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Abstract
AbstractThe most common subtypes of primary cutaneous T-cell lymphomas are mycosis fungoides (MF) and Sézary syndrome (SS). The majority of patients have indolent disease; and given the incurable nature of MF/SS, management should focus on improving symptoms and cosmesis while limiting toxicity. Management of MF/SS should use a “stage-based” approach; treatment of early-stage disease (IA-IIA) typically involves skin directed therapies that include topical corticosteroids, phototherapy (psoralen plus ultraviolet A radiation or ultraviolet B radiation), topical chemotherapy, topical or systemic bexarotene, and radiotherapy. Systemic approaches are used for recalcitrant early-stage disease, advanced-stage disease (IIB-IV), and transformed disease and include retinoids, such as bexarotene, interferon-α, histone deacetylase inhibitors, the fusion toxin denileukin diftitox, systemic chemotherapy including transplantation, and extracorporeal photopheresis. Examples of drugs under active investigation include new histone deacetylase inhibitors, forodesine, monoclonal antibodies, proteasome inhibitors, and immunomodulatory agents, such as lenalidomide. It is appropriate to consider patients for novel agents within clinical trials if they have failed front-line therapy and before chemotherapy is used.
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52
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A Phase II Study of SGN-30 in Cutaneous Anaplastic Large Cell Lymphoma and Related Lymphoproliferative Disorders. Clin Cancer Res 2009; 15:6217-24. [DOI: 10.1158/1078-0432.ccr-09-0162] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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53
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Heid JB, Schmidt A, Oberle N, Goerdt S, Krammer PH, Suri-Payer E, Klemke CD. FOXP3+CD25- tumor cells with regulatory function in Sézary syndrome. J Invest Dermatol 2009; 129:2875-85. [PMID: 19626037 DOI: 10.1038/jid.2009.175] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cutaneous T-cell lymphoma (CTCL) has been suggested by in vitro experiments to represent a malignant CD4+ T-cell proliferation with a regulatory T-cell (Treg) phenotype (CD4+CD25+FOXP3+). We investigated percentages of FOXP3+ and CD25+ cells in the blood of 15 Sézary, 14 mycosis fungoides (MF), and 10 psoriasis (Pso) patients and 20 normal healthy donors (NHDs). We found similar numbers of FOXP3+ cells in MF (10.4% of blood CD4+ cells) and Pso (11.1%) patients and NHDs (9.8%). In 8 of 15 (53%) Sézary patients, significantly reduced percentages of FOXP3+ cells were seen in blood (2.9%) and skin (10.4%). Interestingly, 6 of 15 (40%) Sézary patients showed significantly increased percentages of FOXP3+ cells (39.7% (blood), 20.3% (skin)); however, these cells did not express CD25. In these latter patients, clone-specific TCR-Vbeta-chain antibodies were used to demonstrate that these FOXP3+CD25- cells were monoclonal CTCL tumor cells. FOXP3+CD25- CTCL tumor cells showed a highly demethylated status of the foxp3 gene locus similar to Treg cells, and they were functionally able to suppress IL-2 mRNA induction in TCR-stimulated conventional T cells. Thus, FOXP3+CD25- CTCL tumor cells with functional features of Treg cells define a subgroup of Sézary patients who might carry a different prognosis and might require differential treatment.
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Affiliation(s)
- Julia B Heid
- Tumor Immunology Program, Division of Immunogenetics (D030), German Cancer Research Center, Heidelberg, Germany
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54
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Kunishige JH, McDonald H, Alvarez G, Johnson M, Prieto V, Duvic M. Lymphomatoid papulosis and associated lymphomas: a retrospective case series of 84 patients. Clin Exp Dermatol 2009; 34:576-81. [DOI: 10.1111/j.1365-2230.2008.03024.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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55
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Gualco G, Chioato L, Weiss LM, Harrington WJ, Bacchi CE. Analysis of human T-cell lymphotropic virus in CD25+ anaplastic large cell lymphoma in children. Am J Clin Pathol 2009; 132:28-33. [PMID: 19864230 DOI: 10.1309/ajcp6q7qmuvgmvmf] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is recognized as 2 distinct diseases: anaplastic lymphoma kinase (ALK)+ ALCL and ALK- ALCL. ALK+ ALCL occurs in younger patients and has a better prognosis. Human T-cell lymphotropic virus (HTLV-1) is linked to the development of adult T-cell leukemia/lymphoma (ATLL), which frequently expresses CD25. CD25 is significantly expressed in childhood ALCL. In Brazil, HTLV-1 infection is endemic, and vertical transmission is responsible for spread to children. Of HTLV-1 carriers, 90% or more remain asymptomatic. Some cases of adult HTLV-1-related lymphomas have characteristics of ALCL but are considered CD30+ ATLL subtypes. No similar cases have been described in children. We analyzed 33 cases of pediatric ALCL, CD25+ and CD25-, for proviral HTLV-1 DNA. All cases corresponded to the common histologic ALCL type and were CD30+ in virtually all neoplastic cells. ALK expression was observed in 31 (94%) of 33 cases; CD25 was positive in 27 (82%), including 1 ALK- ALCL case. There was a strong positive correlation between ALK and CD25 expression. None of the cases showed proviral HTLV-1 DNA. ALCL in children has no relationship with HTLV-1; the frequent CD25 expression must be explained by a mechanism different from that in ATLL.
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Affiliation(s)
| | | | - Lawrence M. Weiss
- Division of Pathology, City of Hope National Medical Center, Duarte, CA
| | - William J. Harrington
- University of Miami Miller School of Medicine and Sylvester Cancer Center, Fogarty International Center (AIDS and Tuberculosis Program), Miami, FL
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56
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Wong BY, Gregory SA, Dang NH. Denileukin Diftitox as Novel Targeted Therapy for Lymphoid Malignancies. Cancer Invest 2009; 25:495-501. [PMID: 17882663 DOI: 10.1080/07357900701360096] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Denileukin diftitox (DAB(389)IL-2; Ontak) is a cytotoxic fusion protein designed to target cells expressing the receptor for interleukin-2 (IL-2). It has been approved for treatment of patients with persistent or recurrent cutaneous T-cell lymphoma (CTCL) whose malignant cells express the CD25 component of the IL-2 receptor, but more recent data indicate activity in the setting of not only T-cell but also B-cell malignancies. This review will update the experience to date of denileukin diftitox in T- and B-cell malignancies.
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Affiliation(s)
- Bryan Y Wong
- Department of Hematologic Malignancies, Nevada Cancer Institute, Las Vegas, Nevada 89135, USA
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57
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Kreitman RJ. Recombinant immunotoxins containing truncated bacterial toxins for the treatment of hematologic malignancies. BioDrugs 2009; 23:1-13. [PMID: 19344187 DOI: 10.2165/00063030-200923010-00001] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Immunotoxins are molecules that contain a protein toxin and a ligand that is either an antibody or a growth factor. The ligand binds to a target cell antigen, and the target cell internalizes the immunotoxin, allowing the toxin to migrate to the cytoplasm where it can kill the cell. In the case of recombinant immunotoxins, the ligand and toxin are encoded in DNA that is then expressed in bacteria, and the purified immunotoxin contains the ligand and toxin fused together. Among the most active recombinant immunotoxins clinically tested are those that are targeted to hematologic malignancies. One agent, containing human interleukin-2 and truncated diphtheria toxin (denileukin diftitox), has been approved for use in cutaneous T-cell lymphoma, and has shown activity in other hematologic malignancies, including leukemias and lymphomas. Diphtheria toxin has also been targeted by other ligands, including granulocyte-macrophage colony-stimulating factor and interleukin-3, to target myelogenous leukemia cells. Single-chain antibodies containing variable heavy and light antibody domains have been fused to truncated Pseudomonas exotoxin to target lymphomas and lymphocytic leukemias. Recombinant immunotoxins anti-Tac(Fv)-PE38 (LMB-2), targeting CD25, and RFB4(dsFv)-PE38 (BL22, CAT-3888), targeting CD22, have each been tested in patients. Major responses have been observed after failure of standard chemotherapy. The most successful application of recombinant immunotoxins today is in hairy cell leukemia, where BL22 has induced complete remissions in most patients who were previously treated with optimal chemotherapy.
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Affiliation(s)
- Robert J Kreitman
- Clinical Immunotherapy Section, Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
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58
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Nizar S, Copier J, Meyer B, Bodman-Smith M, Galustian C, Kumar D, Dalgleish A. T-regulatory cell modulation: the future of cancer immunotherapy? Br J Cancer 2009; 100:1697-703. [PMID: 19384299 PMCID: PMC2695683 DOI: 10.1038/sj.bjc.6605040] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
T-regulatory cells suppress anti-tumour immunity in cancer patients and in murine tumour models. Furthermore, their activity is likely to have an effect on the effectiveness of immunotherapeutic treatments for cancer. Here we describe the current status of developing clinical strategies for modulating Treg activity in cancer patients.
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Affiliation(s)
- S Nizar
- Department of Cellular and Molecular Medicine, St George's University of London, London, UK
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59
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Goodman OB, Dang NH. Novel antibody approaches for T-cell lymphomas. ACTA ACUST UNITED AC 2008; 8 Suppl 5:S193-8. [PMID: 19073527 DOI: 10.3816/clm.2008.s.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
T-cell lymphomas are biologically more aggressive--and less responsive than their B-cell counterparts--to conventional chemotherapy. The understanding of the normal physiology of T-cell signaling as well as the pathophysiology of T-cell neoplasia has advanced dramatically in the past decade. Thus, a number of novel cell surface therapeutic targets specific for T-cells have been identified and evaluated as potential monoclonal antibody (MoAb)-based therapeutic targets. Herein, we review a number of these cell surface targets and discuss the development and the clinical evaluation of MoAb therapies directed against these antigens.
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Affiliation(s)
- Oscar B Goodman
- Department of Clinical Oncology, Nevada Cancer Institute, Las Vegas, NV 89135, USA
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60
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Capriotti E, Vonderheid EC, Thoburn CJ, Wasik MA, Bahler DW, Hess AD. Expression of T-plastin, FoxP3 and other tumor-associated markers by leukemic T-cells of cutaneous T-cell lymphoma. Leuk Lymphoma 2008; 49:1190-201. [PMID: 18569641 DOI: 10.1080/10428190802064917] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Peripheral blood cells from 28 patients with leukemic cutaneous T-cell lymphoma including 25 patients with Sezary syndrome were evaluated for expression of regulatory T-cell-associated markers (FoxP3, CD25, CTLA-4, neurophilin-1), T-cell activation markers (CD28 and its ligands B7.1 and B7.2) and NK cell-associated markers (NKG2D and its ligands Mic-A and Mic-B) using real-time quantitative polymerase chain reaction. T-plastin served as a positive genetic marker, and its expression correlated to blood tumor burden. More than 90% of samples had transcripts for CD28 and Mic-B, but less than 30% of samples expressed FoxP3, CTLA-4 and CD25. Expression of Mic-B by neoplastic cells could provide another mechanism to inhibit anti-tumor immune responses. FoxP3 expression correlated with a poor prognosis. Although the underlying mechanisms accounting for this correlation remain unclear, the expression of the Foxp3 and CTLA-4 regulatory elements indicates that a subset of leukemic cases displays a regulatory T-cell phenotype.
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61
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62
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Abstract
Denileukin diftitox (Ontak®) is a novel recombinant fusion protein consisting of peptide sequences for the enzymatically active and membrane translocation domain of diphtheria toxin linked to human IL-2. Denileukin diftitox specifically binds to IL-2 receptors on the cell membrane, is internalized via receptor-mediated endocytosis and inhibits protein synthesis by ADP ribosylation of elongation factor 2, resulting in cell death. This article focuses on the clinical trial that led to the US FDA approval of the drug for cutaneous T-cell lymphoma in 1999, and other investigational studies for hematologic malignancies, recurrent and refractory chronic lymphocytic leukemia, non-Hodgkin B-cell lymphoma, graft-versus-host disease and autoimmune disease, demonstrating the activity and adverse effects of the drug.
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Affiliation(s)
- Madeleine Duvic
- The University of Texas MD Anderson Cancer Center, Division of Internal Medicine, Department of Dermatology, 1515 Holcombe Blvd, Unit 1452, Houston, TX 77030, USA
| | - Rakhshandra Talpur
- The University of Texas MD Anderson Cancer Center, Division of Internal Medicine, Department of Dermatology, 1515 Holcombe Blvd, Unit 1452, Houston, TX 77030, USA
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63
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Rodriguez-Abreu D, Filho VB, Zucca E. Peripheral T-cell lymphomas, unspecified (or not otherwise specified): a review. Hematol Oncol 2008; 26:8-20. [PMID: 18050364 DOI: 10.1002/hon.836] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Peripheral T-cell lymphomas (PTCL) comprises a heterogeneous group of haematological tumours, which originate from mature T-cells, and constitute less than 15% of all non-Hodgkin's lymphomas (NHLs) in adults. The current WHO classification recognizes nine distinct clinicopathologic peripheral T-cell NHLs, being the 'unspecified variant' (PTCL-U) the most common subtype. These neoplasms often present in advanced stage at diagnosis, and most commonly have an aggressive clinical course requiring prompt treatment. The rarity of these tumours requires additional studies to better understand their biology and search for new therapies which may hopefully improve the dismal outcome of most patients. This review aims to describe the pathobiological aspects as well the clinical characteristics and current therapeutic strategies of the PTCLs, with special attention to the group of PTCL-U.
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Affiliation(s)
- Delvys Rodriguez-Abreu
- IOSI, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
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64
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Abstract
This article describes the multiple escape mechanisms used by tumor cells to avoid T-cell-mediated recognition and destruction. The discussion focuses on escape mechanisms that may result from changes at the level of TA-specific cytotoxic T lymphocytes and tumor cells in the tumor microenvironment. Specifically, we discuss the negative impact of regulatory T cells and T-cell apoptosis on the tumor antigen-specific cytotoxic T lymphocyte response. We also discuss changes in the expression of histocompatibility antigens by tumor cells, which may affect tumor cell-immune cell interactions.
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Affiliation(s)
- Soldano Ferrone
- Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213-1863, USA.
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65
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Wasco MJ, Fullen D, Su L, Ma L. The expression of MUM1 in cutaneous T-cell lymphoproliferative disorders. Hum Pathol 2008; 39:557-63. [DOI: 10.1016/j.humpath.2007.08.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 08/15/2007] [Accepted: 08/20/2007] [Indexed: 12/20/2022]
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66
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67
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Vidulich K, Jones D, Duvic M. Cutaneous γ/δ T-Cell Lymphoma Treated with Radiation and Denileukin Diftitox. ACTA ACUST UNITED AC 2008; 8:55-8. [DOI: 10.3816/clm.2008.n.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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68
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69
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Zinzani PL, Ferreri AJM, Cerroni L. Mycosis fungoides. Crit Rev Oncol Hematol 2007; 65:172-82. [PMID: 17950613 DOI: 10.1016/j.critrevonc.2007.08.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Revised: 07/01/2007] [Accepted: 08/23/2007] [Indexed: 11/27/2022] Open
Abstract
Mycosis fungoides (MF) constitutes the most frequent cutaneous T-cell lymphoma. Sezary syndrome is considered by some authors to be an erythrodermic leukemic variant of MF, but is classified separately in the new WHO-EORT classification of cutaneous lymphomas. MF usually occurs in old adults with a 2:1 male to female ratio. Its prognosis is variable and strongly conditioned by the extent and type of skin involvement and presence of extracutaneous disease. Patients with stage IA-disease have an excellent prognosis with an overall long-term life expectancy that is similar to an age-, sex-, and race-matched control population. Almost all patients with stage IA MF will die from causes other than MF, with a median survival >33 years. Only 9% of these patients will progress to more extended disease. Patients with stage IB or IIA have a median survival greater than 11 years. These patients with T2 disease have a likelihood of disease progression of 24% and nearly 20% die of MF. Subgroups with stage IB or IIA have similar prognosis. Patients with cutaneous tumors or generalized erythroderma have a median survival of 3 and 4.5 years, respectively. The majority of these patients will die of MF. Extracutaneous dissemination is observed in less than 10% of patients with patch or plaque disease and in 30-40% of patients with tumors or generalized erythrodermatous involvement. Extracutaneous involvement is directly correlated to the extent of cutaneous disease. The most commonly involved organs are lung, spleen, liver, and gastrointestinal tract. Patients with extracutaneous disease at presentation involving either lymph nodes or viscera have a median survival of <1.5 years. Patients with plaque-type or erythrodermic MF may develop cutaneous tumors with large cell histology, often expressing CD30, which share a common clonal origin as observed in their preexisting MF and are associated with a less favourable outcome.
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Affiliation(s)
- Pier Luigi Zinzani
- L. and A. Seragnoli Institute of Hematology and Oncology, University of Bologna, Bologna, Italy.
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70
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Hathaway T, Subtil A, Kuo P, Foss F. Efficacy of Denileukin Diftitox in Subcutaneous Panniculitis-Like T-Cell Lymphoma. ACTA ACUST UNITED AC 2007; 7:541-5. [DOI: 10.3816/clm.2007.n.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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71
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Cady FM, Morice WG. Flow Cytometric Assessment of T-cell Chronic Lymphoproliferative Disorders. Clin Lab Med 2007; 27:513-32, vi. [PMID: 17658405 DOI: 10.1016/j.cll.2007.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Flow cytometry is frequently used in the evaluation of potential T-cell lineage lymphoproliferative disorders. Although flow cytometry is a useful tool, interpretation of the results can be challenging, because T-cells lack an easily analyzed structural element that can provide a surrogate marker of clonality such as immunoglobulin light chains on B-cells. Thus, routine T-cell phenotyping assays in the clinical laboratory require the comprehensive analysis of several T-cell-associated antigens. Although the detection of aberrant patterns of T-cell antigen expression can be helpful in establishing a diagnosis of T-cell malignancy, these patterns are not always disease specific, and some can overlap significantly with T-cell phenotypes observed in reactive conditions. Thus, arriving at an accurate diagnosis requires correlation of the flow cytometry results with the clinical, morphologic, and molecular results. Furthermore, the integration of these varied pieces of information into a cogent diagnosis requires an understanding of T-cell biology. In this review, the use of flow cytometry to identify T-cell lymphoproliferative disorders, particularly in peripheral blood and bone marrow specimens, is discussed, and a brief overview of T-cell biology to aid the reader in understanding the significance of the flow cytometry results is provided.
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Affiliation(s)
- Francois M Cady
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
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72
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Litzinger MT, Fernando R, Curiel TJ, Grosenbach DW, Schlom J, Palena C. IL-2 immunotoxin denileukin diftitox reduces regulatory T cells and enhances vaccine-mediated T-cell immunity. Blood 2007; 110:3192-201. [PMID: 17616639 PMCID: PMC2200901 DOI: 10.1182/blood-2007-06-094615] [Citation(s) in RCA: 151] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
CD4+CD25+Foxp3+ regulatory T (Treg) cells have been implicated in the lack of effective antitumor immunity. Denileukin diftitox (DAB(389)IL-2), a fusion protein of interleukin 2 (IL-2) and diphtheria toxin, provides a means of targeting Treg cells. In this study, we examined (1) the effect of denileukin diftitox on the deletion of Treg cells in various lymphoid compartments and (2) the dose scheduling of denileukin diftitox in combination with a recombinant poxviral vaccine to enhance antigen-specific immune responses. Treg cells in spleen, peripheral blood, and bone marrow of normal C57BL/6 mice were variously reduced after a single intraperitoneal injection of denileukin diftitox; the reduction was evident within 24 hours and lasted approximately 10 days. Injection of denileukin diftitox 1 day before vaccination enhanced antigen-specific T-cell responses above levels induced by vaccination alone. These studies show for the first time in a murine model (1) the differential effects of denileukin diftitox on Treg cells in different cellular compartments, (2) the advantage of combining denileukin diftitox with a vaccine to enhance antigen-specific T-cell immune responses, (3) the lack of inhibition by denileukin diftitox of host immune responses directed against a live viral vector, and (4) the importance of dose scheduling of denileukin diftitox when used in combination with a vaccine.
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Affiliation(s)
- Mary T Litzinger
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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73
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How low can you go: quality effects of an anti-CD4 antibody. Blood 2007. [DOI: 10.1182/blood-2007-03-079426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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74
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Assudani DP, Horton RBV, Mathieu MG, McArdle SEB, Rees RC. The role of CD4+ T cell help in cancer immunity and the formulation of novel cancer vaccines. Cancer Immunol Immunother 2007; 56:70-80. [PMID: 16555057 PMCID: PMC11030950 DOI: 10.1007/s00262-006-0154-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Accepted: 03/05/2006] [Indexed: 10/24/2022]
Abstract
Recent years have seen the unprecedented surge of interest in the role of CD4+ T cells and the role they play in the development of the immune response. In this symposium review, we examine the evidence for this and discuss their functions, particularly in respect to the cancer immunology, including CD4+CD25+ cells (Treg).
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Affiliation(s)
- Deepak P. Assudani
- School of Biomedical and Natural Sciences, Nottingham Trent University, Clifton lane, NG11 8NS Nottingham, UK
| | - Roger B. V. Horton
- School of Biomedical and Natural Sciences, Nottingham Trent University, Clifton lane, NG11 8NS Nottingham, UK
| | - Morgan G. Mathieu
- School of Biomedical and Natural Sciences, Nottingham Trent University, Clifton lane, NG11 8NS Nottingham, UK
| | - Stephanie E. B. McArdle
- School of Biomedical and Natural Sciences, Nottingham Trent University, Clifton lane, NG11 8NS Nottingham, UK
| | - Robert C. Rees
- School of Biomedical and Natural Sciences, Nottingham Trent University, Clifton lane, NG11 8NS Nottingham, UK
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75
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Targeted therapies in T-cell malignancies. Target Oncol 2006. [DOI: 10.1007/s11523-006-0035-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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76
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Kim EJ, Lin J, Junkins-Hopkins JM, Vittorio CC, Rook AH. Mycosis fungoides and sezary syndrome: An update. Curr Oncol Rep 2006; 8:376-86. [PMID: 16901399 DOI: 10.1007/s11912-006-0061-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mycosis fungoides (MF), and the associated leukemic variant Sezary Syndrome (SS), are the most common group of cutaneous T-cell lymphomas. MF/SS is a non-Hodgkin's lymphoma of mature, skin-homing, clonal, malignant T lymphocytes that initially presents in the skin as patches, plaques, tumors, or generalized erythema (erythroderma) and can involve the lymph nodes and peripheral blood. Much progress has been made in recent years in understanding the origin of the malignant T cell in MF/SS and the pathophysiology and immunology of the disease. This recent work has made a great impact on diagnosis, prognostication, and treatment. In this review, we survey the MF/SS published literature over the past year and highlight some of the important advances.
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Affiliation(s)
- Ellen J Kim
- Department of Dermatology, University of Pennsylvania Health System, Philadelphia, 19104, USA.
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77
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Talpur R, Duvic M. Treatment of Mycosis Fungoides with Denileukin Diftitox and Oral Bexarotene. ACTA ACUST UNITED AC 2006; 6:488-92. [PMID: 16796781 DOI: 10.3816/clm.2006.n.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cutaneous T-cell lymphomas, including mycosis fungoides and Sezary syndrome, are often responsive to treatment, but current therapies have not been shown to increase survival, and in advanced stages, durable remissions are hard to achieve. We present a patient who was initially misdiagnosed with psoriasis and, 16 years later, was diagnosed with mycosis fungoides. Denileukin diftitox was used as a tumor debulking agent to give a partial response that was further improved with a combination of systemic interferon/oral bexarotene and skin-directed psorlen plus UV-A. The purpose of this case report is to show the value of sequential combination therapy for improving overall response.
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Affiliation(s)
- Rakhshandra Talpur
- Department of Dermatology, The University of Texas M. D. Anderson Cancer Center, Houston, 77030-4095, USA
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