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Terré A, Buob D, Cez A, Rodero MP, Georgin-Lavialle S. Waldenstrom macroglobulinaemia with AA amyloidosis reveals a B-cell-restricted NLRP2 variant. Br J Haematol 2024; 204:2117-2120. [PMID: 38462777 DOI: 10.1111/bjh.19383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/24/2024] [Accepted: 02/23/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Alexandre Terré
- Department of Internal Medicine, National Reference Center for Autoinflammatory Diseases and AA amyloidosis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne University, Paris, France
- Laboratoire Mécanismes Cellulaires et Moléculaires des Désordres Hématologiques et Implications Thérapeutiques, Université Paris Cité, Inserm, Institut Imagine, Paris, France
| | - David Buob
- Department of Pathology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne University, Paris, France
| | - Alexandre Cez
- Department of Nephrology and Dialysis, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Mathieu P Rodero
- Laboratoire de Chimie et de Biochimie Pharmacologiques et Toxicologiques, Université Paris Cité, CNRS, Paris, France
| | - Sophie Georgin-Lavialle
- Department of Internal Medicine, National Reference Center for Autoinflammatory Diseases and AA amyloidosis, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne University, Paris, France
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2
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Boccon-Gibod C, Sourdeau E, Morel P, Chapiro E, Nguyen-Khac F, Bravetti C, Davi F, Morel V, Gauthier N, Grenier A, Boussen I, Choquet S, Leblond V, Le Garff-Tavernier M, Baron M, Roos-Weil D. Circulating tumor cells in Waldenström macroglobulinemia. Leukemia 2024; 38:903-907. [PMID: 38332185 DOI: 10.1038/s41375-024-02156-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/06/2024] [Accepted: 01/11/2024] [Indexed: 02/10/2024]
Affiliation(s)
- Clémentine Boccon-Gibod
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France.
| | - Elise Sourdeau
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | | | - Elise Chapiro
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France
| | - Florence Nguyen-Khac
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France
| | - Clotilde Bravetti
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France
| | - Frédéric Davi
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France
| | - Véronique Morel
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Nicolas Gauthier
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Adrien Grenier
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Inès Boussen
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Sylvain Choquet
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Véronique Leblond
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Magali Le Garff-Tavernier
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France
| | - Marine Baron
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Damien Roos-Weil
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France.
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, F-75006, Paris, France.
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Danesin N, Scapinello G, Del Prete D, Naso E, Berno T, Visentin A, Bonaldi L, Martines A, Bertorelle R, Vianello F, Gurrieri C, Zambello R, Castellani C, Fedrigo M, Rizzo S, Angelini A, Trentin L, Piazza F. When Waldenström macroglobulinemia hits the kidney: Description of a case series and management of a "rare in rare" scenario. Cancer Rep (Hoboken) 2024; 7:e2062. [PMID: 38662353 PMCID: PMC11044914 DOI: 10.1002/cnr2.2062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Renal injury related to Waldenström macroglobulinemia (WM) occurs in approximately 3% of patients. Kidney biopsy is crucial to discriminate between distinct histopathological entities such as glomerular (amyloidotic and non-amyloidotic), tubulo-interstitial and non-paraprotein mediated renal damage. In this context, disease characterization, management, relationship between renal, and hematological response have been poorly explored. We collected clinical, genetic and laboratory data of seven cases of biopsy-proven renal involvement by WM managed at our academic center and focused on three cases we judged paradigmatic discussing their histopathological patterns, clinical features, and therapeutic options. CASE In this illustrative case series, we confirm that serum creatinine levels and 24 h proteinuria are parameters that when altered should prompt the clinical suspicion of WM-related renal involvement, even if at present there are not precise cut-off levels recommending the execution of a renal biopsy. In our series AL Amyloidosis (n = 3/7) and tubulo-interstitial infiltration by lymphoma cells (n = 3/7) were the two more represented entities. BTKi did not seem to improve renal function (Case 1), while bortezomib-based regimens demonstrated a beneficial activity on the hematological and organ response, even when used as second-line therapy after chemoimmunotherapy (Case 3) and also with coexistence of anti-MAG neuropathy (Case 2). In case of poor response to bortezomib, standard chemoimmunotherapy (CIT), such as rituximab-bendamustine, represents an effective option (Case 1, 6, and 7). In our series, CIT generates durable responses more frequently in cases with amyloidogenic renal damage (Case 1, 5, and 7). CONCLUSION In this illustrative case series, we confirm that serum creatinine levels and 24 h proteinuria are parameters that when altered should prompt the clinical suspicion of WM-related renal involvement, even if at present there are not precise cut-off levels recommending the execution of a renal biopsy. Studies with higher numerosity are needed to better clarify the pathological and clinical features of renal involvement during WM and to determine the potential benefit of different therapeutic regimens according to the histopathological subtypes.
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Affiliation(s)
- Nicolò Danesin
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Greta Scapinello
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Dorella Del Prete
- Nephrology, Dialysis and Transplantation Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Elena Naso
- Nephrology, Dialysis and Transplantation Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Tamara Berno
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Andrea Visentin
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Laura Bonaldi
- Immunology and Molecular Oncology Diagnostic Unit, Veneto Institute of OncologyIOV‐IRCCSPadovaItaly
| | - Annalisa Martines
- Immunology and Molecular Oncology Diagnostic Unit, Veneto Institute of OncologyIOV‐IRCCSPadovaItaly
| | - Roberta Bertorelle
- Immunology and Molecular Oncology Diagnostic Unit, Veneto Institute of OncologyIOV‐IRCCSPadovaItaly
| | - Fabrizio Vianello
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
- Veneto Institute of Molecular MedicineFondazione per la Ricerca Biomedica AvanzataPadovaItaly
| | - Carmela Gurrieri
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Renato Zambello
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
- Veneto Institute of Molecular MedicineFondazione per la Ricerca Biomedica AvanzataPadovaItaly
| | - Chiara Castellani
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly
| | - Marny Fedrigo
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly
| | - Stefania Rizzo
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly
| | - Annalisa Angelini
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly
| | - Livio Trentin
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
| | - Francesco Piazza
- Hematology Unit, Department of MedicineUniversity of PadovaPadovaItaly
- Veneto Institute of Molecular MedicineFondazione per la Ricerca Biomedica AvanzataPadovaItaly
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Yan M, Meyerson H, Oduro KA, Shetty S, Yoest J. Aggressive Lymphoplasmacytic Neoplasm With an Unusual In-frame Deletion of MYD88 Associated With TRAF3 and TP53 Mutations and Complex Karyotype. Int J Surg Pathol 2024; 32:5-10. [PMID: 37093763 DOI: 10.1177/10668969231168359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Lymphoplasmacytic lymphoma often needs to be differentiated from other B-cell lymphomas with plasmacytic differentiation, especially marginal zone cell lymphoma. Molecular detection of MYD88 p.L265P hotspot mutation supports the diagnosis of lymphoplasmacytic lymphoma since it is seen in about 90% of such lymphoma, which is much higher than other B-cell lymphomas. MYD88 p.L265P is a gain-of-function mutation that enhances the activity of the NF-κB signaling pathway and therefore drives lymphomagenesis. Other mutations in MYD88 are rarely reported. This study aims to report an unusual MYD88 in-frame deletion in an aggressive lymphoplasmacytic neoplasm. This is an IgM-positive, CD5- and CD10-negative mature B-cell lymphoma with prominent plasmacytic differentiation and aggressive features. The clinical and pathologic findings were most consistent with lymphoplasmacytic lymphoma. Next-generation sequencing identified an unusual MYD88 in-frame deletion in the absence of the hotpot p.L265P mutation. Other concurrent pathogenic mutations also include truncating mutations of TRAF3, which is a negative regulator of the NF-κB signaling pathway, and a missense mutation of TP53. Karyotype analysis showed complex karyotypes, including chromosome 6q deletion. By searching literature and online cancer databases, we identified only 8 other mature B-cell lymphomas with MYD88 in-frame deletions, but none of them was diagnosed with lymphoplasmacytic lymphoma. Recognizing such in-frame deletions is necessary to help understand the mutational spectrum of MYD88 in B-cell lymphomas. It remains to be further investigated whether such MYD88 in-frame deletions are also overrepresented in lymphoplasmacytic lymphoma among other B-cell lymphomas.
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Affiliation(s)
- Mingfei Yan
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Howard Meyerson
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Kwadwo A Oduro
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Shashirekha Shetty
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Jennifer Yoest
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
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Khwaja J, Vos JMI, Pluimers TE, Japzon N, Patel A, Salter S, Kwakernaak AJ, Gupta R, Rismani A, Kyriakou C, Wechalekar AD, D'Sa S. Clinical and clonal characteristics of monoclonal immunoglobulin M-associated type I cryoglobulinaemia. Br J Haematol 2024; 204:177-185. [PMID: 37726004 DOI: 10.1111/bjh.19112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/30/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
Monoclonal immunoglobulin M-associated type I cryoglobulinaemia is poorly characterised. We screened 534 patients with monoclonal IgM disorders over a 9-year period and identified 134 patients with IgM type I cryoglobulins. Of these, 76% had Waldenström macroglobulinaemia (WM), 5% had other non-Hodgkin lymphoma (NHL) and 19% had IgM monoclonal gammopathy of undetermined significance (MGUS). Clinically relevant IgM-associated disorders (including cold agglutinin disease [CAD], anti-MAG antibodies, amyloidosis and Schnitzler syndrome) coexisted in 31%, more frequently in MGUS versus WM/NHL (72% vs. 22%/29%, p < 0.001). The majority of those with cryoglobulins and coexistent CAD/syndrome had the molecular characteristics of a CAD clone (wild-type MYD88 in 80%). A half of all patients had active manifestations at cryoglobulin detection: vasomotor (22%), cutaneous (16%), peripheral neuropathy (22%) and hyperviscosity (9%). 16/134 required treatment for cryoglobulin-related symptoms alone at a median of 38 days (range: 6-239) from cryoglobulin detection. At a median follow-up of 3 years (range: 0-10), 3-year cryoglobulinaemia-treatment-free survival was 77% (95% CI: 68%-84%). Age was the only predictor of overall survival. Predictors of cryoglobulinaemia-related treatment/death were hyperviscosity (HR: 73.01; 95% CI: 15.62-341.36, p < 0.0001) and cutaneous involvement (HR: 2.95; 95% CI: 1.13-7.71, p = 0.028). Type I IgM cryoglobulinaemia is more prevalent than previously described in IgM gammopathy and should be actively sought.
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Affiliation(s)
- Jahanzaib Khwaja
- Department of Haematology, University College London Hospital, London, UK
| | - Josephine M I Vos
- Department of Haematology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Tessa E Pluimers
- Department of Haematology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nicole Japzon
- Department of Haematology, University College London Hospital, London, UK
| | - Aisha Patel
- Department of Haematology, University College London Hospital, London, UK
| | | | - Arjan J Kwakernaak
- Department of Internal Medicine, Clinical Immunology/Allergy and Nephrology Amsterdam UMC, Amsterdam, The Netherlands
| | - Rajeev Gupta
- Department of Haematology, University College London Hospital, London, UK
| | - Ali Rismani
- Department of Haematology, University College London Hospital, London, UK
| | | | | | - Shirley D'Sa
- Department of Haematology, University College London Hospital, London, UK
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6
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Chen H, Zhao D, Wang Z, Zhang W, Wang W. Clonally related transformation from Waldenström macroglobulinemia to diffuse large B-cell lymphoma with central nervous system involvement at diagnosis: a case report and literature review. Clin Exp Med 2023; 23:5473-5476. [PMID: 37921873 DOI: 10.1007/s10238-023-01245-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/26/2023] [Indexed: 11/05/2023]
Abstract
Histological transformation to diffuse large B-cell lymphoma (DLBCL) rarely occurs in patients with Waldenström macroglobulinemia (WM). The median time from WM diagnosis to DLBCL is 4-5 years. Extranodal involvement is common in transformed WM. However, central nervous system (CNS) involvement is relatively uncommon. Here, we report a case of a simultaneous diagnosis of WM and clonally related DLBCL, with the involvement of CNS demonstrated by dual enhancement in MRI. Nevertheless, it is unclear if CNS infiltration is caused by DLBCL or WM for the inaccessibility of brain biopsy. Intensified chemotherapy and Bruton tyrosine kinase inhibitor were administrated, and a good response was achieved.Please check the edit made in the article title.we have checked it.
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Affiliation(s)
- Hongyun Chen
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Danqing Zhao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Zi Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Wei Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Wei Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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7
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Hepschke JL, Ramalingam S, Pohl U, Amel-Kashipaz RM, Blanch RJ. A Case of Bing-Neel Syndrome Presenting Like Giant Cell Arteritis. J Neuroophthalmol 2023; 43:575-579. [PMID: 37594854 DOI: 10.1097/wno.0000000000001980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT A 55-year-old woman presented with new-onset headache, scalp tenderness, shoulder arthralgias, night sweats, and loss of appetite. She was diagnosed with giant cell arteritis by her primary care physician and commenced on oral corticosteroids. However, her headache, scalp tenderness, and night sweats persisted. She then developed right Horner syndrome and trigeminal hypoesthesia. Extensive blood work-up revealed mildly elevated inflammatory markers and a paraproteinemia. Subsequent bone marrow biopsy showed lymphoplasmacytic lymphoma, with 10% of hemopoiesis, and staging led to the diagnosis of Waldenstrom macroglobulinemia without nodal or central nervous system (CNS) lesions. Immunohistochemical staining of a temporal artery biopsy showed perivascular lymphoplasmacytic cells and paraprotein deposits. She was diagnosed with CNS involvement of her macroglobulinemia-Bing-Neel syndrome (BNS). Identification of rare CNS involvement of lymphoma is challenging when a patient is already on steroid immunosuppression. In the absence of clear diagnostic criteria, the rare and heterogenous BNS remains a clinical diagnosis.
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Affiliation(s)
- Jenny L Hepschke
- Birmingham Neuro-Ophthalmology Unit (JLH, RJB), Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Departments of Neuroradiology (SR) and Neuropathology (UP, RMA-K), University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Academic Department of Military Surgery and Trauma (RJB), Royal Centre for Defence Medicine, Birmingham, United Kingdom ; and Neuroscience and Ophthalmology (RJB), Robert Aitken Institute of Clinical Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
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Thomson AC, Raviskanthan S, Mortensen PW, Hogan RN, Lee AG. Paraneoplastic Autoimmune Retinopathy Associated With Non-IgM Lymphoplasmacytic Lymphoma. J Neuroophthalmol 2023; 43:e184-e187. [PMID: 37974368 DOI: 10.1097/wno.0000000000001450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Andrew C Thomson
- McGovern Medical School (ACT), The University of Texas Health Science Center at Houston, Houston, Texas; Department of Ophthalmology (SR, PWM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Pathology, Neurology, and Neurological Surgery (RNH), UT Southwestern Medical Center, Dallas, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery (AGL), Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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9
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Durot E, Tomowiak C. Advances in Treatment of Waldenström Macroglobulinemia. Curr Oncol Rep 2023; 25:1375-1386. [PMID: 37855849 DOI: 10.1007/s11912-023-01459-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE OF REVIEW The discovery of recurring somatic mutations, in particular MYD88 and CXCR4 mutations, in Waldenström macroglobulinemia (WM), a rare B-cell lymphoproliferative disorder, led in the last decade to the development of several therapeutic agents with high efficacy. This review aims to provide an overview of available treatments in WM and novel agents, focusing on studies published over recent years. RECENT FINDINGS There is no international consensus on the best first-line option in treatment-naïve patients. Randomized clinical trials are rare in WM and there has been no prospective comparison of chemoimmunotherapy and BTK inhibitors in the frontline setting. Chemoimmunotherapy and BTK inhibitors, the two feasible and most widely used treatments in first-line treatment, represent very different options in terms of duration of therapy, route of administration, cost, and adverse effect. In addition to tumor genotype and patient comorbidities, choice of therapy in WM should take into account these parameters. Results of ongoing and future clinical trials evaluating fixed-duration combinations with BTK inhibitors and novel agents are awaited.
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Affiliation(s)
- Eric Durot
- Hématologie Clinique, CHU de Reims Et UFR Médecine, Reims, France.
| | - Cécile Tomowiak
- Service d'Onco-Hématologie Et Thérapie Cellulaire, CIC INSERM 1402, CHU de Poitiers, Poitiers, France
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10
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Chen X, Chen G, Li Q, Fu Z. 18 F-FDG PET/CT Findings in Waldenström Macroglobulinemia With Mesentery Involvement. Clin Nucl Med 2023; 48:1000-1002. [PMID: 37793165 DOI: 10.1097/rlu.0000000000004867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
ABSTRACT A 74-year-old man presented to the hospital complaining of weight loss, increasing fatigue, and blurred vision. The abdominal ultrasonography initially revealed a massive lesion in the mesentery, which was later confirmed by a contrast-enhanced CT scan. The 18 F-FDG PET/CT scan showed a single, solitary hypermetabolic mass. The patient was finally diagnosed with Waldenström macroglobulinemia with mesentery involvement by the histopathological examination.
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Affiliation(s)
- Xueqi Chen
- From the Department of Nuclear Medicine, Peking University First Hospital, Beijing
| | - Guoqian Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou
| | - Qian Li
- Department of Ultrasound, Shenzhen University General Hospital, Shenzhen, China
| | - Zhanli Fu
- From the Department of Nuclear Medicine, Peking University First Hospital, Beijing
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11
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Alexander AL, Jackson D, Donahue JE, Chirkov A, Banerjee P. Bing Neel Syndrome: A Rare Contributing Factor of Psychosis and Suicidality. Am J Forensic Med Pathol 2023; 44:136-139. [PMID: 36989081 DOI: 10.1097/paf.0000000000000824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
ABSTRACT Suicide rapidly increased in the United States by 30% from 2000 to 2020, accounting for more than 800,000 deaths ( Neurosci Res Program Bull . 1972; 10: 384-8). Studies have shown that there are a multitude of underlying issues, including mental illness, that elevate an individual's risk of dying by suicide ( CDC WONDER: Underlying cause of death, 1999-2019 . Atlanta, GA: US Department of Health and Human Services, CDC; 2020). Presented here is a case of Bing Neel syndrome (BNS) found in a 69-year-old man who died by suicide by jumping off a 135' bridge. His medical history was significant for traumatic brain injury, Waldenstrom macroglobulinemia (WM), major depressive disorder, suicidal ideation, and anxiety. Bing Neel syndrome is a rare central nervous system complication of WM. His wife reported an abrupt mental deterioration starting 5 years before his death, characterized by paranoia, depression, and insomnia. He had been a high-functioning university professor. His decline culminated with the loss of independence in his activities of daily living. At autopsy, it was found that he experienced blunt force injuries related to the fall, causing his death. A neuropathologic examination revealed a brisk and fulminant clonal CD20 + /immunoglobulin M+ lymphocytic infiltrate, involving all sampled regions of his brain, consistent with WM. This workup was critical to obtaining an accurate pathologic diagnosis of BNS and understanding his full clinical status before death. Although BNS was not the proximate cause of death, this diagnosis aided the death investigation as a causal factor in his suicidality and was vital to providing his family closure.
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Affiliation(s)
- Abigail L Alexander
- From the Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Devon Jackson
- Department of Pathology, Howard University Hospital, Washington, DC
| | - John E Donahue
- The Warren Alpert School of Medicine at Brown University
| | - Alexander Chirkov
- Rhode Island State Center for the Office of Medical Examiners, Providence, RI
| | - Priya Banerjee
- From the Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
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Laperche J, Bernstein RA. Cutaneous Paraneoplastic Syndrome Affecting the Hand in a Case of Underlying Waldenström Macroglobulinemia. Hand (N Y) 2023; 18:NP16-NP18. [PMID: 36734296 PMCID: PMC10152533 DOI: 10.1177/15589447231151260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Paraneoplastic syndromes represent the body's immune response to an underlying malignancy. The autoimmune response to cancer can manifest itself in multiple ways, including swelling, thickening, and changes in the hand. We report the case of a 65-year-old man who presented with hand swelling that was initially attributed to a work-related finger laceration. The patient developed edema and stiffness in the hand, which was subsequently diagnosed as Waldenström macroglobulinemia. Hand surgeons should be aware that atypical hand and wrist symptoms should raise the suspicion for the potential of a paraneoplastic syndrome and an underlying malignancy.
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Affiliation(s)
| | - Richard A. Bernstein
- Quinnipiac University, North Haven, CT, USA
- Connecticut Orthopaedics, Hamden, CT, USA
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13
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Munir A, Fazal S, Bhatti AI, Sajjad B. Pharmacokinetics-Pharmacodynamics Modeling and Evaluation of Tumor Response to Bortezomib Proteasome Inhibitor in Waldenstrom Macroglobulinemia. Am J Clin Oncol 2023; 46:150-160. [PMID: 36808095 DOI: 10.1097/coc.0000000000000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Waldenstrom's macroglobulinemia (WM), also known as lymphoplasmacytic lymphoma, is a type of non-Hodgkin's lymphoma in which the malignant cells produce many macroglobulin proteins. It originates from B cells and develops in the bone marrow, where Wm cells combine to produce distinct types of blood cells, resulting in reduced volumes of red blood cells, white blood cells, and platelets, making it harder for the body to fight diseases. Chemoimmunotherapy is being used for the clinical management of WM, but new targeted agents, the BTK inhibitor ibrutinib and the proteasome inhibitor bortezomib, have shown significant improvements in patients with relapsed/refractory WM. However, given its effectiveness, drug resistance and relapse are normal, and there is little research on the pathways responsible for drug effects on the tumor. METHODS In this study, Pharmacokinetics-pharmacodynamic simulations were done to assess the effect of the proteasome inhibitor bortezomib on the tumor. For this purpose, the Pharmacokinetics-pharmacodynamic model was developed. The model parameters were determined and calculated using the Ordinary Differential Equation solver toolbox and the least-squares function. Pharmacokinetic profiles and pharmacodynamic analysis were performed to determine the change in tumor weight associated with the use of proteasome inhibitors. RESULTS Bortezomib and ixazomib have been found to reduce tumor weight briefly, but once the dose is reduced, the tumor begins to grow again. Carfilzomib and oprozomib had better results, and rituximab reduced tumor weight more effectively. CONCLUSION Once validated, it is proposed that a combination of selected drugs can be evaluated in the laboratory to treat WM.
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Affiliation(s)
- Anum Munir
- School of Biosciences, University of Kent, Canterbury
- Department of Applied Biology, The London College UCK, London
| | - Sahar Fazal
- Department of Bioinformatics and Biosciences, Faculty of Health, and Life Sciences
| | - Aamer Iqbal Bhatti
- Department of Electrical Engineering, Capital University of Science and Technology, Islamabad
| | - Bilawal Sajjad
- Smart Sec Solutions, London
- Department of Information Technology, Hazara University Mansehra, Pakistan
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14
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Awata-Shiraiwa M, Yokohama A, Kanai Y, Gotoh N, Kasamatsu T, Handa H, Saitoh T, Murakami H, Hirato J, Ikota H, Tsukamoto N. Waldenström Macroglobulinemia and Non-IgM-Type Lymphoplasmacytic Lymphoma Are Genetically Similar. Acta Haematol 2023; 146:384-390. [PMID: 36917966 DOI: 10.1159/000530100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Waldenström macroglobulinemia (WM) represents a subset of lymphoplasmacytic lymphoma (LPL) with the immunoglobulin (Ig)M paraprotein. MYD88 L265P and CXCR4 mutations are common mutations in WM patients, and mutations in ARID1A and KMT2D (MLL2) have also been reported. However, little information has been accumulated on genetic changes in LPL with other paraproteins like IgG. METHODS We therefore aimed to evaluate genetic differences between WM and LPL with non-IgM paraprotein (non-IgM-type LPL) using targeted next-generation sequencing (NGS) in 20 Japanese patients (10 with WM, 10 with non-IgM-type LPL). RESULTS Mutations were detected in ARID1A (10%), CXCR4 (20%), MYD88 (90%), and KMT2D (0%) for WM patients and in ARID1A (10%), CXCR4 (20%), MYD88 (70%), and KMT2D (10%) for non-IgM-type LPL patients. No significant differences were identified. No mutations were detected in NOTCH2, PRDM1, CD274 (PD-L1), PDCD1LG2 (PD-L2), RAG2, MYBBP1A, TP53, or CD79B. DISCUSSION Mutant allele frequency in MYD88 L265P did not differ significantly between WM and non-IgM-type LPL. Most mutations detected by NGS were subclonal following MYD88 L265P, although one non-IgM-type LPL patient harbored only CXCR4 S338X mutation. Our NGS analyses reveal genetic characteristics in LPL patients and suggest genetic similarities between these two subsets of LPL, WM and non-IgM-type.
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Affiliation(s)
- Maaya Awata-Shiraiwa
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
- Gunma University of Health and Welfare, Maebashi, Japan
| | - Akihiko Yokohama
- Blood Transfusion Service, Gunma University Hospital, Maebashi, Japan
| | - Yukihiro Kanai
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Nanami Gotoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Tetsuhiro Kasamatsu
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Hirokazu Murakami
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
- Gunma University of Health and Welfare, Maebashi, Japan
| | - Junko Hirato
- Clinical Department of Pathology, Public Tomioka General Hospital, Tomioka, Japan
| | - Hayato Ikota
- Clinical Department of Pathology, Gunma University Hospital, Maebashi, Japan
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15
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Abstract
Waldenström macroglobulinemia (WM) is a rare subtype of non-Hodgkin lymphoma characterized by the presence of lymphoplasmacytic lymphoma (LPL) in the bone marrow accompanied by a monoclonal immunoglobulin type M (IgM) in the serum. WM was first described only 80 years ago and became reportable in the US as a malignancy in 1988. Very little systematic research was conducted prior to 2000 to characterize incidence, clinical characteristics, risk factors or diagnostic and prognostic criteria, and there were essentially no WM-specific clinical interventional trials. Since the inaugural meeting of the International Workshop in Waldenström's Macroglobulinemia (IWWM) in 2000, WM has become the focus of a steadily increasing and productive body of research, engaging a growing number of investigators throughout the world. This introductory overview provides summary of the current understanding of the epidemiology of WM/LPL as a backdrop for a series of consensus panel recommendations arising from research presented at the 11th IWWM.
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Affiliation(s)
- Mary L McMaster
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD; Department of Health and Human Services, Commissioned Corps of the United States Public Health Service, Washington, DC.
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16
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Oiwa K, Shirai S, Abe M, Ohigashi H, Iwata I, Otsuka T, Yabe I. [A Case of Bing-Neel Syndrome With Repeated Long Spinal Cord Lesions]. Brain Nerve 2023; 75:69-75. [PMID: 36574974 DOI: 10.11477/mf.1416202280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The patient was a 45-year-old man. Since 2019, he had exhibited repeated steroid-improved dysuria and long spinal cord lesions. At the time of recurrence in June 2020, he exhibited a marked increase in serum IgM levels, suggesting hematopoietic disease. We found an MYD88 L265P mutation in cerebrospinal fluid cells, which subsequently led to the diagnosis of Bing-Neel syndrome (BNS). The patient was treated with Burton's tyrosine kinase inhibitors and his condition progressed without dysuria or worsening of the imaging findings. This case was challenging to differentiate from intractable inflammatory diseases; however, the identification of hyper-IgM helped in the diagnosis. BNS should be differentiated from central nervous system lesions through the identification of hyper-IgM.
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Affiliation(s)
- Kei Oiwa
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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17
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Abstract
Bing-Neel syndrome (BNS) is a rare central nervous system manifestation of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM). We herein report a 62-year-old man with LPL/WM after multiple chemotherapies. He had weakness of lower extremities and elevated serum IgM levels. A bone marrow examination showed lymphoplasmacytic cells infiltration. Contrast-enhanced magnetic resonance imaging suggested enhancing lesions in the cauda equina roots. He was diagnosed with BNS and started on treatment with tirabrutinib 480 mg daily. Within three months, he showed clinical and radiologic improvement. Tirabrutinib may have utility as an effective treatment for BNS.
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Affiliation(s)
- Takashi Oyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazuki Taoka
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Akira Chiba
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Kensuke Matsuda
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroaki Maki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yosuke Masamoto
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Japan
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18
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Nie G, Sun L, Zhang C, Yuan Y, Mao H, Wang Z, Li J, Duan S, Xing C, Zhang B. Clinicopathological features and individualized treatment of kidney involvement in B-cell lymphoproliferative disorder. Front Immunol 2022; 13:903315. [PMID: 36172352 PMCID: PMC9510618 DOI: 10.3389/fimmu.2022.903315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/22/2022] [Indexed: 11/20/2022] Open
Abstract
Background Due to the various clinical and pathological manifestations of kidney involvement in lymphoproliferative disorder (LPD), the whole spectrum of kidney disease in LPD is still unclear, and data on kidney prognosis is scarce. Methods We retrospectively reviewed the renal pathology profiles from January 2010 to December 2021, and 28 patients with B-cell LPD combined with intact renal biopsy data were included. Results There were 20 men and eight women aging 41 to 79 years at the time of renal biopsy (median age 62 years). According to hematological diagnosis, patients were classified into four groups: chronic lymphocytic leukemia (CLL) (group1, n=7), Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) (group 2, n=8; WM, n=6; LPL, n=2), Other non-Hodgkin’s lymphomas (NHL) (group3, n=7; diffuse large B-cell lymphoma (DLBCL), n=2; mucosa-associated lymphoid tissue (MALT) lymphoma, n=4; Low grade B-cell lymphoma, n=1), and monoclonal gammopathy of undetermined significance/monoclonal gammopathy of renal significance (MGUS/MGRS) (group 4, n=6). Median serum creatinine (Scr) level was 129 (range,59-956) umol/L. Eight patients (29%) were presented with acute kidney injury (AKI), and five patients (18%) required hemodialysis upon admission. Twenty-three patients (82%) presented with proteinuria (median protein excretion, 2.14 g/d), 11(39%) of whom had the nephrotic syndrome. Interstitial malignant infiltration was the most frequent renal lesion (n=6). Eight patients underwent immunohistochemistry of renal tissues, of which three patients (CLL, n=1; LPL, n=1; WM, n=1) had confirmed lymphoma infiltrates, and the infiltrating cells in the remaining five patients (CLL, n=1; MALT lymphoma, n=2; MGUS, n=2) were considered unrelated to lymphoma. The most common glomerular diseases were renal amyloidosis (n=4) and membranous nephropathy (n=4). Only 20 patients were treated, 13 of whom were treated with rituximab separately or in combination. The median follow-up time was 11 months. Of these, six had achieved hematological response, complete response in five cases. Eight had achieved renal response. At the end-of-study visit, four patients died and two progressed to end stage kidney disease (ESKD). Conclusion In conclusion, the clinicopathological spectrum of renal involvement in BLPD is diverse. Renal biopsy and immunohistochemistry are required for early diagnosis and prognostic assessment.
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Affiliation(s)
- Guangyan Nie
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Lianqin Sun
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Chengning Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Yanggang Yuan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Huijuan Mao
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Zhen Wang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Jianyong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Suyan Duan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
- *Correspondence: Bo Zhang, ; Suyan Duan, ; Changying Xing,
| | - Changying Xing
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
- *Correspondence: Bo Zhang, ; Suyan Duan, ; Changying Xing,
| | - Bo Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
- Department of Nephrology, Pukou Branch of JiangSu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, China
- *Correspondence: Bo Zhang, ; Suyan Duan, ; Changying Xing,
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19
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Zhang LY, Xiang YH, Li YY, Zhang J. [Clinical Role of M Protein in Multiple Myeloma and Lymphoma --Review]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2022; 30:1281-1285. [PMID: 35981399 DOI: 10.19746/j.cnki.issn.1009-2137.2022.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
M protein is often expressed in multiple myeloma and also can be detected in several lymphoma such as Waldenstrm macroglobulinaemia. M protein level can reflect the malignant degree and even genetic abnormality of multiple myeloma and lymphoma to some extent to predict the progress of the diseases, and the therapeutic response and prognosis of the disease can be evaluated by monitoring the M protein level and its change degree. This article reviews the role of M protein in the progression and prognosis of multiple myeloma and lymphoma, and discusses the differences in M protein expression between multiple myeloma and lymphoma, in order to provide new insights for clinical diagnosis, monitoring and evaluation of therapeutic effect.
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Affiliation(s)
- Liu-Yun Zhang
- School of Medicine University of Electronic Science and Technology of China, Chengdu 610054, Sichuan Province, China
| | - Yun-Hui Xiang
- School of Medicine University of Electronic Science and Technology of China, Chengdu 610054, Sichuan Province, China
| | - Yan-Ying Li
- School of Medicine University of Electronic Science and Technology of China, Chengdu 610054, Sichuan Province, China
| | - Juan Zhang
- Department of Clinical Medical Laboratory Center, The Affiliated Hospital of University of Electronic Science and Technology of China & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan Province, China. E-mail:
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20
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Elamin G, Aljoundi A, Soliman MES. Co-Binding of JQ1 and Venetoclax Exhibited Synergetic Inhibitory Effect for Cancer Therapy; Potential Line of Treatment for the Waldenström Macroglobulinemia Lymphoma. Chem Biodivers 2022; 19:e202100845. [PMID: 35610180 DOI: 10.1002/cbdv.202100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 05/24/2022] [Indexed: 11/11/2022]
Abstract
In recent times, the development of combination therapy has been a focal point in drug discovery. This article explores the potential synergistic effect of co-administration of Bcl2 inhibitor Venetoclax and BET inhibitor JQ1. We envisioned that the 'dual-site'-binding of Bcl2 has significant prospects and paves the way for the next round of rational design of potent Waldenström macroglobulinemia (WM) therapy. The preferential binding mechanisms of the multi-catalytic sites of the Bcl2 enzyme have been a subject of debate in the literature. This study conducted a systematic procedure to explore the preferred binding modes and the structural effects of co-binding at each catalytic active site. Interestingly, a mutual enhanced binding effect was observed - Venetoclax increased the binding affinity of JQ1 by 11.5 %, while JQ1 boosted the binding affinity of Venetoclax by 16.3 % when compared with individual inhibition of each drug. This synergistic binding effect has significantly increased protein stability, with substantial correlated movements and multiple van der Waals interactions. The structural and thermodynamic insights unveiled in this report would assist the future design of improved combined therapy against WM.
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Affiliation(s)
- Ghazi Elamin
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Aimen Aljoundi
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
| | - Mahmoud E S Soliman
- Molecular Bio-computation and Drug Design Laboratory, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4001, South Africa
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21
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Kim S, Bae W, Choi J, Lee TW, Song DH, Bae E, Jang HN, Chang SH, Park DJ. Acute kidney injury due to direct infiltration by lymphoplasmacytic lymphoma secreting IgG paraproteins: A case report. Medicine (Baltimore) 2022; 101:e29449. [PMID: 35713455 PMCID: PMC9276466 DOI: 10.1097/md.0000000000029449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Waldenström's macroglobulinemia is a lymphoplasmacytic lymphoma (LPL) associated with a monoclonal immunoglobulin M protein. Although acute kidney injury (AKI) due to immunoglobulin M paraprotein infiltration into the renal interstitium has been reported, there has been no report of AKI with invasion of the immunoglobulin G paraprotein into the renal interstitium in a patient with LPL. PATIENT CONCERNS A 65-year-old male was admitted to our hospital with fatigue and decreased renal function. He complained of a 3-kg weight loss in the last 3 months. DIAGNOSIS The initial blood urea nitrogen and serum creatinine levels were 55.9 and 1.83 mg/dL, respectively. Serum protein electrophoresis revealed a monoclonal component (3.5 g/dL) in the gamma region and immunofixation electrophoresis showed an immunoglobulin G kappa monoclonal protein. Renal pathology revealed that CD3-CD20+ CD138+ lymphoid cells had infiltrated the renal interstitium. A bone marrow biopsy was compatible with LPL. INTERVENTIONS Intravenous methylprednisolone (1 mg/kg) was administered after confirming the renal pathological findings. OUTCOMES Serum creatinine decreased to 0.8 mg/dL 14 days after treatment. CONCLUSIONS Physicians should recognize LPL secreting various immunoglobulins as a possible cause of AKI when renal failure of unknown etiology and serum immunoglobulin paraprotein is present. A kidney biopsy should be performed for definitive diagnosis and appropriate management.
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Affiliation(s)
- Seongmin Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Wooram Bae
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jungyoon Choi
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Tae Won Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Dae Hyun Song
- Department of Pathology, Gyeongsang National University Changwon Hospital, Changwon, South Korea
- Department of Pathology, Gyeongsang National University College of Medicine
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Eunjin Bae
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Ha Nee Jang
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Se-Ho Chang
- Department of Internal Medicine, Gyeongsang National University College of Medicine
- Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Dong Jun Park
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
- Department of Internal Medicine, Gyeongsang National University College of Medicine
- Institute of Health Science, Gyeongsang National University, Jinju, South Korea
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22
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Arulogun SO, Abbasi MA, Pomplun S, O'Neill AT, Wan S, Wechalekar A, D'Sa SP. Clinicoradiopathological correlation of symptomatic focal bone marrow lesions in Waldenström Macroglobulinaemia. Leuk Lymphoma 2022; 63:1496-1499. [PMID: 35067139 DOI: 10.1080/10428194.2022.2027399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Suzanne O Arulogun
- Clinical Haematology, Cancer Division, University College London Hospital, London, UK
| | - Maaz Ali Abbasi
- Department of Radiology, University College London Hospital, London, UK
| | - Sabine Pomplun
- Department of Histopathology, University College London Hospital, London, UK
| | - Aideen T O'Neill
- Clinical Haematology, Cancer Division, University College London Hospital, London, UK
| | - Simon Wan
- Department of Nuclear Medicine, University College London Hospital, London, UK
| | - Ashutosh Wechalekar
- Clinical Haematology, Cancer Division, University College London Hospital, London, UK
- Division of Medicine, University College London, London, UK
| | - Shirley P D'Sa
- Clinical Haematology, Cancer Division, University College London Hospital, London, UK
- Cancer Institute, University College London, London, UK
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23
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Rodriguez S, Celay J, Goicoechea I, Jimenez C, Botta C, Garcia-Barchino MJ, Garces JJ, Larrayoz M, Santos S, Alignani D, Vilas-Zornoza A, Perez C, Garate S, Sarvide S, Lopez A, Reinhardt HC, Carrasco YR, Sanchez-Garcia I, Larrayoz MJ, Calasanz MJ, Panizo C, Prosper F, Lamo-Espinosa JM, Motta M, Tucci A, Sacco A, Gentile M, Duarte S, Vitoria H, Geraldes C, Paiva A, Puig N, Garcia-Sanz R, Roccaro AM, Fuerte G, San Miguel JF, Martinez-Climent JA, Paiva B. Preneoplastic somatic mutations including MYD88L265P in lymphoplasmacytic lymphoma. Sci Adv 2022; 8:eabl4644. [PMID: 35044826 PMCID: PMC8769557 DOI: 10.1126/sciadv.abl4644] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Normal cell counterparts of solid and myeloid tumors accumulate mutations years before disease onset; whether this occurs in B lymphocytes before lymphoma remains uncertain. We sequenced multiple stages of the B lineage in elderly individuals and patients with lymphoplasmacytic lymphoma, a singular disease for studying lymphomagenesis because of the high prevalence of mutated MYD88. We observed similar accumulation of random mutations in B lineages from both cohorts and unexpectedly found MYD88L265P in normal precursor and mature B lymphocytes from patients with lymphoma. We uncovered genetic and transcriptional pathways driving malignant transformation and leveraged these to model lymphoplasmacytic lymphoma in mice, based on mutated MYD88 in B cell precursors and BCL2 overexpression. Thus, MYD88L265P is a preneoplastic event, which challenges the current understanding of lymphomagenesis and may have implications for early detection of B cell lymphomas.
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Affiliation(s)
- Sara Rodriguez
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Jon Celay
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Ibai Goicoechea
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Cristina Jimenez
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), CIBER-ONC, Salamanca, Spain
| | - Cirino Botta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Maria-José Garcia-Barchino
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Juan-Jose Garces
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Marta Larrayoz
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Susana Santos
- Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Diego Alignani
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Amaia Vilas-Zornoza
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Cristina Perez
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Sonia Garate
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Sarai Sarvide
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Aitziber Lopez
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Hans-Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, DKTK Partner Site Essen, Center for Molecular Biotechnology, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Yolanda R. Carrasco
- Department of Immunology and Oncology, Centro Nacional de Biotecnología (CNB)–CSIC, Madrid, Spain
| | - Isidro Sanchez-Garcia
- Experimental Therapeutics and Translational Oncology Program, Instituto de Biología Molecular y Celular del Cáncer, CSIC/Universidad de Salamanca and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Maria-Jose Larrayoz
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Maria-Jose Calasanz
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Carlos Panizo
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Felipe Prosper
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Jose-Maria Lamo-Espinosa
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Marina Motta
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alessandra Tucci
- Department of Hematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Antonio Sacco
- Clinical Research Development and Phase I Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Massimo Gentile
- Department of Oncohematology, “Annunziata” Hospital, Cosenza, Italy
| | - Sara Duarte
- Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | | | | | - Artur Paiva
- Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
| | - Noemi Puig
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), CIBER-ONC, Salamanca, Spain
| | - Ramon Garcia-Sanz
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), CIBER-ONC, Salamanca, Spain
| | - Aldo M. Roccaro
- Clinical Research Development and Phase I Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Jesus F. San Miguel
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
| | - Jose-Angel Martinez-Climent
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
- Corresponding author. (J.-A.M.-C.); (B.P.)
| | - Bruno Paiva
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Instituto de Investigacion Sanitaria de Navarra (IDISNA), CIBER-ONC, Pamplona, Spain
- Corresponding author. (J.-A.M.-C.); (B.P.)
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24
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Kobayashi H, Asada N, Egusa Y, Ikeda T, Sakamoto M, Abe M, Ennishi D, Sakata M, Takaki A, Kawahara S, Meguri Y, Nishimori H, Fujii N, Matsuoka KI, Sato Y, Yoshino T, Maeda Y. Transformation to diffuse large B-cell lymphoma with germinal center B-cell like subtype and discordant light chain expression in a patient with Waldenström macroglobulinemia/lymphoplasmacytic lymphoma. Int J Hematol 2021; 114:401-407. [PMID: 33907976 DOI: 10.1007/s12185-021-03157-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 01/09/2023]
Abstract
Waldenström macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is a rare indolent B-cell neoplasm, and a gain-of-function mutation in the myeloid differentiation primary response 88 (MYD88), L265P, is a commonly recurring mutation in patients with WM/LPL. Histological transformation of WM/LPL to an aggressive lymphoma such as diffuse large B-cell lymphoma (DLBCL) is rare, and transformed DLBCL has a worse prognosis than de novo DLBCL, partly because transformed DLBCL is mostly classified as non-germinal center B-cell-like (non-GCB) subtype. We herein describe a 75-year-old man with DLBCL with a history of WM/LPL. DLBCL in this patient showed the GCB subtype, and the light chain restriction of DLBCL was different from that of the antecedent WM/LPL, indicating that the two types of lymphoma cells had distinctive origins. However, DLBCL in this patient harbored the MYD88 L265P mutation, and polymerase chain reaction and Sanger sequencing of the DLBCL and WM/LPL for immunoglobulin heavy chain gene rearrangement suggested a clonal relationship between the two lymphomas. Since the outcome of transformed DLBCL is worse than for de novo DLBCL, it is important to evaluate the clonal relationship between primary WM/LPL and the corresponding transformed DLBCL, even if the DLBCL expresses a GCB subtype or discordant light chain restriction.
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Affiliation(s)
- Hiroki Kobayashi
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.
| | - Yuria Egusa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Tomoka Ikeda
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Misa Sakamoto
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Masaya Abe
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Masahiro Sakata
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Akinobu Takaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Soichiro Kawahara
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yusuke Meguri
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Hisakazu Nishimori
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Nobuharu Fujii
- Department of Transfusion Medicine, Okayama University Hospital, Okayama, Okayama, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Okayama, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
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25
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Abstract
It is one of the major aims in cancer research to improve our understanding of the underlying mechanisms which initiate and maintain tumor growth and to translate these findings into novel clinical diagnostic and therapeutic concepts with the ultimate goal to improve patient care. One of the greater success stories in this respect has been Waldenström's Macroglobulinemia (WM), which is an incurable B-cell neoplasm characterized by serum monoclonal immunoglobulin M (IgM) and clonal lymphoplasmacytic cells infiltrating the bone marrow. Recent years have succeeded to describe the molecular landscape of WM in detail, highlighting two recurrently mutated genes, the MYD88 and the CXCR4 genes: MYD88 with an almost constant and recurrent point mutation present in over 90% of patients and CXCR4 with over 40 different mutations in the coding region affecting up to 40% of patients. Intriguingly, both mutations are activating mutations leading in the case of CXCR4 to an indelible activation and perpetual signaling of the chemokine receptor. These data have shed light on the essential role of CXCR4 in this disease and have paved the way to use these findings for predicting treatment response to the Bruton tyrosine kinase (BTK) inhibitor ibrutinib and novel therapeutic approaches in WM, which might be transferable to other related CXCR4 positive diseases. Well known for its central role in cancer progression and distribution, CXCR4 is highlighted in this review with regard to its biology, prognostic and predictive relevance and therapeutic implications in WM.
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Affiliation(s)
- Lisa Marie Kaiser
- Institute of Experimental Cancer Research, CCC and University Hospital Ulm, Germany, 89081, Ulm, Germany
| | - Zachary R Hunter
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Steven P Treon
- Bing Center for Waldenström's Macroglobulinemia, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Christian Buske
- Institute of Experimental Cancer Research, CCC and University Hospital Ulm, Germany, 89081, Ulm, Germany.
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26
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Grimont CN, Castillo Almeida NE, Gertz MA. Current and Emerging Treatments for Waldenström Macroglobulinemia. Acta Haematol 2020; 144:146-157. [PMID: 32810857 DOI: 10.1159/000509286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/09/2020] [Indexed: 12/30/2022]
Abstract
Waldenström macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma. The primary goal of therapy is to reduce symptoms related to direct infiltration of the bone marrow and decrease monoclonal IgM-associated complications. Active agents in the management of WM can be broadly classified as rituximab-alkylator combination therapy, proteasome inhibitor-based therapy, and Bruton's tyrosine kinase inhibitor-based therapy. MYD88L265P and CXCR4 genetic status are pivotal for tailoring treatment options. Ibrutinib is a suitable treatment option for both treatment-naïve and relapsing WM patients. Recent advances in the intracellular B cell and cytokine signaling pathways have contributed to the development of novel therapeutic strategies. Current clinical trials are promising and may further advance WM-directed therapy.
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Affiliation(s)
- Christopher N Grimont
- Division of Hematology, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Natalia E Castillo Almeida
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Morie A Gertz
- Division of Hematology, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA,
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27
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Lee CH, Jeon SY, Yhim HY, Jang KY, Kwak JY. Occurrence of lymphoplasmacytic lymphoma in a chronic myeloid leukemia patient following long-term treatment with tyrosine kinase inhibitors: A case report. Medicine (Baltimore) 2020; 99:e19962. [PMID: 32384445 PMCID: PMC7220158 DOI: 10.1097/md.0000000000019962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION After tyrosine kinase inhibitors (TKIs) targeting BCR-ABL1 were introduced for the treatment of chronic myeloid leukemia, clinical outcomes have improved dramatically. However, together with the increase in the survival rate, a more frequent occurrence of secondary malignancies has been observed as well. TKIs have been demonstrated to be a risk factor of malignancies such as non-Hodgkin lymphoma, prostate cancer, and skin cancer. However, lymphoplasmacytic lymphoma (LPL) has never been reported as a secondary malignancy after TKI treatment in chronic myeloid leukemia (CML). PATIENT CONCERNS An 81-year-old male patient diagnosed with CML and treated with TKIs for a long period (15 years) was admitted due to a chief complaint of abdominal pain. A large abdominal mass was detected by imaging that included computed tomography. DIAGNOSIS LPL was confirmed from biopsies after ultrasonography and sigmoidoscopy. Serum IgM level was increased and M protein and monoclonal gammopathy, IgM_kappa light chain type were detected. INTERVENTIONS The patient received six cycles of R-CHOP chemotherapy. OUTCOMES After chemotherapy, he showed response. The sizes of the abdominal mass and lymph nodes decreased; moreover, serum M protein and IgM levels decreased, as well. CONCLUSION Herein, for the first time, we describe a patient who developed LPL as a secondary malignancy after administration of TKIs for the treatment of CML. Our observations indicate the importance of awareness of this secondary malignancy that can develop in CML patients treated with TKIs.
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MESH Headings
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Biopsy/methods
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Fusion Proteins, bcr-abl/antagonists & inhibitors
- Humans
- Immunoglobulin M/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Male
- Neoplasms, Second Primary/blood
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/pathology
- Prednisone/administration & dosage
- Radiography, Abdominal/methods
- Rituximab/administration & dosage
- Tomography, X-Ray Computed/methods
- Treatment Outcome
- Vincristine/administration & dosage
- Waldenstrom Macroglobulinemia/blood
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/etiology
- Waldenstrom Macroglobulinemia/pathology
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Affiliation(s)
| | | | | | - Kyu Yun Jang
- Department of Pathology, Chonbuk National University Medical School, Jeonju, Republic of Korea
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28
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Abstract
A 64-year-old man previously diagnosed with Waldenstrom's macroglobulinemia presented to our hospital with confusion. Magnetic resonance imaging (MRI) revealed diffuse meningeal enhancement. The patient was diagnosed with Bing-Neel syndrome (BNS) based on an elevated IgM index and the presence of monoclonal IgM protein, as detected by immunofixation electrophoresis of the cerebrospinal fluid. The patient underwent intrathecal and systemic chemotherapy but ultimately died of pneumonia. An autopsy revealed extensive meningeal and perivascular infiltration by malignant cells throughout the brain and spine. Thus, BNS may cause more extensive malignant infiltration into the central nervous system than is revealed by MRI.
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Affiliation(s)
- Sakino Matsuda
- Neurology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Naohiro Sekiguchi
- Hematology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Kenichi Ito
- Hematology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Ken Takaoka
- Neurology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Misako Furuki
- Neurology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Kazuhiko Hirano
- Laboratory and Pathology Division, National Hospital Organization Disaster Medical Center, Japan
| | - Masato Obayashi
- Neurology Division, National Hospital Organization Disaster Medical Center, Japan
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29
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de Graav GN, Maat W, Sandberg Y. [A man with nasal bleedings and blurry vision]. Ned Tijdschr Geneeskd 2019; 162:D2180. [PMID: 30816659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 67-year-old man, experiencing nasal bleedings and shortness of breath for months, had a blurry vision for a few days. Bone marrow biopsy and laboratory findings led to the diagnosis of Waldenström's macroglobulinaemia. Fundoscopy showed cotton wool spots and retinal haemorrhages, associated with Waldenström's retinopathy. Plasmapheresis improved both vision and retinal abnormalities.
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Affiliation(s)
- Gretchen N de Graav
- Maasstad Ziekenhuis, afd. Interne Geneeskunde, Rotterdam
- Contact: dr. G.N. de Graav
| | - Willem Maat
- Maasstad Ziekenhuis, afd. Oogheelkunde, Rotterdam
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30
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Voller LM, Ronkainen SD, Gaddis KJ. Progressive and translucent plaques on the soles. Cutis 2018; 102:310-333. [PMID: 30566545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Lindsey M Voller
- University of Minnesota Medical School, Twin Cities, Minneapolis, Minnesota, USA
| | - Sanna D Ronkainen
- Department of Dermatology, University of Minnesota Medical School, Twin Cities, Minneapolis, Minnesota, USA
| | - Kevin J Gaddis
- Department of Dermatology, University of Minnesota Medical School, Twin Cities, Minneapolis, Minnesota, USA
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31
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Crespi M, Demarzo MG, Brunacci M, Pellegatta G, Ferrando F, Ballestrero A, Grillo F, Savarino V, Giannini EG. Improvement in Waldenström's Macroglobulinemia after Successful Treatment of HCV with Direct-acting Antivirals. Ann Hepatol 2018; 17:1072-1077. [PMID: 30600285 DOI: 10.5604/01.3001.0012.7208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Chronic hepatitis C (HCV) virus infection may be associated with several non-hepatic manifestations, mainly driven by chronic immune stimulation, such as mixed cryoglobulinemia and Non-Hodgkin's Lymphoma. This association has been proved by several meta-analyses and some interventional studies demonstrating that antiviral treatment may be effective in inducing HCV-associated lymphoma regression. The recent advent of direct acting antivirals (DAAs) in the therapeutic armamentarium of HCV infection made possible treatment of patients with advanced liver disease. Here we report on a rare association of a cirrhotic patient with HCV and Waldenström's Macroglobulinemia with severe cryoglobulinemia, who had already failed an interferon-based antiviral regimen, whose haematologic disease was ameliorated by HCV eradication following treatment with sofosbuvir and simeprevir with ribavirin, and where successful treatment was accompanied also by consistent improvement in liver function and parameters of portal hypertension.
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Affiliation(s)
- Mattia Crespi
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Maria Giulia Demarzo
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Matteo Brunacci
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Gaia Pellegatta
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Fabio Ferrando
- Internal Medicine and Oncology Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Alberto Ballestrero
- Internal Medicine and Oncology Unit, Department of Internal Medicine, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Federica Grillo
- Pathology Unit, Department of Surgical Sciences, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Vincenzo Savarino
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
| | - Edoardo G Giannini
- Gastroenterology Unit, Ospedale Policlinico San Martino, IRCCS per l'Oncologia, University of Genoa, Genoa, Italy
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32
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Durani U, Go RS, Kay NE. Immune-mediated hemolytic anemia and thrombocytopenia in clonal B-cell disorders: a review. Clin Adv Hematol Oncol 2018; 16:670-676. [PMID: 30543597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia purpura (ITP) have been associated with B-cell lymphoproliferative disorders. Here, we review the epidemiology, pathogenesis, diagnosis, and treatment of these autoimmune disorders, specifically in the setting of B-cell malignancies. AIHA and ITP are classically associated with chronic lymphocytic leukemia (CLL) but have also been reported in plasmacytic and lymphoproliferative disorders. AIHA includes both warm AIHA and cold agglutinin disease, the latter of which is strongly associated with Waldenström macroglobulinemia. The pathogenesis of these cytopenias varies with the underlying disease, but malignant cells serving as antigen-presenting cells to T lymphocytes, with the generation of autoreactive lymphocytes, may be involved. The diagnosis requires the presence of hemolysis and a positive direct antiglobulin test result. In a minority of cases, the direct antiglobulin test result is negative, and more specialized testing may be required. Data on the prognostic effect of these comorbidities are conflicting, and the prognosis may vary depending on when in the B-cell malignant process the cytopenia(s) develops. The treatment of AIHA and ITP in the setting of B-cell lymphoproliferative disorders often involves treatment of the underlying disorder, although in some cases of CLL, treatment of the underlying disorder is not indicated, and management is similar to that for idiopathic AIHA or ITP.
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MESH Headings
- Anemia, Hemolytic, Autoimmune/epidemiology
- Anemia, Hemolytic, Autoimmune/immunology
- Anemia, Hemolytic, Autoimmune/pathology
- Anemia, Hemolytic, Autoimmune/therapy
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Comorbidity
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Purpura, Thrombocytopenic, Idiopathic/epidemiology
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Purpura, Thrombocytopenic, Idiopathic/pathology
- Purpura, Thrombocytopenic, Idiopathic/therapy
- Waldenstrom Macroglobulinemia/epidemiology
- Waldenstrom Macroglobulinemia/immunology
- Waldenstrom Macroglobulinemia/pathology
- Waldenstrom Macroglobulinemia/therapy
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33
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Kastritis E, Leblond V, Dimopoulos MA, Kimby E, Staber P, Kersten MJ, Tedeschi A, Buske C. Waldenström's macroglobulinaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29:iv41-iv50. [PMID: 29982402 DOI: 10.1093/annonc/mdy146] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- E Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - V Leblond
- Department of Hematology, Pitié Salpêtrière Hospital, Pierre and Marie Curie University, UPMC GRC11-GRECHY, Paris, France
| | - M A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E Kimby
- Division of Hematology, Department of Medicine at Huddinge, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - P Staber
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Vienna General Hospital, Vienna, Austria
| | - M J Kersten
- Department of Hematology, Academic Medical Center
- LYMMCARE (Lymphoma and Myeloma Center Amsterdam), Amsterdam, The Netherlands
| | - A Tedeschi
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - C Buske
- Comprehensive Cancer Center Ulm, Institute of Experimental Cancer Research, University Hospital Ulm, Ulm, Germany
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34
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Li N, Lopez MA, Linares M, Kumar S, Oliva S, Martinez-Lopez J, Xu L, Xu Y, Perini T, Senapedis W, Baloglu E, Shammas MA, Hunter Z, Anderson KC, Treon SP, Munshi NC, Fulciniti M. Dual PAK4-NAMPT Inhibition Impacts Growth and Survival, and Increases Sensitivity to DNA-Damaging Agents in Waldenström Macroglobulinemia. Clin Cancer Res 2018; 25:369-377. [PMID: 30206161 DOI: 10.1158/1078-0432.ccr-18-1776] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 06/11/2018] [Revised: 08/15/2018] [Accepted: 09/07/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE p21-activated kinase 4 (PAK4) plays a significant biological and functional role in a number of malignancies, including multiple myeloma (MM). On the basis of our promising findings in MM, we here characterize PAK4 expression and role in WM cells, as well effect of dual PAK4-NAMPT inhibitor (KPT-9274) against WM cell growth and viability. EXPERIMENTAL DESIGN We have analyzed mRNA and protein expression levels of PAK4 in WM cells, and used loss-of-function approach to investigate its contribution to WM cell viability. We have further tested the in vitro and in vivo effect of KPT-9274 against WM cell growth and viability. RESULTS We report here high-level expression and functional role of PAK4 in WM, as demonstrated by shRNA-mediated knockdown; and significant impact of KPT-9274 on WM cell growth and viability. The growth inhibitory effect of KPT-9274 was associated with decreased PAK4 expression and NAMPT activity, as well as induction of apoptosis. Interestingly, in WM cell lines treated with KPT-9274, we detected a significant impact on DNA damage and repair genes. Moreover, we observed that apart from inducing DNA damage, KPT-9274 specifically decreased RAD51 and the double-strand break repair by the homologous recombination pathway. As a result, when combined with a DNA alkylating agents bendamustine and melphalan, KPT-9274 provided a synergistic inhibition of cell viability in WM cell lines and primary patient WM cells in vitro and in vivo. CONCLUSIONS These results support the clinical investigation of KPT-9274 in combination with DNA-damaging agent for treatment of WM.
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Affiliation(s)
- Na Li
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Department of Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning, China
| | - Michael A Lopez
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Maria Linares
- Hospital Universitario 12 de Octubre, Complutense School of Medicine, Spanish National Cancer Research Centre, Madrid, Spain
| | - Subodh Kumar
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Stefania Oliva
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Joaquin Martinez-Lopez
- Hospital Universitario 12 de Octubre, Complutense School of Medicine, Spanish National Cancer Research Centre, Madrid, Spain
| | - Lian Xu
- Bing Center for Waldenstrom's macroglobulinemia, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Yan Xu
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Tommaso Perini
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | | | - Masood A Shammas
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- VA Boston Healthcare System, Boston, Massachusetts
| | - Zachary Hunter
- Bing Center for Waldenstrom's macroglobulinemia, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Kenneth C Anderson
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Steven P Treon
- Bing Center for Waldenstrom's macroglobulinemia, Dana Farber Cancer Institute, Boston, Massachusetts
| | - Nikhil C Munshi
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
- VA Boston Healthcare System, Boston, Massachusetts
| | - Mariateresa Fulciniti
- LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
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Akasaka T, Kishimori C, Maekawa F, Takeoka K, Hayashida M, Gomyo H, Murayama T, Ohno H. Pulmonary extranodal marginal zone lymphoma that presented with macroglobulinemia and marked plasmacytic cell proliferation carrying the t(14;18)(q32;q21)/MALT1-immunoglobulin heavy-chain fusion gene in pleural fluid. J Clin Exp Hematop 2018; 58:141-147. [PMID: 30089750 PMCID: PMC6408174 DOI: 10.3960/jslrt.18013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
An 80-year-old man presented with the accumulation of pleural fluid in the right thoracic
cavity. Serum electrophoresis revealed an M-component and immunofixation confirmed IgM/λ.
The level of IgM was 1,526 mg/dL. Imaging studies showed an infiltrative condition of the
ipsilateral lung parenchyma. The fluid contained abundant neoplastic cells with the
morphological and immunophenotypic features of plasma cells, which expressed IgM/λ
monoclonal immunoglobulins on the cell surface and in the cytoplasm. The karyotype was
48,XY,+3,add(9)(p13),+12,add(14)(q32),del(16)(q22),−18,+mar, and a series of fluorescence
in situ hybridization studies demonstrated that the add(14) chromosome
represented der(14)t(14;18)(q32;q21), at which the MALT1-immunoglobulin
heavy-chain (IGH) fusion gene was localized. A long-distance polymerase
chain reaction amplified the fragment encompassing the two genes, showing that the
junction occurred at the J6 segment of IGH and 3.7-kb upstream of the
MALT1 breakpoint cluster. We propose that this case represents an
extreme form of the plasmacytic differentiation of extranodal marginal zone lymphoma that
developed in the lung.
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MESH Headings
- Aged, 80 and over
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 14/metabolism
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 18/metabolism
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Heavy Chains/metabolism
- Lung Neoplasms/genetics
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/pathology
- Male
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein/genetics
- Mucosa-Associated Lymphoid Tissue Lymphoma Translocation 1 Protein/metabolism
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Plasma Cells/metabolism
- Plasma Cells/pathology
- Pleural Cavity/metabolism
- Pleural Cavity/pathology
- Translocation, Genetic
- Waldenstrom Macroglobulinemia/genetics
- Waldenstrom Macroglobulinemia/metabolism
- Waldenstrom Macroglobulinemia/pathology
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36
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Priyanka P, Mercier R, Raiker R, Potugari B. Distal Tibia and Foot Involvement in a Patient With Waldenstrom's Macroglobulinemia. WMJ 2018; 117:88-91. [PMID: 30048579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Bone lesions are a rare presentation in Waldenstrom's macroglobulinemia patients. Although lytic bone lesions and generalized osteoporosis have been described variably in literature on Waldenstrom's macroglobulinemia patients, distal long bone and foot involvement has not been described to our knowledge. We report a patient with Waldenstrom's macroglobulinemia with IgM monoclonal spike, plasmacytic infiltration of bone marrow, and symptoms of foot pain, and found to have distal tibia and foot involvement. The symptoms of bone lesions in our patient were significantly improved with radiation treatment. The possibility of distal involvement of long bones in a clinically relevant presentation should be kept in mind in these patients.
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Affiliation(s)
- Priyanka Priyanka
- Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin,
| | - Richard Mercier
- Department of Hemato-oncology, Marshfield Clinic, Marshfield, Wisconsin
| | - Rahul Raiker
- Department of Internal Medicine, West Virginia University, Morgantown, West Virginia
| | - Bindu Potugari
- Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin
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Maffini E, Anderson LD, Sandmaier BM, Green DJ, Storer BE, Niederwieser D, Maziarz RT, Maloney DG, Storb R. Non-myeloablative allogeneic hematopoietic cell transplantation for relapsed or refractory Waldenström macroglobulinemia: evidence for a graft- versus-lymphoma effect. Haematologica 2018; 103:e252-e255. [PMID: 29545343 PMCID: PMC6058792 DOI: 10.3324/haematol.2017.184176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Enrico Maffini
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
| | | | - Brenda M Sandmaier
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
- University of Washington, Department of Medicine, Seattle, WA, USA
| | - Damian J Green
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
- University of Washington, Department of Medicine, Seattle, WA, USA
| | - Barry E Storer
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
- University of Washington, School of Public Health, Seattle, WA, USA
| | | | | | - David G Maloney
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
- University of Washington, Department of Medicine, Seattle, WA, USA
| | - Rainer Storb
- Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle, WA, USA
- University of Washington, Department of Medicine, Seattle, WA, USA
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38
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Thomas SK, Cha SC, Smith DL, Kim KH, Parshottam SR, Rao S, Popescu M, Lee VY, Neelapu SS, Kwak LW. Phase I study of an active immunotherapy for asymptomatic phase Lymphoplasmacytic lymphoma with DNA vaccines encoding antigen-chemokine fusion: study protocol. BMC Cancer 2018; 18:187. [PMID: 29439670 PMCID: PMC5812202 DOI: 10.1186/s12885-018-4094-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 02/05/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is now a renewed interest in cancer vaccines. Patients responding to immune checkpoint blockade usually bear tumors that are heavily infiltrated by T cells and express a high load of neoantigens, indicating that the immune system is involved in the therapeutic effect of these agents; this finding strongly supports the use of cancer vaccine strategies. Lymphoplasmacytic lymphoma (LPL) is a low grade, incurable disease featuring an abnormal proliferation of Immunoglobulin (Ig)-producing malignant cells. Asymptomatic patients are currently managed by a "watchful waiting" approach, as available therapies provide no survival advantage if started before symptoms develop. Idiotypic determinants of a lymphoma surface Ig, formed by the interaction of the variable regions of heavy and light chains, can be used as a tumor-specific marker and effective vaccination using idiotypes was demonstrated in a positive controlled phase III trial. METHODS These variable region genes can be cloned and used as a DNA vaccine, a delivery system holding tremendous potential for streamlining vaccine production. To increase vaccination potency, we are targeting antigen-presenting cells (APCs) by fusing the antigen with a sequence encoding a chemokine (MIP-3α), which binds an endocytic surface receptor on APCs. Asymptomatic phase LPL is an excellent model to test our vaccine since patients have not received chemotherapeutics that interfere with innate immune function and have low tumor burden. We are evaluating the safety of this next-generation DNA vaccine in a first-in-human clinical trial currently enrolling asymptomatic LPL patients. To elucidate the mode of action of this vaccine, we will assess its ability to generate tumor-specific immune responses and examine changes in the immune profile of both the peripheral blood and bone marrow. DISCUSSION This vaccine could shift the current paradigm of clinical management for patients with asymptomatic LPL and inform development of other personalized approaches. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01209871; registered on September 24, 2010.
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Affiliation(s)
- Sheeba K Thomas
- Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Soung-Chul Cha
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, 91010, USA
| | - D Lynne Smith
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, 91010, USA
| | - Kun Hwa Kim
- Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sapna R Parshottam
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sheetal Rao
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Michael Popescu
- Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Vincent Y Lee
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, 91010, USA
| | - Sattva S Neelapu
- Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Larry W Kwak
- Toni Stephenson Lymphoma Center, Department of Hematology and Hematopoietic Stem Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, 91010, USA.
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39
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Chin CK, Leslie C, Grove CS, Van Vliet C, Cheah CY. The Diagnostic, Prognostic, and Therapeutic Utility of Molecular Testing in a Patient with Waldenstrom's Macroglobulinemia. Int J Mol Sci 2017; 18:ijms18102038. [PMID: 28937595 PMCID: PMC5666720 DOI: 10.3390/ijms18102038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 11/16/2022] Open
Abstract
The application of molecular genomics and our understanding of its clinical implications in the diagnosis, prognostication and treatment of lymphoproliferative disorders has rapidly evolved over the past few years. Of particular importance are indolent B-cell malignancies where tumour cell survival and proliferation are commonly driven by mutations involving the B-cell receptor and downstream signalling pathways. In addition, the increasing number of novel therapies and targeted agents have provided clinicians with new therapeutic options with the aim of exploiting such mutations. In this case report, we highlight one such success story involving the diagnostic impact of the MYD88L265P mutation in Waldenstrom’s macroglobulinemia (WM), its prognostic implications and effect on choice of therapy in the era of novel therapies.
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Affiliation(s)
- Collin K Chin
- Department of Haematology, Sir Charles Gairdner Hospital and Pathwest Laboratory Medicine WA, Nedlands 6009, Australia.
| | - Connull Leslie
- Department of Anatomical Pathology, Pathwest Laboratory Medicine WA, Nedlands 6009, Australia.
| | - Carolyn S Grove
- Department of Haematology, Sir Charles Gairdner Hospital and Pathwest Laboratory Medicine WA, Nedlands 6009, Australia.
- Medical School, University of Western Australia, Crawley 6009, Australia.
| | - Chris Van Vliet
- Department of Anatomical Pathology, Pathwest Laboratory Medicine WA, Nedlands 6009, Australia.
| | - Chan Yoon Cheah
- Department of Haematology, Sir Charles Gairdner Hospital and Pathwest Laboratory Medicine WA, Nedlands 6009, Australia.
- Medical School, University of Western Australia, Crawley 6009, Australia.
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40
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Growkova K, Kufová Z, Sevcikova T, Filipová J, Kascak M, Jelínek T, Grosicki S, Barchnicka A, Roziaková Ľ, Mistrík M, Simicek M, Hájek R. Diagnostic Tools of Waldenströms Macroglobulinemia - Best Possibilities for Non-invasive and Long-term Disease Monitoring. Klin Onkol 2017; 30:81-91. [PMID: 28903575 DOI: 10.14735/amko20172s81] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Waldenströms macroglobulinemia (WM) is a B-cell malignancy characterized by high level of monoclonal immunoglobulin M (IgM) paraprotein in blood serum and associated with the bone marrow infiltration by malignant cells with lymphoplasmacytic differentiation. WM remains incurable advances in therapy. Most of WM cases are associated with a somatic point mutation L265P in MYD88. Significantly higher risk of progression from the IgM monoclonal gammopathy of undetermined significance (IgM MGUS) to WM for patients with mutated MYD88 gene suggests that this mutation is an early oncogenic event and plays a central role in development of malignant clones. The second, most prevalent mutation in WM is found in the CXCR4 gene and is often associated with drug resistance and aggressive disease presentation. Therefore, detection of these mutations (MYD88L265P and CXCR4S338X) could be useful diagnostic and prognostic tool for the patients with WM. While detection of these mutations in bone marrow sample is common, the aim of our study was to compare sensitivity of detection of mutation from different cell fraction from peripheral blood and bone marrow. The results show possibility to describe MYD88 and CXCR4 mutation status even from peripheral blood sample (sensitivity for MYD88L265P was 100%, for CXCR4S338X 91%), which significantly facilitate material collection. Moreover, comparable detection sensitivity of these mutations in bone marrow and peripheral blood samples examined before and during the therapy offers a promising tool for more routine diagnostic and monitoring of disease progression.Key words: Waldenström macroglobulinemia - hematology - neoplasms - lymphoma - mutation - MYD88 - CXCR4.
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41
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Timár B. [The pathology and genetic background of lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia]. Magy Onkol 2017; 61:6-11. [PMID: 28273183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
Lymphoplasmacytic lymphoma is a rare low-grade B-cell lymphoma, which is composed of a mixture of small lymphocytes, plasmacytoid cells and plasma cells that typically infiltrate the bone marrow, but lymph nodes and rarely other organs can be involved as well. Waldenström macroglobulinaemia is a lymphoplasmacytic lymphoma with typical bone marrow involvement and is associated with detectable IgM paraproteins. The diagnosis of lymphoplasmacytic lymphoma/Waldenström macroglobulinaemia (LPL/WM) can be challenging, due to similarities to other small B-cell lymphomas with plasmacytic differentiation and/or with IgM paraproteins. The recently discovered MYD88 mutation may help in the diagnosis, as it is present in over 90% of LPL/WMs. This short review covers the pathology of LPL/WM and offers some insight into the new molecular findings that may help in the diagnostic procedure and in the new therapeutic choices.
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Affiliation(s)
- Botond Timár
- I. Sz. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, Budapest, Hungary.
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42
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Fukushima M, Okoshi Y, Fukazawa K, Koshino M, Ishiguro S, Mitsuhashi S, Saitoh H, Iijima T, Kojima H, Hori M. Lymphoplasmacytic Lymphoma Presenting with Diarrhea and Joint Pain Which was Successfully Diagnosed by an MYD88 Mutation Analysis. Intern Med 2017; 56:847-851. [PMID: 28381754 PMCID: PMC5457931 DOI: 10.2169/internalmedicine.56.7340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A 55-year-old man presented to our department with diarrhea, weight loss, fatigability, and polyarthralgia. Blood tests revealed elevated soluble interleukin-2 receptor levels and IgG-type M protein positivity, without any findings that were suggestive of collagen disease. After computed tomography (CT) detected enlarged lymph nodes in the abdominal para-aortic region, lymphoma was suspected. CT-guided needle biopsy of the lymph node did not help to achieve a definitive diagnosis; however, a bone marrow test showed the pathological features of B-cell lymphoma. A genetic examination detected a MYD88 L265P mutation; the mutation analysis was valuable in diagnosing lymphoplasmacytic lymphoma in a IgM-type M protein-negative patient.
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Affiliation(s)
- Masaya Fukushima
- Department of Hematology, Ibaraki Prefectural Central Hospital, Japan
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43
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Abstract
B-cell non-Hodgkin lymphomas with plasmacytic differentiation are a diverse group of entities with extremely variable morphologic features. Diagnostic challenges can arise in differentiating lymphoplasmacytic lymphoma from marginal zone lymphoma and other low-grade B-cell lymphomas. In addition, plasmablastic lymphomas can be difficult to distinguish from diffuse large B-cell lymphoma or other high-grade lymphomas. Judicious use of immunohistochemical studies and molecular testing can assist in appropriate classification.
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MESH Headings
- Diagnosis, Differential
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Plasmacytoma/diagnosis
- Plasmacytoma/immunology
- Plasmacytoma/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Prognosis
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/immunology
- Waldenstrom Macroglobulinemia/pathology
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Affiliation(s)
- Charles M Harmon
- Department of Pathology, University of Michigan Hospitals and Health Systems, 1301 Catherine Street, Ann Arbor, MI 48109, USA
| | - Lauren B Smith
- Department of Pathology, University of Michigan Hospitals and Health Systems, 5320 Medical Science I, 1301 Catherine Street, Ann Arbor, MI 48109-5602, USA.
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44
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King RL, Gonsalves WI, Ansell SM, Greipp PT, Frederick LA, Viswanatha DS, He R, Kyle RA, Gertz MA, Kapoor P, Morice WG, Howard MT. Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. Am J Clin Pathol 2016; 145:843-51. [PMID: 27329639 DOI: 10.1093/ajcp/aqw072] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Lymphoplasmacytic lymphoma (LPL) with non-immunoglobulin M (IgM) paraproteinemia remains poorly understood. The goal of this study was to investigate the clinicopathologic features of LPL in the bone marrow in patients with immunoglobulin G (IgG) or immunoglobulin A (IgA) paraproteins and evaluate MYD88 L265P mutation status to determine the relationship of these cases to Waldenström macroglobulinemia (WM). METHODS Bone marrows from LPL cases with IgG or IgA paraproteins diagnosed between January 1, 2007, and June 30, 2014, were retrieved from the clinical archive. Clinicopathologic features were retrospectively reviewed. MYD88 L265P mutation status was assessed by allele-specific polymerase chain reaction prospectively on all cases. RESULTS Of 27 cases, four were reclassified as multiple myeloma, all MYD88 mutation negative. MYD88 L265P mutations were present in 10 (43%) of 23 remaining cases. No association between MYD88 status and bone marrow morphologic or phenotypic features, including the presence of Dutcher bodies, mast cells, expression of CD19 by plasma cells, or hemosiderin, was identified, although these features were present in a subset of cases, similar to WM. Clinical features of WM such as hyperviscosity were uncommon in this group and did not correlate with MYD88 status. CONCLUSIONS Non-IgM LPLs are a clinically and pathologically heterogeneous group and often harbor MYD88 L265P mutation, albeit at a lower rate than classic WM. MYD88 status does not correlate with any specific pathologic or clinical manifestations.
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Affiliation(s)
| | | | | | | | | | | | - Rong He
- From the Division of Hematopathology
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45
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[Not Available]. Rinsho Ketsueki 2016; 57:87. [PMID: 26935621 DOI: 10.11406/rinketsu.57.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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46
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Thakral B, Kanagal-Shamanna R. Systemic AL amyloidosis associated with Waldenström macroglobulinemia: an unusual presenting complication. Blood 2016; 127:168. [PMID: 27127826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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47
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Terada T. Primary malignant lymphoma of the uterus: a report of four cases. EUR J GYNAECOL ONCOL 2016; 37:159-160. [PMID: 27172736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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48
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Abstract
Significant advances in the diagnosis and treatment of hairy cell leukemia (HCL) have recently been made. Improved distinction of HCL from its mimics though clinical presentations, morphologic and immunophenotypic features, and more recently molecular biology, has highlighted marked differences in treatment response and overall prognosis between these disorders. As our understanding of the unique pathobiology of HCL has grown, exciting new avenues of treatment as well as insight into immune function have been obtained. This review provides an overview of the clinical features and diagnostic attributes of HCL, with contrast to other mature B cell lymphoproliferative disorders with overlapping features.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- B-Lymphocytes/drug effects
- B-Lymphocytes/pathology
- Diagnosis, Differential
- Fatigue/diagnosis
- Fatigue/pathology
- Female
- Humans
- Indoles/therapeutic use
- Leukemia, Hairy Cell/diagnosis
- Leukemia, Hairy Cell/drug therapy
- Leukemia, Hairy Cell/pathology
- Leukemia, Hairy Cell/surgery
- Leukemia, Prolymphocytic, B-Cell/diagnosis
- Leukemia, Prolymphocytic, B-Cell/drug therapy
- Leukemia, Prolymphocytic, B-Cell/pathology
- Leukemia, Prolymphocytic, B-Cell/surgery
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Male
- Mutation
- Proto-Oncogene Proteins B-raf/antagonists & inhibitors
- Proto-Oncogene Proteins B-raf/genetics
- Sex Factors
- Splenectomy
- Splenomegaly/diagnosis
- Splenomegaly/pathology
- Splenomegaly/surgery
- Sulfonamides/therapeutic use
- Vemurafenib
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/pathology
- Waldenstrom Macroglobulinemia/surgery
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Affiliation(s)
- Graeme R Quest
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
| | - James B Johnston
- Section of Hematology/Oncology, CancerCare Manitoba, University of Manitoba, Manitoba, Canada
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49
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Sedlaříková L, Sadílková K, Kubiczková L, Hájek R, Sevčíková S. [Cytokine profiles of multiple myeloma and Waldenström macroglobulinemia]. Klin Onkol 2015; 27:18-23. [PMID: 24635433 DOI: 10.14735/amko201418] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multiple myeloma (MM) and Waldenström macroglobulinemia (WM) are malignant disorders of B lymphocytes. These diseases are characterized by monoclonal immunoglobulin production and bone marrow infiltration, which further lead to disease manifestation mainly via osteolytic lesions and disruption of hematopoiesis. The bone marrow microenvironment plays a crucial role in pathogenesis of both of these diseases, as it is well known that interaction between malignant cells and bone marrow cells facilitates both survival and growth of these tumor cells. The interactions are mediated by several different factors, including cytokines. Their production leads to tumor cell growth, proliferation and survival contributing to pathogenesis of MM and WM. In this review, we focus on function of the most important cytokines in both these diseases.
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50
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Pertesi M, Galia P, Nazaret N, Vallée M, Garderet L, Leleu X, Avet-Loiseau H, Foll M, Byrnes G, Lachuer J, McKay JD, Dumontet C. Rare Circulating Cells in Familial Waldenström Macroglobulinemia Displaying the MYD88 L265P Mutation Are Enriched by Epstein-Barr Virus Immortalization. PLoS One 2015; 10:e0136505. [PMID: 26352266 PMCID: PMC4564105 DOI: 10.1371/journal.pone.0136505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/04/2015] [Indexed: 12/30/2022] Open
Abstract
The MYD88 L265P is a recurrent somatic mutation in neoplastic cells from patients with Waldenström Macroglobulinemia (WM). We identified the MYD88 L265P mutation in three individuals from unrelated families, but its presence did not explain the disease segregation within these WM pedigrees. We observed the mutation in these three individuals at high allele fractions in DNA extracted from EBV-immortalized Lymphoblastoid cell lines established from peripheral blood (LCL), but at much lower allele fractions in DNA extracted directly from peripheral blood, suggesting that this mutation is present in a clonal cell subpopulation rather than of germ-line origin. Furthermore, we observed that the MYD88 L265P mutation is enriched in WM families, detected in 40.5% of patients with familial WM or MGUS (10/22 WM, 5/15 MGUS), compared to 3.5% of patients with familial MM or MGUS (0/72 MM, 4/41 MGUS) (p = 10-7). The mutant allele frequency increased with passages in vitro after immortalization with Epstein-Barr virus (EBV) consistent with the MYD88 L265P described gain-of-function proposed for this mutation. The MYD88 L265P mutation appears to be frequently present in circulating cells in patients with WM, and MGUS, and these cells are amenable to immortalization by EBV.
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Affiliation(s)
- Maroulio Pertesi
- Genetic Cancer Susceptibility, International Agency for Research on Cancer, Lyon, France
| | - Perrine Galia
- Hospices Civils de Lyon, Pierre Bénite, France; INSERM 1052, CNRS 5286, CRCL, Lyon, France; University of Lyon, Lyon, France
- ProfilExpert, Lyon, France
| | | | - Maxime Vallée
- Genetic Cancer Susceptibility, International Agency for Research on Cancer, Lyon, France
| | - Laurent Garderet
- INSERM, UMR_S 938, Proliferation and differentiation of stem cells, Paris, France; AP-HP, Hôpital Saint Antoine, Département d'hématologie et de thérapie cellulaire, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Xavier Leleu
- Service des maladies du sang, Hopital Huriez CHRU, Lille, France; Centre de Recherche INSERM U837, Facteurs de persistance des cellules leucémiques, Institut pour la Recherche sur le Cancer (IRCL), Lille, France
| | - Hervé Avet-Loiseau
- Unité génomique du myélome, Institut Universitaire du Cancer de Toulouse—Oncopole, CRCT INSERM U1037, Toulouse, France
| | - Matthieu Foll
- Genetic Cancer Susceptibility, International Agency for Research on Cancer, Lyon, France
| | - Graham Byrnes
- Biostatistics, International Agency for Research on Cancer, Lyon, France
| | | | - James D. McKay
- Genetic Cancer Susceptibility, International Agency for Research on Cancer, Lyon, France
| | - Charles Dumontet
- Hospices Civils de Lyon, Pierre Bénite, France; INSERM 1052, CNRS 5286, CRCL, Lyon, France; University of Lyon, Lyon, France
- ProfilExpert, Lyon, France
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