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Tiso F, Hebeda KM, Langemeijer SMC, de Graaf AO, Martens JHA, Koorenhof-Scheele TN, Knops R, Kroeze LI, van der Reijden BA, Jansen JH. Erythroid predominance in bone marrow biopsies of AML patients after decitabine treatment correlates with mutation profile and complete remission. Pathobiology 2024:000538953. [PMID: 38643752 DOI: 10.1159/000538953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/15/2024] [Indexed: 04/23/2024] Open
Abstract
INTRODUCTION Acute myeloid leukemia (AML) patients may receive hypomethylating agents (HMAs) such as decitabine (DAC) as part of their treatment. Not all patients respond to this therapy, and if they do the clinical response may occur only after 3 to 6 courses of treatment. Hence, early biomarkers predicting response would be very useful. METHODS We retrospectively analyzed a cohort of 22 AML patients who were treated with DAC. Histology of the bone marrow biopsy, pathogenic mutations and methylation status were related to the treatment response. RESULTS In 8/22 (36%) patients, an erythroid dominant response (EDR) pattern, defined as a ratio of myeloid cells/erythroid cells < 1, was observed. In the remaining 14 cases a myeloid predominance was preserved during treatment. No difference in the hypomethylating effect of DAC treatment was observed in patients with and without EDR, as global 5-methylcytosine levels dropped similarly in both groups. Mutational analysis by NGS using a panel of commonly mutated genes in AML, showed that patients with an early EDR harbored on average less mutations, with U2AF1 mutations occurring more frequently, whereas RUNX1 mutations were underrepresented compared to non-EDR cases. Interestingly, the development of an EDR correlated with complete remission (7/8 cases with an EDR versus only 2/14 cases without an EDR). CONCLUSION We conclude that early histological bone marrow examination for the development of an EDR may be helpful to predict response in AML patients during treatment with DAC.
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Berendsen MR, van Bladel DA, Hesius E, Berganza Irusquieta C, Rijntjes J, van Spriel AB, van der Spek E, Pruijt JF, Kroeze LI, Hebeda KM, Croockewit S, Stevens WB, van Krieken JHJ, Groenen PJ, van den Brand M, Scheijen B. Clonal Relationship and Mutation Analysis in Lymphoplasmacytic Lymphoma/Waldenström Macroglobulinemia Associated With Diffuse Large B-cell Lymphoma. Hemasphere 2023; 7:e976. [PMID: 37928625 PMCID: PMC10621888 DOI: 10.1097/hs9.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023] Open
Abstract
Patients with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) occasionally develop diffuse large B-cell lymphoma (DLBCL). This mostly results from LPL/WM transformation, although clonally unrelated DLBCL can also arise. LPL/WM is characterized by activating MYD88L265P (>95%) and CXCR4 mutations (~30%), but the genetic drivers of transformation remain to be identified. Here, in thirteen LPL/WM patients who developed DLBCL, the clonal relationship of LPL and DLBCL together with mutations contributing to transformation were investigated. In 2 LPL/WM patients (15%), high-throughput sequencing of immunoglobulin gene rearrangements showed evidence of >1 clonal B-cell population in LPL tissue biopsies. In the majority of LPL/WM patients, DLBCL presentations were clonally related to the dominant clone in LPL, providing evidence of transformation. However, in 3 patients (23%), DLBCL was clonally unrelated to the major malignant B-cell clone in LPL, of which 2 patients developed de novo DLBCL. In this study cohort, LPL displayed MYD88L265P mutation in 8 out of eleven patients analyzed (73%), while CXCR4 mutations were observed in 6 cases (55%). MYD88WT LPL biopsies present in 3 patients (27%) were characterized by CD79B and TNFAIP3 mutations. Upon transformation, DLBCL acquired novel mutations targeting BTG1, BTG2, CD79B, CARD11, TP53, and PIM1. Together, we demonstrate variable clonal B-cell dynamics in LPL/WM patients developing DLBCL, and the occurrence of clonally unrelated DLBCL in about one-quarter of LPL/WM patients. Moreover, we identified commonly mutated genes upon DLBCL transformation, which together with preserved mutations already present in LPL characterize the mutational landscape of DLBCL occurrences in LPL/WM patients.
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Affiliation(s)
| | - Diede A.G. van Bladel
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eva Hesius
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Jos Rijntjes
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annemiek B. van Spriel
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Johannes F.M. Pruijt
- Department of Hematology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands
| | - Leonie I. Kroeze
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra Croockewit
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wendy B.C. Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | | | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
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van Bladel DAG, Stevens WBC, Kroeze LI, de Groen RAL, de Groot FA, van der Last-Kempkes JLM, Berendsen MR, Rijntjes J, Luijks JACW, Bonzheim I, van der Spek E, Plattel WJ, Pruijt JFM, de Jonge-Peeters SDPWM, Velders GA, Lensen C, van Bladel ER, Federmann B, Hoevenaars BM, Pastorczak A, van der Werff ten Bosch J, Vermaat JSP, Nooijen PTGA, Hebeda KM, Fend F, Diepstra A, van Krieken JHJM, Groenen PJTA, van den Brand M, Scheijen B. A significant proportion of classic Hodgkin lymphoma recurrences represents clonally unrelated second primary lymphoma. Blood Adv 2023; 7:5911-5924. [PMID: 37552109 PMCID: PMC10558751 DOI: 10.1182/bloodadvances.2023010412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
Despite high cure rates in classic Hodgkin lymphoma (cHL), relapses are observed. Whether relapsed cHL represents second primary lymphoma or an underlying T-cell lymphoma (TCL) mimicking cHL is underinvestigated. To analyze the nature of cHL recurrences, in-depth clonality testing of immunoglobulin (Ig) and T-cell receptor (TCR) rearrangements was performed in paired cHL diagnoses and recurrences among 60 patients, supported by targeted mutation analysis of lymphoma-associated genes. Clonal Ig rearrangements were detected by next-generation sequencing (NGS) in 69 of 120 (58%) diagnoses and recurrence samples. The clonal relationship could be established in 34 cases, identifying clonally related relapsed cHL in 24 of 34 patients (71%). Clonally unrelated cHL was observed in 10 of 34 patients (29%) as determined by IG-NGS clonality assessment and confirmed by the identification of predominantly mutually exclusive gene mutations in the paired cHL samples. In recurrences of >2 years, ∼60% of patients with cHL for whom the clonal relationship could be established showed a second primary cHL. Clonal TCR gene rearrangements were identified in 14 of 125 samples (11%), and TCL-associated gene mutations were detected in 7 of 14 samples. Retrospective pathology review with integration of the molecular findings were consistent with an underlying TCL in 5 patients aged >50 years. This study shows that cHL recurrences, especially after 2 years, sometimes represent a new primary cHL or TCL mimicking cHL, as uncovered by NGS-based Ig/TCR clonality testing and gene mutation analysis. Given the significant therapeutic consequences, molecular testing of a presumed relapse in cHL is crucial for subsequent appropriate treatment strategies adapted to the specific lymphoma presentation.
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Affiliation(s)
| | - Wendy B. C. Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Leonie I. Kroeze
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ruben A. L. de Groen
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fleur A. de Groot
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Jos Rijntjes
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Irina Bonzheim
- Institute of Pathology and Neuropathology, Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | | | - Wouter J. Plattel
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | - Gerjo A. Velders
- Department of Internal Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Chantal Lensen
- Department of Hematology, Bernhoven Hospital, Uden, The Netherlands
| | - Esther R. van Bladel
- Department of Internal Medicine, Slingeland Hospital, Doetinchem, The Netherlands
| | - Birgit Federmann
- Institute of Pathology and Neuropathology, Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
- Department of Translational Immunology, German Cancer Research Center, Medical Hospital Tübingen, Tübingen, Germany
| | | | - Agata Pastorczak
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - Jutte van der Werff ten Bosch
- Department of Pediatric Hematology and Oncology, University Hospital Brussels, Brussels, Belgium
- Department of Pediatrics, Paola Children’s Hospital, Antwerp, Belgium
| | - Joost S. P. Vermaat
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Falko Fend
- Institute of Pathology and Neuropathology, Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Arjan Diepstra
- Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
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Staal AHJ, Cortenbach KRG, Gorris MAJ, van der Woude LL, Srinivas M, Heijmen RH, Geuzebroek GSC, Grewal N, Hebeda KM, de Vries IJM, DeRuiter MC, van Kimmenade RRJ. Adventitial adaptive immune cells are associated with ascending aortic dilatation in patients with a bicuspid aortic valve. Front Cardiovasc Med 2023; 10:1127685. [PMID: 37057097 PMCID: PMC10086356 DOI: 10.3389/fcvm.2023.1127685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/14/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundBicuspid aortic valve (BAV) is associated with ascending aorta aneurysms and dissections. Presently, genetic factors and pathological flow patterns are considered responsible for aneurysm formation in BAV while the exact role of inflammatory processes remains unknown.MethodsIn order to objectify inflammation, we employ a highly sensitive, quantitative immunohistochemistry approach. Whole slides of dissected, dilated and non-dilated ascending aortas from BAV patients were quantitatively analyzed.ResultsDilated aortas show a 4-fold increase of lymphocytes and a 25-fold increase in B lymphocytes in the adventitia compared to non-dilated aortas. Tertiary lymphoid structures with B cell follicles and helper T cell expansion were identified in dilated and dissected aortas. Dilated aortas were associated with an increase in M1-like macrophages in the aorta media, in contrast the number of M2-like macrophages did not change significantly.ConclusionThis study finds unexpected large numbers of immune cells in dilating aortas of BAV patients. These findings raise the question whether immune cells in BAV aortopathy are innocent bystanders or contribute to the deterioration of the aortic wall.
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Affiliation(s)
- Alexander H. J. Staal
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Kimberley R. G. Cortenbach
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Mark A. J. Gorris
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Division of Immunotherapy, Oncode Institute, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lieke L. van der Woude
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Division of Immunotherapy, Oncode Institute, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Mangala Srinivas
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Cell Biology and Immunology, Wageningen University and Research, Wageningen, Netherlands
| | - Robin H. Heijmen
- Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Nimrat Grewal
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - I. Jolanda M. de Vries
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marco C. DeRuiter
- Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands
| | - Roland R. J. van Kimmenade
- Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands
- *Correspondence: Roland R. J. van Kimmenade,
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van Eekelen L, Litjens G, Hebeda KM. Artificial Intelligence in Bone Marrow Histological Diagnostics: Potential Applications and Challenges. Pathobiology 2023; 91:8-17. [PMID: 36791682 PMCID: PMC10937040 DOI: 10.1159/000529701] [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: 12/30/2022] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The expanding digitalization of routine diagnostic histological slides holds a potential to apply artificial intelligence (AI) to pathology, including bone marrow (BM) histology. In this perspective, we describe potential tasks in diagnostics that can be supported, investigations that can be guided, and questions that can be answered by the future application of AI on whole-slide images of BM biopsies. These range from characterization of cell lineages and quantification of cells and stromal structures to disease prediction. First glimpses show an exciting potential to detect subtle phenotypic changes with AI that are due to specific genotypes. The discussion is illustrated by examples of current AI research using BM biopsy slides. In addition, we briefly discuss current challenges for implementation of AI-supported diagnostics.
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Affiliation(s)
- Leander van Eekelen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
- Computational Pathology Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Litjens
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
- Computational Pathology Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
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6
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Hesius EAM, van Laar L, Oosterveld M, van Spriel AB, Scheijen B, Leeuwis JW, Marres HAM, Groenen PJTA, Stevens WBC, van der Spek E, van den Brule AJC, Hoevenaars BM, Hebeda KM, van den Brand M. Reclassification of diffuse large B cell lymphoma to large B cell lymphoma with IRF4 rearrangement in an adult population. Histopathology 2023; 82:1013-1020. [PMID: 36779226 DOI: 10.1111/his.14885] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/16/2023] [Accepted: 02/09/2023] [Indexed: 02/14/2023]
Abstract
AIMS Large B cell lymphoma with IRF4 rearrangement (LBCL-IRF4) is a new entity in the 2017 revised World Health Organisation (WHO) classification that was initially mainly reported in children. After identification of a 79-year-old patient, we assessed how often IRF4 rearrangements can be detected in adult diffuse large B cell lymphomas (DLBCLs) which have to be reclassified to LBCL-IRF4 based on fluorescence in-situ hybridisation (FISH) for IRF4. METHODS AND RESULTS With FISH, we studied the presence of IRF4 rearrangements in 238 lymphomas that were diagnosed as DLBCL according to the previous WHO classification of 2008. CONCLUSIONS In addition to the index patient, an IRF4 rearrangement was detected in another five of 237 patients (2%). The immunohistochemical profile of these five IRF4 rearranged lymphomas was consistent with previous reports of LBCL-IRF4. One case was recognised to represent transformation of follicular lymphoma rather than de-novo LBCL-IRF4. BCL6 rearrangements were found in two cases of LBCL-IRF4; BCL2 and MYC rearrangements were excluded. Patients presented with limited stage disease with involvement of the head and neck in three patients, and involvement of the lung and thyroid in two others. This study shows that, although rare, LBCL-IRF4 should also be considered in older patients and at localisations other than the head and neck region.
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Affiliation(s)
- Eva A M Hesius
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lidia van Laar
- Pathology-DNA, Rijnstate Hospital, Arnhem, the Netherlands.,Pathology-DNA, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Margriet Oosterveld
- Department of Hematology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Annemiek B van Spriel
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Henri A M Marres
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Wendy B C Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Brigiet M Hoevenaars
- Department of Pathology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michiel van den Brand
- Pathology-DNA, Rijnstate Hospital, Arnhem, the Netherlands.,Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
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7
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Groenen PJTA, van den Brand M, Kroeze LI, Amir AL, Hebeda KM. Read the clonotype: Next-generation sequencing-based lymphocyte clonality analysis and perspectives for application in pathology. Front Oncol 2023; 13:1107171. [PMID: 36845702 PMCID: PMC9945094 DOI: 10.3389/fonc.2023.1107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023] Open
Abstract
Clonality assessment using the unique rearrangements of immunoglobulin (IG) and T-cell receptor (TR) genes in lymphocytes is a widely applied supplementary test for the diagnosis of B-cell and T-cell lymphoma. To enable a more sensitive detection and a more precise comparison of clones compared with conventional clonality analysis based on fragment analysis, the EuroClonality NGS Working Group developed and validated a next-generation sequencing (NGS)-based clonality assay for detection of the IG heavy and kappa light chain and TR gene rearrangements for formalin-fixed and paraffin-embedded tissues. We outline the features and advantages of NGS-based clonality detection and discuss potential applications for NGS-based clonality testing in pathology, including site specific lymphoproliferations, immunodeficiency and autoimmune disease and primary and relapsed lymphomas. Also, we briefly discuss the role of T-cell repertoire of reactive lymphocytic infiltrations in solid tumors and B-lymphoma.
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Affiliation(s)
- Patricia J. T. A. Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands,*Correspondence: Patricia J. T. A. Groenen,
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Pathology-DNA, Location Rijnstate Hospital, Arnhem, Netherlands
| | - Leonie I. Kroeze
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Avital L. Amir
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Konnie M. Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
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8
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Berendsen MR, Bladel DAGV, Hesius E, de Groot FA, Kroeze LI, Rijntjes J, Luijks JACW, Hoevenaars B, Halilovic A, Nooijen P, Bladel EV, Jonge-Peeters SD, Lensen C, Pruijt H, van der Spek E, Vermaat JSP, Hess C, Hebeda KM, Stevens WBC, van Krieken JHJM, van den Brand M, Groenen PJTA, Scheijen B. Detection of Second Primary Lymphoma in Late Diffuse Large B-cell Lymphoma Recurrences. Mod Pathol 2023; 36:100119. [PMID: 36805792 DOI: 10.1016/j.modpat.2023.100119] [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: 10/21/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
Approximately one-third of patients with diffuse large B-cell lymphoma (DLBCL) relapse and often require salvage chemotherapy followed by autologous stem cell transplantation. In most cases, the clonal relationship between the first diagnosis and subsequent relapse is not assessed, thereby potentially missing the identification of second primary lymphoma. In this study, the clonal relationship of 59 paired DLBCL diagnoses and recurrences was established by next-generation sequencing-based detection of immunoglobulin gene rearrangements. Among 50 patients with interpretable results, 43 patients (86%) developed clonally related relapsed disease. This was observed in 100% of early recurrences (<2 years), 80% of the recurrences with an interval between 2 and 5 years, and 73% of late recurrences (≥5 years). On the other hand, 7 (14%) out of 50 patients displayed different dominant clonotypes in primary DLBCL and clinical recurrences, confirming the occurrence of second primary DLBCL; 37% of DLBCL recurrences that occurred ≥4 years after diagnosis were shown to be second primary lymphomas. The clonally unrelated cases were Epstein-Barr virus positive in 43% of the cases, whereas this was only 5% in the relapsed DLBCL cases. In conclusion, next-generation sequencing-based clonality testing in late recurrences should be considered in routine diagnostics to distinguish relapse from second primary lymphoma, as this latter group of patients with DLBCL may benefit from less-intensive treatment strategies.
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Affiliation(s)
- Madeleine R Berendsen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Diede A G van Bladel
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Eva Hesius
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fleur A de Groot
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leonie I Kroeze
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos Rijntjes
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen A C W Luijks
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brigiet Hoevenaars
- Department of Pathology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Altuna Halilovic
- Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Peet Nooijen
- Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Esther van Bladel
- Department of Hematology, Slingeland Hospital, Doetinchem, The Netherlands
| | | | - Chantal Lensen
- Department of Hematology, Bernhoven Hospital, Uden, The Netherlands
| | - Hans Pruijt
- Department of Hematology Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Joost S P Vermaat
- Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Corine Hess
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wendy B C Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Han J M van Krieken
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
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9
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Kolijn PM, Huijser E, Wahadat MJ, van Helden-Meeuwsen CG, van Daele PLA, Brkic Z, Rijntjes J, Hebeda KM, Groenen PJTA, Versnel MA, Thurlings RM, Langerak AW. Extranodal marginal zone lymphoma clonotypes are detectable prior to eMZL diagnosis in tissue biopsies and peripheral blood of Sjögren's syndrome patients through immunogenetics. Front Oncol 2023; 13:1130686. [PMID: 37035202 PMCID: PMC10076775 DOI: 10.3389/fonc.2023.1130686] [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: 12/23/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Activated B cells play a key role in the pathogenesis of primary Sjögren's syndrome (pSS) through the production of autoantibodies and the development of ectopic germinal centers in the salivary glands and other affected sites. Around 5-10% of pSS patients develop B-cell lymphoma, usually extranodal marginal zone lymphomas (eMZL) of the mucosa-associated lymphoid tissue (MALT). The aim of the current study is to investigate if the eMZL clonotype is detectable in prediagnostic blood and tissue biopsies of pSS patients. Methods/Results We studied prediagnostic tissue biopsies of three pSS patients diagnosed with eMZL and four pSS controls through immunoglobulin (IG) gene repertoire sequencing. In all three cases, we observed the eMZL clonotype in prediagnostic tissue biopsies. Among controls, we observed transient elevation of clonotypes in two pSS patients. To evaluate if eMZL clonotypes may also be detected in the circulation, we sequenced a peripheral blood mononuclear cell (PBMC) sample drawn at eMZL diagnosis and two years prior to eMZL relapse in two pSS patients. The eMZL clonotype was detected in the peripheral blood prior to diagnosis in both cases. Next, we selected three pSS patients who developed eMZL lymphoma and five additional pSS patients who remained lymphoma-free. We sequenced the IG heavy chain (IGH) gene repertoire in PBMC samples taken a median of three years before eMZL diagnosis. In two out of three eMZL patients, the dominant clonotype in the prediagnostic PBMC samples matched the eMZL clonotype in the diagnostic biopsy. The eMZL clonotypes observed consisted of stereotypic IGHV gene combinations (IGHV1-69/IGHJ4 and IGHV4-59/IGHJ5) associated with rheumatoid factor activity, a previously reported feature of eMZL in pSS. Discussion In conclusion, our results indicate that eMZL clonotypes in pSS patients are detectable prior to overt eMZL diagnosis in both tissue biopsies and peripheral blood through immunogenetic sequencing, paving the way for the development of improved methods of early detection of eMZL.
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Affiliation(s)
- P. Martijn Kolijn
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, Rotterdam, Netherlands
| | - Erika Huijser
- Department of Immunology, Erasmus MC, Rotterdam, Netherlands
| | - M. Javad Wahadat
- Department of Immunology, Erasmus MC, Rotterdam, Netherlands
- Department of Paediatric Rheumatology, Sophia Children’s Hospital, Erasmus MC, Rotterdam, Netherlands
| | | | - Paul L. A. van Daele
- Department of Immunology, Erasmus MC, Rotterdam, Netherlands
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, Rotterdam, Netherlands
| | - Zana Brkic
- Department of Internal Medicine, Division of Clinical Immunology, Erasmus MC, Rotterdam, Netherlands
| | - Jos Rijntjes
- Department of Pathology, Radboudumc, Nijmegen, Netherlands
| | | | | | | | | | - Anton W. Langerak
- Department of Immunology, Laboratory Medical Immunology, Erasmus MC, Rotterdam, Netherlands
- *Correspondence: Anton W. Langerak,
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10
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Kroeze LI, Scheijen B, Hebeda KM, Rijntjes J, Luijks JACW, Evers D, Hobo W, Groenen PJTA, van den Brand M. PAX5 P80R-mutated B-cell acute lymphoblastic leukemia with transformation to histiocytic sarcoma: clonal evolution assessment using NGS-based immunoglobulin clonality and mutation analysis. Virchows Arch 2022:10.1007/s00428-022-03428-y. [PMID: 36241730 DOI: 10.1007/s00428-022-03428-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/14/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022]
Abstract
Clonality assessment by the detection of immunoglobulin (IG) gene rearrangements is an important method to determine whether two concurrent or subsequent lymphoid malignancies in one patient are clonally related. Here, we report the detailed clonality analysis in a patient with a diagnosis of B-cell acute lymphoblastic leukemia (B-ALL) followed by a histiocytic sarcoma (HS), in which we were able to study clonal evolution by applying next generation sequencing (NGS) to identify IG rearrangements and gene mutations. Using the sequence information of the NGS-based IG clonality analysis, multiple related subclones could be distinguished in the PAX5 P80R-mutated B-ALL. Notably, only one of these subclones evolved into HS after acquiring a RAF1 mutation. This case demonstrates that NGS-based IG clonality assessment and mutation analysis provide clear added value for clonal comparison and thereby improves clinicobiological understanding.
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Affiliation(s)
- Leonie I Kroeze
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.
| | - B Scheijen
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands.,Radboud Institute for Molecular Life Sciences, Nijmegen, the Netherlands
| | - K M Hebeda
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands
| | - J Rijntjes
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands
| | - J A C W Luijks
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands
| | - D Evers
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - W Hobo
- Department of Laboratory Medicine - Laboratory of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - P J T A Groenen
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands
| | - M van den Brand
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA, Nijmegen, the Netherlands
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11
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van Bladel DAG, Stevens WBC, van den Brand M, Kroeze LI, Groenen PJTA, van Krieken JHJM, Hebeda KM, Scheijen B. Novel Approaches in Molecular Characterization of Classical Hodgkin Lymphoma. Cancers (Basel) 2022; 14:cancers14133222. [PMID: 35805000 PMCID: PMC9264882 DOI: 10.3390/cancers14133222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary The unique tumor composition of classical Hodgkin lymphoma (cHL), with only a small fraction of malignant Hodgkin and Reed–Sternberg cells within the tumor tissue, has created many challenges to characterize the genetic alterations that drive this lymphoid malignancy. Major advances in sequencing technologies and detailed analysis of circulating tumor DNA in blood samples of patients have provided important contributions to enhance our understanding of the pathogenesis of cHL. In this review, we provide an overview of the recent advances in genotyping the clonal and mutational landscape of cHL. In addition, we discuss different next-generation sequencing applications to characterize tumor tissue and cell-free DNA, which are now available to improve the diagnosis of cHL, and to monitor therapeutic response or disease progression during treatment and follow up of cHL patients. Abstract Classical Hodgkin lymphoma (cHL) represents a B-cell lymphoproliferative disease characterized by clonal immunoglobulin gene rearrangements and recurrent genomic aberrations in the Hodgkin Reed–Sternberg cells in a reactive inflammatory background. Several methods are available for the molecular analysis of cHL on both tissue and cell-free DNA isolated from blood, which can provide detailed information regarding the clonal composition and genetic alterations that drive lymphoma pathogenesis. Clonality testing involving the detection of immunoglobulin and T cell receptor gene rearrangements, together with mutation analysis, represent valuable tools for cHL diagnostics, especially for patients with an atypical histological or clinical presentation reminiscent of a reactive lesion or another lymphoma subtype. In addition, clonality assessment may establish the clonal relationship of composite or subsequent lymphoma presentations within one patient. During the last few decades, more insight has been obtained on the molecular mechanisms that drive cHL development, including recurrently affected signaling pathways (e.g., NF-κB and JAK/STAT) and immune evasion. We provide an overview of the different approaches to characterize the molecular composition of cHL, and the implementation of these next-generation sequencing-based techniques in research and diagnostic settings.
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Affiliation(s)
- Diede A. G. van Bladel
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
- Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, The Netherlands
| | - Wendy B. C. Stevens
- Radboud University Medical Center, Department of Hematology, 6525 GA Nijmegen, The Netherlands;
| | - Michiel van den Brand
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
- Pathology-DNA, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
| | - Leonie I. Kroeze
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
| | - Patricia J. T. A. Groenen
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
| | - J. Han J. M. van Krieken
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
| | - Konnie M. Hebeda
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
| | - Blanca Scheijen
- Radboud University Medical Center, Department of Pathology, 6525 GA Nijmegen, The Netherlands; (D.A.G.v.B.); (M.v.d.B.); (L.I.K.); (P.J.T.A.G.); (J.H.J.M.v.K.); (K.M.H.)
- Radboud Institute for Molecular Life Sciences, 6525 GA Nijmegen, The Netherlands
- Correspondence:
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12
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Reedijk AM, Beishuizen A, Coebergh JWW, Hoeben BA, Kremer LC, Hebeda KM, Pieters R, Loeffen JL, Karim-Kos HE. Progress against non-Hodgkin's lymphoma in children and young adolescents in the Netherlands since 1990: Stable incidence, improved survival and lower mortality. Eur J Cancer 2022; 163:140-151. [DOI: 10.1016/j.ejca.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/22/2022]
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13
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Broeren MGA, Wang JJ, Balzaretti G, Groenen PJTA, van Schaik BDC, Chataway T, Kaffa C, Bervoets S, Hebeda KM, Bounova G, Pruijn GJM, Gordon TP, De Vries N, Thurlings RM. Proteogenomic analysis of the autoreactive B cell repertoire in blood and tissues of patients with Sjögren's syndrome. Ann Rheum Dis 2022; 81:644-652. [PMID: 35144926 PMCID: PMC8995816 DOI: 10.1136/annrheumdis-2021-221604] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Abstract
Objective To comparatively analyse the aberrant affinity maturation of the antinuclear and rheumatoid factor (RF) B cell repertoires in blood and tissues of patients with Sjögren’s syndrome (SjS) using an integrated omics workflow. Methods Peptide sequencing of anti-Ro60, anti-Ro52, anti-La and RF was combined with B cell repertoire analysis at the DNA, RNA and single cell level in blood B cell subsets, affected salivary gland and extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) of patients with SjS. Results Affected tissues contained anti-Ro60, anti-Ro52, anti-La and RF clones as a small part of a polyclonal infiltrate. Anti-Ro60, anti-La and anti-Ro52 clones outnumbered RF clones. MALT lymphoma tissues contained monoclonal RF expansions. Autoreactive clones were not selected from a restricted repertoire in a circulating B cell subset. The antinuclear antibody (ANA) repertoires displayed similar antigen-dependent and immunoglobulin (Ig) G1-directed affinity maturation. RF clones displayed antigen-dependent, IgM-directed and more B cell receptor integrity-dependent affinity maturation. This coincided with extensive intra-clonal diversification in RF-derived lymphomas. Regeneration of clinical disease manifestations after rituximab coincided with large RF clones, which not necessarily belonged to the lymphoma clone, that displayed continuous affinity maturation and intra-clonal diversification. Conclusion The ANA and RF repertoires in patients with SjS display tissue-restricted, antigen-dependent and divergent affinity maturation. Affinity maturation of RF clones deviates further during RF clone derived lymphomagenesis and during regeneration of the autoreactive repertoire after temporary disruption by rituximab. These data give insight into the molecular mechanisms of autoreactive inflammation in SjS, assist MALT lymphoma diagnosis and allow tracking its response to rituximab.
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Affiliation(s)
- Mathijs G A Broeren
- Department of Rheumatology, Radboudumc, Nijmegen, The Netherlands.,Department of Biomolecular Chemistry, Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Jing J Wang
- Department of Immunology, Flinders University, Adelaide, South Australia, Australia
| | - Giulia Balzaretti
- Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | | | - Barbera D C van Schaik
- Bioinformatics Laboratory, Department of Epidemiology and Data Science, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Tim Chataway
- College of Medicine and Public Health, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Charlotte Kaffa
- Radboud Technology Center for Bioinformatics, Radboudumc, Nijmegen, The Netherlands
| | - Sander Bervoets
- Radboud Technology Center for Bioinformatics, Radboudumc, Nijmegen, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboudumc, Nijmegen, The Netherlands
| | | | - Ger J M Pruijn
- Department of Biomolecular Chemistry, Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Thomas P Gordon
- SA Pathology, Department of Immunology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Niek De Vries
- Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
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14
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Cortenbach KRG, Staal AHJ, Schoffelen T, Gorris MAJ, Van der Woude LL, Jansen AFM, Poyck P, Van Suylen RJ, Wever PC, Bleeker-Rovers CP, Srinivas M, Hebeda KM, van Deuren M, Van der Meer JW, De Vries JM, Van Kimmenade RRJ. Differences in local immune cell landscape between Q fever and atherosclerotic abdominal aortic aneurysms identified by multiplex immunohistochemistry. eLife 2022; 11:72486. [PMID: 35137689 PMCID: PMC8871373 DOI: 10.7554/elife.72486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Chronic Q fever is a zoonosis caused by the bacterium Coxiella burnetii which can manifest as infection of an abdominal aortic aneurysm (AAA). Antibiotic therapy often fails, resulting in severe morbidity and high mortality. Whereas previous studies have focused on inflammatory processes in blood, the aim of this study was to investigate local inflammation in aortic tissue. Methods: Multiplex immunohistochemistry was used to investigate local inflammation in Q fever AAAs compared to atherosclerotic AAAs in aorta tissue specimen. Two six-plex panels were used to study both the innate and adaptive immune systems. Results: Q fever AAAs and atherosclerotic AAAs contained similar numbers of CD68+ macrophages and CD3+ T cells. However, in Q fever AAAs, the number of CD68+CD206+ M2 macrophages was increased, while expression of GM-CSF was decreased compared to atherosclerotic AAAs. Furthermore, Q fever AAAs showed an increase in both the number of CD8+ cytotoxic T cells and CD3+CD8-FoxP3+ regulatory T cells. Finally, Q fever AAAs did not contain any well-defined granulomas. Conclusions: These findings demonstrate that despite the presence of pro-inflammatory effector cells, persistent local infection with C. burnetii is associated with an immune-suppressed microenvironment. Funding: This work was supported by SCAN consortium: European Research Area - CardioVascualar Diseases (ERA-CVD) grant [JTC2017-044] and TTW-NWO open technology grant [STW-14716].
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Affiliation(s)
| | - Alexander HJ Staal
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences
| | - Teske Schoffelen
- Department of Internal Medicine, Radboud University Medical Centre
| | - Mark AJ Gorris
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences
| | | | - Anne FM Jansen
- Department of Internal Medicine, Radboud University Medical Centre
| | - Paul Poyck
- Department of Surgery, Radboud University Medical Centre
| | | | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Ziekenhuis
| | | | - Mangala Srinivas
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences
| | | | | | | | - Jolanda M De Vries
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences
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15
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van Bladel DAG, van den Brand M, Rijntjes J, Pamidimarri Naga S, Haacke DLCM, Luijks JACW, Hebeda KM, van Krieken JHJM, Groenen PJTA, Scheijen B. Clonality assessment and detection of clonal diversity in classic Hodgkin lymphoma by next-generation sequencing of immunoglobulin gene rearrangements. Mod Pathol 2022; 35:757-766. [PMID: 34862451 PMCID: PMC9174053 DOI: 10.1038/s41379-021-00983-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 02/06/2023]
Abstract
Clonality analysis in classic Hodgkin lymphoma (cHL) is of added value for correctly diagnosing patients with atypical presentation or histology reminiscent of T cell lymphoma, and for establishing the clonal relationship in patients with recurrent disease. However, such analysis has been hampered by the sparsity of malignant Hodgkin and Reed-Sternberg (HRS) cells in a background of reactive immune cells. Recently, the EuroClonality-NGS Working Group developed a novel next-generation sequencing (NGS)-based assay and bioinformatics platform (ARResT/Interrogate) to detect immunoglobulin (IG) gene rearrangements for clonality testing in B-cell lymphoproliferations. Here, we demonstrate the improved performance of IG-NGS compared to conventional BIOMED-2/EuroClonality analysis to detect clonal gene rearrangements in 16 well-characterized primary cHL cases within the IG heavy chain (IGH) and kappa light chain (IGK) loci. This was most obvious in formalin-fixed paraffin-embedded (FFPE) tissue specimens, where three times more clonal cases were detected with IG-NGS (9 cases) compared to BIOMED-2 (3 cases). In total, almost four times more clonal rearrangements were detected in FFPE with IG-NGS (N = 23) as compared to BIOMED-2/EuroClonality (N = 6) as judged on identical IGH and IGK targets. The same clonal rearrangements were also identified in paired fresh frozen cHL samples. To validate the neoplastic origin of the detected clonotypes, IG-NGS clonality analysis was performed on isolated HRS cells, demonstrating identical clonotypes as detected in cHL whole-tissue specimens. Interestingly, IG-NGS and HRS single-cell analysis after DEPArray™ digital sorting revealed rearrangement patterns and copy number variation profiles indicating clonal diversity and intratumoral heterogeneity in cHL. Our data demonstrate improved performance of NGS-based detection of IG gene rearrangements in cHL whole-tissue specimens, providing a sensitive molecular diagnostic assay for clonality assessment in Hodgkin lymphoma.
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Affiliation(s)
- Diede A. G. van Bladel
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.461760.20000 0004 0580 1253Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Michiel van den Brand
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.415930.aPathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands
| | - Jos Rijntjes
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Samhita Pamidimarri Naga
- grid.461760.20000 0004 0580 1253Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Demi L. C. M. Haacke
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen A. C. W. Luijks
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Konnie M. Hebeda
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. Han J. M. van Krieken
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Patricia J. T. A. Groenen
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands. .,Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.
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16
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van Eekelen L, Pinckaers H, van den Brand M, Hebeda KM, Litjens G. Using deep learning for quantification of cellularity and cell lineages in bone marrow biopsies and comparison to normal age-related variation. Pathology 2021; 54:318-327. [PMID: 34772487 DOI: 10.1016/j.pathol.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 01/21/2023]
Abstract
Cellularity estimation forms an important aspect of the visual examination of bone marrow biopsies. In clinical practice, cellularity is estimated by eye under a microscope, which is rapid, but subjective and subject to inter- and intraobserver variability. In addition, there is little consensus in the literature on the normal variation of cellularity with age. Digital image analysis may be used for more objective quantification of cellularity. As such, we developed a deep neural network for the segmentation of six major cell and tissue types in digitized bone marrow trephine biopsies. Using this segmentation, we calculated the overall bone marrow cellularity in a series of biopsies from 130 patients across a wide age range. Using intraclass correlation coefficients (ICC), we measured the agreement between the quantification by the neural network and visual estimation by two pathologists and compared it to baseline human performance. We also examined the age-related changes of cellularity and cell lineages in bone marrow and compared our results to those found in the literature. The network was capable of accurate segmentation (average accuracy and dice score of 0.95 and 0.76, respectively). There was good neural network-pathologist agreement on cellularity measurements (ICC=0.78, 95% CI 0.58-0.85). We found a statistically significant downward trend for cellularity, myelopoiesis and megakaryocytes with age in our cohort. The mean cellularity began at approximately 50% in the third decade of life and then decreased ±2% per decade to 40% in the seventh and eighth decade, but the normal range was very wide (30-70%).
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Affiliation(s)
- Leander van Eekelen
- Faculty of Biomedical Engineering, Technical University Eindhoven, Eindhoven, the Netherlands; Computational Pathology Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans Pinckaers
- Computational Pathology Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands; Pathology-DNA, Rijnstate Hospital, Arnhem, the Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Geert Litjens
- Computational Pathology Group, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
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17
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Arens AIJ, Hebeda KM, Hutchings M, Plattel WJ, Stevens WBC. Axillary lymph nodes on PET in Hodgkin lymphoma after COVID-19 vaccination. EJHaem 2021; 2:885-886. [PMID: 34904137 PMCID: PMC8656373 DOI: 10.1002/jha2.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Anne I J Arens
- Department of Radiology and Nuclear Medicine Radboud University Medical Center Nijmegen The Netherlands
| | - Konnie M Hebeda
- Department of Pathology Radboud University Medical Center Nijmegen The Netherlands
| | | | - Wouter J Plattel
- Department of Haematology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Wendy B C Stevens
- Department of Haematology Radboud University Medical Center Nijmegen The Netherlands
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18
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Leenders AM, Kroeze LI, Rijntjes J, Luijks J, Hebeda KM, Darzentas N, Langerak AW, van den Brand M, Groenen PJTA. Multiple Immunoglobulin κ Gene Rearrangements within a Single Clone Unraveled by Next-Generation Sequencing-Based Clonality Assessment. J Mol Diagn 2021; 23:1097-1104. [PMID: 34020040 DOI: 10.1016/j.jmoldx.2021.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022] Open
Abstract
Clonality assessment of the Ig heavy- and light-chain genes (IGH and IGK) using GeneScan analysis is an important supplemental assay in diagnostic testing for lymphoma. Occasionally cases with an IGK rearrangement pattern that cannot readily be assigned to a monoclonal lymphoma are encountered, whereas the occurrence of biclonal lymphomas is rare, and the result of the IGH locus of these cases is in line with monoclonality. Three such ambiguous cases were assessed for clonality using next-generation sequencing. Information on the sequences of the rearrangements, combined with knowledge of the complex organization of the IGK locus, pointed to two explanations that can attribute seemingly biclonal IGK rearrangements to a single clone. In two cases, this explanation involved inversion rearrangements on the IGK locus, whereas in the third case, the cross-reactivity of primers generated an additional clonal product. In conclusion, next-generation sequencing-based clonality assessment allows for the detection of both inversion rearrangements and the cross-reactivity of primers, and can therefore facilitate the interpretation of cases of lymphoma with complex IGK rearrangement patterns.
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Affiliation(s)
- A Meilinde Leenders
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Leonie I Kroeze
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jos Rijntjes
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jeroen Luijks
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Nikos Darzentas
- Department of Hematology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anton W Langerak
- Department of Immunology, Laboratory for Medical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Centre, Nijmegen, the Netherlands
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19
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van den Brand M, Nooijen PTGA, van der Laan KD, de Bruin PC, van Leeuwen AMG, Leeuwis JW, Meijer JW, Otte-Höller I, Hebeda KM. Discrepancies in digital hematopathology diagnoses for consultation and expert panel analysis. Virchows Arch 2021; 478:535-540. [PMID: 32840673 PMCID: PMC7973407 DOI: 10.1007/s00428-020-02907-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 07/23/2020] [Accepted: 08/10/2020] [Indexed: 10/26/2022]
Abstract
Digital pathology with whole-slide imaging (WSI) has a large potential to make the process of expert consultation and expert panel diagnosis more rapid and more efficient. However, comparison with the current methods is necessary for validation of the technique. In this study, we determined if digital assessment of whole-slide images of hematopathology specimens with a focus on the assessment of lymphoma can be used for consultation and panel diagnostics. Ninety-three histological specimens with a suspicion for lymphoma were assessed both with conventional microscopy and digital microscopy with a wash out period between assessments. A consensus diagnosis was based on full concordance between the pathologists or, in case of discordances, was reached at a joint session at a multi-headed microscope. In 81% of the cases, there was a full concordance between digital and light microscopical assessment for all three pathologists. Discordances between conventional microscopy and digital pathology were present in 3% of assessments. In comparison with the consensus diagnosis, discordant diagnoses were made in 5 cases with digital microscopy and in 3 cases with light microscopy. The reported level of confidence and need for additional investigations were similar between assessment by conventional and by digital microscopy. In conclusion, the performance of assessment by digital pathology is in general comparable with that of conventional light microscopy and pathologists feel confident using digital pathology for this subspecialty.
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Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, P. O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
- Pathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands.
| | | | - Kimberly D van der Laan
- Department of Pathology, Radboud University Medical Center, P. O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Peter C de Bruin
- Pathology-DNA, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | | | - Jos W Meijer
- Pathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands
| | - Irene Otte-Höller
- Department of Pathology, Radboud University Medical Center, P. O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, P. O. Box 9101, 6500, HB, Nijmegen, The Netherlands
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20
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Leguit RJ, Raymakers RAP, Hebeda KM, Goldschmeding R. CCN2 (Cellular Communication Network factor 2) in the bone marrow microenvironment, normal and malignant hematopoiesis. J Cell Commun Signal 2021; 15:25-56. [PMID: 33428075 PMCID: PMC7798015 DOI: 10.1007/s12079-020-00602-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 12/20/2020] [Indexed: 02/06/2023] Open
Abstract
CCN2, formerly termed Connective Tissue Growth Factor, is a protein belonging to the Cellular Communication Network (CCN)-family of secreted extracellular matrix-associated proteins. As a matricellular protein it is mainly considered to be active as a modifier of signaling activity of several different signaling pathways and as an orchestrator of their cross-talk. Furthermore, CCN2 and its fragments have been implicated in the regulation of a multitude of biological processes, including cell proliferation, differentiation, adhesion, migration, cell survival, apoptosis and the production of extracellular matrix products, as well as in more complex processes such as embryonic development, angiogenesis, chondrogenesis, osteogenesis, fibrosis, mechanotransduction and inflammation. Its function is complex and context dependent, depending on cell type, state of differentiation and microenvironmental context. CCN2 plays a role in many diseases, especially those associated with fibrosis, but has also been implicated in many different forms of cancer. In the bone marrow (BM), CCN2 is highly expressed in mesenchymal stem/stromal cells (MSCs). CCN2 is important for MSC function, supporting its proliferation, migration and differentiation. In addition, stromal CCN2 supports the maintenance and longtime survival of hematopoietic stem cells, and in the presence of interleukin 7, stimulates the differentiation of pro-B lymphocytes into pre-B lymphocytes. Overexpression of CCN2 is seen in the majority of B-acute lymphoblastic leukemias, especially in certain cytogenetic subgroups associated with poor outcome. In acute myeloid leukemia, CCN2 expression is increased in MSCs, which has been associated with leukemic engraftment in vivo. In this review, the complex function of CCN2 in the BM microenvironment and in normal as well as malignant hematopoiesis is discussed. In addition, an overview is given of data on the remaining CCN family members regarding normal and malignant hematopoiesis, having many similarities and some differences in their function.
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Affiliation(s)
- Roos J Leguit
- Department of Pathology, University Medical Center Utrecht, H04-312, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Reinier A P Raymakers
- Department of Hematology, UMCU Cancer Center, Heidelberglaan 100 B02.226, 3584 CX, Utrecht, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Roel Goldschmeding
- Department of Pathology, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
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21
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Kemps PG, Hebeda KM, Pals ST, Verdijk RM, Lam KH, Bruggink AH, de Lil HS, Ruiterkamp B, de Heer K, van Laar JAM, Valk PJM, Mutsaers P, Levin M, Hogendoorn PCW, van Halteren AGS. Spectrum of histiocytic neoplasms associated with diverse haematological malignancies bearing the same oncogenic mutation. J Pathol Clin Res 2021; 7:10-26. [PMID: 32852896 PMCID: PMC7737785 DOI: 10.1002/cjp2.177] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
Abstract
Histiocytic disorders are a spectrum of rare diseases characterised by the accumulation of macrophage-, dendritic cell-, or monocyte-differentiated cells in various tissues and organs. The discovery of recurrent genetic alterations in many of these histiocytoses has led to their recognition as clonal neoplastic diseases. Moreover, the identification of the same somatic mutation in histiocytic lesions and peripheral blood and/or bone marrow cells from histiocytosis patients has provided evidence for systemic histiocytic neoplasms to originate from haematopoietic stem/progenitor cells (HSPCs). Here, we investigated associations between histiocytic disorders and additional haematological malignancies bearing the same genetic alteration(s) using the nationwide Dutch Pathology Registry. By searching on pathologist-assigned diagnostic terms for the various histiocytic disorders, we identified 4602 patients with a putative histopathological diagnosis of a histiocytic disorder between 1971 and 2019. Histiocytosis-affected tissue samples of 187 patients had been analysed for genetic alterations as part of routine molecular diagnostics, including from nine patients with an additional haematological malignancy. Among these patients, we discovered three cases with different histiocytic neoplasms and additional haematological malignancies bearing identical oncogenic mutations, including one patient with concomitant KRAS p.A59E mutated histiocytic sarcoma and chronic myelomonocytic leukaemia (CMML), one patient with synchronous NRAS p.G12V mutated indeterminate cell histiocytosis and CMML, and one patient with subsequent NRAS p.Q61R mutated Erdheim-Chester disease and acute myeloid leukaemia. These cases support the existence of a common haematopoietic cell-of-origin in at least a proportion of patients with a histiocytic neoplasm and additional haematological malignancy. In addition, they suggest that driver mutations in particular genes (e.g. N/KRAS) may specifically predispose to the development of an additional clonally related haematological malignancy or secondary histiocytic neoplasm. Finally, the putative existence of derailed multipotent HSPCs in these patients emphasises the importance of adequate (bone marrow) staging, molecular analysis and long-term follow-up of all histiocytosis patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Erdheim-Chester Disease/genetics
- Erdheim-Chester Disease/pathology
- Erdheim-Chester Disease/therapy
- Fatal Outcome
- GTP Phosphohydrolases/genetics
- Genetic Predisposition to Disease
- Histiocytic Sarcoma/genetics
- Histiocytic Sarcoma/pathology
- Histiocytic Sarcoma/therapy
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukemia, Myelomonocytic, Chronic/pathology
- Leukemia, Myelomonocytic, Chronic/therapy
- Male
- Membrane Proteins/genetics
- Middle Aged
- Mutation
- Phenotype
- Proto-Oncogene Proteins p21(ras)/genetics
- Retrospective Studies
- Treatment Outcome
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Affiliation(s)
- Paul G Kemps
- Department of PaediatricsLeiden University Medical CenterLeidenThe Netherlands
| | - Konnie M Hebeda
- Department of PathologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Steven T Pals
- Department of PathologyAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Robert M Verdijk
- Department of PathologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
- Department of PathologyLeiden University Medical CenterLeidenThe Netherlands
| | - King H Lam
- Department of PathologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Annette H Bruggink
- PALGA Foundation (Nationwide Network and Registry of Histopathology and Cytopathology)HoutenThe Netherlands
| | - Heleen S de Lil
- Department of HaematologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Bart Ruiterkamp
- Department of HaematologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Koen de Heer
- Department of HaematologyAmsterdam University Medical CentersAmsterdamThe Netherlands
- Department of HaematologyFlevoziekenhuisAlmereThe Netherlands
| | - Jan AM van Laar
- Department of Internal MedicineErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
- Department of ImmunologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Peter JM Valk
- Department of HaematologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Pim Mutsaers
- Department of HaematologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Mark‐David Levin
- Department of Internal MedicineAlbert Schweitzer ZiekenhuisDordrechtThe Netherlands
| | | | - Astrid GS van Halteren
- Department of PaediatricsLeiden University Medical CenterLeidenThe Netherlands
- Princess Máxima Center for Paediatric OncologyUtrechtThe Netherlands
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22
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Swiderska-Chadaj Z, Hebeda KM, van den Brand M, Litjens G. Artificial intelligence to detect MYC translocation in slides of diffuse large B-cell lymphoma. Virchows Arch 2020; 479:617-621. [PMID: 32979109 PMCID: PMC8448690 DOI: 10.1007/s00428-020-02931-4] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/24/2020] [Accepted: 09/15/2020] [Indexed: 02/02/2023]
Abstract
In patients with suspected lymphoma, the tissue biopsy provides lymphoma confirmation, classification, and prognostic factors, including genetic changes. We developed a deep learning algorithm to detect MYC rearrangement in scanned histological slides of diffuse large B-cell lymphoma. The H&E-stained slides of 287 cases from 11 hospitals were used for training and evaluation. The overall sensitivity to detect MYC rearrangement was 0.93 and the specificity 0.52, showing that prediction of MYC translocation based on morphology alone was possible in 93% of MYC-rearranged cases. This would allow a simple and fast prescreening, saving approximately 34% of genetic tests with the current algorithm.
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Affiliation(s)
- Zaneta Swiderska-Chadaj
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. .,Faculty of Electrical Engineering, Warsaw University of Technology, Warsaw, Poland.
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Pathology-DNA, Rijnstate Hospital, Arnhem, the Netherlands
| | - Geert Litjens
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein 10, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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23
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Bergen MG, Saes JL, Simons A, Hebeda KM, Henskens YM, Barteling W, Huys E, Laros‐van Gorkom BA, Schols SE, Preijers FW, Jongmans MC, Jansen JH, Reijden BA. Platelet CD34 expression in a patient with a partial deletion of transcription factor subunit CBFB. Am J Hematol 2020; 95:E136-E139. [PMID: 32124467 PMCID: PMC7317484 DOI: 10.1002/ajh.25770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/21/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Maaike G.J.M. Bergen
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
| | - Joline L. Saes
- Department of HematologyRadboudumc Nijmegen The Netherlands
- Hemophilia Treatment Center Nijmegen – Eindhoven – Maastricht Nijmegen The Netherlands
| | - Annet Simons
- Department of Human GeneticsRadboudumc Nijmegen The Netherlands
| | | | - Yvonne M.C. Henskens
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
- Central Diagnostic Laboratory, Unit for Hemostasis and TransfusionMaastricht University Medical Center Maastricht The Netherlands
| | - Wideke Barteling
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
| | - Erik Huys
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
| | - Britta A.P. Laros‐van Gorkom
- Department of HematologyRadboudumc Nijmegen The Netherlands
- Hemophilia Treatment Center Nijmegen – Eindhoven – Maastricht Nijmegen The Netherlands
| | - Saskia E.M. Schols
- Department of HematologyRadboudumc Nijmegen The Netherlands
- Hemophilia Treatment Center Nijmegen – Eindhoven – Maastricht Nijmegen The Netherlands
| | - Frank W. Preijers
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
| | - Marjolijn C.J. Jongmans
- Department of Human GeneticsRadboudumc Nijmegen The Netherlands
- Department of Medical GeneticsUniversity Medical Center Utrecht Utrecht The Netherlands
- Princess Máxima Center for Pediatric Oncology Utrecht The Netherlands
| | - Joop H. Jansen
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
| | - Bert A. Reijden
- Department of Laboratory Medicine, Laboratory of HematologyRadboudumc and Radboud Institute for Molecular Life Sciences Nijmegen The Netherlands
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24
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Reedijk AMJ, Zijtregtop EAM, Coebergh JWW, Meyer-Wentrup FAG, Hebeda KM, Zwaan CM, Janssens GOR, Pieters R, Plattel WJ, Dinmohamed AG, Zijlstra JM, Kremer LCM, Lugtenburg PJ, Beishuizen A, Karim-Kos HE. Improved survival for adolescents and young adults with Hodgkin lymphoma and continued high survival for children in the Netherlands: a population-based study during 1990-2015. Br J Haematol 2020; 189:1093-1106. [PMID: 32030738 PMCID: PMC7318561 DOI: 10.1111/bjh.16491] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/24/2019] [Indexed: 11/26/2022]
Abstract
Population‐based studies that assess long‐term patterns of incidence, major aspects of treatment and survival are virtually lacking for Hodgkin lymphoma (HL) at a younger age. This study assessed the progress made for young patients with HL (<25 years at diagnosis) in the Netherlands during 1990–2015. Patient and tumour characteristics were extracted from the population‐based Netherlands Cancer Registry. Time trends in incidence and mortality rates were evaluated with average annual percentage change (AAPC) analyses. Stage at diagnosis, initial treatments and site of treatment were studied in relation to observed overall survival (OS). A total of 2619 patients with HL were diagnosed between 1990 and 2015. Incidence rates increased for 18–24‐year‐old patients (AAPC + 1%, P = 0·01) only. Treatment regimens changed into less radiotherapy and more ‘chemotherapy only’, different for age group and stage. Patients aged 15–17 years were increasingly treated at a paediatric oncology centre. The 5‐year OS for children was already high in the early 1990s (93%). For patients aged 15–17 and 18–24 years the 5‐year OS improved from 84% and 90% in 1990–1994 to 96% and 97% in 2010–2015, respectively. Survival for patients aged 15–17 years was not affected by site of treatment. Our present data demonstrate that significant progress in HL treatment has been made in the Netherlands since 1990.
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Affiliation(s)
| | - Eline A M Zijtregtop
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Dutch Childhood Oncology Group, Utrecht, the Netherlands
| | - Jan Willem W Coebergh
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Friederike A G Meyer-Wentrup
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Dutch Childhood Oncology Group, Utrecht, the Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Dutch Childhood Oncology Group, Utrecht, the Netherlands.,Department of Pediatric Oncology/Hematology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Geert O R Janssens
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Wouter J Plattel
- Department of Hematology, University Medical Center Groningen, Groningen, the Netherlands
| | - Avinash G Dinmohamed
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Josée M Zijlstra
- Department of Hematology location VU Medical Center, Amsterdam UMC, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Department of Pediatric Oncology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Dutch Childhood Oncology Group, Utrecht, the Netherlands
| | - Henrike E Karim-Kos
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
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25
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Hebeda KM, Tzankov A, Boudova L, Saft L, Hasserjian RP, de Boer M, Fend F, Orazi A, Leguit R. Challenges in Diagnosing Myelodysplastic Syndromes in the Era of Genetic Testing: Proceedings of the 13th Workshop of the European Bone Marrow Working Group. Pathobiology 2018; 86:62-75. [PMID: 29982244 DOI: 10.1159/000489678] [Citation(s) in RCA: 3] [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: 02/19/2018] [Accepted: 04/30/2018] [Indexed: 11/19/2022] Open
Abstract
The 13th workshop of the European Bone Marrow Working Group in Utrecht, The Netherlands, was devoted to studying myelodysplastic syndromes (MDS) and their boundaries. The panel received 44 cases submitted to the 3 invited categories, which included: reactive cytopenias with dysplasia, idiopathic cytopenia of undetermined significance, clonal haematopoiesis of indeterminate potential, idiopathic dysplasia of uncertain significance and overt MDS. For this summary, we have selected 17 cases that highlight difficulties in separating true MDS from other causes of cytopenia and the intricate relationship between clonal haematopoiesis and true MDS. In addition, cases of overt MDS with challenging features were also selected. All cases were stained for p53 expression. Using instructive submitted cases we discuss the following: (1) cytopenia with clonal haematopoiesis not fulfilling MDS criteria, (2) cytopenia and/or dysplasia with germline mutations and/or familial history suggesting an underlying gene defect, (3) MDS based on a recurrent chromosomal abnormality and (4) overt MDS with diagnostic difficulties due to concurrent treatment or disease. The lively discussion in the open forum of the workshop illustrated the need for better integrative understanding of the evolution of acquired genetic abnormalities in haematopoiesis, and the challenge of diagnosing true MDS in cytopenic patients with genetic abnormalities, either germline or acquired.
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Affiliation(s)
- Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The
| | - Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Ludmila Boudova
- Department of Pathology, Charles University Hospital, Pilsen, Czech Republic
| | - Leonie Saft
- Department of Pathology and Cytology, Karolinska University Hospital and Institute, Stockholm, Sweden
| | - Rob P Hasserjian
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mirthe de Boer
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Falko Fend
- Department of Pathology, University of Tuebingen, Tuebingen, Germany
| | - Attilio Orazi
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Roos Leguit
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
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26
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Schreuder MI, van den Brand M, Hebeda KM, Groenen PJTA, van Krieken JH, Scheijen B. Novel developments in the pathogenesis and diagnosis of extranodal marginal zone lymphoma. J Hematop 2017; 10:91-107. [PMID: 29225710 PMCID: PMC5712330 DOI: 10.1007/s12308-017-0302-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/13/2017] [Indexed: 12/15/2022] Open
Abstract
Extranodal marginal zone lymphoma (EMZL), mostly represented by mucosa-associated lymphoid tissue (MALT) type, also referred to as MALT lymphoma, is a clinically heterogeneous entity within the group of low-grade B cell lymphomas that arises in a wide range of different extranodal sites, including the stomach, lung, ocular adnexa, and skin. It represents the third most common non-Hodgkin lymphoma in the Western world, and the median age of occurrence is around 60 years. One characteristic aspect in a subset of EMZL detectable in about 25% of the cases is the presence of specific chromosomal translocations involving the genes MALT1 and BCL10, which lead to activation of the NF-κB signaling pathway. Another unique aspect is that several infectious agents, such as Helicobacter pylori in the case of gastric EMZL, and autoimmune disorders, like Sjögren syndrome, have been implicated in the pathogenesis of this cancer. Recent findings as summarized in this review have further improved our understanding of the complex pathobiology of this disease and have been essential to better define novel treatment strategies. In addition, many of these specific features are currently being implemented for the diagnosis of EMZL.
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Affiliation(s)
- Max I Schreuder
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands.,Pathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands
| | - Patricia J T A Groenen
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands
| | - J Han van Krieken
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands.,Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Blanca Scheijen
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 AG Nijmegen, The Netherlands.,Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
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van den Brand M, Rijntjes J, Hebeda KM, Menting L, Bregitha CV, Stevens WBC, van der Velden WJFM, Tops BBJ, van Krieken JHJM, Groenen PJTA. Recurrent mutations in genes involved in nuclear factor-κB signalling in nodal marginal zone lymphoma-diagnostic and therapeutic implications. Histopathology 2016; 70:174-184. [PMID: 27297871 DOI: 10.1111/his.13015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/13/2016] [Indexed: 12/27/2022]
Abstract
AIMS To investigate the spectrum of mutations in 20 genes involved in B-cell receptor and/or Toll-like receptor signalling resulting in activation of nuclear factor-κB (NF-κB) in 20 nodal marginal zone lymphomas (NMZLs), 20 follicular lymphomas (FLs), and 11 cases of B-cell lymphoma, unclassifiable (BCL-u). METHODS AND RESULTS Nodal marginal zone lymphomas were diagnosed according to strict criteria, including the expression of at least one putative marginal zone marker (MNDA and/or IRTA1). Cases that showed features of NMZL but did not fulfil all criteria were included as BCL-u. All FLs were required to have a BCL2 rearrangement. Mutations were found in: nine NMZLs, with recurrent mutations in TNFAIP3 and CD79B; 12 FLs, with recurrent mutations in TNFRSF14, TNFAIP3, and CARD11; and five cases of BCL-u, with recurrent mutations in TNFRSF14. TNFRSF14 mutations were present in FL and BCL-u, but not in any of the NMZLs. In the BCL-u group, TNFRSF14 mutations clustered with a FL immunophenotype. CONCLUSIONS These results suggest that TNFRSF14 mutations point towards a diagnosis of FL, and can be used in the sometimes difficult distinction between NMZL and FL, but to apply this in diagnostics would require confirmation in an independent cohort. In addition, the presence or absence of specific mutations in pathways converging on NF-κB could be important for decisions regarding targeted treatment.
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Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jos Rijntjes
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Laura Menting
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carolyn V Bregitha
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wendy B C Stevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Bastiaan B J Tops
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J Han J M van Krieken
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
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28
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de Winde CM, Veenbergen S, Young KH, Xu-Monette ZY, Wang XX, Xia Y, Jabbar KJ, van den Brand M, van der Schaaf A, Elfrink S, van Houdt IS, Gijbels MJ, van de Loo FAJ, Bennink MB, Hebeda KM, Groenen PJTA, van Krieken JH, Figdor CG, van Spriel AB. Tetraspanin CD37 protects against the development of B cell lymphoma. J Clin Invest 2016; 126:653-66. [PMID: 26784544 DOI: 10.1172/jci81041] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 12/03/2015] [Indexed: 12/13/2022] Open
Abstract
Worldwide, B cell non-Hodgkin lymphoma is the most common hematological malignancy and represents a substantial clinical problem. The molecular events that lead to B cell lymphoma are only partially defined. Here, we have provided evidence that deficiency of tetraspanin superfamily member CD37, which is important for B cell function, induces the development of B cell lymphoma. Mice lacking CD37 developed germinal center-derived B cell lymphoma in lymph nodes and spleens with a higher incidence than Bcl2 transgenic mice. We discovered that CD37 interacts with suppressor of cytokine signaling 3 (SOCS3); therefore, absence of CD37 drives tumor development through constitutive activation of the IL-6 signaling pathway. Moreover, animals deficient for both Cd37 and Il6 were fully protected against lymphoma development, confirming the involvement of the IL-6 pathway in driving tumorigenesis. Loss of CD37 on neoplastic cells in patients with diffuse large B cell lymphoma (DLBCL) directly correlated with activation of the IL-6 signaling pathway and with worse progression-free and overall survival. Together, this study identifies CD37 as a tumor suppressor that directly protects against B cell lymphomagenesis and provides a strong rationale for blocking the IL-6 pathway in patients with CD37- B cell malignancies as a possible therapeutic intervention.
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MESH Headings
- Animals
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/metabolism
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Germinal Center/metabolism
- Germinal Center/pathology
- Interleukin-6/genetics
- Interleukin-6/metabolism
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Mice
- Mice, Inbred BALB C
- Mice, Knockout
- Tetraspanins/genetics
- Tetraspanins/metabolism
- Tumor Suppressor Proteins/genetics
- Tumor Suppressor Proteins/metabolism
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29
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Strobbe L, Valke LLFG, Diets IJ, van den Brand M, Aben K, Raemaekers JMM, Hebeda KM, van Krieken JHJM. A 20-year population-based study on the epidemiology, clinical features, treatment, and outcome of nodular lymphocyte predominant Hodgkin lymphoma. Ann Hematol 2016; 95:417-23. [PMID: 26732883 PMCID: PMC4742486 DOI: 10.1007/s00277-015-2578-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 12/09/2015] [Indexed: 12/31/2022]
Abstract
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a subtype of Hodgkin lymphoma characterized by a unique clinical and histological presentation. Because of the rare nature of this disease, few large-scale studies are available. We conducted a cohort study in which patients were identified in the Netherlands Cancer Registry in the Southeast of the Netherlands between 1990 and 2010. Of these patients, we collected all clinical characteristics and re-reviewed pathologic material to confirm NLPHL diagnosis. Seventy-three histologically confirmed cases of NLPHL were analyzed with a median follow-up of 65 months (range 4–257 months). Median age at diagnosis was 43 years (range 1–87); 84.9 % of the patients were male; B symptoms were present in 5.5 %; and stage I/II disease was most common (75.4 %). Patients were primarily treated with radiotherapy (50.7 %), chemotherapy (26 %), combined modality (radiotherapy and chemotherapy) (11 %), or surgical excision with careful watch-and-wait (12.3 %). Relapses occurred in seven patients (9.6 %) after a median of 26 months (21–74 months). Six patients (8.2 %) developed histologic transformation to large cell lymphoma. Five patients (6.8 %) died during follow-up due to progression of NLPHL (n = 1), histologic transformation (n = 2) and intercurrent deaths (n = 2). The estimated 10-year overall survival was 94.0 % and the 10-year progression-free survival 75.8 %. Our study confirms the distinct characteristics of NLPHL with a relatively good long-term prognosis. It may be possible to reduce treatment intensity in early stage NLPHL without affecting long-term outcome.
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Affiliation(s)
- L Strobbe
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6525 GA Nijmegen, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
| | - L L F G Valke
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6525 GA Nijmegen, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - I J Diets
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6525 GA Nijmegen, Postbus 9101, 6500 HB, Nijmegen, The Netherlands
| | - M van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K Aben
- Department of Registry and Research, Comprehensive Cancer Center, Utrecht, The Netherlands
| | - J M M Raemaekers
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6525 GA Nijmegen, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.,Department of Hematology, Rijnstate Hospital, Arnhem, The Netherlands
| | - K M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J H J M van Krieken
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
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30
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van den Brand M, van der Velden WJFM, Diets IJ, Ector GICG, de Haan AFJ, Stevens WBC, Hebeda KM, Groenen PJTA, van Krieken HJM. Clinical features of patients with nodal marginal zone lymphoma compared to follicular lymphoma: similar presentation, but differences in prognostic factors and rate of transformation. Leuk Lymphoma 2015; 57:1649-56. [DOI: 10.3109/10428194.2015.1106535] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Janssen NA, Hebeda KM, Stevens WB, van der Velden WJ. A "body armor" of leukemia cutis. Am J Hematol 2015; 90:751. [PMID: 25611338 DOI: 10.1002/ajh.23948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 01/15/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Nico A.F. Janssen
- Department of Hematology; Radboud University Medical Center; Nijmegen The Netherlands
- Department of Internal Medicine; Radboud University Medical Center; Nijmegen The Netherlands
| | - Konnie M. Hebeda
- Department of Pathology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Wendy B.C. Stevens
- Department of Hematology; Radboud University Medical Center; Nijmegen The Netherlands
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32
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Waanders E, Hebeda KM, Kamping EJ, Groenen PJTA, Simons A, Hoischen A, Jongmans MCJ, Hoogerbrugge PM, van Leeuwen FN, Kuiper RP, Te Loo DMWM. Independent development of lymphoid and histiocytic malignancies from a shared early precursor. Leukemia 2015. [PMID: 26202925 DOI: 10.1038/leu.2015.193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- E Waanders
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - K M Hebeda
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E J Kamping
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - P J T A Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Simons
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - A Hoischen
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - M C J Jongmans
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - P M Hoogerbrugge
- Princess Máxima Center for Pediatric Oncology, De Bilt, The Netherlands
| | - F N van Leeuwen
- Department of Pediatric Oncology, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - R P Kuiper
- Department of Human Genetics, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - D M W M Te Loo
- Department of Pediatric Oncology, Radboud University Medical Center and Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
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33
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Appenzeller S, Gilissen C, Rijntjes J, Tops BBJ, Kastner-van Raaij A, Hebeda KM, Nissen L, Dutilh BE, van Krieken JHJM, Groenen PJTA. Immunoglobulin rearrangement analysis from multiple lesions in the same patient using next-generation sequencing. Histopathology 2015; 67:843-58. [DOI: 10.1111/his.12714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/14/2015] [Indexed: 01/16/2023]
Affiliation(s)
- Silke Appenzeller
- Center for Molecular and Biomolecular Informatics; Radboud Institute for Molecular Life Sciences; Radboud University Medical Center; Nijmegen The Netherlands
- Core Unit Systems Medicine; University of Wuerzburg; Wuerzburg Germany
| | - Christian Gilissen
- Department of Genetics; Radboud University Medical Center; Nijmegen The Netherlands
| | - Jos Rijntjes
- Department of Pathology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Bastiaan B J Tops
- Department of Pathology; Radboud University Medical Center; Nijmegen The Netherlands
| | | | - Konnie M Hebeda
- Department of Pathology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Loes Nissen
- Department of Gastroenterology and Hepatology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Bas E Dutilh
- Center for Molecular and Biomolecular Informatics; Radboud Institute for Molecular Life Sciences; Radboud University Medical Center; Nijmegen The Netherlands
| | - J Han J M van Krieken
- Department of Pathology; Radboud University Medical Center; Nijmegen The Netherlands
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34
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van den Brand M, Mathijssen JJM, Garcia-Garcia M, Hebeda KM, Groenen PJTA, Falini B, Serrano S, van Krieken JHJM. Immunohistochemical differentiation between follicular lymphoma and nodal marginal zone lymphoma--combined performance of multiple markers. Haematologica 2015; 100:e358-60. [PMID: 26069292 DOI: 10.3324/haematol.2014.120956] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Mar Garcia-Garcia
- Department of Pathology, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Spain
| | - Konnie M Hebeda
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
| | | | - Brunangelo Falini
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Italy
| | - Sergio Serrano
- Department of Pathology, Hospital del Mar-IMIM, Universitat Autònoma de Barcelona, Spain
| | - J Han J M van Krieken
- Department of Pathology, Radboud university medical center, Nijmegen, the Netherlands
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35
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Stevens-Kroef MJ, Hebeda KM, Verwiel ET, Kamping EJ, van Cleef PH, Kuiper RP, Groenen PJ. Microarray-based genomic profiling and in situ hybridization on fibrotic bone marrow biopsies for the identification of numerical chromosomal abnormalities in myelodysplastic syndrome. Mol Cytogenet 2015; 8:33. [PMID: 26023320 PMCID: PMC4447009 DOI: 10.1186/s13039-015-0136-5] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 04/16/2015] [Indexed: 11/21/2022] Open
Abstract
Background Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematological malignancies. In MDS patients with a fibrotic bone marrow the aspiration of cells often fails (dry-tap), which hampers standard karyotyping. Obtaining genetic data from these fibrotic marrows is therefore challenging, and up till now in situ hybridization applied to bone marrow biopsies is the only option. The microarray-based genomic profiling technology has already proven its value for bone marrow aspirates and peripheral blood samples, but has never been applied to the technically challenging bone marrow biopsies. We describe an approach for microarray-based genomic profiling on bone marrow biopsies and demonstrate its ability to obtain clinically relevant cytogenetic aberrations. In addition the data were compared with those obtained by in situ hybridization and karyotyping. Results We have evaluated the success rate of microarray-based genomic profiling by studying twenty-one bone marrow biopsies (7 fibrotic MDS, 12 non-fibrotic MDS and 2 reactive), by microarray-based genomic profiling and in situ hybridization (12 of 21 cases). The data obtained with these techniques were compared with conventional karyotyping data on corresponding bone marrow aspirates. Of the 15 copy number aberrations that were detected by in situ hybridization, 13 were concordant with microarray-based genomic profiling and karyotyping, whereas two hybridizations were misinterpreted. In 20 of 21 patients, the data obtained by microarray-based genomic profiling and karyotyping were identical or differences could be explained by the presence of marker chromosomes, complex karyotypes, clonal heterogeneity or disease progression. Conclusions We demonstrate that genome wide microarray-based genomic profiling performed on bone marrow biopsies has a similar success rate compared to in situ hybridization, and prevents misinterpretation of chromosomal losses as observed by FISH. In addition, equal to even higher resolutions were obtained with genomic profiling compared to conventional karyotyping. Our findings indicate that microarray-based profiling, even on bone marrow biopsies, is a valid approach for the identification of genetic abnormalities. This is a valuable substitution in cases of fibrotic MDS lacking cytogenetic results.
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Affiliation(s)
- Marian Jpl Stevens-Kroef
- Department of Human Genetics, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Konnie M Hebeda
- Department of Pathology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Eugène T Verwiel
- Department of Human Genetics, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Eveline J Kamping
- Department of Human Genetics, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Patricia H van Cleef
- Department of Pathology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Roland P Kuiper
- Department of Human Genetics, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Patricia Jta Groenen
- Department of Pathology, Radboud university medical center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Martinez LL, Friedländer E, van der Laak JA, Hebeda KM. Abundance of IgG4+ plasma cells in isolated reactive lymphadenopathy is no indication of IgG4-related disease. Am J Clin Pathol 2014; 142:459-66. [PMID: 25239412 DOI: 10.1309/ajcpx6vf6bgzvjge] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES IgG4-related disease is a recently recognized condition that can be associated with lymphadenopathy, with several histologic patterns and increased absolute number and ratio of immunoglobulin G4 (IgG4)-positive plasma cells. However, these findings are considered to be not exclusively specific for IgG4-related disease. METHODS The occurrence of the histologic patterns reported in patients with isolated lymphadenopathy was studied and correlated with the clinical presentation to determine their predictive value for IgG4-related lymphadenopathy. RESULTS We found cases meeting all histologic criteria for IgG4-related lymphadenopathy, without clinical signs of IgG4-related disease. The only pattern that was not seen in this series was an inflammatory pseudotumor-like picture. CONCLUSION Without a clinical suspicion of IgG4-related disease, these morphologic patterns and high numbers of IgG4-positive plasma cells should be interpreted with care to avoid an erroneous diagnosis of IgG4-related disease.
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Affiliation(s)
- Laura Louzao Martinez
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Elza Friedländer
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - Konnie M. Hebeda
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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37
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van den Brand M, Hoevenaars BM, Sigmans JHM, Meijer JWR, van Cleef PHJ, Groenen PJTA, Hebeda KM, van Krieken JHJM. Sequential immunohistochemistry: a promising new tool for the pathology laboratory. Histopathology 2014; 65:651-7. [DOI: 10.1111/his.12446] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/23/2014] [Indexed: 01/31/2023]
Affiliation(s)
- Michiel van den Brand
- Department of Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
| | | | - Jessica H M Sigmans
- Department of Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Jos W R Meijer
- Department of Pathology; Rijnstate Hospital; Arnhem The Netherlands
| | | | | | - Konnie M Hebeda
- Department of Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - J Han J M van Krieken
- Department of Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
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Monteferrario D, Bolar NA, Marneth AE, Hebeda KM, Bergevoet SM, Veenstra H, Laros-van Gorkom BAP, MacKenzie MA, Khandanpour C, Botezatu L, Fransen E, Van Camp G, Duijnhouwer AL, Salemink S, Willemsen B, Huls G, Preijers F, Van Heerde W, Jansen JH, Kempers MJE, Loeys BL, Van Laer L, Van der Reijden BA. A dominant-negative GFI1B mutation in the gray platelet syndrome. N Engl J Med 2014; 370:245-53. [PMID: 24325358 DOI: 10.1056/nejmoa1308130] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The gray platelet syndrome is a hereditary, usually autosomal recessive bleeding disorder caused by a deficiency of alpha granules in platelets. We detected a nonsense mutation in the gene encoding the transcription factor GFI1B (growth factor independent 1B) that causes autosomal dominant gray platelet syndrome. Both gray platelets and megakaryocytes had abnormal marker expression. In addition, the megakaryocytes had dysplastic features, and they were abnormally distributed in the bone marrow. The GFI1B mutant protein inhibited nonmutant GFI1B transcriptional activity in a dominant-negative manner. Our studies show that GFI1B, in addition to being causally related to the gray platelet syndrome, is key to megakaryocyte and platelet development.
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Affiliation(s)
- Davide Monteferrario
- From the Department of Laboratory Medicine, Laboratory of Hematology, Radboud University Medical Center, Nijmegen Center for Molecular Life Sciences (D.M., A.E.M., S.M.B., H.V., G.H., F.P., W.V.H., J.H.J., B.A.V.R.) and the Departments of Pathology (K.M.H., B.W.), Hematology (B.A.P.L.G., M.A.M., G.H.), Cardiology (A.L.D.), and Human Genetics (S.S., M.J.E.K.), Radboud University Medical Center - all in Nijmegen, the Netherlands; the Department of Medical Genetics, Antwerp University Hospital and University of Antwerp (N.A.B., E.F., G.V.C., B.L.L., L.V.L.) and the Statua Center for Statistics, University of Antwerp (E.F.), Antwerp, Belgium; and the Department of Hematology, University Hospital, Essen, Germany (C.K., L.B.)
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Strobbe L, van der Schans SAM, Heijker S, Meijer JWR, Mattijssen EJMV, Mandigers CMPW, de Kievit IM, Raemaekers JMM, Hebeda KM, van Krieken JHJM. Evaluation of a panel of expert pathologists: review of the diagnosis and histological classification of Hodgkin and non-Hodgkin lymphomas in a population-based cancer registry. Leuk Lymphoma 2013; 55:1018-22. [PMID: 23885798 DOI: 10.3109/10428194.2013.827787] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Correct histological classification of malignant lymphomas is important but has always been a difficult challenge. Since 2001 the World Health Organization (WHO) classification has been used, which should make it easier to define distinct disease entities. The purpose of this study was to evaluate the usefulness of a panel of expert hematopathologists in reviewing the diagnosis of malignant lymphomas and to examine whether the discordance between primary and panel diagnoses has declined throughout the years. All patients with a primary malignant lymphoma diagnosed between 2000-2001 and 2005-2006 were identified through the population based cancer registry. All diagnoses were reviewed by a panel of three expert pathologists. In 2000-2001, 344 patients were included, and in 2005-2006, 370 patients. The overall discordance rate decreased from 14% in 2000-2001 to 9% in 2005-2006 (p = 0.06). We were able to identify lymphoma subgroups with the highest discordance rates and lowest discordance rates (mantle cell lymphoma and classical Hodgkin lymphoma), which remained unchanged throughout the years. Based on these results we would propose to review all cases of malignant lymphoma with the exception of mantle cell lymphoma and classical Hodgkin lymphoma, when the initial pathologist has no doubt about the diagnosis.
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40
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van Groningen LFJ, Preijers FWMB, Jansen JH, Hebeda KM, van der Velden WJFM. A “complicated” fracture: a Philadelphia chromosome-positive myeloid sarcoma of the bone. Ann Hematol 2013; 92:1287-8. [DOI: 10.1007/s00277-013-1691-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 01/30/2013] [Indexed: 10/27/2022]
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41
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van der Voort R, Volman TJH, Verweij V, Linssen PCM, Maas F, Hebeda KM, Dolstra H. Homing characteristics of donor T cells after experimental allogeneic bone marrow transplantation and posttransplantation therapy for multiple myeloma. Biol Blood Marrow Transplant 2012; 19:378-86. [PMID: 23266741 DOI: 10.1016/j.bbmt.2012.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 12/14/2012] [Indexed: 01/13/2023]
Abstract
Relapse and graft-versus-host disease remain major problems associated with allogeneic bone marrow (BM) transplantation (allo-BMT) and posttransplantation therapy in patients with multiple myeloma (MM) and other hematologic malignancies. A possible strategy for selectively enhancing the graft-versus-myeloma response and possibly reducing graft-versus-host disease is to increase the migration of alloreactive T cells toward the MM-containing BM. In the present study, we characterized the BM-homing behavior of donor-derived effector T cells in a novel allo-BMT model for the treatment of MM. We observed that posttransplantation immunotherapy consisting of donor lymphocyte infusion (DLI) and vaccination with minor histocompatibility antigen-loaded dendritic cells (DCs) was associated with prolonged survival compared with allo-BMT with no further treatment. Moreover, CD8(+) effector T cells expressing inflammatory homing receptors, including high levels of CD44, LFA-1, and inflammatory chemokine receptors, were recruited to MM-bearing BM. This was paralleled by strongly increased expression of IFN-γ and IFN-γ-inducible chemokines, including CXCL9, CXCL10, and CXCL16, especially in mice treated with DLI plus minor histocompatibility antigen-loaded DC vaccination. Remarkably, expression of the homeostatic chemokine CXCL12 was reduced. Furthermore, IFN-γ and TNF-α induced BM endothelial cells to express high levels of the inflammatory chemokines and reduced or unaltered levels of CXCL12. Finally, presentation of CXCL9 by multiple BM endothelial cell-expressed heparan sulfate proteoglycans triggered transendothelial migration of effector T cells. Taken together, our data demonstrate that both post-transplantation DLI plus miHA-loaded DC vaccination and MM growth result in an increased expression of inflammatory homing receptors on donor T cells, decreased levels of the homeostatic BM-homing chemokine CXCL12, and strong induction of inflammatory chemokines in the BM. Thus, along with increasing the population of alloreactive T cells, post-transplantation immunotherapy also might contribute to a more effective graft-versus-tumor response by switching homeostatic T cell migration to inflammation-driven migration.
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Affiliation(s)
- Robbert van der Voort
- Department of Laboratory Medicine, Laboratory of Hematology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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42
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van der Laak JAWM, van Engelen N, Melissen M, Hebeda KM. Automated measurement of MIB-1 positive area as an alternative to counting in follicular lymphoma. Cytometry A 2012; 81:527-31. [DOI: 10.1002/cyto.a.22053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 11/10/2022]
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43
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Koopmans SM, Bot FJ, Lam KH, van Marion AM, de Raeve H, Hebeda KM. Reproducibility of histologic classification in nonfibrotic myeloproliferative neoplasia. Am J Clin Pathol 2011; 136:618-24. [PMID: 21917685 DOI: 10.1309/ajcp2ug9sggwahua] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Early phases of polycythemia vera, essential thrombocythemia, and primary myelofibrosis (PMF) can be difficult to distinguish by morphologic studies alone because they share many morphologic characteristics. Histologic criteria according to the 2008 World Health Organization (WHO) classification are part of the myeloproliferative neoplasia (MPN) diagnosis. Our aim was to assess the reproducibility of morphologic characteristics and determine their relative importance for histologic diagnoses on selected trephine biopsy sections. For the study, 56 prefibrotic MPN trephine specimens were blindly reviewed by 4 hematopathologists using a scoring list of 16 histologic characteristics mentioned in the WHO classification. Consensus was defined as agreement by 3 of 4 hematopathologists. High degrees of consensus were reached for individual major morphologic features used in the WHO classification, especially for the nuclear features of megakaryocytes (83%). Some of the features correlated positively or negatively with the histologic diagnosis of PMF. Consensus for the histologic classification of MPN was reached in 39 (70%) of 56 cases without knowledge of clinical data. This finding indicates a difference in the relative importance assigned to individual histologic characteristics by different hematopathologists.
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Affiliation(s)
- Suzanne M. Koopmans
- Department of Pathology, University Hospital Maastricht, Maastricht, the Netherlands
| | - Freek J. Bot
- Department of Pathology, University Hospital Maastricht, Maastricht, the Netherlands
- Haga Hospital, The Hague, the Netherlands
| | - King H. Lam
- Erasmus MC Rotterdam, Rotterdam, the Netherlands
| | - Arienne M.W. van Marion
- Department of Pathology, University Hospital Maastricht, Maastricht, the Netherlands
- VieCuri Medical Center, Venlo, the Netherlands
| | | | - Konnie M. Hebeda
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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44
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Croles FN, Hebeda KM, Kats-Ugurlu G, Hermans JJ, Bonenkamp HJ, van der Velden WJFM. Splenic gas as a result of a non-Hodgkin's lymphoma in a patient with common variable immunodeficiency. J Clin Oncol 2011; 29:e666-7. [PMID: 21646607 DOI: 10.1200/jco.2011.35.6659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Frederik N Croles
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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45
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Abstract
The introduction in pathology practice of a new biomarker that is contributing to define a disease requires a series of investigations. Now that new biomarkers are being discovered continuously it is important to learn from successful examples of markers that are presently widely used. In this historical account the steps are described that have led to the use of immunohistochemical staining of tissue samples with an antibody against cyclinD1 to diagnose mantle cell lymphoma. Furthermore, a short outlook is given on the introduction of proteomics as a tool in the diagnosis of lymphoma and the potential route to be taken for introducing this technology into clinical practice.
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Affiliation(s)
- Johan H J M van Krieken
- Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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46
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Manders P, Spruijt L, Kets CM, Willems HW, Bodmer D, Hebeda KM, Nagtegaal ID, van Krieken JHJM, Ligtenberg MJL, Hoogerbrugge N. Young age and a positive family history of colorectal cancer are complementary selection criteria for the identification of Lynch syndrome. Eur J Cancer 2011; 47:1407-13. [PMID: 21273057 DOI: 10.1016/j.ejca.2010.12.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 12/16/2010] [Accepted: 12/22/2010] [Indexed: 11/28/2022]
Abstract
Families at high risk for Lynch syndrome can effectively be recognised by microsatellite instability (MSI) testing. The aim of the present study is to compare the effectiveness of a MSI test for the identification of Lynch syndrome in patients selected by a pathologist mainly based on young age at diagnosis (MSI-testing-indicated-by-a-Pathologist; MIPA), with that of patients selected by a clinical geneticist mainly based on family history (MSI-testing-indicated-by-Family-History; MIFH). Patients with a Lynch syndrome associated tumour were selected using MIPA (n=362) or MIFH (n=887). Germline DNA mutation testing was performed in 171 out of 215 patients (80%) with a MSI positive tumour. MSI was tested positive in 20% of the MIPA-group group compared to 16% in the MIFH-group (P=0.291). In 91 of 171 patients with MSI positive tumours tested for germline mutations were identified as Lynch syndrome patients: 42% in the MIPA-group and 56% in the MIFH-group (P=0.066). Colorectal cancer (CRC) or endometrial cancer (EC) presenting at an age below 50 years would have led to the diagnosis of Lynch syndrome in 89% of these families (CRC below 50 years: 88% and EC below 50 years: 12%). Families detected by MIPA were characterised more often by extracolonic Lynch syndrome associated malignancies, especially EC (P<0.001). Our results indicate that recognition of Lynch syndrome by CRC or EC below 50 years is as effective as a positive family history. Families from patients selected by individual criteria more often harbour extracolonic Lynch syndrome associated malignancies.
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Affiliation(s)
- P Manders
- Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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47
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Jansen C, Feuth T, Raemaekers JMM, Rijntjes J, Meijer JW, Westenend PJ, van Baarlen J, van Krieken JHJM, Hebeda KM, Groenen PJTA. Protein profiling in pathology: analysis and evaluation of 239 frozen tissue biopsies for diagnosis of B-cell lymphomas. Proteomics Clin Appl 2010; 4:519-27. [PMID: 21137069 DOI: 10.1002/prca.200900120] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 11/27/2009] [Accepted: 12/03/2009] [Indexed: 11/09/2022]
Abstract
PURPOSE We determined the potential value of protein profiling of tissue samples by assessing how precise this approach enables discrimination of B-cell lymphoma from reactive lymph nodes, and how well the profiles can be used for lymphoma classification. EXPERIMENTAL DESIGN Protein lysates from lymph nodes (n=239) from patients with the diagnosis of reactive hyperplasia (n=44), follicular lymphoma (n=63), diffuse large B-cell lymphoma (n=43), mantle cell lymphoma (n=47), and chronic lymphocytic leukemia/small lymphocytic B-cell lymphoma (n=42) were analysed by SELDI-TOF MS. Data analysis was performed by (i) classification and regression tree-based analysis and (ii) binary and polytomous logistic regression analysis. RESULTS After internal validation by the leave-one-out principle, both the classification and regression tree and logistic regression classification correctly identified the majority of the malignant (87 and 96%, respectively) and benign cases (73 and 75%, respectively). Classification was less successful since approximately one-third of the cases of each group were misclassified according to the histological classification. However, an additional mantle cell lymphoma case that was misclassified as chronic lymphocytic leukemia/small lymphocytic B-cell lymphoma initially was identified based on the protein profile. CONCLUSIONS AND CLINICAL RELEVANCE SELDI-TOF MS protein profiling allows for reliable identification of the majority of malignant lymphoma cases; however, further validation and testing robustness in a diagnostic setting is needed.
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Affiliation(s)
- Corine Jansen
- Department of Pathology, Radboud University Nijmegen Medical Centre, The Netherlands
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48
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Hebeda KM, Fend F. Changed concepts and definitions of myeloproliferative neoplasms (MPN), myelodysplastic syndromes (MDS) and myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in the updated 2008 WHO classification. J Hematop 2009; 2:205-10. [PMID: 20309429 PMCID: PMC2798935 DOI: 10.1007/s12308-009-0048-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Accepted: 09/03/2009] [Indexed: 11/29/2022] Open
Abstract
The purpose of this overview is to discuss the changes in the 2008 WHO classification of myeloid neoplasms, with exclusion of acute myeloid leukaemia. Specific mutations or rearrangements leading to constitutive activation of growth factor receptors or cytoplasmic tyrosine kinases are now recognised as recurrent genetic events characterising the group of myeloproliferative neoplasms (MPN). A newly introduced subgroup consists of patients with persistent eosinophilia and myeloid or lymphoid proliferations harbouring specific genetic changes involving platelet-derived growth factor receptors alpha and beta (PDGFRA and PDGFRB) or fibroblast growth factor receptor 1 (FGFR1). The clinical relevance of recognising myeloid neoplasms with aberrant tyrosine kinase activity is based in novel treatment options with tyrosine kinase inhibitors. The myelodysplastic syndromes (MDS) without increased blasts are further divided into subtypes of refractory cytopaenias with unilineage dysplasia. A new provisional entity is refractory cytopaenia of childhood. Down syndrome- and therapy-related myeloid neoplasms, including MDS, were moved to the section of acute myeloid leukaemia and related precursor neoplasms.
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Affiliation(s)
- Konnie M. Hebeda
- Department of Pathology, University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - F. Fend
- Institute of Pathology, University Hospital Tübingen, Tübingen, Germany
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49
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Bosman G, Langemeijer SMC, Hebeda KM, Raemaekers JMM, Pickkers P, van der Velden WJFM. The role of rituximab in a case of EBV-related lymphoproliferative disease presenting with haemophagocytosis. Neth J Med 2009; 67:364-365. [PMID: 19767670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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50
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Ligtenberg MJL, Kuiper RP, Chan TL, Goossens M, Hebeda KM, Voorendt M, Lee TYH, Bodmer D, Hoenselaar E, Hendriks-Cornelissen SJB, Tsui WY, Kong CK, Brunner HG, van Kessel AG, Yuen ST, van Krieken JHJM, Leung SY, Hoogerbrugge N. Heritable somatic methylation and inactivation of MSH2 in families with Lynch syndrome due to deletion of the 3' exons of TACSTD1. Nat Genet 2008; 41:112-7. [PMID: 19098912 DOI: 10.1038/ng.283] [Citation(s) in RCA: 532] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/07/2008] [Indexed: 12/17/2022]
Abstract
Lynch syndrome patients are susceptible to colorectal and endometrial cancers owing to inactivating germline mutations in mismatch repair genes, including MSH2 (ref. 1). Here we describe patients from Dutch and Chinese families with MSH2-deficient tumors carrying heterozygous germline deletions of the last exons of TACSTD1, a gene directly upstream of MSH2 encoding Ep-CAM. Due to these deletions, transcription of TACSTD1 extends into MSH2. The MSH2 promoter in cis with the deletion is methylated in Ep-CAM positive but not in Ep-CAM negative normal tissues, thus revealing a correlation between activity of the mutated TACSTD1 allele and epigenetic inactivation of the corresponding MSH2 allele. Gene silencing by transcriptional read-through of a neighboring gene in either sense, as demonstrated here, or antisense direction, could represent a general mutational mechanism. Depending on the expression pattern of the neighboring gene that lacks its normal polyadenylation signal, this may cause either generalized or mosaic patterns of epigenetic inactivation.
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Affiliation(s)
- Marjolijn J L Ligtenberg
- Department of Human Genetics 849, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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