18828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
The use of CD19 chimeric antigen receptor T-cell (CAR-T) therapy for relapsed/refractory solid organ transplantation (SOT)-related post-transplant lymphoproliferative disorder (PTLD) is not well studied. We conducted a multicentre, retrospective analysis of adults with relapsed/refractory SOT-associated PTLD. Among 22 relapsed/refractory SOT-PTLD patients, the pathology was monomorphic B cell. Prior SOTs included 14 kidney (64%), three liver (14%), two heart (9%), one intestinal (5%), one lung (5%), and one pancreas after kidney transplant (5%). The median time from SOT to PTLD diagnosis was 107 months. Pre-CAR-T bridging therapy was used in 55% of patients, and immunosuppression was stopped completely before CAR-T infusion in 64%. Eighteen (82%) patients experienced cytokine release syndrome: one (5%) each grade (G) 3 and G4. The immune effector cell-associated neurotoxicity syndrome was observed in 16 (73%) patients: six (27%) G3 and two (9%) G4. The overall response rate was 64% (55% complete response). Three patients (14%) experienced allograft rejection after CAR-T. The two-year progression-free survival and overall survival rates were 35% and 58%, respectively. Additionally, the achievement of CR post-CAR-T was strongly associated with survival. Collectively, the safety and efficacy of CD19 CAR-T therapy in relapsed/refractory SOT-related PTLD appeared similar to pivotal CAR-T data, including approximately one-third of patients achieving sustained remission.
Collapse
Affiliation(s)
- Marshall McKenna
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Narendranath Epperla
- Division of Hematology, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Armin Ghobadi
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jieqi Liu
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Aleksandr Lazaryan
- Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Uroosa Ibrahim
- Department of Hematology and Oncology, Bone Marrow Transplantation and Cellular Therapy Program, Mount Sinai Hospital, New York, New York, USA
| | - Caron A Jacobson
- Division of Hematologic Malignancies, Harvard Medical School, Dana Faber Cancer Institute, Boston, Massachusetts, USA
| | - Seema G Naik
- Penn State Cancer Institute, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Loretta Nastoupil
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sayan Mullick Chowdhury
- Division of Hematology, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Timothy J Voorhees
- Division of Hematology, Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Miriam T Jacobs
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Umar Farooq
- Division of Hematology, Oncology and Blood & Marrow Transplantation, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA
| | - Keren Osman
- Department of Hematology and Oncology, Bone Marrow Transplantation and Cellular Therapy Program, Mount Sinai Hospital, New York, New York, USA
| | - Adam J Olszewski
- Lifespan Cancer Institute, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Andrew M Evens
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| |
Collapse
|
27
|
Wennerås C, Aranburu A, Wass L, Grankvist A, Staffas A, Soboli A, Mårtensson IL, Fogelstrand L, Lewerin C. Infection with Neoehrlichia mikurensis promotes the development of malignant B-cell lymphomas. Br J Haematol 2023; 201:480-488. [PMID: 36650117 DOI: 10.1111/bjh.18652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
The tick-borne pathogen Neoehrlichia (N.) mikurensis is implicated in persistent infection of the vascular endothelium. B cells are crucial for the host defence to this infection. Chronic stimulation of B cells may result in B-cell transformation and lymphoma. Five patients with malignant B-cell lymphoma and concomitant N. mikurensis infection were investigated regarding clinical picture, lymphoma subtype, B-cell lymphoma immunophenotype and IGHV (variable region of the immunoglobulin heavy) gene repertoire. Three of the five patients improved markedly and ceased lymphoma treatment after doxycycline treatment to eliminate N. mikurensis. Sequencing the B-cell lymphoma IGHV genes revealed preferred usage of the IGHV1 (IGHV1-2, and -69) and IGHV3 (IGHV3-15, -21, -23) families. In conclusion, N. mikurensis infection may drive the development of malignant B-cell lymphomas. Eradication of the pathogen appears to induce remission with apparent curing of the lymphoma in some cases.
Collapse
Affiliation(s)
- Christine Wennerås
- Institute of Biomedicine, Department of Infectious Diseases, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Alaitz Aranburu
- Department of Rheumatology and Inflammation, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Linda Wass
- Institute of Biomedicine, Department of Infectious Diseases, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anna Grankvist
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anna Staffas
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anastasia Soboli
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Inga-Lill Mårtensson
- Department of Rheumatology and Inflammation, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Linda Fogelstrand
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Catharina Lewerin
- Department of Hematology and Coagulation, Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| |
Collapse
|
28
|
Zhang M, Yang Y. High-grade B-cell lymphoma with MYC and BCL2 rearrangements with abundant multinucleated giant tumor cells. EJHaem 2023; 4:503-504. [PMID: 37206289 PMCID: PMC10188453 DOI: 10.1002/jha2.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Man Zhang
- Department of Pathology, Immunology and Laboratory MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Yu Yang
- Department of Pathology, Immunology and Laboratory MedicineUniversity of Florida College of MedicineGainesvilleFloridaUSA
| |
Collapse
|
29
|
Parilla M, Quesada AE, Medeiros LJ, Thakral B. An update on genetic aberrations in T-cell neoplasms. Pathology 2023; 55:287-301. [PMID: 36801152 DOI: 10.1016/j.pathol.2022.12.350] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/17/2022] [Accepted: 12/26/2022] [Indexed: 01/20/2023]
Abstract
T-cell neoplasms are a highly heterogeneous group of leukaemias and lymphomas that represent 10-15% of all lymphoid neoplasms. Traditionally, our understanding of T-cell leukaemias and lymphomas has lagged behind that of B-cell neoplasms, in part due to their rarity. However, recent advances in our understanding of T-cell differentiation, based on gene expression and mutation profiling and other high throughput methods, have better elucidated the pathogenetic mechanisms of T-cell leukaemias and lymphomas. In this review, we provide an overview of many of the molecular abnormalities that occur in various types of T-cell leukaemia and lymphoma. Much of this knowledge has been used to refine diagnostic criteria that has been included in the fifth edition of the World Health Organization. This knowledge is also being used to improve prognostication and identify novel therapeutic targets, and we expect this progress will continue, eventually resulting in improved outcomes for patients with T-cell leukaemias and lymphomas.
Collapse
|
30
|
Wilson MR, Barrett A, Cheah CY, Eyre TA. How I manage mantle cell lymphoma: indolent versus aggressive disease. Br J Haematol 2023; 201:185-198. [PMID: 36807902 DOI: 10.1111/bjh.18697] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
Mantle cell lymphoma (MCL) is a mature B-cell lymphoma with a variable clinical course and historically poor prognosis. Management is challenging in part due to the heterogeneity of the disease course, with indolent and aggressive subtypes now well recognised. Indolent MCL is often characterised by a leukaemic presentation, SOX11 negativity and low proliferation index (Ki-67). Aggressive MCL is characterised by rapid onset widespread lymphadenopathy, extra-nodal involvement, blastoid or pleomorphic histology and high Ki-67. Tumour protein p53 (TP53) aberrations in aggressive MCL are recognised with clear negative impact on survival. Until recently, trials have not addressed these specific subtypes separately. With the increasing availability of targeted novel agents and cellular therapies, the treatment landscape is constantly evolving. In this review, we describe the clinical presentation, biological factors, and specific management considerations of both indolent and aggressive MCL and discuss current and potential future evidence which may help move to a more personalised approach.
Collapse
Affiliation(s)
| | - Aisling Barrett
- Haematology and Cancer Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, UK
| | - Chan Yoon Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Division of Internal Medicine, University of Western Australia, Perth, Australia
| | - Toby A Eyre
- Haematology and Cancer Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, UK
| |
Collapse
|
31
|
Obeid J, Hiniker SM, Schroers‐Martin J, Guo HH, No HJ, Moding EJ, Advani RH, Alizadeh AA, Hoppe RT, Binkley MS. Investigating and modeling positron emission tomography factors associated with large cell transformation from low-grade lymphomas. EJHaem 2023; 4:90-99. [PMID: 36819184 PMCID: PMC9928791 DOI: 10.1002/jha2.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022]
Abstract
Low-grade lymphomas have a 1%-3% annual risk of transformation to a high-grade histology, and prognostic factors remain undefined. We set to investigate the role of positron emission tomography (PET) metrics in identification of transformation in a retrospective case-control series of patients matched by histology and follow-up time. We measured PET parameters including maximum standard uptake value (SUV-max) and total lesion glycolysis (TLG), and developed a PET feature and lactate dehydrogenase (LDH)-based model to identify transformation status within discovery and validation cohorts. For our discovery cohort, we identified 53 patients with transformation and 53 controls with a similar distribution of follicular lymphoma (FL). Time to transformation and control follow-up time was similar. We observed a significant incremental increase in SUV-max and TLG between control, pretransformation and post-transformation groups (P < 0.05). By multivariable analysis, we identified a significant interaction between SUV-max and TLG such that SUV-max had highest significance for low volume cases (P = 0.04). We developed a scoring model incorporating SUV-max, TLG, and serum LDH with improved identification of transformation (area under the curve [AUC] = 0.91). Our model performed similarly for our validation cohort of 23 patients (AUC = 0.90). With external and prospective validation, our scoring model may provide a specific and noninvasive tool for risk stratification for patients with low-grade lymphoma.
Collapse
Affiliation(s)
- Jean‐Pierre Obeid
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Susan M. Hiniker
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Joseph Schroers‐Martin
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - H. Henry Guo
- Department of RadiologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Hyunsoo Joshua No
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Everett J. Moding
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Ranjana H. Advani
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - Ash A. Alizadeh
- Department of MedicineDivision of Oncology, Stanford University School of MedicineStanfordCaliforniaUSA
| | - Richard T. Hoppe
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Michael S. Binkley
- Department of Radiation OncologyStanford University School of MedicineStanfordCaliforniaUSA
| |
Collapse
|
32
|
Lin C, Galal A, Rizzieri D, Chawla S, Lee ST, Georgy A, Dabovic K, Strack T, McKinney M. Combinatorial Efficacy and Toxicity of an Engineered Toxin Body MT-3724 with Gemcitabine and Oxaliplatin in Relapsed or Refractory Diffuse Large B Cell Lymphoma. Cancer Invest 2023; 41:1-10. [PMID: 36657101 PMCID: PMC10387504 DOI: 10.1080/07357907.2022.2162073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023]
Abstract
MT-3724 is an engineered direct-kill immunotoxin comprised of a CD20-specific scFv fused to a Shiga-like toxin subunit. In this phase IIa study, eight patients with relapsed diffuse large B-cell lymphoma were treated with MT-3724 combined with gemcitabine and oxaliplatin (GEMOX). The objective response rate was 85.7%, with a median duration of response of 2.2 months. The 12-month overall survival and progression-free survival were 71.4% and 28.6%, respectively. Two patients experienced grade 2 capillary leak syndrome (CLS). Combination therapy with MT-3724 and GEMOX demonstrated an early efficacy signal but was limited by the incidence of CLS.
Collapse
Affiliation(s)
- Chenyu Lin
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Ahmed Galal
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | | | - Sant Chawla
- Sarcoma Oncology Center, Santa Monica, CA, USA
| | - Seung T. Lee
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | - Matthew McKinney
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| |
Collapse
|
33
|
Jung J, Gokhale S, Xie P. TRAF3: A novel regulator of mitochondrial physiology and metabolic pathways in B lymphocytes. Front Oncol 2023; 13:1081253. [PMID: 36776285 PMCID: PMC9911533 DOI: 10.3389/fonc.2023.1081253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023] Open
Abstract
Mitochondria, the organelle critical for cell survival and metabolism, are exploited by cancer cells and provide an important therapeutic target in cancers. Mitochondria dynamically undergo fission and fusion to maintain their diverse functions. Proteins controlling mitochondrial fission and fusion have been recognized as essential regulators of mitochondrial functions, mitochondrial quality control, and cell survival. In a recent proteomic study, we identified the key mitochondrial fission factor, MFF, as a new interacting protein of TRAF3, a known tumor suppressor of multiple myeloma and other B cell malignancies. This interaction recruits the majority of cytoplasmic TRAF3 to mitochondria, allowing TRAF3 to regulate mitochondrial morphology, mitochondrial functions, and mitochondria-dependent apoptosis in resting B lymphocytes. Interestingly, recent transcriptomic, metabolic and lipidomic studies have revealed that TRAF3 also vitally regulates multiple metabolic pathways in B cells, including phospholipid metabolism, glucose metabolism, and ribonucleotide metabolism. Thus, TRAF3 emerges as a novel regulator of mitochondrial physiology and metabolic pathways in B lymphocytes and B cell malignancies. Here we review current knowledge in this area and discuss relevant clinical implications.
Collapse
Affiliation(s)
- Jaeyong Jung
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, United States.,Graduate Program in Cellular and Molecular Pharmacology, Rutgers University, Piscataway, NJ, United States
| | - Samantha Gokhale
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, United States.,Graduate Program in Cellular and Molecular Pharmacology, Rutgers University, Piscataway, NJ, United States
| | - Ping Xie
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, United States.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| |
Collapse
|
34
|
Al-Maghrabi JA. Primary lymphoma of the kidney: Pathology experience from 2 tertiary hospitals in Western Saudi Arabia. Saudi Med J 2023; 44:29-37. [PMID: 36634947 PMCID: PMC9987681 DOI: 10.15537/smj.2023.44.1.20220772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To document the clinicopathological features of primary renal lymphoma (PRL) at 2 tertiary hospitals in the western region of the Kingdom of Saudi Arabia. METHODS Data were retrieved from all PRLs that were diagnosed at King Abdulaziz University Hospital and King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia, between January 2002 and April 2022. Histopathological and immunohistochemical slides were reviewed, and additional immunohistochemistry stains were carried out in selected cases. Follow-up data were also collected. RESULTS There were 17 identified cases of PRL. The age of the patients ranged from 4-76 years (median: 50.5 years and mean: 46.8 years), 11 (64.7%) were males, and 6 (35.3%) were females. There were 12 cases of diffuse large B-cell lymphoma, 3 cases of Burkitt's lymphoma, and 2 cases of post-transplant lymphoproliferative disorder. The median follow-up duration was 22 months. The one-year overall survival rate was 71% and the 2-year overall survival rate was 43% during follow-up. CONCLUSION Primary renal lymphomas in Saudi patients are more common in males and seen in a relatively younger age group compared to the available worldwide data. The diagnosis of PRL is important to avoid tumor dissemination and unnecessary nephrectomy. Diffuse large B-cell lymphoma is the most common pathological type and non-germinal center B-cell is the most common subtype.
Collapse
Affiliation(s)
- Jaudah A. Al-Maghrabi
- From the Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, and from the Department of Pathology, King Faisal Specialist Hospital and Research center, Jeddah, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Jaudah A. Al-Maghrabi, Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-0812-9592
| |
Collapse
|
35
|
Mohamed S, Lucchini E, Sirianni F, Porrazzo M, Ballotta L, Ballerini M, De Sabbata GM, De Bellis E, Cappuccio I, Granzotto M, Toffoletto B, Fortunati I, Russignan A, Florea EE, Torelli L, Zaja F. Serological and cellular response to mRNA-SARS-CoV2 vaccine in patients with hematological lymphoid malignancies: Results of the study "Cervax". Front Oncol 2023; 13:1133348. [PMID: 36923438 PMCID: PMC10008958 DOI: 10.3389/fonc.2023.1133348] [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: 12/28/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023] Open
Abstract
messenger RNA (mRNA)-Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccines such as BNT162b2 became available in late 2020, but hematological malignancy patients (HM pts) were not evaluated in initial registration trials. We hereby report the results of a prospective, unicentric, observational study Response to COVID-19 Vaccination in hEmatological malignancies (CERVAX) developed to assess the postvaccine serological and T-cell-mediated response in a cohort of SARS-CoV2-negative HM pts vaccinated with BNT162b2. Patients with lymphomas [non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL)], chronic lymphocytic leukemia (CLL), and multiple myeloma (MM); off-therapy for at least 3 months; in a watch-and-wait program; or in treatment with ibrutinib, venetoclax, and lenalidomide were included. Different time points were considered to assess the serological response to the vaccine: before the second dose (T1), at 3-6-12 months after the first dose (T2-3-4, respectively). Since March 2021, 39 pts have been enrolled: 15 (38%) NHL, 12 (31%) CLL, and 12 (31%) MM. There were 13 of the 39 pts (33%) seroconverted at T1; an increase of the serological response was registered after the second dose (T2) (22/39 pts, 56%) and maintained after 6 months (22/39 pts, 56%) and 12 months (24/39 pts, 61%) from the first dose (T3-T4, respectively). Non-serological responders at T4 were 7/39 (18%): 0/15 NHL, 1/12 MM (8%), and 6/12 CLL (50%). All of them were on therapy (one lenalidomide, three ibrutinib, and three venetoclax). SARS-CoV2-reactive T-cell analysis (interferon gamma release assays) was available since June 2022 and was evaluated at 12 months (T4) from the first dose of vaccine in 31/39 pts (79%). T-cell-mediated-responders were 17/31 (55%): most of them were NHL and MM (47%, 41% and 12% for NHL, MM, and CLL, respectively). Both serological and T-cell non-responders were represented by pts on active therapy (venetoclax/ibrutinib). During the period of observation, eight (20.5%) pts developed mild SARS-CoV2 infection; no coronavirus disease 19 (COVID-19)-related deaths or hospitalizations were registered. In conclusion, in our cohort of lymphoproliferative pts receiving BNT162b2, CLL diagnosis and venetoclax/ibrutinib seem to be related with a lower humoral or T-mediated response. Nevertheless, the efficacy of mRNA vaccine in HM pts and the importance to continue the vaccine program even in non-responders after the first dose are supported in our study by demonstrating that a humoral and T-cell-mediated seroconversion should be observed even in the subsets of heavily immunocompromised pts.
Collapse
Affiliation(s)
- Sara Mohamed
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Elisa Lucchini
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Francesca Sirianni
- SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marika Porrazzo
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Laura Ballotta
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.,Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy
| | - Mario Ballerini
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | | | - Eleonora De Bellis
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Ilaria Cappuccio
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Marilena Granzotto
- SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Barbara Toffoletto
- SC Laboratorio Analisi, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Ilaria Fortunati
- Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy
| | - Anna Russignan
- Dipartimento di Medicina, sezione Ematologia, University of Verona, Verona, Italy
| | | | - Lucio Torelli
- Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy
| | - Francesco Zaja
- UCO Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.,Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste, Italy
| |
Collapse
|
36
|
Liu Y, Du Z, Huang J, Li T, Zhang J, Li Y, Yi W, Chen C. Ferroptosis in hematological malignant tumors. Front Oncol 2023; 13:1127526. [PMID: 37139157 PMCID: PMC10149970 DOI: 10.3389/fonc.2023.1127526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Ferroptosis is a kind of iron-dependent programmed cell death discovered in recent years. Its main feature is the accumulation of lipid reactive oxygen species in cells, eventually leading to oxidative stress and cell death. It plays a pivotal role in normal physical conditions and the occurrence and development of various diseases. Studies have shown that tumor cells of the blood system, such as leukemia cells and lymphoma cells, are sensitive to the response to ferroptosis. Regulators that modulate the Ferroptosis pathway can accelerate or inhibit tumor disease progression. This article reviews the mechanism of ferroptosis and its research status in hematological malignancies. Understanding the mechanisms of ferroptosis could provide practical guidance for treating and preventing these dreaded diseases.
Collapse
Affiliation(s)
- Yong Liu
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Zefan Du
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Junbin Huang
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Tianwen Li
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Jing Zhang
- Department of Breast and Thyroid Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, China
| | - Yixian Li
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Wenfang Yi
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
- *Correspondence: Wenfang Yi, ; Chun Chen,
| | - Chun Chen
- Pediatric Hematology Laboratory, Division of Hematology/Oncology, Department of Pediatrics, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
- *Correspondence: Wenfang Yi, ; Chun Chen,
| |
Collapse
|
37
|
Turkin AM, Melnikova-Pitskhelauri TV, Fadeeva LM, Kozlov AV, Oshorov AV, Kravchuk AD, Kozlova YA, Petryaikin AV, Ryzhova MV, Pronin IN. [Perifocal edema and glymphatic system dysfunction: quantitative assessment based on diffusion tensor magnetic resonance imaging]. Zh Vopr Neirokhir Im N N Burdenko 2023; 87:45-54. [PMID: 37830468 DOI: 10.17116/neiro20238705145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Pathogenesis of peritumoral cerebral edema is unclear and potentially associated with glymphatic system dysfunction. Diffusion tensor MRI (DT-MRI) with analysis of ALPS (Analysis along the Perivascular Space) index may be valuable for assessment of edema. This approach visualizes fluid flow along perivascular spaces of deep cerebral veins. OBJECTIVE To assess glymphatic system function in supratentorial tumors and healthy volunteers using DT-MRI. MATERIAL AND METHODS There were 52 patients (59% men) aged 43 (28-64) years with supratentorial tumors (meningioma - 20, grade 3-4 glioma - 15, metastases - 9, lymphoma - 8). Tumors and perifocal edema did not involve deep cerebral veins. The control group included 6 healthy volunteers aged 34-66 years. MRI protocol (Signa HDxt, 3 T) contained standard T1, T2, T2FLAIR, DWI and post-contrast T1 (3D BRAVO). DT-MRI had the following parameters: TR=10 000 ms, TEmin=102 ms, FOV=240 mm, isotropic voxel size 3×3×3 mm3, 60 directions of diffusion gradients. Measurements were carried out at b-factor 0 and 1000 s/mm2. Analysis was carried out in the ReadyView software. RESULTS Right- and left-sided ALPS indices were similar in the control group (p=0.917). Perifocal edema (regardless of histological type of tumor) in the ipsilateral hemisphere was accompanied by significantly lower ALPS index (p<0.005), while these values in contralateral (intact) hemisphere were similar in both groups (p=0.7). CONCLUSION We found significantly lower ALPS index in deep parts of the affected hemisphere in patients with perifocal edema. These data can indicate the role of glymphatic system dysfunction in pathogenesis of this pathology.
Collapse
Affiliation(s)
- A M Turkin
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - L M Fadeeva
- Burdenko Neurosurgical Center, Moscow, Russia
| | - A V Kozlov
- Burdenko Neurosurgical Center, Moscow, Russia
- Andijan State Medical Institute, Andijan, Uzbekistan
| | - A V Oshorov
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - Yu A Kozlova
- Botkin Moscow City Clinical Hospital, Moscow, Russia
| | - A V Petryaikin
- Research Practical Clinical Center for Diagnostics and Telemedicine Technologies, Moscow, Russia
| | - M V Ryzhova
- Burdenko Neurosurgical Center, Moscow, Russia
| | - I N Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
| |
Collapse
|
38
|
Rebmann E, Nabergoj M, Grandjean B, Stakia P, Stern A, Medinger M, Masouridi‐Levrat S, Dantin C, Schanz U, Baldomero H, Passweg J, Nair G, Rovo A, Chalandon Y. Allogeneic hematopoietic stem cell transplantation in non-Hodgkin lymphoma in Switzerland, 30 years of experience: Sooner is better. EJHaem 2022; 4:258-261. [PMID: 36819159 PMCID: PMC9928653 DOI: 10.1002/jha2.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/30/2022] [Indexed: 11/15/2022]
Abstract
Due to relatively high nonrelapse mortality (NRM), allogeneic hematopoietic stem cell transplantation (allo-HSCT) in non-Hodgkin's lymphoma (NHL) remains the ultimate line of treatment but the only curable approach in a setting of relapse/refractory disease. Here, we conducted a retrospective, multicenter, registry-based analysis on patients who underwent allo-HSCT for NHL in Switzerland, over 30-year (1985-2020) period. The study included 301 allo-HSCTs performed for NHL patients in three University Hospitals of Switzerland (Zurich, Basel and Geneva) 09/1985 to 05/2020. We assessed in univariate and multivariable analysis the impact on survivals (overall survival [OS], relapse free survival [RFS], relapse incidence [RI], and non-treatment related mortality [NRM]). The maximum follow-up was 25 years with median follow-up for alive patients of 61 months. The median age at allo-HSCT was 51 years. Three- and -year OS was - 59.5% and 55.4%; 3- and 5-year PFS was 50% and 44%; 3- and 5-year NRM was 21.7% and 23.6%. RI at 3 and 5 years was 27.4% and 34.9%. In conclusion, our analysis of the entire Swiss experience of allo-HSCT in patients with NHL shows promising 5- and possibly 10-year OS and relatively acceptable NRM rates for such population, the majority being not in complete remission (CR) at the time of transplantation.
Collapse
Affiliation(s)
- Ekaterina Rebmann
- Department of HematologyUniversity Hospital of Bern (Inselspital)BernSwitzerland,Department of Oncology‐HematologyHospital of Neuchâtel (RHNE)NeuchâtelSwitzerland
| | - Mitja Nabergoj
- Department of HematologyL'Hôpital Riviera‐ChablaisVaud‐ValaisSwitzerland
| | - Bastien Grandjean
- Department of HematologyUniversity Hospital of Bern (Inselspital)BernSwitzerland
| | - Paraskevi Stakia
- Department of HematologyGeneva University Hospitals (HUG)GenèveSwitzerland
| | - Alix Stern
- Department of Oncology‐HematologyHospital of Neuchâtel (RHNE)NeuchâtelSwitzerland,Faculty of MedicineUniversity of BaselBaselSwitzerland
| | - Michael Medinger
- Department of HematologyUniversity Hospital of Basel (USB)BaselSwitzerland
| | | | - Carole Dantin
- Department of HematologyGeneva University Hospitals (HUG)GenèveSwitzerland
| | - Urs Schanz
- Department of HematologyUniversity Hospital of Zurich (UZH)ZürichSwitzerland
| | - Helen Baldomero
- Department of HematologyUniversity Hospital of Basel (USB)BaselSwitzerland,SBST Data Registry OfficeUnivesiry Hospital of BaselBaselSwitzerland
| | - Jakob Passweg
- Department of HematologyUniversity Hospital of Basel (USB)BaselSwitzerland,Faculty of MedicineUniversity of BaselBaselSwitzerland
| | - Gayathri Nair
- Department of HematologyUniversity Hospital of Zurich (UZH)ZürichSwitzerland
| | - Alicia Rovo
- Department of HematologyUniversity Hospital of Bern (Inselspital)BernSwitzerland
| | - Yves Chalandon
- Department of HematologyGeneva University Hospitals (HUG)GenèveSwitzerland,Faculty of MedicineUniversity of GenevaGenevaSwitzerland
| |
Collapse
|
39
|
Du H, Yang L, Yan B, Zhao J, Wang M. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas. Open Med (Wars) 2022; 17:1252-1258. [PMID: 35892082 PMCID: PMC9281589 DOI: 10.1515/med-2022-0517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Research has suggested a significant prognostic value of ST-T changes in various cardiovascular diseases and malignant tumors. However, their role in predicting prognosis in patients with peripheral T-cell lymphomas (PTCLs) remains unknown. Here, we investigated the prognostic potential of ST-T changes in all-cause mortality of PTCLs patients. In total, 131 patients with PTCLs between January 2015 and April 2020 were enrolled. Univariable and multivariable COX proportional hazards regression models were used to find the relationship between ST-T changes and all-cause mortality in these patients. A significant difference in all-cause mortality was found between patients with ST-T abnormalities and those without definite abnormalities in the ST-T segments (P = 0.027). Multivariable Cox risk regression analysis indicated that patients with ST-T changes had greater all-cause mortality than patients with normal ST-T segments in the intermediate-high/high-risk groups (P < 0.001). In addition, ST-T changes were markedly distinction in patients with hypoproteinemia than in those with no definite abnormalities in the ST-T segments (P = 0.021). ST-T changes may serve as potential, simple, and effective prognostic factors for all-cause mortality in PTCLs patients, especially in the intermediate-high/high-risk and hypoproteinemia groups. Therefore, regular ECG monitoring is recommended to guide the clinical treatment of patients with PTCLs.
Collapse
Affiliation(s)
- Hanzhi Du
- Department of Haematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lihong Yang
- Department of Clinical Research Centre, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Bin Yan
- Department of Clinical Research Centre, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Juan Zhao
- Department of Haematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mengchang Wang
- Department of Haematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
40
|
Zhu K, Jamroz A, Huang S, Villa D, Freeman CL, Scott DW, Slack G, Sehn LH, Connors JM, Toze CL, Savage KJ, Gerrie AS. Outcomes of Hodgkin variant Richter transformation in chronic lymphocytic leukaemia and small lymphocytic lymphoma in British Columbia. Br J Haematol 2022; 198:684-692. [PMID: 35567407 DOI: 10.1111/bjh.18241] [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: 02/12/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/30/2022]
Abstract
Hodgkin variant Richter transformation (HvRT) is a rare and challenging complication of chronic lymphocytic leukaemia (CLL) for which information on prognostic factors and treatment approaches remain limited. We analysed characteristics and survival outcomes of a population-based cohort of 32 patients with HvRT identified in British Columbia over a 40-year period. Median interval from CLL diagnosis to HvRT was 5.6 years (range, 0-33.6), with five cases diagnosed concurrently. Most patients (80%) had treatment for CLL prior to HvRT. Median age at HvRT was 71 years (range, 51-86) and the majority of patients had high-risk disease, including stage 3-4 in 87% and International Prognostic Score (IPS) ≥ 4 in 65%. Two-year progression-free (PFS) and overall survival (OS) from HvRT were 47% (95% CI: 29%-64%) and 57% (95% CI: 38%-72%), respectively. OS from HvRT was significantly worse in those with anaemia (p = 0.02), elevated lactate dehydrogenase (p = 0.04), high IPS (p = 0.04), and worse performance status (p = 0.001). For those treated with curative-intent ABVD/ABVD-like therapy, 2-year PFS and OS were 70% (95% CI: 45%-85%) and 74% (95% CI: 49%-89%), respectively. In this real-world population-based cohort, HvRT was associated with poor clinical outcomes overall; however, those able to tolerate curative-intent therapy had similar survival to older patients with de novo HL.
Collapse
Affiliation(s)
- Kai Zhu
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Jamroz
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Steven Huang
- Leukemia/Bone Marrow Transplant Program of BC and Division of Hematology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Diego Villa
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ciara L Freeman
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Centre, Tampa, Florida, USA
| | - David W Scott
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Graham Slack
- Department of Pathology and Laboratory Medicine, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laurie H Sehn
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph M Connors
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cynthia L Toze
- Leukemia/Bone Marrow Transplant Program of BC and Division of Hematology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kerry J Savage
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alina S Gerrie
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
41
|
Kuhnl A, Roddie C, Kirkwood AA, Tholouli E, Menne T, Patel A, Besley C, Chaganti S, Sanderson R, O'Reilly M, Norman J, Osborne W, Bloor A, Lugthart S, Malladi R, Patten PEM, Neill L, Martinez-Cibrian N, Kennedy H, Phillips EH, Jones C, Sharplin K, El-Sharkawi D, Latif AL, Mathew A, Uttenthal B, Stewart O, Marzolini MAV, Townsend W, Cwynarski K, Ardeshna K, Ardavan A, Robinson K, Pagliuca A, Collins GP, Johnson R, McMillan A. A national service for delivering CD19 CAR-Tin large B-cell lymphoma - The UK real-world experience. Br J Haematol 2022; 198:492-502. [PMID: 35485402 DOI: 10.1111/bjh.18209] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/22/2022] [Accepted: 04/08/2022] [Indexed: 01/01/2023]
Abstract
CD19 CAR-T have emerged as a new standard treatment for relapsed/refractory (r/r) large B-cell lymphoma (LBCL). CAR-T real-world (RW) outcomes published to date suggest significant variability across countries. We provide results of a large national cohort of patients intended to be treated with CAR-T in the UK. Consecutive patients with r/r LBCL approved for CAR-T by the National CAR-T Clinical Panel between December 2018 and November 2020 across all UK CAR-T centres were included. 404/432 patients were approved [292 axicabtagene ciloleucel (axi-cel), 112 tisagenlecleucel (tisa-cel)], 300 (74%) received the cells. 110/300 (38.3%) patients achieved complete remission (CR) at 6 months (m). The overall response rate was 77% (52% CR) for axi-cel, 57% (44% CR) for tisa-cel. The 12-month progression-free survival was 41.8% (axi-cel) and 27.4% (tisa-cel). Median overall survival for the intention-to-treat population was 10.5 m, 16.2 m for infused patients. The incidence of grade ≥3 cytokine release syndrome and neurotoxicity were 7.6%/19.6% for axi-cel and 7.9%/3.9% for tisa-cel. This prospective RW population of CAR-T eligible patients offers important insights into the clinical benefit of CD19 CAR-T in LBCL in daily practice. Our results confirm long-term efficacy in patients receiving treatment similar to the pivotal trials, but highlight the significance of early CAR-T failure.
Collapse
Affiliation(s)
- Andrea Kuhnl
- Department of Haematology, King's College Hospital, London, UK
| | - Claire Roddie
- Department of Haematology, University College London Hospitals, London, UK.,UCL Cancer Institute, University College London, London, UK
| | - Amy A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK
| | - Eleni Tholouli
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - Amit Patel
- Department of Haematology, The Christie Hospital, Manchester, UK
| | - Caroline Besley
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - Sridhar Chaganti
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - Robin Sanderson
- Department of Haematology, King's College Hospital, London, UK
| | - Maeve O'Reilly
- Department of Haematology, University College London Hospitals, London, UK
| | - Jane Norman
- Department of Haematology, Manchester Royal Infirmary, Manchester, UK
| | - Wendy Osborne
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - Adrian Bloor
- Department of Haematology, The Christie Hospital, Manchester, UK
| | - Sanne Lugthart
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | - Ram Malladi
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK.,Department of Haematology, Addenbrookes Hospital, Cambridge, UK
| | - Piers E M Patten
- Department of Haematology, King's College Hospital, London, UK.,Comprehensive Cancer Centre, King's College London, London, UK
| | - Lorna Neill
- Department of Haematology, University College London Hospitals, London, UK
| | | | - Hannah Kennedy
- Department of Haematology, Freeman Hospital, Newcastle, UK
| | - Elizabeth H Phillips
- Department of Medical Oncology, The Christie Hospital, Manchester, UK.,Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Ceri Jones
- Department of Haematology, University Hospital of Wales, Cardiff, UK
| | - Kirsty Sharplin
- Department of Haematology, University Hospitals Bristol and Weston, Bristol, UK
| | | | | | - Amrith Mathew
- Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | | | - Orla Stewart
- Department of Haematology, King's College Hospital, London, UK
| | | | - William Townsend
- Department of Haematology, University College London Hospitals, London, UK
| | - Kate Cwynarski
- Department of Haematology, University College London Hospitals, London, UK
| | - Kirit Ardeshna
- Department of Haematology, University College London Hospitals, London, UK
| | - Arzhang Ardavan
- NCRI Consumer Forum, London, UK.,Department of Physics, University of Oxford, UK
| | | | | | - Graham P Collins
- Department of Haematology, Oxford University Hospital, Oxford, UK
| | | | - Andrew McMillan
- Department of Haematology, Nottingham University Hospitals, Nottingham, UK
| |
Collapse
|
42
|
Elessa D, Debureaux PE, Villesuzanne C, Davi F, Bravetti C, Harel S, Talbot A, Oksenhendler E, Malphettes M, Thieblemont C, Moatti H, Maarek O, Arnulf B, Royer B. Inflammatory Waldenström's macroglobulinaemia: A French monocentric retrospective study of 67 patients. Br J Haematol 2022; 197:728-735. [PMID: 35393650 DOI: 10.1111/bjh.18157] [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: 12/18/2021] [Revised: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 11/30/2022]
Abstract
Waldenström's macroglobulinaemia (WM) is a B-cell neoplasm resulting from bone marrow lymphoplasmacytic infiltration and monoclonal IgM secretion. Some patients present concomitant inflammatory syndrome attributed to the disease activity; we named this syndrome inflammatory WM (IWM). We retrospectively analysed all WM patients seen in a single tertiary referral centre from January 2007 to May 2021, and after excluding aetiologies for the inflammatory syndrome using a pertinent blood workup, including C-reactive protein (CRP), and imaging, we identified 67 (28%) IWM, 166 (68%) non-IWM, and nine (4%) WM with inflammatory syndrome of unknown origin. At treatment initiation, IWM patients had more severe anaemia (median Hb 90 vs 99 g/l; p < 0.01), higher platelet count (median 245 vs 196 × 109/l; p < 0.01) and comparable serum IgM level (median 24.9 vs 23.0 g/l; p = 0.28). A positive correlation was found between inflammatory and haematological responses (minimal response or better) (odds ratio 32.08; 95% confidence interval 8.80-98.03; p < 0.001). Overall survivals (OS) were similar (median OS: 17 vs 20 years; p = 0.11) but time to next treatment (TNT) was significantly shorter for IWM (TNT1: 1.6 vs 4.8 years, p < 0.0001). IWM mostly shared the same presentation and outcome as WM without inflammatory syndrome.
Collapse
Affiliation(s)
- Dikelele Elessa
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Pierre-Edouard Debureaux
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Camille Villesuzanne
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Frederic Davi
- Laboratory of Haematology, Hopital Pitie-Salpetriere, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Clotilde Bravetti
- Laboratory of Haematology, Hopital Pitie-Salpetriere, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Stephanie Harel
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Alexis Talbot
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Eric Oksenhendler
- University of Paris, Paris, France.,Department of Clinical Immunology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marion Malphettes
- University of Paris, Paris, France.,Department of Clinical Immunology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Catherine Thieblemont
- University of Paris, Paris, France.,Department of Haemato-Oncology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Hannah Moatti
- University of Paris, Paris, France.,Department of Haemato-Oncology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Odile Maarek
- University of Paris, Paris, France.,Laboratory of Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Bertrand Arnulf
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| | - Bruno Royer
- Department of Immuno Haematology, Hopital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France.,University of Paris, Paris, France
| |
Collapse
|
43
|
Tutino F, Giovannini E, Pastorino S, Ferrando O, Giovacchini G, Ciarmiello A. Methodological aspects and prognostic value of metabolic tumor volume assessed with 18F-FDG PET/CT in lymphomas. Curr Radiopharm 2022; 15:259-270. [PMID: 35352655 DOI: 10.2174/1874471015666220329120631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 11/22/2022]
Abstract
Metabolic tumor volume (MTV) assessed by pretreatment 18F-FDG PET/CT has shown significant prognostic value across many lymphoma types, although not yet used in clinical practice for technical concerns and need for standardization. Numerous studies on the prognostic value of MTV in lymphomas have been published in recent years, but there is still no full agreement on the best methodology for MTV calculation. In this paper, we reviewed the methodological aspects of MTV assessment and reported recent works about its impact on outcome in lymphomas, with a focus on Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL).
Collapse
Affiliation(s)
| | | | - Sara Pastorino
- Nuclear Medicine Unit, Sant'Andrea Hospital, La Spezia, Italy
| | | | | | | |
Collapse
|
44
|
Yang L, He J, Lin X, Zhao D, Lin X, Yan Z, Chen F. B-Cell Lymphoma Associated with COVID 19 Infection: A Case Report. Curr Med Imaging 2022; 18:1231-1234. [PMID: 35352666 DOI: 10.2174/1573405618666220329210311] [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: 12/15/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The most commen publications are related about COVID-19 diagnose in hematological malignancy patients, However, here we report a case involving a patient who was diagnosed with B-cell lymphoma while undergoing treatment for COVID-19, including the changes in major clinical symptoms and medical examinations, then explain of the probable causes of the case. CASE PRESENTATION A 74-year-old woman with a previous history of oesophageal cancer was admitted to the hospital after having cough and sputum for 15 days. Despite the COVID-19 symptoms, this patient did not have fever at time of the onset. Results of routine blood tests were normal at first but then declined with persistent fever, A whole-body CT examination ruled out the possibility of tumor-metastasis-related fever. This patient had no hepatosplenomegaly or regional lymphadenopathy, and there was no concrete evidence of haemophagocytic lymphohistiocytosis or lymphoma until bone marrow biopsy results confirmed the latter. CONCLUSION We describe an uncommen case of COVID-19 who was finally diagnosed with B-cell lymphoma. An awareness of persistent fever and declined routine blood tests caused by haematological malignancies instead of COVID-19 itself can aid in providing appropriate guidelines for management and treatment.
Collapse
Affiliation(s)
- Lili Yang
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Jiawei He
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Xiaoji Lin
- Department of Hematology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Dandan Zhao
- Department of Endocrinology, Wenzhou Medical University Affiliated Yueqing Hospital, Yueqing, Zhejiang 325000, China
| | - Xianhui Lin
- Department of Pathology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Feng Chen
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| |
Collapse
|
45
|
Kaji FA, Martinez-Calle N, Sovani V, Fox CP. Rare central nervous system lymphomas. Br J Haematol 2022; 197:662-678. [PMID: 35292959 PMCID: PMC9310777 DOI: 10.1111/bjh.18128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Central nervous system (CNS) lymphomas are rare malignancies characterised by lymphoid infiltration into the brain, spinal cord, cranial nerves, meninges and/or eyes in the presence or absence of previous or concurrent systemic disease. Most CNS lymphomas are of the diffuse large B-cell lymphoma (DLBCL) subtype for which treatment strategies, particularly the use of high-dose methotrexate-based protocols and consolidation with autologous stem cell transplantation, are well established. Other histopathological subtypes of CNS lymphoma are comparatively less common with published data on these rare lymphomas dominated by smaller case series and retrospective reports. Consequently, there exists little clinical consensus on the optimal methods to diagnose and manage these clinically and biologically heterogeneous CNS lymphomas. In this review article, we focus on rarer CNS lymphomas, summarising the available clinical data on incidence, context, diagnostic features, reported management strategies, and clinical outcomes.
Collapse
Affiliation(s)
- Furqaan Ahmed Kaji
- Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Vishakha Sovani
- Department of Histopathology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | |
Collapse
|
46
|
Hunter N, Haylock R. Radiation risks of lymphoma and multiple myeloma incidence in the updated NRRW-3 cohort in the UK: 1955-2011. J Radiol Prot 2022; 42:011517. [PMID: 33721859 DOI: 10.1088/1361-6498/abee96] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
The effect of external radiation on lymphoma, including non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL) and multiple myeloma (MM) incidence was evaluated in the National Registry for Radiation Workers based upon the third analysis cohort but with an additional 10 years of follow-up. The study includes 172 452 workers, of whom (90%) were men with 5.25 million person-years of follow-up from 1955 through to the end of 2011. A total of 711 cases of NHL, 113 cases of HL and 279 cases of MM were registered. Poisson regression was used to estimate the excess relative risk per unit of cumulative exposure to ionising radiation. A statistically significant association was found between radiation dose and the incidence of NHL and MM. There was no evidence of radiation associated excess risk for HL. The reported associations are based on a very small proportion of exposed workers, in particular among workers with cumulative doses above 0.5 Sv so should be treated with caution, further investigations are necessary to confirm our results.
Collapse
Affiliation(s)
- Nezahat Hunter
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards (CRCE), Chilton, Oxon OX11 0RQ, United Kingdom
| | - Richard Haylock
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards (CRCE), Chilton, Oxon OX11 0RQ, United Kingdom
| |
Collapse
|
47
|
Jain MD, Spiegel JY. Imagining the cell therapist: Future CAR T cell monitoring and intervention strategies to improve patient outcomes. EJHaem 2022; 3:46-53. [PMID: 35844298 PMCID: PMC9175904 DOI: 10.1002/jha2.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 12/26/2022]
Abstract
Chimeric antigen receptor (CAR) T cell therapy is now approved for the standard of care treatment of several types of relapsed or refractory hematologic malignancies. Future advances may extend cellular therapies to solid tumors or even non-malignant diseases. As patient need grows, a clinical specialty of "cell therapy" may emerge. Here, we envision the needs of a clinical cell therapist to monitor and intervene upon patients receiving cell therapies. These include: (1) monitoring patient T cell quality and the host immune environment to ensure optimal timing for cell therapy. (2) Tumor antigen profiling to personalize CAR T cell targeting. (3) Real-time monitoring of CAR T cells and circulating tumor DNA to modulate CAR T cell activity to maximize tumor eradication while mitigating toxicity. (4) Monitoring of CAR rejection and anti-CAR immunity posttreatment to inform re-dosing and subsequent cell therapy strategies. Armed with these tools, the future Cell Therapist may optimize and personalize treatment to avoid toxicity and improve efficacy universally across CAR designs.
Collapse
Affiliation(s)
- Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular ImmunotherapyMoffitt Cancer Center, and Department of Oncologic SciencesMorsani College of MedicineUniversity of South FloridaTampaFloridaUSA
| | - Jay Y. Spiegel
- Division of Transplant and Cellular TherapySylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| |
Collapse
|
48
|
Cowell JK, Hu T. Mechanisms of resistance to FGFR1 inhibitors in FGFR1-driven leukemias and lymphomas: implications for optimized treatment. Cancer Drug Resist 2021; 4:607-619. [PMID: 34734169 PMCID: PMC8562765 DOI: 10.20517/cdr.2021.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Myeloid and lymphoid neoplasms with eosinophilia and FGFR1 rearrangements (MLN-eo FGFR1) disease is derived from a pluripotent hematopoietic stem cell and has a complex presentation with a myeloproliferative disorder with or without eosinophilia and frequently presents with mixed lineage T- or B-lymphomas. The myeloproliferative disease frequently progresses to AML and lymphoid neoplasms can develop into acute lymphomas. No matter the cell type involved, or clinical presentation, chromosome translocations involving the FGFR1 kinase and various partner genes, which leads to constitutive activation of downstream oncogenic signaling cascades. These patients are not responsive to treatment regimens developed for other acute leukemias and survival is poor. Recent development of specific FGFR1 inhibitors has suggested an alternative therapeutic approach but resistance is likely to evolve over time. Mouse models of this disease syndrome have been developed and are being used for preclinical evaluation of FGFR1 inhibitors. Cell lines from these models have now been developed and have been used to investigate the mechanisms of resistance that might be expected in clinical cases. So far, a V561M mutation in the kinases domain and deletion of PTEN have been recognized as leading to resistance and both operate through the PI3K/AKT signaling axis. One of the important consequences is the suppression of PUMA, a potent enforcer of apoptosis, which operates through BCL2. Targeting BCL2 in the resistant cells leads to suppression of leukemia development in mouse models, which potentially provides an opportunity to treat patients that become resistant to FGFR1 inhibitors. In addition, elucidation of molecular mechanisms underlying FGFR1-driven leukemias and lymphomas also provides new targets for combined treatment as another option to bypass the FGFR1 inhibitor resistance and improve patient outcome.
Collapse
Affiliation(s)
- John K Cowell
- Georgia Cancer Center, 1410 Laney Walker Blvd, Augusta, GA 30912, USA
| | - Tianxiang Hu
- Georgia Cancer Center, 1410 Laney Walker Blvd, Augusta, GA 30912, USA
| |
Collapse
|
49
|
Errichetti E, Geller S, Zalaudek I, Longo C, Kyrgidis A, Akay BN, Piccolo V, Myskowski P, Vitiello P, Russo T, Argenziano G, Sławińska M, Sokołowska-Wojdyło M, Sobjanek M, Toncic RJ, Rados J, Drvar DL, Ceovic R, Kaminska-Winciorek G, Zaballos P, Reggiani C, Kremic Z, Lanssens S, Güleç AT, Lobato-Berezo A, Damiani G, Maione V, Calzavara-Pinton P, Sotiriou E, Stinco G, Apalla Z, Lallas A. Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society. J Am Acad Dermatol 2021:S0190-9622(21)02673-6. [PMID: 34695527 DOI: 10.1016/j.jaad.2021.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available. OBJECTIVE To describe dermatoscopic features of nodular/plaque-type PCLs, comparing them with those of clinical mimickers (pseudolymphomas, tumors, and inflammatory lesions) and investigating possible differences according to histologic subtypes. METHODS Participants were invited to join this retrospective, multicenter case-control study by submitting histologically/immunohistochemically confirmed instances of nodular/plaque-type PCLs and controls. Standardized assessments of the dermatoscopic images and comparative analyses were performed. RESULTS A total of 261 lesions were included (121 PCLs and 140 controls). Orange structureless areas were the strongest PCL dermatoscopic predictor on multivariate analysis compared with tumors and noninfiltrative inflammatory dermatoses. On the other hand, a positive association was found between PCLs and either unfocused linear vessels with branches or focal white structureless areas compared with infiltrative inflammatory dermatoses, whereas white lines were predictive of PCLs over pseudolymphomas. Differences in the vascular pattern were also seen between B- and T-cell PCLs and among B-cell PCL subtypes. LIMITATIONS Retrospective design and the lack of a dermatoscopic-pathologic correlation analysis. CONCLUSION Nodular/plaque-type PCLs display dermatoscopic clues, which may partially vary according to histologic subtype and whose diagnostic relevance depends on the considered clinical differential diagnoses.
Collapse
|
50
|
Al Tabaa Y, Bailly C, Kanoun S. FDG-PET/CT in Lymphoma: Where Do We Go Now? Cancers (Basel) 2021; 13:cancers13205222. [PMID: 34680370 PMCID: PMC8533807 DOI: 10.3390/cancers13205222] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 01/06/2023] Open
Abstract
18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is an essential part of the management of patients with lymphoma at staging and response evaluation. Efforts to standardize PET acquisition and reporting, including the 5-point Deauville scale, have enabled PET to become a surrogate for treatment success or failure in common lymphoma subtypes. This review summarizes the key clinical-trial evidence that supports PET-directed personalized approaches in lymphoma but also points out the potential place of innovative PET/CT metrics or new radiopharmaceuticals in the future.
Collapse
Affiliation(s)
- Yassine Al Tabaa
- Scintidoc Nuclear Medicine Center, 25 rue de Clémentville, 34070 Montpellier, France
- Correspondence:
| | - Clement Bailly
- CRCINA, INSERM, CNRS, Université d’Angers, Université de Nantes, 44093 Nantes, France;
- Nuclear Medicine Department, University Hospital, 44093 Nantes, France
| | - Salim Kanoun
- Nuclear Medicine Department, Institute Claudius Regaud, 31100 Toulouse, France;
- Cancer Research Center of Toulouse (CRCT), Team 9, INSERM UMR 1037, 31400 Toulouse, France
| |
Collapse
|