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Xochelli A, Bikos V, Polychronidou E, Galigalidou C, Agathangelidis A, Charlotte F, Moschonas P, Davis Z, Colombo M, Roumelioti M, Sutton LA, Groenen P, van den Brand M, Boudjoghra M, Algara P, Traverse-Glehen A, Ferrer A, Stalika E, Karypidou M, Kanellis G, Kalpadakis C, Mollejo M, Pangalis G, Vlamos P, Amini RM, Pospisilova S, Gonzalez D, Ponzoni M, Anagnostopoulos A, Giudicelli V, Lefranc MP, Espinet B, Panagiotidis P, Piris MA, Du MQ, Rosenquist R, Papadaki T, Belessi C, Ferrarini M, Oscier D, Tzovaras D, Ghia P, Davi F, Hadzidimitriou A, Stamatopoulos K. Disease-biased and shared characteristics of the immunoglobulin gene repertoires in marginal zone B cell lymphoproliferations. J Pathol 2019; 247:416-421. [PMID: 30484876 DOI: 10.1002/path.5209] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 11/12/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
The B cell receptor immunoglobulin (Ig) gene repertoires of marginal zone (MZ) lymphoproliferations were analyzed in order to obtain insight into their ontogenetic relationships. Our cohort included cases with MZ lymphomas (n = 488), i.e. splenic (SMZL), nodal (NMZL) and extranodal (ENMZL), as well as provisional entities (n = 76), according to the WHO classification. The most striking Ig gene repertoire skewing was observed in SMZL. However, restrictions were also identified in all other MZ lymphomas studied, particularly ENMZL, with significantly different Ig gene distributions depending on the primary site of involvement. Cross-entity comparisons of the MZ Ig sequence dataset with a large dataset of Ig sequences (MZ-related or not; n = 65 837) revealed four major clusters of cases sharing homologous ('public') heavy variable complementarity-determining region 3. These clusters included rearrangements from SMZL, ENMZL (gastric, salivary gland, ocular adnexa), chronic lymphocytic leukemia, but also rheumatoid factors and non-malignant splenic MZ cells. In conclusion, different MZ lymphomas display biased immunogenetic signatures indicating distinct antigen exposure histories. The existence of rare public stereotypes raises the intriguing possibility that common, pathogen-triggered, immune-mediated mechanisms may result in diverse B lymphoproliferations due to targeting versatile progenitor B cells and/or operating in particular microenvironments. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Vasilis Bikos
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Eleftheria Polychronidou
- Information Technologies Institute, CERTH, Thessaloniki, Greece
- Department of Informatics, Ionian University, Corfu, Greece
| | | | - Andreas Agathangelidis
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frédéric Charlotte
- Department of Pathology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Monica Colombo
- Molecular Pathology, Ospedale Policlinico SanMartino, Genoa, Italy
| | - Maria Roumelioti
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Lesley-Ann Sutton
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Patricia Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Myriam Boudjoghra
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | | | - Ana Ferrer
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - Maria Karypidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | | | | | | | | | - Rose-Marie Amini
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - David Gonzalez
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | | | | | - Véronique Giudicelli
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Marie-Paule Lefranc
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Blanca Espinet
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | | | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Manlio Ferrarini
- Direzione Scientifica, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliera Universitaria (AOU) San Martino-IST, Genoa, Italy
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | | | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frederic Davi
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Mansouri L, Noerenberg D, Young E, Mylonas E, Abdulla M, Frick M, Asmar F, Ljungström V, Schneider M, Yoshida K, Skaftason A, Pandzic T, Gonzalez B, Tasidou A, Waldhueter N, Rivas-Delgado A, Angelopoulou M, Ziepert M, Arends CM, Couronné L, Lenze D, Baldus CD, Bastard C, Okosun J, Fitzgibbon J, Dörken B, Drexler HG, Roos-Weil D, Schmitt CA, Munch-Petersen HD, Zenz T, Hansmann ML, Strefford JC, Enblad G, Bernard OA, Ralfkiaer E, Erlanson M, Korkolopoulou P, Hultdin M, Papadaki T, Grønbæk K, Lopez-Guillermo A, Ogawa S, Küppers R, Stamatopoulos K, Stavroyianni N, Kanellis G, Rosenwald A, Campo E, Amini RM, Ott G, Vassilakopoulos TP, Hummel M, Rosenquist R, Damm F. Frequent NFKBIE deletions are associated with poor outcome in primary mediastinal B-cell lymphoma. Blood 2016; 128:2666-2670. [PMID: 27670424 DOI: 10.1182/blood-2016-03-704528] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/16/2016] [Indexed: 12/19/2022] Open
Abstract
We recently reported a truncating deletion in the NFKBIE gene, which encodes IκBε, a negative feedback regulator of NF-κB, in clinically aggressive chronic lymphocytic leukemia (CLL). Because preliminary data indicate enrichment of NFKBIE aberrations in other lymphoid malignancies, we screened a large patient cohort (n = 1460) diagnosed with different lymphoid neoplasms. While NFKBIE deletions were infrequent in follicular lymphoma, splenic marginal zone lymphoma, and T-cell acute lymphoblastic leukemia (<2%), slightly higher frequencies were seen in diffuse large B-cell lymphoma, mantle cell lymphoma, and primary central nervous system lymphoma (3% to 4%). In contrast, a remarkably high frequency of NFKBIE aberrations (46/203 cases [22.7%]) was observed in primary mediastinal B-cell lymphoma (PMBL) and Hodgkin lymphoma (3/11 cases [27.3%]). NFKBIE-deleted PMBL patients were more often therapy refractory (P = .022) and displayed inferior outcome compared with wild-type patients (5-year survival, 59% vs 78%; P = .034); however, they appeared to benefit from radiotherapy (P =022) and rituximab-containing regimens (P = .074). NFKBIE aberrations remained an independent factor in multivariate analysis (P = .003) and when restricting the analysis to immunochemotherapy-treated patients (P = .008). Whole-exome sequencing and gene expression profiling verified the importance of NF-κB deregulation in PMBL. In summary, we identify NFKBIE aberrations as a common genetic event across B-cell malignancies and highlight NFKBIE deletions as a novel poor-prognostic marker in PMBL.
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Affiliation(s)
- Larry Mansouri
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Daniel Noerenberg
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Emma Young
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Elena Mylonas
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Maysaa Abdulla
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Mareike Frick
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Fazila Asmar
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Viktor Ljungström
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Markus Schneider
- Institute of Cell Biology (Cancer Research), Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Aron Skaftason
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Tatjana Pandzic
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Blanca Gonzalez
- Department of Pathology, Hospital Clinic and Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Anna Tasidou
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | - Nils Waldhueter
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | | | - Maria Angelopoulou
- Department of Haematology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Marita Ziepert
- Institute for Medical Informatics, Statistics, and Epidemiology, University at Leipzig, Leipzig, Germany
| | | | - Lucile Couronné
- Service d'Hématologie Adulte, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Dido Lenze
- Institute of Pathology, Charité, University Medical Center, Berlin, Germany
| | - Claudia D Baldus
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Christian Bastard
- INSERM U918, Université de Rouen, Centre Henri Becquerel, Rouen, France
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Bernd Dörken
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Hans G Drexler
- Leibniz-Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Damien Roos-Weil
- Université Paris-Sud, Orsay, France
- INSERM, U1170, Institut Gustave Roussy, Villejuif, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
| | - Clemens A Schmitt
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - Helga D Munch-Petersen
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thorsten Zenz
- Departments of Molecular Therapy in Haematology and Oncology and Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- German Consortium for Translational Cancer Research, Heidelberg, Germany
| | - Martin-Leo Hansmann
- Dr. Senckenberg Institute of Pathology, Goethe University, Frankfurt am Main, Germany
| | - Jonathan C Strefford
- Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Gunilla Enblad
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Olivier A Bernard
- Université Paris-Sud, Orsay, France
- INSERM, U1170, Institut Gustave Roussy, Villejuif, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
| | - Elisabeth Ralfkiaer
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Martin Erlanson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Penelope Korkolopoulou
- Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Magnus Hultdin
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | | | - Kirsten Grønbæk
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Kostas Stamatopoulos
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Niki Stavroyianni
- Hematology Department and Hematopoietic Cell Transplantation Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Elias Campo
- Department of Pathology, Hospital Clinic and Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Rose-Marie Amini
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany; and
| | - Theodoros P Vassilakopoulos
- Department of Haematology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michael Hummel
- Institute of Pathology, Charité, University Medical Center, Berlin, Germany
| | - Richard Rosenquist
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Frederik Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
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3
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Bikos V, Karypidou M, Stalika E, Baliakas P, Xochelli A, Sutton LA, Papadopoulos G, Agathangelidis A, Papadopoulou E, Davis Z, Algara P, Kanellis G, Traverse-Glehen A, Mollejo M, Anagnostopoulos A, Ponzoni M, Gonzalez D, Pospisilova S, Matutes E, Piris MA, Papadaki T, Ghia P, Rosenquist R, Oscier D, Darzentas N, Tzovaras D, Belessi C, Hadzidimitriou A, Stamatopoulos K. An Immunogenetic Signature of Ongoing Antigen Interactions in Splenic Marginal Zone Lymphoma Expressing IGHV1-2*04 Receptors. Clin Cancer Res 2015; 22:2032-40. [PMID: 26647217 DOI: 10.1158/1078-0432.ccr-15-1170] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 11/19/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Prompted by the extensive biases in the immunoglobulin (IG) gene repertoire of splenic marginal-zone lymphoma (SMZL), supporting antigen selection in SMZL ontogeny, we sought to investigate whether antigen involvement is also relevant post-transformation. EXPERIMENTAL DESIGN We conducted a large-scale subcloning study of the IG rearrangements of 40 SMZL cases aimed at assessing intraclonal diversification (ID) due to ongoing somatic hypermutation (SHM). RESULTS ID was identified in 17 of 21 (81%) rearrangements using the immunoglobulin heavy variable (IGHV)1-2*04 gene versus 8 of 19 (40%) rearrangements utilizing other IGHV genes (P= 0.001). ID was also evident in most analyzed IG light chain gene rearrangements, albeit was more limited compared with IG heavy chains. Identical sequence changes were shared by subclones from different patients utilizing the IGHV1-2*04 gene, confirming restricted ongoing SHM profiles. Non-IGHV1-2*04 cases displayed both a lower number of ongoing SHMs and a lack of shared mutations (per group of cases utilizing the same IGHV gene). CONCLUSIONS These findings support ongoing antigen involvement in a sizable portion of SMZL and further argue that IGHV1-2*04 SMZL may represent a distinct molecular subtype of the disease.
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Affiliation(s)
- Vasilis Bikos
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece. Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Maria Karypidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece. Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | | | - Panagiotis Baliakas
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | | | - Andreas Agathangelidis
- Division of Experimental Oncology and Department of Onco-Hematology, Università Vita-Salute San Raffaele and Istituto Scientifico San Raffaele, Milan, Italy
| | | | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Patricia Algara
- Department of Pathology, Hospital Virgen de la Salud, Toledo, Spain
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | | | - Manuela Mollejo
- Department of Pathology, Hospital Virgen de la Salud, Toledo, Spain
| | | | | | - David Gonzalez
- Section of Haemato-Oncology, Institute of Cancer Research, London, United Kingdom
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Estella Matutes
- Section of Haemato-Oncology, Institute of Cancer Research, London, United Kingdom
| | - Miguel Angel Piris
- Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | | | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, Università Vita-Salute San Raffaele and Istituto Scientifico San Raffaele, Milan, Italy
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Nikos Darzentas
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | | | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Kostas Stamatopoulos
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece. Institute of Applied Biosciences, CERTH, Thessaloniki, Greece. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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4
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Papadavid E, Korkolopoulou P, Levidou G, Saetta AA, Papadaki T, Siakantaris M, Nikolaou V, Oikonomidi A, Chatziandreou I, Marinos L, Kolialexi A, Stratigos A, Rigopoulos D, Psyrri A, Patsouris E, Antoniou C. In situ assessment of PI3K and PTEN alterations in mycosis fungoides: correlation with clinicopathological features. Exp Dermatol 2015; 23:931-3. [PMID: 25267489 DOI: 10.1111/exd.12547] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 11/28/2022]
Abstract
Deregulated signalling through phosphatidylinositol 3-kinase (PI3K) pathway plays a critical role in tumour initiation and progression. We have already shown that AKT is activated in skin lesions in Mycosis Fungoides (MF) and we herein further investigate the frequency and clinical significance of PTEN and PI3K at the protein and at the DNA level as well as the presence of AKT1 mutations in skin lesions from 50 patients with MF clinical stages I-IV in relation to clinicopathological features. Increased p-AKT expression correlated with poor prognosis in plaques (P = 0.0198), whereas p-AKT was an independent predictor of poor survival in the entire cohort (P = 0.017, HR = 1.012). PTEN cytoplasmic expression was found low or absent in all 77.3% of cases and inversely correlated with advanced clinical stages (P = 0.0744). Molecular analysis showed no AKT1 mutation, no PI3KCA copy number gain, only 1 case with PI3KCA mutation in exon 9 and 3 cases with PTEN mutations (7%) in exons 7, 8 and 5. The latter correlated with disease (P = 0.0253) and progression (P < 0.0001) free survival in tumour stage. Although activation of PI3K/AKT signalling pathway due to PTEN alterations is rarely attributed to abnormalities in PTEN, PI3K, and AKT1 genes, PTEN mutations exert a negative effect on patients' prognosis with tumours.
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Affiliation(s)
- Evangelia Papadavid
- 1st Department of Dermatology, Cutaneous lymphoma Clinic, A Syngros Hospital, University of Athens, Medical School, Athens, Greece; 2d Department of Dermatology, Cutaneous Lymphoma Clinic, ATTIKON University General Hospital, University of Athens, Medical School, Athens, Greece
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5
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Nikolaou V, Papadavid E, Economidi A, Marinos L, Moustou E, Karampidou K, Papadaki T, Stratigos A, Antoniou C. Mycosis fungoides in the era of antitumour necrosis factor-α treatments. Br J Dermatol 2015; 173:590-3. [PMID: 25639382 DOI: 10.1111/bjd.13705] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- V Nikolaou
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece.
| | - E Papadavid
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
| | - A Economidi
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
| | - L Marinos
- Hemopathology Department, 'Evagelismos' Hospital, Athens, Greece
| | - E Moustou
- Psoriasis Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
| | - K Karampidou
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
| | - T Papadaki
- Hemopathology Department, 'Evagelismos' Hospital, Athens, Greece
| | - A Stratigos
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece.,Psoriasis Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
| | - C Antoniou
- Lymphoma Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece.,Psoriasis Clinic, 'A. Sygros' Hospital for Skin Diseases, 5 I. Dragoumi Str., 16121, Athens, Greece
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6
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Xochelli A, Sutton LA, Agathangelidis A, Stalika E, Karypidou M, Marantidou F, Lopez AN, Papadopoulos G, Supikova J, Groenen P, Boudjogra M, Sundstrom C, Ponzoni M, Francova HS, Anagnostopoulos A, Pospisilova S, Papadaki T, Tzovaras D, Ghia P, Pott C, Davi F, Campo E, Rosenquist R, Hadzidimitriou A, Belessi C, Stamatopoulos K. Molecular evidence for antigen drive in the natural history of mantle cell lymphoma. Am J Pathol 2015; 185:1740-8. [PMID: 25843681 DOI: 10.1016/j.ajpath.2015.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/23/2015] [Accepted: 02/26/2015] [Indexed: 10/24/2022]
Abstract
To further our understanding about antigen involvement in mantle cell lymphoma (MCL), we analyzed the expression levels of activation-induced cytidine deaminase (AID), a key player in B-cell responses to antigen triggering, in 133 MCL cases; assessed the functionality of AID by evaluating in vivo class switch recombination in 52 MCL cases; and sought for indications of ongoing antigen interactions by exploring intraclonal diversification within 14 MCL cases. The AID full-length transcript and the most frequent splice variants (AID-ΔE4a, AID-ΔE) were detected in 128 (96.2%), 96 (72.2%), and 130 cases (97.7%), respectively. Higher AID full-length transcript levels were significantly associated (P < 0.001) with lack of somatic hypermutation within the clonotypic immunoglobulin heavy variable (IGHV) genes. Median AID transcript levels were higher in lymph node material compared to cases in which peripheral blood was analyzed, implying that clonal behavior is influenced by the microenvironment. Switched tumor-derived IGHV-IGHD-IGHJ transcripts were identified in 5 of 52 cases (9.6%), all of which displayed somatic hypermutation and AID-mRNA expression. Finally, although most cases exhibited low levels of intraclonal diversification, analysis of the mutational activity revealed a precise targeting of somatic hypermutation indicative of an active, ongoing interaction with antigen(s). Collectively, these findings strongly allude to antigen involvement in the natural history of MCL, further challenging the notion of antigen naivety.
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Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece; Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Andreas Agathangelidis
- Laboratory of B cell Neoplasia and Lymphoma Unit, Division of Molecular Oncology and Department of Onco-Hematology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Evangelia Stalika
- Institute of Applied Biosciences, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece; Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Maria Karypidou
- Institute of Applied Biosciences, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece; Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Alba Navarro Lopez
- Insititut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Giorgos Papadopoulos
- Information Technologies Institute, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Jana Supikova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno and Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Patricia Groenen
- Department of Pathology, Radboud University, Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Myriam Boudjogra
- Biological Hematology Service, Hopital Pitie-Salpetriere, and UPMC Univ Paris 06, UMRS 1138, Paris, France
| | - Christer Sundstrom
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Maurilio Ponzoni
- Pathology Unit and Unit of Lymphoid Malignancies, Istituto Scientifico San Raffaele, Milan, Italy
| | - Hana Skuhrova Francova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno and Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Sarka Pospisilova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno and Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Dimitris Tzovaras
- Information Technologies Institute, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Paolo Ghia
- Laboratory of B cell Neoplasia and Lymphoma Unit, Division of Molecular Oncology and Department of Onco-Hematology, Università Vita-Salute San Raffaele, Milan, Italy
| | - Christiane Pott
- II. Medizinische Klinik und Poliklinik, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Frederic Davi
- Biological Hematology Service, Hopital Pitie-Salpetriere, and UPMC Univ Paris 06, UMRS 1138, Paris, France
| | - Elias Campo
- Insititut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Center for Research and Technology Hellas, Thessaloniki, Greece; Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Triantafyllopoulou I, Nikolaou V, Marinos L, Papadaki T, Antoniou C. Tumor stage mycosis fungoides in nonblood-related family members. J Am Acad Dermatol 2014; 71:1001-2. [PMID: 25437960 DOI: 10.1016/j.jaad.2013.11.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 11/17/2013] [Accepted: 11/19/2013] [Indexed: 10/24/2022]
Affiliation(s)
- Ioanna Triantafyllopoulou
- First Department of Dermatology, Andreas Syggros University Hospital of Cutaneous and Venereal Diseases, Athens, Greece.
| | - Vasiliki Nikolaou
- First Department of Dermatology, Andreas Syggros University Hospital of Cutaneous and Venereal Diseases, Athens, Greece
| | - Leonidas Marinos
- Department of Hemopathology, Evangelismos Hospital, Athens, Greece
| | | | - Christina Antoniou
- First Department of Dermatology, Andreas Syggros University Hospital of Cutaneous and Venereal Diseases, Athens, Greece
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Nikolaou V, Papadavid E, Ekonomidi A, Dalamaga M, Marinos L, Stratigos A, Papadaki T, Antoniou C. Association of clinicopathological characteristics with secondary neoplastic lymphoproliferative disorders in patients with lymphomatoid papulosis. Leuk Lymphoma 2014; 56:1303-7. [PMID: 25242096 DOI: 10.3109/10428194.2014.958821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Lymphomatoid papulosis (LyP) refers to an indolent cutaneous lymphoma. The association of prognostic clinicopathological risk factors with a second hematologic malignancy has not yet been determined. We investigated the prognostic effect of clinicopathological characteristics on the occurrence of a second lymphoma, as well as the first-line treatment, in 24 patients diagnosed with LyP using logistic regression models. We showed that lymphoma occurrence was associated with a lower mean age at onset of LyP symptoms, histological types B and C, head-located LyP lesions and a higher frequency of LyP recurrences. In multivariate analyses, histologic type A was associated with a lower risk of second lymphoma (odds ratio [OR] = 0.12, 95% confidence interval [CI] 0.014-0.98; p = 0.045) adjusting for age of LyP first symptomatology, and an important increased lymphoma-free survival rate (long-rank test; p = 0.06). Clinicopathological characteristics are important in defining the clearance or persistence of LyP lesions and may predict the occurrence of a second lymphoma.
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Affiliation(s)
- Vassiliki Nikolaou
- Dermatology Department, Andreas Syggros Hospital, Athens University Medical School , Athens , Greece
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Matikas A, Kanellis G, Papadimitriou C, Papadaki T, Kotsakis A, Dimopoulos MA, Georgoulias V. Plasmablastic lymphoma of the breast in an immunocompetent patient: long-lasting complete response induced by chemotherapy and autologous stem cell trasplantation. Anticancer Res 2014; 34:5111-5115. [PMID: 25202100] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Plasmablastic lymphoma (PBL) is a rare entity which is often causally related to infection by the Human Immunodeficiency Virus (HIV). Despite its predilection for oral cavity involvement, multiple cases of extra-oral involvement have been reported in the literature, more often among immunocompetent individuals. CASE REPORT Herein we present the first case of primary PBL of the breast in an otherwise immunocompetent 36-year-old woman who was successfully treated with consolidation megatherapy and autologous stem cell transplantation. CONCLUSION PBL carries a particularly poor prognosis and more intensive treatment is usually warranted. However, no treatment guidelines exist and treatment choices are made based on case reports and small retrospective case series.
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Affiliation(s)
- Alexios Matikas
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece
| | - George Kanellis
- Department of Hematopathology, "Evangelismos" Hosptial, Athens, Greece
| | - Christos Papadimitriou
- Bone Marrow Transplantation Unit, Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece
| | - Theodora Papadaki
- Department of Hematopathology, "Evangelismos" Hosptial, Athens, Greece
| | - Athanasios Kotsakis
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece
| | - Meletios A Dimopoulos
- Bone Marrow Transplantation Unit, Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece
| | - Vassilis Georgoulias
- Department of Medical Oncology, University General Hospital of Heraklion, Heraklion, Greece
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Patsatsi A, Koletsa T, Sotiriadis D, Batsis I, Sakellari I, Anagnostopoulos A, Papadaki T, Kostopoulos I. Silent T-cell lymphoma of γδ T-cell origin initially presented as panniculitis. J Eur Acad Dermatol Venereol 2014; 29:1244-5. [PMID: 24641297 DOI: 10.1111/jdv.12477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- A Patsatsi
- 2nd Department of Dermatology, Aristotle University School of Medicine, Thessaloniki, Greece
| | - T Koletsa
- Department of Pathology, Aristotle University School of Medicine, Thessaloniki, Greece
| | - D Sotiriadis
- 2nd Department of Dermatology, Aristotle University School of Medicine, Thessaloniki, Greece
| | - I Batsis
- Department of Hematology, George Papanikolaou General Hospital, Thessaloniki, Greece
| | - I Sakellari
- Department of Hematology, George Papanikolaou General Hospital, Thessaloniki, Greece
| | - A Anagnostopoulos
- Department of Hematology, George Papanikolaou General Hospital, Thessaloniki, Greece
| | - T Papadaki
- Department of Hematopathology, Evangelismos Hospital, Athens, Greece
| | - I Kostopoulos
- Department of Pathology, Aristotle University School of Medicine, Thessaloniki, Greece
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11
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Stalika E, Papalexandri A, Iskas M, Stavroyianni N, Kanellis G, Kotta K, Pontikoglou C, Siorenta A, Anagnostopoulos A, Papadaki H, Papadaki T, Stamatopoulos K. Familial CD3+ T large granular lymphocyte leukemia: evidence that genetic predisposition and antigen selection promote clonal cytotoxic T-cell responses. Leuk Lymphoma 2013; 55:1781-7. [PMID: 24180333 DOI: 10.3109/10428194.2013.861065] [Citation(s) in RCA: 6] [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] [Indexed: 11/13/2022]
Abstract
CD3+ T-large granular lymphocyte (T-LGL) proliferations often present with cytopenias and splenomegaly and are linked to autoimmunity, especially rheumatoid arthritis and Felty's syndrome. We report here the intra-family occurrence of T-LGL leukemia in a father and son, both presenting with cytopenias and splenomegaly. Both patients carried the HLA-DRB1*04 allele, strongly associated with rheumatoid arthritis and Felty's syndrome, exhibited distinctive histopathological features suggestive of immune-mediated suppression of hematopoiesis and expressed a remarkably skewed T-cell receptor beta chain gene repertoire with overtime evolution (clonal drift). Immunoinformatics analysis and comparisons with clonotype sequences from various entities revealed (quasi)identities between (i) father and son, and (ii) father or son and patients with autoimmune disorders, T-LGL leukemia or chronic idiopathic neutropenia. Altogether, our results further corroborate antigen selection in the ontogeny of T-LGL leukemia and point to the interplay between genetics and the (micro)environment in shaping the outcome of cytotoxic T cell responses.
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Affiliation(s)
- Evangelia Stalika
- Hematology Department and HCT Unit, G. Papanicolaou Hospital , Thessaloniki , Greece
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12
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Stamatopoulos K, Belessi C, Papadaki T, Stavroyianni N, Hadzidimitriou A, Kosmas C, Laoutaris N, Fassas A, Anagnostopoulos A. Somatic Hypermutation Patterns in Germinal Center B Cell Malignancies. Hematology 2013; 8:319-28. [PMID: 14530174 DOI: 10.1080/10245330310001612143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Kostas Stamatopoulos
- Hematology Department and HCT Unit, G Papanicolaou Hospital, Thessaloniki, Greece.
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13
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Stalika E, Kanellis G, Papalexandri A, Iskas M, Vrakidou E, Demonakou M, Anagnostopoulos A, Stamatopoulos K, Papadaki T. Cytotoxic T cell-mediated gastritis after rituximab treatment for gastric malt lymphoma. Leuk Lymphoma 2013; 55:702-5. [DOI: 10.3109/10428194.2013.810736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Levidou G, Siakantaris M, Papadaki T, Papadavid E, Vassilakopoulos TP, Angelopoulou MK, Marinos L, Nikolaou V, Economidi A, Antoniou C, Patsouris E, Korkolopoulou P. A comprehensive immunohistochemical approach of AKT/mTOR pathway and p-STAT3 in mycosis fungoides. J Am Acad Dermatol 2013; 69:375-84. [PMID: 23685026 DOI: 10.1016/j.jaad.2013.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 12/19/2012] [Accepted: 04/08/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although the expression pattern of phosphorylated (p)-mTOR pathway components has attracted scientific interest in several neoplasms, to our knowledge, there is no published information regarding its significance in mycosis fungoides (MF). OBJECTIVE We sought to perform a comprehensive simultaneous assessment of key members of AKT/mTOR pathway along with p-extracellular signal-regulated kinase (ERK), NOTCH1, and p-STAT3 in patients with MF. METHODS In all, 54 skin biopsy specimens (21 tumors, 30 plaques, and 3 folliculotropic MF) from 50 patients with MF were analyzed immunohistochemically for p-mTOR, its upstream p-AKT, its downstream effectors p-p70S6K and p-4E-BP1, and for p-ERK1/2, NOTCH1, and p-STAT3. RESULTS p-mTOR was coexpressed with p-p70S6K in 67.3% of lesions, but coexpression with other molecules was less common. p-p70S6K and marginally NOTCH1 displayed higher H-scores in tumors than in plaques. Significant correlations were recorded between p-ERK and p-4E-BP1, as well as between NOTCH1 and p-p70S6K or p-4E-BP1. NOTCH1, p-4E-BP1, and p-p70S6K expression were associated with advanced stage. In survival analysis simultaneous overexpression of p-AKT and p-p70S6K, along with p-4E-BP1 positivity, adversely affected cancer-specific, disease-free, and progression-free survival in advanced-stage cases. LIMITATIONS A limitation may be the small number of cases included in our investigation, precluding multivariate survival analysis. CONCLUSIONS Activation of AKT/mTOR pathway in MF appears to be correlated with NOTCH1, p-ERK, and p-STAT3 and is implicated in the acquisition of a more aggressive phenotype. The combination of p-AKT, p-p70S6K, and p-4E-BP1 emerges as a significant potential prognostic marker in patients with advanced stage.
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Affiliation(s)
- Georgia Levidou
- Department of Pathology, University of Athens, Medical School, Athens, Greece.
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15
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Baliakas P, Kanellis G, Stavroyianni N, Fameli M, Anagnostopoulos A, Stamatopoulos K, Papadaki T. The role of bone marrow biopsy examination at diagnosis of chronic lymphocytic leukemia: a reappraisal. Leuk Lymphoma 2013; 54:2377-84. [DOI: 10.3109/10428194.2013.780653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Panagiotis Baliakas
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Maria Fameli
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | | | - Kostas Stamatopoulos
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Kontopidou FN, Yiakoumis X, Kokoris SI, Dimitriadou EM, Dimopoulou MN, Moschogiannis M, Korkolopoulou P, Kyrtsonis MC, Siakantaris MP, Papadaki T, Tsaftaridis P, Plata E, Papadaki HE, Vassilakopoulos TP. Treatment of splenic marginal zone lymphoma with rituximab monotherapy: progress report and comparison with splenectomy. Oncologist 2013; 18:190-7. [PMID: 23345547 DOI: 10.1634/theoncologist.2012-0251] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Treatment of splenic marginal zone lymphoma (SMZL) patients is not standardized. Recent data suggest that rituximab is highly effective and could be considered as initial therapy. AIM To assess the efficacy of rituximab monotherapy in a large series of patients with SMZL and compare these results with splenectomy results. METHODS The studied population included 85 patients. Fifty-eight received rituximab at a dose of 375 mg/m2 per week for 6 weeks as induction followed by maintenance at the same dose every 2 months for 1-2 years, whereas 27 patients were treated using splenectomy only. RESULTS The overall response rate to rituximab 2 months after the end of induction was 95% (complete response [CR], 45%; unconfirmed CR, 26%; partial response, 24%). The median times to hematologic and clinical response were 2 weeks and 3 weeks, respectively. Forty-three of 55 patients already completed the maintenance phase: 28 sustained their initial response, 14 improved their response, and one progressed. Eighty-five percent of splenectomized patients responded, and two were treated with rituximab as consolidation after splenectomy and achieved a CR. The 5-year overall and progression-free survival (PFS) rates for rituximab-treated and splenectomized patients were 92% and 77% (p = .09) and 73% and 58% (p = .06), respectively. Furthermore, maintenance therapy with rituximab resulted in a longer duration of response (at 5 years, PFS was 84% for patients receiving maintenance and 36% for patients without maintenance, p <.0001). CONCLUSIONS Rituximab is a very effective and well-tolerated therapy and may be substituted for splenectomy as the first-line treatment of choice for patients with SMZL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Disease-Free Survival
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Male
- Middle Aged
- Retrospective Studies
- Rituximab
- Splenectomy/adverse effects
- Splenectomy/methods
- Splenic Neoplasms/drug therapy
- Splenic Neoplasms/pathology
- Splenic Neoplasms/surgery
- Treatment Outcome
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Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, University Hospital of Heraklion, P.O. Box 1352, Heraklion, Crete, Greece.
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Navarro A, Clot G, Royo C, Jares P, Hadzidimitriou A, Agathangelidis A, Bikos V, Darzentas N, Papadaki T, Salaverria I, Pinyol M, Puig X, Palomero J, Vegliante MC, Amador V, Martinez-Trillos A, Stefancikova L, Wiestner A, Wilson W, Pott C, Calasanz MJ, Trim N, Erber W, Sander B, Ott G, Rosenwald A, Colomer D, Giné E, Siebert R, Lopez-Guillermo A, Stamatopoulos K, Beà S, Campo E. Molecular subsets of mantle cell lymphoma defined by the IGHV mutational status and SOX11 expression have distinct biologic and clinical features. Cancer Res 2012; 72:5307-16. [PMID: 22915760 DOI: 10.1158/0008-5472.can-12-1615] [Citation(s) in RCA: 197] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mantle cell lymphoma (MCL) is a heterogeneous disease with most patients following an aggressive clinical course, whereas others having an indolent behavior. We conducted an integrative and multidisciplinary analysis of 177 MCL to determine whether the immunogenetic features of the clonotypic B-cell receptors (BcR) may identify different subsets of tumors. Truly unmutated (100% identity) IGHV genes were found in 24% cases, 40% were minimally/borderline mutated (99.9%-97%), 19% significantly mutated (96.9%-95%), and 17% hypermutated (<95%). Tumors with high or low mutational load used different IGHV genes, and their gene expression profiles were also different for several gene pathways. A gene set enrichment analysis showed that MCL with high and low IGHV mutations were enriched in memory and naive B-cell signatures, respectively. Furthermore, the highly mutated tumors had less genomic complexity, were preferentially SOX11-negative, and showed more frequent nonnodal disease. The best cut-off of germline identity of IGHV genes to predict survival was 97%. Patients with high and low mutational load had significant different outcome with 5-year overall survival (OS) of 59% and 40%, respectively (P = 0.004). Nodal presentation and SOX11 expression also predicted for poor OS. In a multivariate analysis, IGHV gene status and SOX11 expression were independent risk factors. In conclusion, these observations suggest the idea that MCL with mutated IGHV, SOX11-negativity, and nonnodal presentation correspond to a subtype of the disease with more indolent behavior.
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Affiliation(s)
- Alba Navarro
- Pathology and Hematology Departments, Hospital Clínic, University of Barcelona, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Spain
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18
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Bikos V, Stalika E, Baliakas P, Darzentas N, Davis Z, Traverse-Glehen A, Dagklis A, Kanellis G, Anagnostopoulos A, Tsaftaris A, Ponzoni M, Berger F, Felman P, Ghia P, Papadaki T, Oscier D, Belessi C, Stamatopoulos K. Selection of antigen receptors in splenic marginal-zone lymphoma: further support from the analysis of the immunoglobulin light-chain gene repertoire. Leukemia 2012; 26:2567-9. [PMID: 22858907 DOI: 10.1038/leu.2012.207] [Citation(s) in RCA: 15] [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: 12/14/2022]
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Bikos V, Darzentas N, Hadzidimitriou A, Davis Z, Hockley S, Traverse-Glehen A, Algara P, Santoro A, Gonzalez D, Mollejo M, Dagklis A, Gangemi F, Bosler DS, Bourikas G, Anagnostopoulos A, Tsaftaris A, Iannitto E, Ponzoni M, Felman P, Berger F, Belessi C, Ghia P, Papadaki T, Dogan A, Degano M, Matutes E, Piris MA, Oscier D, Stamatopoulos K. Over 30% of patients with splenic marginal zone lymphoma express the same immunoglobulin heavy variable gene: ontogenetic implications. Leukemia 2012; 26:1638-46. [PMID: 22222599 DOI: 10.1038/leu.2012.3] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We performed an immunogenetic analysis of 345 IGHV-IGHD-IGHJ rearrangements from 337 cases with primary splenic small B-cell lymphomas of marginal-zone origin. Three immunoglobulin (IG) heavy variable (IGHV) genes accounted for 45.8% of the cases (IGHV1-2, 24.9%; IGHV4-34, 12.8%; IGHV3-23, 8.1%). Particularly for the IGHV1-2 gene, strong biases were evident regarding utilization of different alleles, with 79/86 rearrangements (92%) using allele (*)04. Among cases more stringently classified as splenic marginal-zone lymphoma (SMZL) thanks to the availability of splenic histopathological specimens, the frequency of IGHV1-2(*)04 peaked at 31%. The IGHV1-2(*)04 rearrangements carried significantly longer complementarity-determining region-3 (CDR3) than all other cases and showed biased IGHD gene usage, leading to CDR3s with common motifs. The great majority of analyzed rearrangements (299/345, 86.7%) carried IGHV genes with some impact of somatic hypermutation, from minimal to pronounced. Noticeably, 75/79 (95%) IGHV1-2(*)04 rearrangements were mutated; however, they mostly (56/75 cases; 74.6%) carried few mutations (97-99.9% germline identity) of conservative nature and restricted distribution. These distinctive features of the IG receptors indicate selection by (super)antigenic element(s) in the pathogenesis of SMZL. Furthermore, they raise the possibility that certain SMZL subtypes could derive from progenitor populations adapted to particular antigenic challenges through selection of VH domain specificities, in particular the IGHV1-2(*)04 allele.
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Affiliation(s)
- V Bikos
- Democritus University of Thrace, Alexandroupolis, Greece
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Nikolaou V, Siakantaris MP, Vassilakopoulos TP, Papadavid E, Stratigos A, Economidi A, Marinos L, Papadaki T, Antoniou C. PUVA plus interferon α2b in the treatment of advanced or refractory to PUVA early stage mycosis fungoides: a case series. J Eur Acad Dermatol Venereol 2011; 25:354-7. [DOI: 10.1111/j.1468-3083.2010.03732.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Terpos E, Tasidou A, Eleftherakis-Papaiakovou E, Christoulas D, Gavriatopoulou M, Gkotzamanidou M, Roussou M, Kastritis E, Papadaki T, Dimopoulos MA. Expression of CCL3 by Neoplastic Cells in Patients with Waldenström's Macroglobulinemia: An Immunohistochemical Study in Bone Marrow Biopsies of 67 Patients. Clinical Lymphoma Myeloma and Leukemia 2011; 11:115-7. [DOI: 10.3816/clml.2011.n.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Stalika E, Papalexandri A, Kannelis G, Batsis I, Papadaki T, Anagnostopoulos A, Stamatopoulos K. Transient monoclonal CD3+ T large granular lymphocyte proliferation in a case of mantle cell lymphoma with Rituximab-associated late onset neutropenia. Hematol Oncol 2010; 29:144-6. [PMID: 20842646 DOI: 10.1002/hon.963] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 07/13/2010] [Accepted: 07/14/2010] [Indexed: 11/11/2022]
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Sikalias N, Alexiou K, Demonakou M, Mylona SC, Papadaki T, Ekonomou N. Non-polypoidal, synchronous mantle-cell lymphoma of small intestine: a rare case. World J Surg Oncol 2010; 8:69. [PMID: 20707926 PMCID: PMC2933587 DOI: 10.1186/1477-7819-8-69] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Accepted: 08/13/2010] [Indexed: 11/10/2022] Open
Abstract
Herein is reported the case of a mantle cell lymphoma (MCL) with synchronous double intestinal location. A 74 - year old male presented with mild abdominal pain. CT scan imaging indicated invasion of lateral intestinal cavity by large mass formation. Exploratory laparotomy was performed and two solid extra-mural masses were isolated and excised. Histology revealed non- polypoid double synchronous lymphoma of mantle cell origin, an unusual presentation of the disease.
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Affiliation(s)
- Nikolaos Sikalias
- 1st Surgical Department, Sismanogleio General Hospital, (st, Sismanogliou 1st), Marousi-Athens (15126), Greece.
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Tsagarakis NJ, Kentrou NA, Papadimitriou KA, Pagoni M, Kokkini G, Papadaki H, Pappa V, Marinakis T, Anagnostopoulos NI, Vadikolia C, Anagnostopoulos A, Angelopoulou MK, Terpos E, Poziopoulos C, Anargyrou K, Rontogianni D, Papadaki T, Psarra A, Kontopidou FN, Skoumi D, Papadhimitriou SI, Paterakis G. Acute lymphoplasmacytoid dendritic cell (DC2) leukemia: Results from the Hellenic Dendritic Cell Leukemia Study Group. Leuk Res 2010; 34:438-46. [DOI: 10.1016/j.leukres.2009.09.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 09/05/2009] [Accepted: 09/05/2009] [Indexed: 01/29/2023]
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Stalika E, Stavroyianni N, Anagnostopoulos A, Papadaki H, Papadaki T, Stamatopoulos K. P083 A father and his son presenting with cytopenias associated with CD3 T large granular lymphocyte proliferation. Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70163-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Marinos L, Economaki E, Stavroyianni N, Papadaki C, Xylouri I, Lalayanni C, Paterakis G, Pouliou E, Athanasiadou A, Kokkini G, Papadaki H, Fassas A, Anagnostopoulos A, Stamatopoulos K, Papadaki T. P082 Hematological manifestations and histopathological findings in T-large granular lymphocyte leukemia. Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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27
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Smilevska T, Tsakou E, Hadzidimitriou A, Bikos V, Stavroyianni N, Laoutaris N, Fassas A, Alphanagnostopoulos A, Papadaki T, Belessi C, Stamatopoulos K. Immunoglobulin kappa gene repertoire and somatic hypermutation patterns in follicular lymphoma. Blood Cells Mol Dis 2008; 41:215-8. [PMID: 18640859 DOI: 10.1016/j.bcmd.2008.06.002] [Citation(s) in RCA: 12] [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: 06/05/2008] [Accepted: 06/11/2008] [Indexed: 12/30/2022]
Abstract
Immunoglobulin kappa gene usage and somatic mutation patterns were studied in a series of 47 IGKV-J rearrangements amplified in 42 follicular lymphoma (FL) cases. The IGKV1-39/1D-39 gene predominated and was significantly over-represented compared to normal cells, autoreactive cells or other B cell lymphomas. The impact of somatic hypermutation varied significantly; nevertheless, mutation distribution patterns indicated pressure for preservation of the B cell receptor. In conclusion, the present series demonstrates biased usage of IGKV genes in FL and alludes to the important role of immunoglobulin kappa light chains in antigen selection of the clonogenic B cells in FL.
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Affiliation(s)
- Tatjana Smilevska
- Hematology Department and Hematopoietic Cell Transplantation Unit, G. Papanicolaou Hospital, 57010 Asvestohori, Thessaloniki, Greece
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Stamatopoulos K, Papadaki T, Pontikoglou C, Athanasiadou I, Stavroyianni N, Bux J, Batsis I, Pyrovolaki K, Paterakis G, Anagnostou D, Anagnostopoulos A, Papadaki HA. Lymphocyte subpopulation imbalances, bone marrow hematopoiesis and histopathology in rituximab-treated lymphoma patients with late-onset neutropenia. Leukemia 2008; 22:1446-9. [PMID: 18185527 DOI: 10.1038/sj.leu.2405077] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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29
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Matutes E, Oscier D, Montalban C, Berger F, Callet-Bauchu E, Dogan A, Felman P, Franco V, Iannitto E, Mollejo M, Papadaki T, Remstein ED, Salar A, Solé F, Stamatopoulos K, Thieblemont C, Traverse-Glehen A, Wotherspoon A, Coiffier B, Piris MA. Splenic marginal zone lymphoma proposals for a revision of diagnostic, staging and therapeutic criteria. Leukemia 2007; 22:487-95. [PMID: 18094718 DOI: 10.1038/sj.leu.2405068] [Citation(s) in RCA: 204] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Since the initial description of splenic marginal zone lymphoma (SMZL) in 1992, an increasing number of publications have dealt with multiple aspects of SMZL diagnosis, molecular pathogenesis and treatment. This process has identified multiple inconsistencies in the diagnostic criteria and lack of clear guidelines for the staging and treatment. The authors of this review have held several meetings and exchanged series of cases with the objective of agreeing on the main diagnostic, staging and therapeutic guidelines for patients with this condition. Specific working groups were created for diagnostic criteria, immunophenotype, staging and treatment. As results of this work, guidelines are proposed for diagnosis, differential diagnosis, staging, prognostic factors, treatment and response criteria. The guidelines proposed here are intended to contribute to the standardization of the diagnosis and treatment of these patients, and should facilitate the future development of clinical trials that could define more precisely predictive markers for histological progression or lack of response, and evaluate new drugs or treatments.
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Affiliation(s)
- E Matutes
- Section of Haemato-Oncology, Institute of Cancer Research, London, UK
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Papadaki T, Stamatopoulos K, Mavrommatis T, Anagnostopoulos A, Anagnostou D. A unique case of IgD-only splenic marginal-zone lymphoma with mutated immunoglobulin genes: ontogenetic implications. Leuk Res 2007; 32:155-7. [PMID: 17420049 DOI: 10.1016/j.leukres.2007.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 02/28/2007] [Revised: 02/28/2007] [Accepted: 03/02/2007] [Indexed: 11/20/2022]
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare indolent lymphoma subtype which accounts for less than 1% of all non-Hodgkin's lymphomas. We here report a unique case of IgD-only SMZL with mutated immunoglobulin variable region genes and discuss possible ontogenetic derivation.
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31
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Masgala A, Christopoulos C, Giannakou N, Boukis H, Papadaki T, Anevlavis E. Plasmablastic lymphoma of visceral cranium, cervix and thorax in an HIV-negative woman. Ann Hematol 2007; 86:615-8. [PMID: 17361427 DOI: 10.1007/s00277-007-0280-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 02/26/2007] [Indexed: 02/03/2023]
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Papadaki T, Stamatopoulos K, Belessi C, Pouliou E, Parasi A, Douka V, Laoutaris N, Fassas A, Anagnostopoulos A, Anagnostou D. Splenic Marginal-zone Lymphoma: One or More Entities? A Histologic, Immunohistochemical, and Molecular Study of 42 Cases. Am J Surg Pathol 2007; 31:438-46. [PMID: 17325486 DOI: 10.1097/01.pas.0000213419.08009.b0] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We analyzed 42 splenic marginal-zone lymphoma (SMZL) cases diagnosed on splenectomy specimens after established World Health Organization criteria. A predominantly nodular growth pattern was observed in 24 cases; the remainder showed predominantly (11/42) or exclusively (7/42) diffuse infiltration. Twenty-one cases showed the "classic" biphasic appearance; 13 cases exhibited marginal-zone morphology; finally, 8 cases were composed predominantly of small cells. CD21 and CD35 were expressed by 12/42 and 17/38 cases, respectively. DBA.44 was detected in 24/42 cases. Seventeen of 37 cases were surface IgD (SIgD)-positive. Twenty-one of 22 analyzed cases were SIgM-positive (12/21 coexpressed SIgD). Five of 37 cases were SIgG-positive. CD27 staining was observed in 21/35 cases; 7/18 CD27-positive cases coexpressed SIgD; 7/14 CD27-negative cases were SIgD-positive. Forty IGHV-D-J rearrangements were amplified in 34/42 cases: the IGHV4-34 gene predominated, followed by IGHV1-2. Using the 98% homology cut-off, 25/40 (62.5%) IGHV sequences were considered as "mutated": 10/11 cases with monomorphous, marginal-zone morphology were IGHV-mutated; in contrast, 4/6 cases with monomorphous, small-cell morphology were IGHV-unmutated. Five of 7 cases expressing IGHV1 subgroup genes had biphasic morphology, whereas 6/9 IGHV3-expressing cases had monomorphous, marginal-zone morphology. Most IGHV-mutated cases (14/20; 70%) were SIgD-negative; in contrast, 8/11 IGHV-unmutated cases expressed SIgD. CD27 was detected in 10/17 IGHV-mutated and 6/10 IGHV-unmutated cases. Seven of 11 CD27-negative cases were IGHV-mutated; 5/7 CD27-negative/IGHV-mutated cases expressed DBA.44. These results confirm the considerable histologic, immunohistochemical, and molecular heterogeneity of SMZL and indicate an origin from the diverse resident B-cell populations of the normal SMZ.
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Stamatopoulos K, Economidou D, Papadaki T, Vadikolia C, Papathanasiou M, Memmos D, Fassas A. Large granular lymphocyte leukemia after renal transplantation: an immunologic, immunohistochemical, and genotypic study. Transplantation 2007; 83:102-3. [PMID: 17220805 DOI: 10.1097/01.tp.0000239189.45186.74] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Stamatopoulos K, Belessi C, Papadaki T, Kalagiakou E, Stavroyianni N, Douka V, Afendaki S, Saloum R, Parasi A, Anagnostou D, Laoutaris N, Fassas A, Anagnostopoulos A. Immunoglobulin heavy- and light-chain repertoire in splenic marginal zone lymphoma. Mol Med 2006; 10:89-95. [PMID: 15706403 PMCID: PMC1431370 DOI: 10.2119/2005-00001.stamatopoulos] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Accepted: 01/17/2005] [Indexed: 11/06/2022] Open
Abstract
The considerable heterogeneity in morphology, immunophenotype, genotype, and clinical behavior of splenic marginal zone lymphoma (SMZL) hinders firm conclusions on the origin and differentiation stage of the neoplastic cells. Immunoglobulin (IG) gene usage and somatic mutation patterns were studied in a series of 43 SMZL cases. Clonal IGHV-D-J rearrangements were amplified in 42/43 cases (4 cases carried double rearrangements). Among IGHV-D-J rearrangements, IGHV3 and IGHV4 subgroup genes were used with the highest frequency. Nineteen IGHV genes were unmutated (> 98% homology to the closest germline IGHV gene), whereas 27/46 were mutated. Clonal IGKV-J and IGLV-J gene rearrangements were amplified in 36/43 cases, including 31 IGKV-J (8/31 in lambda light-chain expressing cases) and 12 IGLV-J rearrangements; 9/31 IGKV and 6/12 IGLV sequences were mutated. IGKV-J and IGLV-J rearrangements used 14 IGKV and 9 IGLV different germline genes. Significant evidence for positive selection by classical T-dependent antigen was found in only 5/27 IGHV and 6/15 IGKV+IGLV mutated genes. These results provide evidence for the diverse B-cell subpopulations residing in the SMZ, which could represent physiologic equivalents of distinct SMZL subtypes. Furthermore, they indicate that in SMZL, as in other B cell malignancies, a complementarity imprint of antigen selection might be witnessed either by IGHV, IGKV, or IGLV rearranged sequences.
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Androudi S, Letko E, Meniconi M, Papadaki T, Ahmed M, Foster C. Safety and efficacy of intravitreal triamcinolone acetonide for uveitis macular edema. Am J Ophthalmol 2005. [DOI: 10.1016/j.ajo.2005.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stamatopoulos K, Belessi C, Hadzidimitriou A, Smilevska T, Kalagiakou E, Hatzi K, Stavroyianni N, Athanasiadou A, Tsompanakou A, Papadaki T, Kokkini G, Paterakis G, Saloum R, Laoutaris N, Anagnostopoulos A, Fassas A. Immunoglobulin light chain repertoire in chronic lymphocytic leukemia. Blood 2005; 106:3575-83. [PMID: 16076869 DOI: 10.1182/blood-2005-04-1511] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Immunoglobulin kappa (IGK) and immunoglobulin lambda (IGL) light chain repertoire was analyzed in 276 chronic lymphocytic leukemia (CLL) cases and compared with the relevant repertoires from normal, autoreactive, and neoplastic cells. Twenty-one functional IGKV genes were used in IGKV-J rearrangements of 179 kappa-CLL cases; the most frequent genes were IGKV3-20(A27), IGKV1-39/1D-39(O2/O12), IGKV1-5(L12), IGKV4-1(B3), and IGKV2-30(A17); 90 (50.3%) of 179 IGK sequences were mutated (similarity < 98%). Twenty functional IGLV genes were used in IGLV-J rearrangements of 97 lambda-CLL cases; the most frequent genes were IGLV3-21(VL2-14), IGLV2-8(VL1-2), and IGLV2-14(VL1-4); 44 of 97 IGL sequences (45.4%) were mutated. Subsets with "CLL-biased" homologous complementarity-determining region 3 (CDR3) were identified: (1) IGKV2-30-IGKJ2, 7 sequences with homologous kappa CDR3 (KCDR3), 5 of 7 associated with homologous IGHV4-34 heavy chains; (2) IGKV1-39/1D-39-IGKJ1/4, 4 unmutated sequences with homologous KCDR3, 2 of 4 associated with homologous IGHV4-39 heavy chains; (3) IGKV1-5-IGKJ1/3, 4 sequences with homologous KCDR3, 2 of 4 associated with unmutated nonhomologous IGHV4-39 heavy chains; (4) IGLV1-44-IGLJ2/3, 2 sequences with homologous lambda CDR3 (LCDR3), associated with homologous IGHV4-b heavy chains; and (5) IGLV3-21-IGLJ2/3, 9 sequences with homologous LCDR3, 3 of 9 associated with homologous IGHV3-21 heavy chains. The existence of subsets that comprise given IGKV-J/IGLV-J domains associated with IGHV-D-J domains that display homologous CDR3 provides further evidence for the role of antigen in CLL pathogenesis.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Complementarity Determining Regions/genetics
- Female
- Gene Rearrangement, B-Lymphocyte, Heavy Chain/genetics
- Gene Rearrangement, B-Lymphocyte, Light Chain/genetics
- Humans
- Immunoglobulin Variable Region/genetics
- Immunoglobulin kappa-Chains/genetics
- Immunoglobulin lambda-Chains/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Somatic Hypermutation, Immunoglobulin/genetics
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Affiliation(s)
- Kostas Stamatopoulos
- Hematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanicolaou Hospital, Thessaloniki, Greece.
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37
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Papadaki HA, Stamatopoulos K, Damianaki A, Gemetzi C, Anagnostopoulos A, Papadaki T, Eliopoulos AG, Eliopoulos GD. Activated T-lymphocytes with myelosuppressive properties in patients with chronic idiopathic neutropenia. Br J Haematol 2005; 128:863-76. [PMID: 15755293 DOI: 10.1111/j.1365-2141.2005.05380.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To characterize the cellular components responsible for the impaired granulopoiesis in chronic idiopathic neutropenia (CIN), we investigated the origin of the proapoptotic cytokine producing cells in the bone marrow (BM) microenvironment of CIN patients. We found that the interferon gamma (IFN gamma) and/or Fas-ligand expressing cells in patient BM mononuclear cells and long-term BM culture stroma cells were the CD3(+) T-lymphocytes but not the CD14(+) monocytes/macrophages. The percentage of activated T-lymphocytes was increased in patients' BM as indicated by the proportions of human leucocyte antigen (HLA)-DR(+), CD25(+), CD38(+), CD69(+) and Fas(+) cells within the CD3(+) fraction. Intracellular IFN gamma expression was higher in the BM than peripheral blood of the patients and was associated with increased BM T-lymphocyte numbers. In crossover experiments, patient CD3(+) T-lymphocytes conferred autologous and allogeneic haemopoietic progenitor cell colony inhibition. Patients' T-cell receptor repertoire and polymerase chain reaction analysis did not reveal any clonal T-lymphocyte expansion, suggesting the absence of a direct, antigen-driven recognition of CD34(+) myeloid progenitor cells by patient T-lymphocytes. We conclude that CIN patients have increased number of activated T-lymphocytes in the BM, probably in the setting of a localized polyclonal immune reaction and that these cells confer an inhibitory effect on myelopoiesis through myelosuppressive cytokines including Fas-ligand and IFN gamma.
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Affiliation(s)
- H A Papadaki
- Department of Haematology, University of Crete School of Medicine, Heraklion, Crete, Greece.
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38
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Georgoulias P, Demakopoulos N, Papadaki T, Ioannidis G, Kokkini G, Mortzos G. Incidental Thallium Uptake in Bilateral Breast Lymphoma During Myocardial Perfusion Scintigram. Clin Nucl Med 2004; 29:121-3. [PMID: 14734915 DOI: 10.1097/01.rlu.0000110750.58984.3c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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39
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Affiliation(s)
- Theodora Papadaki
- Hemopathology Department, Evangelismos Hospital, 10676 Athens, Greece
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40
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41
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Papadaki T, Stamatopoulos K, Kosmas C, Kapsimali V, Economopoulos T. A unique case of splenic marginal zone-cell lymphoma with synchronous clonal T-cell large granular lymphocyte proliferation: an immunologic, immunohistochemical and genotypic study. Leuk Res 2003; 27:85-7. [PMID: 12479857 DOI: 10.1016/s0145-2126(02)00128-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We describe a case of synchronous splenic marginal zone-cell lymphoma (SMZL) and T-cell large granular lymphocyte leukemia involving the spleen, liver, bone marrow and peripheral blood. The synchronous occurrence of these two processes was documented by morphological, immunophenotypical and molecular (PCR) analyses of all affected tissues. The pathogenetic mechanisms which may be responsible for the concomitant appearance of these two rather infrequent entities in the same anatomic sites are discussed.
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MESH Headings
- Bone Marrow/pathology
- Clone Cells/pathology
- DNA, Neoplasm/genetics
- Female
- Gene Rearrangement, T-Lymphocyte
- Humans
- Immunophenotyping
- Leukemia, Lymphoid/genetics
- Leukemia, Lymphoid/immunology
- Leukemia, Lymphoid/pathology
- Leukemia, T-Cell/genetics
- Leukemia, T-Cell/immunology
- Leukemia, T-Cell/pathology
- Liver/pathology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Middle Aged
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/immunology
- Neoplasms, Multiple Primary/pathology
- Polymerase Chain Reaction
- Splenic Neoplasms/genetics
- Splenic Neoplasms/immunology
- Splenic Neoplasms/pathology
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Affiliation(s)
- T Papadaki
- Hemopathology Department and Immunology Laboratory, Evangelismos Hospital, Athens University, Athens, Greece
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42
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Kyriazopoulos P, Stamatopoulos K, Kosmas C, Belessi C, Stavroyianni N, Yataganas X, Papadaki T. Absence of somatic hypermutation in the open reading frame of the bcl-2 gene participating in the t(14;18) chromosomal translocation in follicular lymphoma. Leuk Lymphoma 2002; 43:2391-3. [PMID: 12613529 DOI: 10.1080/1042819021000040107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The information concerning potential effects of somatic hypermutation on bcl-2 sequences translocated to the immunoglobulin heavy chain gene (IgH) locus in follicular lymphoma (FL) is rather limited. We analysed the complete open reading frame (ORF) of the bcl-2 gene for the presence of mutations in 24 bcl-2/IgH-positive diagnostic FL samples by the single strand conformation polymorphism (SSCP) technique. A prior analysis on many of these FL samples had revealed a consistent pattern of somatic hypermutation in IgH genes. Abnormally migrating bands on SSCP gels were identified only in 4/24 samples. This result provides strong support for the notion that in FL the translocated bcl-2 coding region is not targeted by somatic hypermutation.
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MESH Headings
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- DNA Mutational Analysis
- Gene Rearrangement, B-Lymphocyte, Heavy Chain/genetics
- Genes, bcl-2/genetics
- Humans
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Open Reading Frames/genetics
- Somatic Hypermutation, Immunoglobulin
- Translocation, Genetic
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Affiliation(s)
- Panayiotis Kyriazopoulos
- First Department of Medicine, Athens University School of Medicine, Laikon General Hospital, 21 Apolloniou Street, GR-163 41, Athens, Greece
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43
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Papadaki T, Stamatopoulos K, Kosmas C, Paterakis G, Kapsimali V, Kokkini G, Economopoulos T, Stefanoudaki-Sofianatou K, Marinakis T, Gardikas E, Kalmantis T. Clonal T-large granular lymphocyte proliferations associated with clonal B cell lymphoproliferative disorders: report of eight cases. Leukemia 2002; 16:2167-9. [PMID: 12357377 DOI: 10.1038/sj.leu.2402643] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2002] [Accepted: 05/14/2002] [Indexed: 11/09/2022]
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44
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Kosmas C, Stamatopoulos K, Stavroyianni N, Tsavaris N, Papadaki T. Anti-CD20-based therapy of B cell lymphoma: state of the art. Leukemia 2002; 16:2004-15. [PMID: 12357351 DOI: 10.1038/sj.leu.2402639] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2002] [Accepted: 05/07/2002] [Indexed: 11/09/2022]
Abstract
Over the last 5 years, studies applying the chimeric anti-CD20 MAb have renewed enthusiasm and triggered world-wide application of anti-CD20 MAb-based therapies in B cell non-Hodgkin's lymphoma (NHL). Native chimeric anti-CD20 and isotope-labeled murine anti-CD20 MAbs are currently employed with encouraging results as monotherapy or in combination with conventional chemotherapy and in consolidation of remission after treatments with curative intent (ie after/ in combination with high-dose chemotherapy and hematopoietic stem cell rescue). On the available experience, anti-CD20 MAb-based therapeutic strategies will be increasingly integrated in the treatment of B cell NHL and related malignancies.
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Affiliation(s)
- C Kosmas
- Department of Medicine, 2nd Division of Medical Oncology, Metaxa Cancer Hospital, Piraeus, Greece
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45
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Stamatopoulos K, Yataganas X, Papadaki T, Paterakis G. Unusually prolonged survival of a case of acute megakaryoblastic leukemia secondary to long-standing polycythemia vera. Leuk Res 2002; 26:699-700. [PMID: 12008090 DOI: 10.1016/s0145-2126(01)00166-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Papadaki T, Stamatopoulos K, Stavroyianni N, Paterakis G, Phisphis M, Stefanoudaki-Sofianatou K. Evidence for T-large granular lymphocyte-mediated neutropenia in Rituximab-treated lymphoma patients: report of two cases. Leuk Res 2002; 26:597-600. [PMID: 12007508 DOI: 10.1016/s0145-2126(01)00183-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report two cases with B cell malignancies (case #1: refractory mantle cell lymphoma; case #2: lymphocyte predominant Hodgkin's disease (LPHD)) who developed neutropenia post-Rituximab therapy in a setting of significant infiltration of the peripheral blood (PB) and bone marrow (BM) by T cells with an immunophenotype of large granular lymphocytes. Possible pathogenetic mechanisms are discussed.
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Affiliation(s)
- T Papadaki
- Hemopathology Unit, Evangelismos Hospital, Athens, Greece
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47
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Belessi C, Stamatopoulos K, Stavroyianni N, Zoi K, Papadaki T, Kosmas C. Somatic hypermutation targeting to intrinsic hotspots of immunoglobulin genes in follicular lymphoma and multiple myeloma. Leukemia 2001; 15:1772-8. [PMID: 11681420 DOI: 10.1038/sj.leu.2402258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this study, we analyzed the targeting of the somatic hypermutation (SHM) mechanism at specific hotspot sequence motifs in the V(H) and Vkappa genes of 10 follicular lymphoma (FL) cases and the Vkappa and Vlambda genes of 11 kappa- and six lamda-light chain expressing multiple myeloma (MM) cases. These sequences were analyzed for targeting of specific motifs, ie certain highly mutable trinucleotides (3-NTPs), the tetranucleotide (4-NTP) RGYW and its complementary, WRCY (where R = purine, Y = pyrimidine and W = A or T). Comparisons were carried out between mutation frequencies in RGYW vs WRCY and the incidence of mutations in complementarity determining region (CDR)-1 vs CDR2 vs CDR3. Statistically significant differences were obtained when comparing: (1) the ratio of mutations in 4-NTPs (RGYW, WRCY, RGYW+WRCY)/mutations in the whole V sequence in MM-Vkappa vs MM-Vlamda; (2) the total number of mutated 4-NTPs in MM-Vkappa vs FL-Vkappa; (3) the number of mutated RGYW 4-NTPs in MM-Vkappa vs FL-Vkappa and FL-V(H) vs FL-Vkappa; (4) the number of mutated WRCY 4-NTPs in MM-Vkappa vs FL-Vkappa (P= 0.006) and FL-V(H) vs FL-Vkappa; (5) the targeting of RGYW vs WRCY in the CDRs of FL-V(H) genes. Similar results (regarding statistical significance) were obtained when undertaking intergroup comparisons for 3-NTPs. These findings conform well with relevant data derived from normal peripheral B cells. The differences observed in favor of 4-NTP (RGYW and WRCY) targeting in FL-V(H) vs FL-Vkappa and MM-Vkappa vs FL-Vkappa may implicate differences in the evolution of SHM coupled with selection in different stages of B cell ontogeny. Several explanations can be offered for the fact that hotspot sequences were not always targeted by SHM in FL and MM: (1) other unrecognized motifs may be targets of SHM; (2) 'inappropriately' introduced mutations were fixed and propagated by the neoplastic process; (3) certain FL and MM cases might have lost their ability to correct mutations introduced in classic hotspots due to deficient mismatch-repair (MMR) mechanisms; conversely, in other cases with intact MMR function, the hotspot to non-hotspot targeting of somatic hypermutation is balanced.
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Affiliation(s)
- C Belessi
- Hematology Laboratory, General Hospital of Nikea, Piraeus, Greece
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48
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Konstantopoulos K, Kapsimalis V, Vaiopoulos G, Kokkinis C, Papadaki T, Psarra K, Ekonomidou J. Simultaneous appearance of mycosis fungoides and chronic lymphocytic leukemia in the same patient. Haematologia (Budap) 2001; 30:41-3. [PMID: 10841324 DOI: 10.1163/15685590051129878] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A patient is presented having simultaneously chronic lymphocytic leukemia with a monoclonal B-lymphocyte population and mycosis fungoides with atypical T-cell population in the skin lesion and in the enlarged lymphoid nodes confirmed by detailed phenotyping.
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Affiliation(s)
- K Konstantopoulos
- First Department of Internal Medicine, Athens University Medical School at Laikon Hospital, Greece
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49
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Nicolatou-Galitis O, Papadaki T, Moschovi M, Moshovi M, Kamma JJ, van Vliet-Constantinidou C, Tsoumakas C, Kattamis A, Tzortzatou-Stathopoulou F. Gingival overgrowth as the initial paraneoplastic manifestation of Hodgkin's lymphoma in a child. A case report. J Periodontol 2001; 72:107-12. [PMID: 11210066 DOI: 10.1902/jop.2001.72.1.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this paper is to present the first case of gingival overgrowth, premature root resorption, and alveolar bone loss, which preceded the diagnosis of a stage IVB Hodgkin's lymphoma (HL) in a 9-year-old boy. METHODS The child presented complaining of gingival pain which first appeared 3 months prior. Clinical examination revealed inflamed, hyperplastic gingivae, while x-ray showed premature root resorption and alveolar bone loss. Medical work-up was significant for cervical lymphadenopathy. Gingival biopsy, followed by lymph node resection, was performed twice. RESULTS Histological examination of both gingival biopsies disclosed a mixed inflammatory infiltrate, while classical Hodgkin's lymphoma of the nodular sclerosis type was diagnosed from the second lymph node biopsy. Chemotherapy was instituted with mustard-vincristine-procarbazine-prednizone and adriamycine-bleomycine-vinblastine-dacarbazine. Remission of the lymphoma was observed with concomitant regression of the gingival overgrowth. CONCLUSIONS The inflammatory gingival overgrowth, premature root resorption of deciduous teeth, and alveolar bone loss in this case, in conjunction with the regression of gingival overgrowth which followed the completion of chemotherapy, are strongly indicative of a paraneoplastic manifestation of HL. The postulated mechanism for the development of the manifestation is the constitutive activation of the transcription factor NF-kB. The gingival inflammatory reaction was probably further aggravated by the bacterial-stimulated cytokine secretion released by monocytes.
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Affiliation(s)
- O Nicolatou-Galitis
- Department of Oral Pathology and Surgery, School of Dentistry, University of Athens, Greece.
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50
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Stamatopoulos K, Kosmas C, Belessi C, Stavroyianni N, Kyriazopoulos P, Papadaki T. Molecular insights into the immunopathogenesis of follicular lymphoma. Immunol Today 2000; 21:298-305. [PMID: 10825742 DOI: 10.1016/s0167-5699(00)01650-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Follicular lymphoma is caused by the transformation of a germinal-center-derived B cell with a t(14;18) chromosomal translocation. The distribution of somatic mutations within immunoglobulin genes indicates that follicular-lymphoma cells can interact with antigen. In addition, nonimmunoglobulin genes such as BCL6 seem to undergo somatic hypermutation. Here, Kostas Stamatopoulos and colleagues relate the molecular data about immunoglobulin genes and the protooncogenes BCL2 and BCL6 to the pathogenesis and evolution of follicular lymphoma.
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MESH Headings
- B-Lymphocyte Subsets/immunology
- B-Lymphocyte Subsets/pathology
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Clonal Deletion
- DNA Nucleotidyltransferases/metabolism
- Embryonal Carcinoma Stem Cells
- Gene Rearrangement, B-Lymphocyte
- Genes, Immunoglobulin
- Germinal Center/pathology
- Hematopoiesis/genetics
- Hodgkin Disease/pathology
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Immunoglobulin kappa-Chains/genetics
- Lymphoma, Follicular/etiology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/immunology
- Lymphoma, Follicular/pathology
- Models, Immunological
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Neoplastic Stem Cells/immunology
- Neoplastic Stem Cells/pathology
- Reed-Sternberg Cells/pathology
- Translocation, Genetic
- VDJ Recombinases
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Affiliation(s)
- K Stamatopoulos
- First Department of Medicine, Athens University School of Medicine and Laikon General Hospital, Athens, Greece
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