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Samara VC, de Havenon A. Rare case of T-cell lymphoma presenting as acute myelopathy. BMJ Case Rep 2016; 2016:bcr-2016-217944. [PMID: 27769981 DOI: 10.1136/bcr-2016-217944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute myelopathy is a rare presentation of systemic T-cell lymphoma. We present the case of a man aged 68 years with a diffuse erythematous maculopapular rash, followed by lower extremity paresthesias and progressive lower extremity weakness. Spinal MRI showed longitudinally extensive T2 hyperintensity with diffuse contrast enhancement. An atypical clonal T-lymphocyte population was identified in cerebrospinal fluid, peripheral blood and bone marrow aspirate, indicating a malignant T-cell lymphoproliferative disorder. The patient was treated with intrathecal and systemic chemotherapy. Unfortunately, he was not responsive to chemotherapy.
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Affiliation(s)
| | - Adam de Havenon
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
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102
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Burudpakdee C, Lin HM, Wang W, Seetasith A, Zhu Y, Bonthapally V, Carson KR. Clinical and economic burden of peripheral T-cell lymphoma in commercially insured patients in the United States: findings using real-world claims data. J Med Econ 2016; 19:965-72. [PMID: 27152635 DOI: 10.1080/13696998.2016.1187622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This retrospective cohort study utilized real-world claims data to assess the clinical and economic burden of peripheral T-cell lymphoma (PTCL) over the continuum of care in the US. METHODS Data were extracted from US administrative claims databases to identify adult patients with PTCL (ICD-9-CM code 202.7X) diagnosed between October 2007 and June 2011. Patients had to have ≥6 months of continuous enrollment before and ≥12 months of continuous enrollment after their index date (date of first PTCL diagnosis). PTCL patients were matched (1:5) by age, sex, region, plan type, payer type, and length of continuous enrollment, to a control group of randomly selected patients without PTCL. Patient-level healthcare resource utilization data and associated costs (in US dollars) were measured. Mean costs per patient per month were determined. RESULTS Of 2820 patients with PTCL, 1000 met all inclusion criteria (median age = 57 years; 57.5% male) and were matched to the control group (n = 5000). On an average monthly basis, PTCL patients were hospitalized more frequently (0.07 vs 0.01 admissions; p < 0.0001) and had a longer length of hospital stay (6.4 vs 4.0 days; p < 0.0001) compared with controls. PTCL patients also had higher monthly utilization of pharmacy services (2.85 vs 0.97 prescriptions; p < 0.0001), office visits (1.35 vs 0.34 visits; p < 0.0001), ER visits (0.07 vs 0.02 visits; p < 0.0001), hospice stays (0.05 vs 0.01 stays; p < 0.0001) and other patient services/procedures. Overall, PTCL patients incurred higher average monthly costs per patient compared with control patients ($6327.84 vs $388.39; p < 0.0001), driven mainly by hospitalizations (32.2% of overall costs) and pharmacy services (19.6%). CONCLUSIONS This is the first real-world study to quantify healthcare resource utilization, costly treatment, and overall medical expenditure in commercially insured PTCL patients. Better tolerated and more effective treatments may improve disease management and reduce the clinical and economic burden of PTCL.
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Affiliation(s)
- Chakkarin Burudpakdee
- a IMS Health , Fairfax , VA , USA
- b University of North Carolina at Charlotte , Charlotte , NC , USA
| | - Huamao Mark Lin
- c Millennium Pharmaceuticals , Inc., Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | | | | | - Yanyan Zhu
- c Millennium Pharmaceuticals , Inc., Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Vijayveer Bonthapally
- c Millennium Pharmaceuticals , Inc., Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Kenneth R Carson
- e Washington University School of Medicine , St. Louis , MO , USA
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103
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First-line therapy of peripheral T-cell lymphoma: extension and long-term follow-up of a study investigating the role of autologous stem cell transplantation. Blood Cancer J 2016; 6:e452. [PMID: 27471868 PMCID: PMC5030384 DOI: 10.1038/bcj.2016.63] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 12/15/2022] Open
Abstract
Current guidelines recommend consolidation with autologous stem cell transplantation (autoSCT) after induction chemotherapy for most patients with peripheral T-cell lymphoma (PTCL). This assumption is based on five prospective phase II studies, three of which included <50 patients with limited follow-up. Here we present the final analysis of the prospective German study. The treatment regimen consisted of four to six cycles of CHOP chemotherapy followed by mobilizing therapy and stem cell collection. Patients in complete remission (CR) or partial remission (PR) underwent myeloablative chemo(radio)therapy and autoSCT. From January 2001 to July 2010, 111 patients were enrolled in the study. The main subgroups were PTCL not specified (n=42) and angioimmunoblastic T-cell lymphoma (n=37). Seventy-five (68%) of the 111 patients received transplantation. The main reason for not receiving autoSCT was progressive disease. In an intent-to-treat analysis, the complete response rate after myeloablative therapy was 59%. The estimated 5-year overall survival, disease-free survival and progression-free survival rates were 44%, 54% and 39%, respectively. The results of this study confirm that upfront autoSCT can result in long-term remissions in patients with all major subtypes of PTCL and therefore should be part of first-line therapy whenever possible.
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104
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Saillard C, Guermouche H, Derrieux C, Bruneau J, Frenzel L, Couronne L, Asnafi V, Macintyre E, Trinquand A, Lhermitte L, Molina T, Suarez F, Lemonnier F, Kosmider O, Delarue R, Hermine O, Cheminant M. Response to 5-azacytidine in a patient with TET2-mutated angioimmunoblastic T-cell lymphoma and chronic myelomonocytic leukaemia preceded by an EBV-positive large B-cell lymphoma. Hematol Oncol 2016; 35:864-868. [PMID: 27353473 DOI: 10.1002/hon.2319] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/19/2022]
Abstract
We report the case of a patient with a history of Epstein-Barr virus-positive large B-cell lymphoma, who relapsed with an angioimmunoblastic T-cell lymphoma (AITL) associated with a chronic myelomonocytic leukaemia (CMML). We performed targeted next-generation sequencing on CMML and AITL DNA, which revealed mutations of TET2, DNMT3A, SRSF2, NRAS and IDH1, thus confirming that the spectrum of AITL mutations share similarities with myeloid disorders. The frequencies of TET2/DNMT3A and SRSF2 variants could support the hypothesis that TET2/DNMT3A mutations occurred in an early progenitor cell, which later progressed to both the AITL and CMML clones. Treatment with 5-azacytidine led to the complete remission of both diseases. Thus, targeting DNA methylation abnormalities in AITL may be an alternative strategy to chemotherapy. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Colombe Saillard
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Helene Guermouche
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Cochin Hospital, AP-HP, Paris, France
| | - Coralie Derrieux
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Julie Bruneau
- Department of Pathology, Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Laurent Frenzel
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Lucile Couronne
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France.,INSERM UMR 1163 and CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Imagine Institute, Paris, France
| | - Vahid Asnafi
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Elizabeth Macintyre
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Amélie Trinquand
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Ludovic Lhermitte
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Thierry Molina
- Department of Pathology, Imagine Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Felipe Suarez
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France.,INSERM UMR 1163 and CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Imagine Institute, Paris, France
| | - Francois Lemonnier
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France
| | - Olivier Kosmider
- Biological Hematology, Paris Descartes-Sorbonne Paris Cité University, Cochin Hospital, AP-HP, Paris, France
| | - Richard Delarue
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France.,INSERM UMR 1163 and CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Imagine Institute, Paris, France
| | - Olivier Hermine
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France.,INSERM UMR 1163 and CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Imagine Institute, Paris, France
| | - Morgane Cheminant
- Clinical Hematology, IMAGINE Institute, Paris Descartes-Sorbonne Paris Cité University, Necker Hospital, AP-HP, Paris, France.,INSERM UMR 1163 and CNRS ERL 8254, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, Imagine Institute, Paris, France
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105
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Fu T, Yang W, Zhang X, Xu X. Peripheral T-cell lymphoma unspecified type presenting with a pneumothorax as the initial manifestation: A case report and literature review. Oncol Lett 2016; 11:4069-4076. [PMID: 27313743 DOI: 10.3892/ol.2016.4518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 01/13/2016] [Indexed: 11/05/2022] Open
Abstract
The present study describes the case of a 51-year-old male presenting with a pneumothorax, in whom a final diagnosis of peripheral T-cell lymphoma unspecified type (PTCL-u) was determined. As the patient had experienced a shortness of breath subsequent to exercise for a period of 2 months, a fiber bronchoscopy was performed; however, no abnormalities were initially identified. Following the bronchoscopy, the patient suffered a recurrent pneumothorax with symptoms of emaciation, night sweats and a fever. The combination of computed tomography and interstitial lung pathology results suggested a high probability of malignant lymphoma. Further test results confirmed this diagnosis, including the fiber bronchoscopy biopsy report, which indicated a large amount of lymphocyte aggregation, and an ultrasound that identified several supraclavicular and left submandibular enlarged lymph nodes (largest size, 2.3×1.3 cm), with an absent hilar lymph node. A biopsy of the left cervical lymph node was performed, with post-operative pathological analysis confirming a diagnosis of peripheral T-cell lymphoma unspecified (stage IVB). The patient received two cycles of CHOP chemotherapy, and the symptoms alleviated following completion of the treatment, with chest radiography indicating that the pneumothorax had disappeared. The patient subsequently refused further treatment due to financial difficulty, and succumbed to the disease 6 months later.
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Affiliation(s)
- Tianhong Fu
- Division of Pathology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Wei Yang
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Xuejin Zhang
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiaofeng Xu
- Division of Hematology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang 310003, P.R. China
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106
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Fukushima R, Kobayashi Y, Fukuhara S, Miyamoto K, Munakata W, Maruyama D, Kim SW, Watanabe T, Taniguchi H, Maeshima A, Tobinai K. A retrospective analysis of combination chemotherapy consisting cyclophosphamide, vincristine, prednisolone and procarbazine (C-MOPP) for pretreated aggressive non-Hodgkin lymphoma. J Chemother 2016; 28:116-22. [PMID: 27093518 DOI: 10.1080/1120009x.2015.1110898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The C-MOPP regimen, consisting cyclophosphamide, vincristine, prednisolone and procarbazine, has been used for treatment of non-Hodgkin lymphoma; however, there are few reports of this therapy against aggressive lymphoma. We performed a retrospective analysis of previously treated 89 patients who had received C-MOPP therapy from 1999 to 2013 at our institution. Median age was 67 (range, 22-81) years. Twenty-eight patients obtained CR, 5 obtained PR, and overall response rate was 37% (33/89). The estimated 1-year overall survival and progression-free survival rates were 61 and 33%, respectively. Major grade > 2 toxicities were leucopenia (55%) and neutropenia (52%). Efficacy and toxicity were in line with other recent studies involving new agents, given that the subjects mainly consisted of elderly outpatients. These data provide a rationale for the use of C-MOPP as a current control treatment arm when the response to new cancer therapy agents is evaluated.
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Affiliation(s)
- Ryoko Fukushima
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Yukio Kobayashi
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Suguru Fukuhara
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Ken'ichi Miyamoto
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Wataru Munakata
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Dai Maruyama
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Sung-Won Kim
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Takashi Watanabe
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
| | - Hirokazu Taniguchi
- b Department of Pathology and Clinical Laboratory , National Cancer Center Hospital , Tokyo , Japan
| | - Akiko Maeshima
- b Department of Pathology and Clinical Laboratory , National Cancer Center Hospital , Tokyo , Japan
| | - Kensei Tobinai
- a Department of Hematology , National Cancer Center Hospital , Tokyo , Japan
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107
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Jia B, Hu S, Yang J, Zhou S, Liu P, Qin Y, Gui L, Yang S, Lin H, Zhang C, Xing P, Wang L, Dong M, Zhou L, Sun Y, He X, Shi Y. Comparison of gemcitabin, cisplatin, and dexamethasone (GDP), CHOP, and CHOPE in the first-line treatment of peripheral T-cell lymphomas. ACTA ACUST UNITED AC 2016; 21:536-41. [PMID: 27077778 DOI: 10.1080/10245332.2016.1152084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Optimal chemotherapy regimen for peripheral T-cell lymphomas (PTCL) has not been fully defined. This study aimed to evaluate the optimal chemotherapy regimen in the first-line treatment for PTCL patients. METHODS Between 2003 and 2014, 93 consecutive patients with PTCL were enrolled in this study. Of 93 patients, 42 patients received CHOPE, 40 patients with CHOP, and 11 patients with GDP regimen. RESULTS Response could be evaluated in 88 of 93 patients at the end of primary treatment. The CR rate for patients received CHOP (n = 38), CHOPE (n = 39), and GDP (n = 11) were 28.9, 51.3, and 45.5%, respectively, (P = 0.132) with an ORR of 65.8, 76.9, and 90.9%, respectively, (P = 0.210). The median follow-up time was 17.1 (1.4-108.3) months. Median progression-free survival (PFS) in CHOP (n = 40), CHOPE (n = 42), and GDP (n = 11) groups were 6.0, 15.3, and 9.7 months (P = 0.094) with 1-year PFS of 35.0, 54.8, and 45.5%, respectively, (P = 0.078). One-year OS for patients received CHOP (n = 40), CHOPE (n = 42), and GDP (n = 11) were 65.0, 83.3, and 100%, respectively, (P = 0.013) (CHOP vs CHOPE, P = 0.030; CHOP vs GDP, P = 0.024; CHOPE vs GDP, P = 0.174). CONCLUSION CHOPE has a trend to improve CR rate, 1-year PFS and OS compared with CHOP alone. GDP shows promising efficacy which worth further exploration in large cohort studies. Clinical experience presented in this study may serve as reference for future large cohort studies.
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Affiliation(s)
- Bo Jia
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Shaoxuan Hu
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Jianliang Yang
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Shengyu Zhou
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Peng Liu
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Yan Qin
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Lin Gui
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Sheng Yang
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Hua Lin
- b Department of Medical Record Library, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Changgong Zhang
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Puyuan Xing
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Lin Wang
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Mei Dong
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Liqiang Zhou
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Yan Sun
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Xiaohui He
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
| | - Yuankai Shi
- a Department of Medical Oncology, Cancer Hospital , Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs , No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021 , China
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108
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Iqbal J, Wilcox R, Naushad H, Rohr J, Heavican TB, Wang C, Bouska A, Fu K, Chan WC, Vose JM. Genomic signatures in T-cell lymphoma: How can these improve precision in diagnosis and inform prognosis? Blood Rev 2016; 30:89-100. [DOI: 10.1016/j.blre.2015.08.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/07/2015] [Accepted: 08/10/2015] [Indexed: 01/08/2023]
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109
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Saillard C, El Cheikh J, Granata A, Coso D, Schiano JM, Bouabdallah R, Blaise D, Charrier N, Broussais F. Histone deacetylase inhibitor abexinostat (S78454/PCI-24781) as a successful approach in a case of refractory peripheral angio-immunoblastic T-cell lymphoma, as a bridge to reduced intensity conditioning haplo-identical allogenic stem cell transplant. Leuk Lymphoma 2016; 57:714-6. [PMID: 26750740 DOI: 10.3109/10428194.2015.1061190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Colombe Saillard
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Jean El Cheikh
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Angela Granata
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Diane Coso
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Jean-Marc Schiano
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Reda Bouabdallah
- a Hematology Department , Institut Paoli Calmettes , Marseille , France
| | - Didier Blaise
- a Hematology Department , Institut Paoli Calmettes , Marseille , France ;,b Aix Marseille University , Marseille , France
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O'Connor OA, Horwitz S, Masszi T, Van Hoof A, Brown P, Doorduijn J, Hess G, Jurczak W, Knoblauch P, Chawla S, Bhat G, Choi MR, Walewski J, Savage K, Foss F, Allen LF, Shustov A. Belinostat in Patients With Relapsed or Refractory Peripheral T-Cell Lymphoma: Results of the Pivotal Phase II BELIEF (CLN-19) Study. J Clin Oncol 2015; 33:2492-9. [PMID: 26101246 DOI: 10.1200/jco.2014.59.2782] [Citation(s) in RCA: 362] [Impact Index Per Article: 40.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Peripheral T-cell lymphomas (PTCLs) represent a diverse group of non-Hodgkin lymphomas with a poor prognosis and no accepted standard of care for patients with relapsed or refractory disease. This study evaluated the efficacy and tolerability of belinostat, a novel histone deacetylase inhibitor, as a single agent in relapsed or refractory PTCL. PATIENTS AND METHODS Patients with confirmed PTCL who experienced progression after ≥ one prior therapy received belinostat 1,000 mg/m(2) as daily 30-minute infusions on days 1 to 5 every 21 days. Central assessment of response used International Working Group criteria. Primary end point was overall response rate. Secondary end points included duration of response (DoR) and progression-free and overall survival. RESULTS A total of 129 patients were enrolled, with a median of two prior systemic therapies. Overall response rate in the 120 evaluable patients was 25.8% (31 of 120), including 13 complete (10.8%) and 18 partial responses (15%). Median DoR by International Working Group criteria was 13.6 months, with the longest ongoing patient at ≥ 36 months. Median progression-free and overall survival were 1.6 and 7.9 months, respectively. Twelve of the enrolled patients underwent stem-cell transplantation after belinostat monotherapy. The most common grade 3 to 4 adverse events were anemia (10.8%), thrombocytopenia (7%), dyspnea (6.2%), and neutropenia (6.2%). CONCLUSION Monotherapy with belinostat produced complete and durable responses with manageable toxicity in patients with relapsed or refractory PTCL across the major subtypes, irrespective of number or type of prior therapies. These results have led to US Food and Drug Administration approval of belinostat for this indication.
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Affiliation(s)
- Owen A O'Connor
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA.
| | - Steven Horwitz
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Tamás Masszi
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Achiel Van Hoof
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Peter Brown
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Jeannette Doorduijn
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Georg Hess
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Wojciech Jurczak
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Poul Knoblauch
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Shanta Chawla
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Gajanan Bhat
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Mi Rim Choi
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Jan Walewski
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Kerry Savage
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Francine Foss
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Lee F Allen
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
| | - Andrei Shustov
- Owen A. O'Connor, Columbia University Medical Center; Steven Horwitz, Memorial Sloan Kettering Cancer Center, New York, NY; Tamás Masszi, St Istvan and St Laszlo Hospital, Budapest, Hungary; Achiel Van Hoof, General Hospital St-Jan, Brugge, Belgium; Peter Brown, Rigshospitalet; Poul Knoblauch, Topotarget, Copenhagen, Denmark; Jeannette Doorduijn, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands; Georg Hess, Johannes Gutenberg-University, Mainz, Germany; Wojciech Jurczak, Jagiellonian University, Krakow; Jan Walewski, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland; Shanta Chawla, Gajanan Bhat, Mi Rim Choi, and Lee F. Allen, Spectrum Pharmaceuticals, Irvine, CA; Kerry Savage, British Columbia Cancer Agency Centre, Vancouver, British Columbia, Canada; Francine Foss, Yale Cancer Center, New Haven, CT; and Andrei Shustov, University of Washington Medical Center, Seattle, WA
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Sharma M, Pro B. Bone Marrow Transplantation for Peripheral T-Cell Non-Hodgkins’ Lymphoma in First Remission. Curr Treat Options Oncol 2015; 16:34. [DOI: 10.1007/s11864-015-0347-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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de Leval L, Parrens M, Le Bras F, Jais JP, Fataccioli V, Martin A, Lamant L, Delarue R, Berger F, Arbion F, Bossard C, Copin MC, Canioni D, Charlotte F, Damaj G, Dartigues P, Fabiani B, Ledoux-Pilon A, Montagne K, Molina T, Patey M, Tas P, Peoch M, Petit B, Petrella T, Picquenot JM, Rousset T, Rousselet MC, Soubeyran I, Thiebault S, Tournilhac O, Xerri L, Gisselbrecht C, Haioun C, Delsol G, Gaulard P. Angioimmunoblastic T-cell lymphoma is the most common T-cell lymphoma in two distinct French information data sets. Haematologica 2015; 100:e361-4. [PMID: 26045291 DOI: 10.3324/haematol.2015.126300] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Laurence de Leval
- Institut de Pathologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Marie Parrens
- Département de Pathologie, Hôpital Pessac, Bordeaux, France
| | - Fabien Le Bras
- Unité Hémopathies Lymphoïdes, Hôpital Henri Mondor, Assistance publique-Hôpitaux de Paris (AP-HP), F-94010 Créteil, France
| | | | | | - Antoine Martin
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Avicenne, APHP, Bobigny, France
| | | | | | - Françoise Berger
- Département de Pathologie, Hôpital Lyon-Sud, Pierre-Benite, France
| | - Flavie Arbion
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Bretonneau, Tours, France
| | - Céline Bossard
- Service d'Anatomie et Cytologie Pathologiques, Hôpital Hôtel Dieu, Nantes, France
| | | | | | - Frédéric Charlotte
- Département de Pathologie, Hôpital La Pitié-Salpétrière, AP-HP, Paris, France
| | | | - Peggy Dartigues
- Département de Pathologie, Institut Gustave Roussy; université Paris Sud-11, Villejuif, France
| | - Bettina Fabiani
- Département d'Anatomie Pathologique, Hôpital Saint-Antoine, AP-HP, Paris, France
| | | | - Karine Montagne
- Service de Pathologie, Hôpitaux de Brabois, Vandoeuvre, France
| | - Thierry Molina
- Département de Pathologie, Hôpital Necker, AP-HP, Paris, France
| | - Martine Patey
- Laboratoire Central d'Anatomie et de Cytologie Pathologiques, Hôpital Robert Debré, Reims, France
| | - Patrick Tas
- Service d'Anatomie et Cytologie Pathologiques, CHU Pontchaillou, Rennes, France
| | - Michel Peoch
- Service d'Anatomie et Cytologie Pathologiques, CHRU de St Etienne, France
| | - Barbara Petit
- Département de Pathologie, CHU Dupuytren, Limoges, France
| | - Tony Petrella
- Service d'Anatomie et Cytologie Pathologique, CHU Dijon, France
| | | | - Thérèse Rousset
- Laboratoire d'Anatomie et Cytologie Pathologiques, Hôpital Gui de Chauliac, Montpellier, France
| | | | | | | | - Olivier Tournilhac
- Service de Thérapie Cellulaire et d'Hématologie clinique adulte, EA3846, Inserm CIC-501, Université d'Auvergne CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - Luc Xerri
- Département de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | | | - Corinne Haioun
- Unité Hémopathies Lymphoïdes, Hôpital Henri Mondor, Assistance publique-Hôpitaux de Paris (AP-HP), F-94010 Créteil, France
| | - Georges Delsol
- Département de Pathologie, Hôpital Purpan, Toulouse, France
| | - Philippe Gaulard
- Département de Pathologie, Hôpital Henri Mondor, APHP, Créteil, France INSERM U955, Créteil, France Université Paris Est, Créteil, France
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Hematopoietic stem cell transplantation in nodal T cell non-hodgkin lymphomas: revisiting the issues. Biol Blood Marrow Transplant 2015; 21:777-9. [PMID: 25783633 DOI: 10.1016/j.bbmt.2015.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 03/11/2015] [Indexed: 11/23/2022]
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Dupuis J, Morschhauser F, Ghesquières H, Tilly H, Casasnovas O, Thieblemont C, Ribrag V, Bossard C, Le Bras F, Bachy E, Hivert B, Nicolas-Virelizier E, Jardin F, Bastie JN, Amorim S, Lazarovici J, Martin A, Coiffier B. Combination of romidepsin with cyclophosphamide, doxorubicin, vincristine, and prednisone in previously untreated patients with peripheral T-cell lymphoma: a non-randomised, phase 1b/2 study. LANCET HAEMATOLOGY 2015; 2:e160-5. [PMID: 26687958 DOI: 10.1016/s2352-3026(15)00023-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 02/12/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Romidepsin is a histone deacetylase inhibitor approved in the USA for patients with recurrent or refractory peripheral T-cell lymphoma and has shown activity in this setting with mainly haematological and gastrointestinal toxicity. Although it has limited efficacy, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy is widely used for treatment of de-novo peripheral T-cell lymphoma. We aimed to assess the safety, tolerability, and activity of romidepsin combined with CHOP in patients with previously untreated disease. METHODS We enrolled patients aged 18-80 years with histologically proven, previously untreated, peripheral T-cell lymphoma (Eastern Cooperative Oncology Group performance status ≤2) into a dose-escalation (phase 1b) and expansion (phase 2) study at nine Lymphoma Study Association centres in France. In the dose-escalation phase, we allocated consecutive blocks of three participants to receive eight 3 week cycles of CHOP (intravenous cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), and vincristine 1.4 mg/m(2) [maximum 2 mg] on day 1 and oral prednisone 40 mg/m(2) on days 1-5) in association with varying doses of romidepsin. The starting dose was 10 mg/m(2) intravenously on days 1 and 8 of each cycle, and we used a 3 + 3 design. We assessed dose-limiting toxicities only during the first two cycles. The primary endpoint was to determine the recommended dose for the combination. For the phase 2 study, we aimed to increase the cohort of patients receiving the recommended dose to a total of 25 patients. Patients were assessed for safety outcomes at least twice per cycle according to the Common Terminology Criteria for Adverse Events, version 4.0. Safety analyses included all patients who received at least one dose of romidepsin and CHOP. This trial is registered at the European Clinical Trials Database (EudraCT), number 2010-020962-91 and ClinicalTrials.gov, number NCT01280526. FINDINGS Between Jan 13, 2011, and May 21, 2013, we enrolled 37 patients (18 treated in phase 1b and 19 patients in phase 2). Three of six patients initially treated at 10 mg/m(2) had a dose-limiting toxicity. The dose-escalation committee decided to modify the study protocol to redefine dose-limiting toxicities with regard to haematological toxicity. Three patients were treated with 8 mg/m(2) of romidepsin, an additional three at 10 mg/m(2) (one dose-limiting toxicity), and six patients at 12 mg/m(2) (three dose-limiting toxicities). We chose romidepsin 12 mg/m(2) as the recommended dose for phase 2. Of the 37 patients treated, three had early cardiac events (two myocardial infarctions and one acute cardiac failure). No deaths were attributable to toxicity. 25 (68%) of 37 patients had at least one serious adverse event. Overall, the most frequent serious adverse events were febrile neutropenia (five [14%] of 37 patients), physical health deterioration (five [14%]), lung infection (four [11%]), and vomiting (three [8%]). 33 (89%) of patients had grade 3-4 neutropenia, and 29 (78%) had grade 3-4 thrombocytopenia. INTERPRETATION Romidepsin can be combined with CHOP but this combination should now be tested in comparison to CHOP alone in a randomised trial. FUNDING Celgene.
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Affiliation(s)
- Jehan Dupuis
- Lymphoid Malignancies Unit, Henri Mondor University Hospital, Créteil, France
| | - Franck Morschhauser
- Department of Hematology, GRITA Unit, Claude Huriez University Hospital, Lille, France
| | | | - Hervé Tilly
- Department of Hematology, Henri Becquerel Cancer Center, Rouen, France
| | | | | | - Vincent Ribrag
- Department of Hematology, Gustave Roussy Cancer Center, Villejuif, France
| | - Céline Bossard
- Department of Pathology, Hôtel Dieu University Hospital, Nantes, France
| | - Fabien Le Bras
- Lymphoid Malignancies Unit, Henri Mondor University Hospital, Créteil, France
| | - Emmanuel Bachy
- Department of Hematology, Hospices Civils de Lyon and University Lyon 1, Lyon, France
| | - Bénédicte Hivert
- Department of Hematology, GRITA Unit, Claude Huriez University Hospital, Lille, France
| | | | - Fabrice Jardin
- Department of Hematology, Henri Becquerel Cancer Center, Rouen, France
| | | | - Sandy Amorim
- Department of Hematology-Oncology, Saint Louis Hospital, Paris, France
| | - Julien Lazarovici
- Department of Hematology, Gustave Roussy Cancer Center, Villejuif, France
| | - Antoine Martin
- Department of Pathology, Avicenne University Hospital, Bobigny, France
| | - Bertrand Coiffier
- Department of Hematology, Hospices Civils de Lyon and University Lyon 1, Lyon, France.
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Abstract
Peripheral T-cell lymphomas (PTCLs) are an uncommon group of lymphoproliferative disorders accounting for approximately 10-15 % of all non-Hodgkin lymphomas (NHL) in Western countries. Although PTCLs are associated with poor prognosis, outcomes vary with disease subtype. The standard of care has been anthracycline-based induction combination chemotherapy, however, with the exception of low-risk ALK-positive anaplastic large cell lymphoma, relapse rates are high. Therefore, consolidation with autologous stem cell transplantation is usually recommended for patients deemed candidates, and with aggressive subtypes. In recent years, a number of novel agents including pralatrexate, histone deacetylase inhibitors, immunotoxins, proteasome inhibitors, aurora kinase inhibitors and the CD30 antibody-drug conjugate brentuximab vedotin, have shown promise in the treatment of PTCLs. Studies are underway to explore the activity of these newer agents used in the frontline setting.
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Affiliation(s)
- M Gooptu
- Thomas Jefferson University, 834, Chestnut Street, Suite 320, Philadelphia, PA, 19107, USA
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Abstract
T-cell lymphomas are a group of predominantly rare hematologic malignancies that tend to recapitulate different stages of T-cell development, in a similar way that B-cell lymphomas do. As opposed to B-cell lymphomas, the understanding of the biology and the classification of T-cell lymphomas are somewhat rudimentary, and numerous entities are still included as 'provisional categories' in the World Health Classification of hematolopoietic malignancies. A relevant and useful classification of these disorders have been difficult to accomplish because of the rarity nature of them, the relative lack of understanding of the molecular pathogenesis, and their morphological and immunophenotypical complexity. Overall, T-cell lymphomas represent only 15 % of all non-Hodgkin lymphomas. This review is focused on addressing the current status of the categories of mature T-cell leukemias and lymphomas (nodal and extranodal) using an approach that incorporates histopathology, immunophenotype, and molecular understanding of the nature of these disorders, using the same philosophy of the most recent revised WHO classification of hematopoietic malignancies.
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Affiliation(s)
- Alejandro Ariel Gru
- Department of Pathology and Dermatology, Divisions of Hematopathology and Dermatopathology, Cutaneous Lymphoma Program, The Ohio State University Wexner Medical Center, Richard Solove 'The James' Comprehensive Cancer Center, 333 W 10th Ave, Columbus, OH, 43210, USA,
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Quesada AE, Nguyen ND, Rios A, Brown RE. Morphoproteomics identifies constitutive activation of the mTORC2/Akt and NF-κB pathways and expressions of IGF-1R, Sirt1, COX-2, and FASN in peripheral T-cell lymphomas: pathogenetic implications and therapeutic options. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:8732-8739. [PMID: 25674239 PMCID: PMC4313980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 11/26/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Gaining a better understanding of the molecular circuitries and pathways implicated in the malignant growth and biological behavior of T cell lymphomas may identify potential cellular targets with clinical therapeutic potential. The immunohistochemical characterization of key cellular proteins participating in these pathways can provide surrogate markers of biological activity. The mammalian target of rapamycin complex (mTORC) signaling pathway has been implicated in T-cell lymphopoiesis. The mTORC2 pathway involves downstream activation of nuclear factor (NF)-κB and p-Akt (Ser 473). Fatty acid synthase (FASN) and insulin-like growth factor-1 receptor (IGF-1R) are expressed upstream of the mTORC and NF-κB signaling pathways. Cyclooxygenase (COX)-2 products influence these pathways. Our goal was to use morphoproteomics to characterize the expression patterns of the proteins in various peripheral T-cell lymphomas. DESIGN Ten cases of peripheral T-cell lymphoma (PTCL) were examined for expression of proteins along the mTORC, Akt and NF-κB pathways and affiliated tumorigenic molecules. These included two angioimmunoblastic PTCL, one natural killer/PTCL, one anaplastic large PTCL, and six PTCL not otherwise specified. Immunostaining for phosphorylated (p) mTOR (Ser 2448), p-Akt (Ser 473), p-NF-κBp65 (Ser 536), IGF-1R (Tyr1165/1166), silent mating type information regulation 2 homolog 1 (Sirt1), COX-2 and FASN was performed on paraffin-embedded tissue for each case. Percent expression was scored using bright-field microscopy with high expression designated as more than 50% of the cells with positive stain in the appropriate subcellular compartment. RESULTS All ten cases demonstrated nuclear staining for p-mTOR (Ser 2448) corresponding to mTORC 2, and all cases showed strong, diffuse nuclear staining for p-NF-κBp65 (Ser 536). All ten also showed nuclear and cytoplasmic staining for p-Akt (Ser 473) and cytoplasmic staining for IGF-1R. High expressions for nuclear Sirt1, and cytoplasmic COX-2 and FASN were detected in 7, 9, and 8 out of 10 cases, respectively. Six out of 10 cases demonstrated high expression of all the mentioned markers. CONCLUSION The constitutive activation of mTORC2, NF-κB, p-Akt and the concomitant expression of IGF-1R suggests convergence of these molecular pathways in T-cell lymphoma. The results of this study also suggest that mTORC2 may be a common denominator among this heterogeneous group of lymphomas. Interference of key nodes of this pathway may carry a clinical therapeutic benefit. Agents that may be considered based on existing data include: bortezomib to inhibit NF-κB pathway activation; metformin to inhibit both NF-κB and mTORC2 and histone deacteylase inhibitors to inhibit mTORC2 pathway signaling. Furthermore, panobinostat inhibits Sirt1 pathway when present, and celecoxib inhibits NF-κB pathway activation independent of COX2.
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Affiliation(s)
- Andrés E Quesada
- Department of Pathology and Laboratory Medicine, The University of Texas at HoustonUSA
| | - Nghia D Nguyen
- Department of Pathology and Laboratory Medicine, The University of Texas at HoustonUSA
| | - Adan Rios
- Department of Internal Medicine, Division of Oncology, The University of Texas at HoustonUSA
| | - Robert E Brown
- Department of Pathology and Laboratory Medicine, The University of Texas at HoustonUSA
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Martín-Sánchez E, Odqvist L, Rodríguez-Pinilla SM, Sánchez-Beato M, Roncador G, Domínguez-González B, Blanco-Aparicio C, García Collazo AM, Cantalapiedra EG, Fernández JP, del Olmo SC, Pisonero H, Madureira R, Almaraz C, Mollejo M, Alves FJ, Menárguez J, González-Palacios F, Rodríguez-Peralto JL, Ortiz-Romero PL, Real FX, García JF, Bischoff JR, Piris MA. PIM kinases as potential therapeutic targets in a subset of peripheral T cell lymphoma cases. PLoS One 2014; 9:e112148. [PMID: 25386922 PMCID: PMC4227704 DOI: 10.1371/journal.pone.0112148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 10/13/2014] [Indexed: 01/18/2023] Open
Abstract
Currently, there is no efficient therapy for patients with peripheral T cell lymphoma (PTCL). The Proviral Integration site of Moloney murine leukemia virus (PIM) kinases are important mediators of cell survival. We aimed to determine the therapeutic value of PIM kinases because they are overexpressed in PTCL patients, T cell lines and primary tumoral T cells. PIM kinases were inhibited genetically (using small interfering and short hairpin RNAs) and pharmacologically (mainly with the pan-PIM inhibitor (PIMi) ETP-39010) in a panel of 8 PTCL cell lines. Effects on cell viability, apoptosis, cell cycle, key proteins and gene expression were evaluated. Individual inhibition of each of the PIM genes did not affect PTCL cell survival, partially because of a compensatory mechanism among the three PIM genes. In contrast, pharmacological inhibition of all PIM kinases strongly induced apoptosis in all PTCL cell lines, without cell cycle arrest, in part through the induction of DNA damage. Therefore, pan-PIMi synergized with Cisplatin. Importantly, pharmacological inhibition of PIM reduced primary tumoral T cell viability without affecting normal T cells ex vivo. Since anaplastic large cell lymphoma (ALK+ ALCL) cell lines were the most sensitive to the pan-PIMi, we tested the simultaneous inhibition of ALK and PIM kinases and found a strong synergistic effect in ALK+ ALCL cell lines. Our findings suggest that PIM kinase inhibition could be of therapeutic value in a subset of PTCL, especially when combined with ALK inhibitors, and might be clinically beneficial in ALK+ ALCL.
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Affiliation(s)
- Esperanza Martín-Sánchez
- Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Lina Odqvist
- Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | - Margarita Sánchez-Beato
- Onco-hematology Area, Instituto de Investigación Sanitaria Hospital Universitario Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Giovanna Roncador
- Monoclonal Antibodies Core Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | - Carmen Blanco-Aparicio
- Experimental Therapeutics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Ana M. García Collazo
- Experimental Therapeutics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | | | - Joaquín Pastor Fernández
- Experimental Therapeutics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Soraya Curiel del Olmo
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Helena Pisonero
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Rebeca Madureira
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carmen Almaraz
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Manuela Mollejo
- Pathology Department, Hospital Virgen de la Salud, Toledo, Spain
| | | | | | | | - José Luis Rodríguez-Peralto
- Pathology Department, 12 de Octubre University Hospital, Medical School Universidad Complutense, Instituto i+12, Madrid, Spain
| | - Pablo L. Ortiz-Romero
- Dermatology Department, 12 de Octubre University Hospital, Medical School Universidad Complutense, Instituto i+12, Madrid, Spain
| | - Francisco X. Real
- Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Juan F. García
- Translational Research Laboratory, M. D. Anderson Cancer Center Madrid, Madrid, Spain
| | - James R. Bischoff
- Experimental Therapeutics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Miguel A. Piris
- Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Cancer Genomics Group, Marqués de Valdecilla Research Institute (IDIVAL) & Pathology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
- * E-mail:
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Global transcriptome analysis and enhancer landscape of human primary T follicular helper and T effector lymphocytes. Blood 2014; 124:3719-29. [PMID: 25331115 DOI: 10.1182/blood-2014-06-582700] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
T follicular helper (Tfh) cells are a subset of CD4(+) T helper cells that migrate into germinal centers and promote B-cell maturation into memory B and plasma cells. Tfh cells are necessary for promotion of protective humoral immunity following pathogen challenge, but when aberrantly regulated, drive pathogenic antibody formation in autoimmunity and undergo neoplastic transformation in angioimmunoblastic T-cell lymphoma and other primary cutaneous T-cell lymphomas. Limited information is available on the expression and regulation of genes in human Tfh cells. Using a fluorescence-activated cell sorting-based strategy, we obtained primary Tfh and non-Tfh T effector cells from tonsils and prepared genome-wide maps of active, intermediate, and poised enhancers determined by chromatin immunoprecipitation-sequencing, with parallel transcriptome analyses determined by RNA sequencing. Tfh cell enhancers were enriched near genes highly expressed in lymphoid cells or involved in lymphoid cell function, with many mapping to sites previously associated with autoimmune disease in genome-wide association studies. A group of active enhancers unique to Tfh cells associated with differentially expressed genes was identified. Fragments from these regions directed expression in reporter gene assays. These data provide a significant resource for studies of T lymphocyte development and differentiation and normal and perturbed Tfh cell function.
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120
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Real-world data on prognostic factors and treatment in peripheral T-cell lymphomas: a study from the Swedish Lymphoma Registry. Blood 2014; 124:1570-7. [PMID: 25006130 DOI: 10.1182/blood-2014-04-573089] [Citation(s) in RCA: 267] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Peripheral T-cell lymphomas (PTCLs) are rare lymphomas with mostly poor outcome with current treatment. The addition of etoposide to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and upfront consolidation with autologous stem cell transplantation (auto-SCT) have shown promising results but have never been tested in randomized trials. As a complement to retrospective analyses of clinical trials, we aimed at analyzing prognostic factors and outcome in an unselected, population-based cohort. Through the Swedish Lymphoma Registry, we identified 755 PTCL patients diagnosed during a 10-year period. In addition to International Prognostic Index factors, male gender was associated with an adverse overall survival (OS) (hazard ratio [HR], 1.28; P = .011) and progression-free survival (PFS) (HR, 1.26; P = .014). In an intention-to-treat analysis in 252 nodal PTCL and enteropathy-associated T-cell lymphoma patients (excluding anaplastic lymphoma kinase-positive anaplastic large cell lymphoma), upfront auto-SCT was associated with a superior OS (HR, 0.58; P = .004) and PFS (HR, 0.56; P = .002) compared with patients treated without auto-SCT. The addition of etoposide to CHOP resulted in superior PFS in patients ≤60 years (HR, 0.49; P = .008). This study is the largest population-based PTCL cohort reported so far and provides important information on outcome in PTCL outside the setting of clinical trials.
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