51
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Ma L, Bandarchi B, Glusac EJ. Fatal subcutaneous panniculitis-like T-cell lymphoma with interface change and dermal mucin, a dead ringer for lupus erythematosus. J Cutan Pathol 2005; 32:360-5. [PMID: 15811122 DOI: 10.1111/j.0303-6987.2005.00331.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a 48-year-old man who presented with ulcerated plaques and nodules of the lower extremities. Skin biopsies revealed a dense lymphocytic infiltrate involving the dermis and the subcutis in a lobular and septal pattern. No overt cytological atypia was present. Notably, several features resembling lupus erythematosus were present, including vacuolar interface change and abundant dermal mucin deposition. The patient developed pulmonary nodules, and a lung biopsy showed a perivascular and interstitial lymphoid infiltrate without overt atypia. The cutaneous and pulmonary lymphoid infiltrates showed similar immunohistochemical profiles: CD3(+) CD4(-) CD8(+/-) CD56(+). Monoclonal rearrangements of the T-cell receptor gamma gene with similar migration patterns were identified from both locations. The patient developed fatal hemophagocytic syndrome, involving liver, spleen, lymph nodes, and bone marrow. This case is one amongst the rare reports of subcutaneous panniculitis-like T-cell lymphoma with systemic involvement.
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Affiliation(s)
- Linglei Ma
- Department of Pathology, Yale New Haven Hospital, Yale University, School of Medicine, New Haven, CT 06520, USA
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52
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Srivastava BIS, Srivastava MD. Establishment and characterization of SRIK-NKL: a novel CD8+ natural killer/T cell line derived from a patient with leukemic phase of acute lymphoblastic lymphoma. Leuk Res 2005; 29:771-83. [PMID: 15927673 DOI: 10.1016/j.leukres.2004.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2004] [Accepted: 12/17/2004] [Indexed: 11/30/2022]
Abstract
The distinction between T cells and NK cells is difficult, and becoming more complex, as the diversity of the human lymphocyte repertoire is evident. We report the establishment of a permanent CD8+ NK/T cell line (SRIK-NKL) from a patient with leukemic phase of acute lymphoblastic lymphoma having characteristics of both NK and T cells, and extensively describe its phenotype, including cytotoxic activity, NK cell receptor expression, and other molecules critical for immune function. We further compare SRIK-NKL to other available NK/NK-T cell lines. SRIK-NKL may be useful for studying NK cell development, functions, and modulation, leading to novel strategies for treatment of autoimmune disease, infection, and cancer.
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Affiliation(s)
- Bejai I S Srivastava
- Department of Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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53
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Sra KK, Waguespack-LaBiche J, Rapini R, Jordon R, Raimer S, Tyring S. T/natural killer–cell lymphomas. J Am Acad Dermatol 2005; 52:708-10. [PMID: 15793533 DOI: 10.1016/j.jaad.2004.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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54
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Armor JF, Fazili J, Toubia N, Kern W, Kamble R, Kharfan-Dabaja MA. Remission of natural-killer cell lymphoma of the liver with anti-hepatitis C therapy. Am J Hematol 2005; 78:212-5. [PMID: 15726605 DOI: 10.1002/ajh.20286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Non-Hodgkin lymphomas (NHL) consist of a diverse group of lymphoproliferative neoplasms with unique patterns of biology, behavior, and differing responses to therapy. A rare subtype of malignancy arising from cells of putative natural killer (NK) origin is being recognized as a distinct clinicopathological entity. Viruses including hepatitis C have been reported in association with various types of NHL but not the NK-cell subtype. We hereby report a unique case of a patient with hepatitis C who developed hepatic NK-cell lymphoma and chronic NK-cell leukemia. Interestingly, we observed clinical and radiologic remission of the neoplasm following treatment with anti-hepatitis C therapy.
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Affiliation(s)
- Jess F Armor
- Section of Hematology-Oncology and OU Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
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55
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Turinelli V, Marchal T, Ponce F, Bonnefont-Rebeix C, Fournel-Fleury C. Aggressive large granular lymphocyte lymphomas in five dogs: a clinical cytohistological and immunological study. ACTA ACUST UNITED AC 2005. [DOI: 10.1007/s00580-004-0531-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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56
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Abstract
Mature T-cell and NK-cell leukemias are a group of relatively uncommon neoplasms derived from mature or postthymic T-cells accounting for a relatively small percentage of lymphoid malignancies. The recent availability of modern immunophenotypic and molecular tools has allowed a better distinction of these disorders from their B-cell counterparts. Similarly, identification of recurrent cytogenetic abnormalities, as well as plausible mechanisms through which these molecular events influence cellular signaling pathways, have created further insight into the pathogenesis of these disorders. Furthermore, the availability of new agents such as alemtuzumab has generated significant interest in devising specific therapeutic strategies for these malignancies. Herein, we review the clinical and pathological features of mature T-cell leukemias.
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MESH Headings
- Adult
- Alemtuzumab
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/therapeutic use
- Antineoplastic Agents/therapeutic use
- Human T-lymphotropic virus 1
- Humans
- Immunophenotyping
- Leukemia, Lymphoid
- Leukemia, Prolymphocytic/diagnosis
- Leukemia, Prolymphocytic/drug therapy
- Leukemia, Prolymphocytic/genetics
- Leukemia, T-Cell/blood
- Leukemia, T-Cell/diagnosis
- Leukemia, T-Cell/drug therapy
- Leukemia, T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/diagnosis
- Leukemia-Lymphoma, Adult T-Cell/drug therapy
- Leukemia-Lymphoma, Adult T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/virology
- Middle Aged
- Tumor Virus Infections
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Affiliation(s)
- Farhad Ravandi
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
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57
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Grimbacher B, Schäffer AA, Peter HH. The genetics of hypogammaglobulinemia. Curr Allergy Asthma Rep 2004; 4:349-58. [PMID: 15283873 DOI: 10.1007/s11882-004-0083-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Etiologies for human hypogammaglobulinemias are diverse and include genetic and nongenetic causes. Although recent reviews focus on the complex genetics of common variable immunodeficiency, in this review, we survey different causes of hypogammaglobulinemias and discuss possible mechanisms.
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Affiliation(s)
- Bodo Grimbacher
- Division of Rheumatology and Clinical Immunology, Medical School, University of Freiburg, Germany.
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58
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Yang X, Wasserman PG, Bhargava A, Iqbal U, Ragnauth S, Fuchs A. Challenge in diagnosis of CD56+ lymphoproliferative disorders: two cases of CD56+CD33+ lymphoma/leukemia. Arch Pathol Lab Med 2004; 128:e100-3. [PMID: 15270596 DOI: 10.5858/2004-128-e100-cidocl] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Two cases of CD56+CD33+ leukemia/lymphoma are reported. The patient in case 1 presented with skin rash, diffuse lymphadenopathy, and hepatosplenomegaly. Blasts with monocytoid and lymphoid features were present in the peripheral blood. The tumor cells expressed HLA-DR, CD4, CD33, CD38, and CD56. Cytogenetic analysis revealed del(2)(p13),del(9)(q22),add(6)(q25),add(12)(p12),-13,-18, and -20. The clinicopathologic features were similar to those of blastic natural killer cell leukemia/lymphoma or type 2 dentritic cell leukemia. The patient in case 2 presented with generalized weakness and skin erythema not responding to antibiotics. Circulating blasts with monocytoid features were seen in the peripheral blood. The tumor cells expressed CD7, CD13, CD33, CD38, and CD56, and cytogenetic analysis revealed -5,add(7)(p22),-8, del(10)(p11.2),-12,der(13; 14)(p10;p10),+14,-16,-18,-19, and del(20)(q13.1). The clinicopathologic features were consistent with a myeloid/ natural killer cell precursor acute leukemia. Both disorders are aggressive hematopoietic malignancies that have similar clinical presentation and morphology but differ in immunophenotype and cytogenetic features.
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MESH Headings
- Aged
- Antigens, CD/analysis
- Antigens, Differentiation, Myelomonocytic/analysis
- Antigens, Neoplasm/analysis
- Bone Marrow/pathology
- CD56 Antigen/analysis
- Cell Lineage
- Cytoplasmic Granules/ultrastructure
- DNA, Neoplasm/genetics
- Fatal Outcome
- Female
- Humans
- Immunophenotyping
- Karyotyping
- Kidney Calculi/complications
- Killer Cells, Natural/pathology
- Leukemia, Lymphoid/classification
- Leukemia, Lymphoid/complications
- Leukemia, Lymphoid/diagnosis
- Leukemia, Lymphoid/genetics
- Leukemia, Lymphoid/pathology
- Lymph Nodes/pathology
- Lymphoma, Non-Hodgkin/classification
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/pathology
- Middle Aged
- Multiple Organ Failure/etiology
- Neoplastic Stem Cells/pathology
- Sialic Acid Binding Ig-like Lectin 3
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Affiliation(s)
- Xu Yang
- Department of Pathology, Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA
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59
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Randall B, Moss HE, Rodd JM, Greer M, Tyler LK. Distinctiveness and correlation in conceptual structure: behavioral and computational studies. J Exp Psychol Learn Mem Cogn 2004; 30:393-406. [PMID: 14979813 DOI: 10.1037/0278-7393.30.2.393] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patients with category-specific deficits have motivated a range of hypotheses about the structure of the conceptual system. One class of models claims that apparent category dissociations emerge from the internal structure of concepts rather than fractionation of the system into separate substores. This account claims that distinctive properties of concepts in the living domain are vulnerable because of their weak correlation with other features. Given the assumption that mutual activation among correlated properties produces faster activation in the normal system, the authors predicted a disadvantage for the distinctive features of living things for unimpaired adults. Results of a speeded feature verification study supported this prediction, as did a computational simulation in which networks mapped from orthography to semantics.
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Affiliation(s)
- Billi Randall
- Centre for Speech and Language, Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom
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60
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Goldschmidt N, Amir G, Krieger M, Gilead L, Paltiel O. Fatal hemophagocytic syndrome in a patient with panniculitis-like T-cell lymphoma and no clinical evidence of disease. Leuk Lymphoma 2004; 44:1803-6. [PMID: 14692537 DOI: 10.1080/1042819031000104042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Panniculitis-like T-cell lymphoma is an uncommon type of extranodal T-cell lymphoma which presents clinically with subcutaneous nodules. The clinical course can either be indolent or rapidly progressive, often complicated by hemophagocytic syndrome. We report a patient with primary subcutaneous disease and initial complete response to combination chemotherapy. The patient experienced an early relapse which responded to salvage chemotherapy. However, she died shortly thereafter with hemophagocytic syndrome, polymicrobial sepsis and systemic fungal infection. At autopsy there was no evidence of lymphoma in the bone marrow or other organs. We emphasize that a fatal hemophagocytic syndrome can occur despite minimal or even without evidence: of clinically active lymphoma as demonstrated by autopsy in this case.
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Affiliation(s)
- Neta Goldschmidt
- Department of Hematology, Hadassah Medical Center, Jerusalem 91120, Israel
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61
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Wells J, Kosky CA, Scolyer RA, Lee S, Bye PTP, Young GAR, Davies L. Unusual case of subcutaneous panniculitis-like T-cell lymphoma. Australas J Dermatol 2004; 45:114-8. [PMID: 15068459 DOI: 10.1111/j.1440-0960.2004.00058.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An unusual case of subcutaneous panniculitis-like T-cell lymphoma is presented involving multiple organ systems, which eventually culminated in rapid demise from the haemophagocytic syndrome, after an initial protracted course. A 44-year-old man presented in April 2001 with bronchiolitis obliterans organising pneumonia that initially responded well to corticosteroids. However, the condition relapsed on attempted prednisone withdrawal in January 2002 and the patient was noted to have developed truncal subcutaneous nodules. Initial skin biopsy revealed lobular panniculitis, with negative microbiological culture. In July 2002, mononeuritis multiplex was diagnosed after the patient presented with paresthesiae and was treated with pulse cyclophosphamide therapy. By November 2002 there was ulceration of the subcutaneous nodules. Repeat skin biopsy revealed subcutaneous panniculitis-like T-cell lymphoma. The clinical manifestations were supportive of an unifying diagnosis of malignancy involving pulmonary, cutaneous and nervous systems. Combination chemotherapy with fludarabine, mitoxantrone and dexamethasone was commenced. However, the patient deteriorated, with fevers, weight loss, pancytopenia and laboratory features consistent with the haemophagocytic syndrome. Despite maximal supportive therapy the patient succumbed to his disease.
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Affiliation(s)
- Jillian Wells
- Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
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62
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Rosche B, Jacobsen M, Cepok S, Barth P, Sommer N, Hemmer B. Myositis in a patient with large granular leukocyte leukemia. Muscle Nerve 2004; 29:873-7. [PMID: 15170622 DOI: 10.1002/mus.10570] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We describe the case of a 58-year-old patient with subacute progressive weakness in both legs accompanied by recurrent opportunistic infections. White cell count was normal, but immunophenotyping revealed an increased number of CD8(+) T cells and deficiency of natural killer cells, B cells, and CD4(+) T cells in the peripheral blood. Large granular leukocyte (LGL) leukemia was diagnosed based on a clonal T-cell receptor rearrangement. Muscle biopsy demonstrated severe myositis with extensive CD8(+) T-cell infiltrates. Since no evidence of microbial muscle infection was found, autoimmune myositis was diagnosed. Immunosuppressive treatment resulted in clinical improvement and normalization of creatine kinase (CK) serum levels. The immunological phenotype of the patient and the positive response to treatment adds further to the concept that CD8(+) T cells mediate disease in autoimmune myositis.
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Affiliation(s)
- Berit Rosche
- Clinical Neuroimmunology Group, Department of Neurology, Philipps University, Rudolf Bultmann Strasse 8, Marburg 35033, Germany
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63
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Fernández-Vázquez A, Fernández González A, Abad Requejo P, Cárcaba Fernández V, Fernández Pérez J, González Marroquín A, Colunga Argüelles D. Paniculitis extensa en mujer de 64 años. Rev Clin Esp 2004. [DOI: 10.1016/s0014-2565(04)71557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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64
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EBV-associated, extranodal NK-cell lymphoma, nasal type of the breast, after heart transplantation. Mod Pathol 2003. [DOI: 10.1038/modpathol.3800040] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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65
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Matsuo Y, Drexler HG. Immunoprofiling of cell lines derived from natural killer-cell and natural killer-like T-cell leukemia-lymphoma. Leuk Res 2003; 27:935-45. [PMID: 12860014 DOI: 10.1016/s0145-2126(03)00024-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
T-cells and natural killer (NK)-cells can be distinguished by their immunophenotype and molecular biological studies though there is overlap in T- and NK-cell antigen expression, function, and malignant diseases. The relatively new cell type of NKT-cells (also termed NK-like T-cells) represents a subpopulation of T-cells that share some characteristics with NK-cells. T- and NKT-cells have their T-cell receptor (TCR) genes rearranged while NK-cells are identified molecularly and immunologically by the absence of TCR gene rearrangements and TCR protein and lack of certain surface antigens. Various continuous malignant cell lines have been derived from patients with T-cell, NK- and NKT-cell neoplasms. These cell lines possess several traits typical of the respective diseases. Characterization of these cell lines which was the objective of this study will facilitate future studies of cell biology and therapeutics for which cell lines are indispensable models. In view of the imprecision of morphological criteria alone, we analyzed a series of seven NK-cell, five NKT-cell and five T-cell lines using functional and immunophenotypic tools. All T-cell lines were negative for the presence of azurophilic granules, NK activity and Epstein-Barr virus (EBV). In contrast, 7/7 NK-cell and 4/5 NKT-cell lines displayed the azurophilic granules but only three of these combined twelve NK/NKT-cell lines showed significant NK activity which may be explained by the functional immaturity of the cells. EBV was found in 5/7 NK-cell and in 1/5 NKT-cell lines. As expected, T-cell lines were commonly positive for T-cell surface antigens and negative for NK-cell markers, and NK-cell lines vice versa; nevertheless, a number of immunomarkers were shared between T- and NK-cell lines. NKT-cell lines express T-cell, NK-cell and markers shared between T- and NK-cells. Sets of markers distinctive for the three types of cell lines are presented. The composite data gained on the present panels of cell lines allow for the operational definition of typical NK- and NKT-cell line profiles. Such cell lines will prove invaluable as informative models for studies of normal and neoplastic NK- and NKT-cell biology.
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MESH Headings
- Antigens, CD/analysis
- Cytotoxicity, Immunologic
- DNA, Viral/analysis
- Herpesvirus 4, Human/genetics
- Humans
- Immunophenotyping
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Leukemia, T-Cell/immunology
- Leukemia, T-Cell/pathology
- Lymphoma, T-Cell/immunology
- Lymphoma, T-Cell/pathology
- Receptors, Antigen, T-Cell, alpha-beta
- Receptors, Antigen, T-Cell, gamma-delta
- Tumor Cells, Cultured
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Affiliation(s)
- Yoshinobu Matsuo
- Hayashibara Biochemical Labs, Fujisaki Cell Center, Okayama 702-8006, Japan
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66
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Porcu P, Baiocchi RA, Magro C. Recent developments in the biology and therapy of T-cell and natural killer-cell lymphomas. Curr Opin Oncol 2003; 15:353-62. [PMID: 12960516 DOI: 10.1097/00001622-200309000-00002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW T-cell/natural killer (T/NK)-cell lymphomas represent a group of poor-risk lymphoproliferative disorders that have only recently been recognized as distinct clinicopathologic entities. The average outcome with currently available therapy is substantially inferior to that of aggressive B-cell lymphomas. Significant gaps remain in our knowledge of their origin, diagnosis, and clinical spectrum. This review outlines recent developments in the biology and molecular genetics of these disorders, current diagnostic challenges, and future avenues for therapy. RECENT FINDINGS Several cancer-prone transgenic mouse models that develop predominantly T/NK-cell lymphomas have been produced in the past 2 to 3 years. These models point to an important role for chronic cytokine stimulation and for disruption of genes involved in the control of chromatin remodeling and maintenance of genome integrity in the pathogenesis of T-cell lymphomas. The recognition of T/NK-cell lymphomas has been greatly facilitated by the broad acceptance of standard diagnostic criteria and by the increasing availability of assays for the analysis of T-cell receptor rearrangement and a more precise definition of functional T/NK-cell subsets. New drugs with potential for use in T/NK-cell lymphomas, including monoclonal antibodies, tyrosine kinase inhibitors, synthetic retinoids, immunoconjugates, and immunosuppressive molecules with novel mechanisms of action are in the early phase of clinical investigation. SUMMARY Much remains to be learned in the pathogenesis, clinical spectrum, and optimal therapy of T/NK-cell lymphomas. The availability of animal models of disease, new diagnostic tools, and targeted drugs with novel mechanisms of action should lead to rapid progress in this group of malignancies in the near future.
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Affiliation(s)
- Pierluigi Porcu
- Division of Hematology/Oncology, Department of Medicine, Ohio State University, Columbus, Ohio 43210, USA.
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67
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Abstract
We describe a case of a dog with hepatosplenic lymphoma, a disease characterized by infiltration of the liver, spleen, and bone marrow with gammadelta T cells, absence of peripheral lymphadenopathy, and an aggressive clinical course. Physical examination findings, hematologic and biochemical abnormalities, and clinical course of the disease in this patient were similar to those in humans. Immunophenotyping of liver and spleen aspirates supported an antemortem diagnosis of T-cell lymphoma consistent with hepatosplenic lymphoma. The diagnosis was confirmed postmortem by a combination of routine histopathology, showing a consistent pattern of organ involvement, and immunohistochemistry showing the infiltrating neoplastic lymphocytes to be T cells expressing the gammadelta T-cell receptor. To our knowledge, this is the first reported case of hepatosplenic lymphoma in a dog.
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Affiliation(s)
- M M Fry
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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68
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Sun HS, Su IJ, Lin YC, Chen JS, Fang SY. A 2.6 Mb interval on chromosome 6q25.2-q25.3 is commonly deleted in human nasal natural killer/T-cell lymphoma. Br J Haematol 2003; 122:590-9. [PMID: 12899714 DOI: 10.1046/j.1365-2141.2003.04419.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Natural killer (NK)/T-cell lymphoma is a special subtype of rare malignant lymphoma that is more prevalent in Asia than in America and Europe. This newly characterized haemato-lymphoid malignancy is highly aggressive and frequently present in nasal and upper aerodigestive sites. Several studies have reported the commonly deleted region of chromosome 6q21-25 in this particular type of lymphoma. To refine the smallest region of overlapping (SRO) deletion for localization of potential tumour suppressor (TS) genes, we performed loss of heterozygosity (LOH) and homozygosity mapping of deletion (HOMOD) analyses on 37 nasal and nasal-type NK/T-cell lymphoma patients using a panel of 25 microsatellite markers, covering the 6q21-q25 region. In all patients studied, LOH was detected in eight (89%) paired-sample patients, while hemizygous deletion was detected in three (11%) single-sample patients. Combination of the LOH and HOMOD results defined a distinct 3 Mb SRO on chromosome 6q25. Quantitative multiplex polymerase chain reaction analysis of 10 sequence-tagged sites further refined the putative TS-gene-containing region to a 2.6 Mb interval between TIAM2 and SNX9. Eighteen known genes/Unigene clusters and 25 hypothetical genes are located within this 2.6 Mb region, but none are previously identified TS genes. These results provide a framework for future positional cloning of novel TS gene(s) at 6q25.2-q25.3.
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Affiliation(s)
- H Sunny Sun
- Institute of Molecular Medicine, National Cheng Kung University Medical College, 1 University Road, Tainan 70101, Taiwan, ROC.
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69
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Abstract
Modern diagnosis of mature B- and T-cell leukemias requires integration of morphologic, immunophenotypic, and molecular genetic features. This integrative approach has allowed more precise definitions of specific disease entities. This in turn provides better information for clinicians to select proper therapy and determine prognosis. The characteristic pathologic features of these disorders are reviewed.
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MESH Headings
- Bone Marrow/immunology
- Bone Marrow/pathology
- Chromosome Aberrations
- Humans
- Immunophenotyping
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, T-Cell/genetics
- Leukemia, T-Cell/immunology
- Leukemia, T-Cell/pathology
- Molecular Biology
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Affiliation(s)
- Eric D Hsi
- Department of Clinical Pathology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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70
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Plasilova M, Risitano A, Maciejewski JP. Application of the molecular analysis of the T-cell receptor repertoire in the study of immune-mediated hematologic diseases. Hematology 2003; 8:173-81. [PMID: 12745651 DOI: 10.1080/1024533031000107505] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
The basis for the vast recognition spectrum of the T-cell receptor (TCR) can be determined by the rearrangement and recombination of the variable, diversity and joining regions of the variable portions of beta (B) and alpha (A) chains as well as their recombination and modification. Analysis of the TCR rearrangement has been routinely used to detect clonality for the diagnosis of lymphoid malignancies. However, molecular analysis of the TCR repertoire can be a powerful tool in the study of T-cell responses to pathogens and in autoimmune diseases. The concept of the oligoclonality in the context of cellular immune responses is based on the presence of immunodominant T-cell clones within distinct T-cell subpopulations used for analysis. Under normal circumstances, a limited number of clones undergo periodic expansions in reaction to foreign antigens. Under pathologic conditions, though, the derailment of immune regulation allows expansions of specific and potentially pathogenic T-cell clones. For example, large granular lymphocyte (LGL) leukemia illustrates an extreme expansion of a single T-cell clone associated with a distinct autoimmune pathology, which suggests an exaggerated clonal response to a specific antigenic target. In immune-mediated bone marrow failure syndromes, clonal rearrangement of the TCR cannot be detected in unseparated blood or marrow. Nevertheless, individual T-cell clones can significantly expand and may allow for demonstration of oligoclonality in selected T-cell populations. These subpopulations are defined, for example, by a specific beta (B)-chain usage or other phenotypic markers. Given the diversity of the TCR recognition spectrum, the task of identifying immunodominant clonotypes derived from unique complementarity determining region-3 (CDR3) sequences is very complex. However, expanded T-cell clones likely represent immunodominant responses which can be detected on the molecular level using analysis of the individual TCR VB-chain representation, CDR3 size fragment skewing, and determination of the frequency of individual clonotypic sequences. In the future, TCR VB clonotypes may be applied as a diagnostic tool, analogous to serologic markers. As an investigative tool in hematology, molecular analysis of the TCR utilization pattern and the detection of immunodominant clonotypes represents a novel approach in the study of immune-mediated hematologic diseases, such as aplastic anemia (AA), some forms of myelodysplasia (MDS), anti-leukemic immune surveillance, graft-versus-leukemia effects and graft-versus-host disease (GvHD).
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MESH Headings
- Anemia, Aplastic/genetics
- Anemia, Aplastic/immunology
- Anemia, Aplastic/pathology
- Autoimmune Diseases/genetics
- Autoimmune Diseases/immunology
- Autoimmune Diseases/pathology
- Bone Marrow/immunology
- Bone Marrow/pathology
- Clone Cells/immunology
- Complementarity Determining Regions/genetics
- Epitopes, T-Lymphocyte/immunology
- Forecasting
- Gene Rearrangement, T-Lymphocyte
- Genes, T-Cell Receptor beta
- Hematologic Diseases/genetics
- Hematologic Diseases/immunology
- Hematologic Diseases/pathology
- Hemoglobinuria, Paroxysmal/genetics
- Hemoglobinuria, Paroxysmal/immunology
- Hemoglobinuria, Paroxysmal/pathology
- Humans
- Immunodominant Epitopes/immunology
- Leukemia, T-Cell/genetics
- Leukemia, T-Cell/immunology
- Lymphocyte Activation
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/immunology
- Myelodysplastic Syndromes/pathology
- Receptors, Antigen, T-Cell/genetics
- T-Lymphocyte Subsets/immunology
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Affiliation(s)
- Magdalena Plasilova
- Experimental Hematology and Hematopoiesis Section, Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH, R40, USA.
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Warren HS, Christiansen FT, Witt CS. Functional inhibitory human leucocyte antigen class I receptors on natural killer (NK) cells in patients with chronic NK lymphocytosis. Br J Haematol 2003; 121:793-804. [PMID: 12780796 DOI: 10.1046/j.1365-2141.2003.04342.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chronic natural killer (NK) lymphocytosis is a rare disorder characterized by an indolent clinical course. Despite high NK cell numbers, many patients present with only mild clinical symptoms, and are often asymptomatic. NK cells are equipped with a range of receptors that bind human leucocyte antigen (HLA)-class I molecules. The killer immunoglobulin-like receptors (KIR, CD158) bind groups of HLA alleles, the CD94/NKG2 receptors bind HLA-E, and the CD85j (ILT2, LIR-1) receptor binds to the relatively non-polymorphic alpha3 domain of HLA molecules. Inhibitory HLA class I receptors silence NK cells against cells expressing normal levels of HLA class I. Analysis of NK cells in six patients with chronic NK lymphocytosis revealed a high level of the inhibitory CD94/NKG2A receptor on all NK cells. In four patients, KIR were absent, in one patient a single KIR was expressed in the absence of self-ligand, and in one patient CD85j and multiple KIR were expressed. Cytotoxicity assays demonstrated that all HLA class I receptors were functional. The ability of monoclonal antibodies to block the receptors and allow killing of autologous target cells established that both receptor and ligand expression were adequate for inhibitory function. We propose that the silent behaviour of NK cells in patients with chronic NK lymphocytosis is due to effective inhibitory HLA class I receptors.
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Affiliation(s)
- Hilary S Warren
- Division of Immunology and Genetics, John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia.
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