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Wang YH, Hsieh CY, Hsiao LT, Lin TL, Liu YC, Yao M, Tan TD, Ko BS. Stem cell transplant for mantle cell lymphoma in Taiwan. Sci Rep 2022; 12:5662. [PMID: 35383213 PMCID: PMC8983774 DOI: 10.1038/s41598-022-09539-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/17/2022] [Indexed: 11/09/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a B-cell lymphoma featuring an aggressive course and a progressive relapsing pattern. International guidelines recommend early consolidative autologous stem cell transplant (auto-SCT) for eligible patients while reserving allogeneic SCT (allo-SCT) as therapy for refractory cases. Since data describing the implementation of transplants in the Asian population with MCL are limited, we aimed to analyze post-SCT outcomes of 99 MCL patients from the Taiwan Bone Marrow Transplant Registry database. The median age was 56 years, and 11% of the patients had blastoid variant MCL. Ninety-four patients received auto-SCT, while 13 patients received allo-SCT, eight of which received allo-SCT after failing auto-SCT. Before auto-SCT, 52% of the patients were in their first complete remission (CR1). Overall, 37 patients (39%) relapsed after auto-SCT. The median post-auto-SCT progression-free survival and overall survival (OS) were 43.6 months and not reached, respectively. Blastoid variant MCL, transplant not received in CR1, and disease progression within 12 months post-auto-SCT independently predicted inferior OS in multivariable analysis. The median post-allo-SCT OS was 74 months. Two patients (15%) died of MCL recurrence post-allo-SCT. Three patients with refractory diseases were salvaged with ibrutinib or venetoclax to allo-SCT. Treatment strategies incorporating novel agents warrant further optimization.
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Affiliation(s)
- Yu-Hung Wang
- Stem Cell and Leukaemia Proteomics Laboratory, University of Manchester, Manchester, UK
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Tsai Hsiao
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tung-Liang Lin
- Division of Hematology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Chang Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming Yao
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tran-Der Tan
- Division of Hematology and Medical Oncology, Koo Foundation Sun Yat-Sen Cancer Center, No. 125, Lih-Der Road, Pei-Tou District, Taipei, 112, Taiwan.
| | - Bor-Sheng Ko
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Hematological Oncology, National Taiwan University Cancer Center, No. 57, Lane 155, Section 3 of Keelung Rd, Taipei, 100, Taiwan.
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Clinical characteristics and outcomes of primary versus secondary gastrointestinal mantle cell lymphoma. Blood Cancer J 2021; 11:8. [PMID: 33414416 PMCID: PMC7791108 DOI: 10.1038/s41408-020-00394-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/04/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022] Open
Abstract
Primary gastrointestinal (GI) mantle cell lymphoma (MCL) is rare and the optimal management is unknown. We reviewed 800 newly diagnosed MCL cases and found 22 primary (2.8%) and 79 (9.9%) secondary GI MCL cases. Age, sex, and performance status were similar between primary and secondary cases. Secondary cases had more elevations in lactate dehydrogenase (28% vs 0%, P = 0.03) and a trend for a higher MCL international prognostic index (P = 0.07). Observation or local therapy was more common for primary GI MCL (29% vs 8%, P < 0.01), and autologous stem-cell transplant was more common for secondary GI MCL (35% vs 14%, P < 0.05). The median follow-up was 85 months. Primary and secondary GI MCL had similar 5-year progression-free survival (PFS) (30% vs 28%, P = 0.59) and overall survival (OS) (65% vs 66%, P = 0.83). The extent of GI involvement in primary GI MCL affected treatment selection but not outcome, with a 5-year PFS of 43% vs 14% vs 31% (P = 0.48) and OS of 57% vs 71% vs 69% (P = 0.54) in cases with single lesion vs multiple lesions in 1 organ vs multiple lesions in ≥2 organs. Less aggressive frontline treatment for primary GI MCL is reasonable. It is unknown whether more aggressive treatment can result in improved outcomes. Primary GI MCL is rare. These patients tend to be treated less aggressively in the frontline setting yet have similar outcomes as those with secondary GI MCL. Less aggressive frontline treatment for primary GI MCL is reasonable given decent outcome, although it is unknown whether more aggressive treatment can result in improved outcomes.
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Yoon DH, Cao J, Chen TY, Izutsu K, Kim SJ, Kwong YL, Lin TY, Thye LS, Xu B, Yang DH, Kim WS. Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group. J Hematol Oncol 2020; 13:21. [PMID: 32183871 PMCID: PMC7079508 DOI: 10.1186/s13045-020-00855-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/03/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mantle cell lymphoma (MCL) is a B cell malignancy that can be aggressive and with a poor prognosis; the clinical course is heterogeneous. The epidemiology of MCL in Asia is not well documented but appears to comprise 2-6% of all lymphoma cases based on available data, with variation observed between countries. Although international guidelines are available for the treatment of MCL, there is a lack of published data or guidance on the clinical characteristics and management of MCL in patient populations from Asia. This paper aims to review the available treatment and, where clinical gaps exist, provide expert consensus from the Asian Lymphoma Study Group (ALSG) on appropriate MCL management in Asia. BODY: Management strategies for MCL are patient- and disease stage-specific and aim to achieve balance between efficacy outcomes and toxicity. For asymptomatic patients with clearly indolent disease, observation may be an appropriate strategy. For stage I/II disease, following international guidelines is appropriate, which include either a short course of conventional chemotherapy followed by consolidated radiotherapy, less aggressive chemotherapy regimens, or a combination of these approaches. For advanced disease, the approach is based on the age and fitness of the patient. For young, fit patients, the current practice for induction therapy differs across Asia, with cytarabine having an important role in this setting. Hematopoietic stem cell transplantation (HSCT) may be justified in selected patients because of the high relapse risk. In elderly patients, specific chemoimmunotherapy regimens available in each country/region are a treatment option. For maintenance therapy after first-line treatment, the choice of approach should be individualized, with cost being an important consideration within Asia. For relapsed/refractory disease, ibrutinib should be considered as well as other follow-on compounds, if available. CONCLUSION Asian patient-specific data for the treatment of MCL are lacking, and the availability of treatment options differs between country/region within Asia. Therefore, there is no clear one-size-fits-all approach and further investigation on the most appropriate sequence of treatment that should be considered for this heterogeneous disease.
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Affiliation(s)
- Dok Hyun Yoon
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Junning Cao
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Tsai-Yun Chen
- National Cheng Kung University Hospital, Tainan, Taiwan
| | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
| | - Seok Jin Kim
- School of Medicine, Sungkyunkwan University, Samsung Medical Center 115 Irown-Ro, Gangnam-Gu, Seoul, South Korea
| | | | - Tong Yu Lin
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | | | - Bing Xu
- Hospital of Xiamen University, Xiamen, China
| | - Deok Hwan Yang
- Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Won Seog Kim
- School of Medicine, Sungkyunkwan University, Samsung Medical Center 115 Irown-Ro, Gangnam-Gu, Seoul, South Korea.
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Yim RL, Wong KY, Kwong YL, Loong F, Leung CY, Chu R, Lam WWL, Hui PK, Lai R, Chim CS. Methylation of miR-155-3p in mantle cell lymphoma and other non-Hodgkin's lymphomas. Oncotarget 2015; 5:9770-82. [PMID: 25211095 PMCID: PMC4259436 DOI: 10.18632/oncotarget.2390] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin's lymphoma (NHL). In cancers, tumor suppressive microRNAs may be silenced by DNA hypermethylation. By microRNA profiling of representative EBV-negative MCL cell lines before and after demethylation treatment, miR-155-3p was found significantly restored. Methylation-specific PCR, verified by pyrosequencing, showed complete methylation of miR-155-3p in one MCL cell line (REC-1). 5-aza-2′-deoxycytidine treatment of REC-1 led to demethylation and re-expression of miR-155-3p. Over-expression of miR-155-3p led to increased sub-G1 apoptotic cells and reduced cellular viability, demonstrating its tumor suppressive properties. By luciferase assay, lymphotoxin-beta (LT-β) was validated as a miR-155-3p target. In 31 primary MCL, miR-155-3p was found hypermethylated in 6(19%) cases. To test if methylation of miR-155-3p was MCL-specific, miR-155-3p methylation was tested in an additional 191 B-cell, T-cell and NK-cell NHLs, yielding miR-155-3p methylation in 66(34.6%) including 36(27%) non-MCL B-cell, 24(53%) T-cell and 6(46%) of NK-cell lymphoma. Moreover, in 72 primary NHL samples with RNA, miR-155-3p methylation correlated with miR-155-3p downregulation (p = 0.024), and LT-β upregulation (p = 0.043). Collectively, miR-155-3p is a potential tumor suppressive microRNA hypermethylated in MCL and other NHL subtypes. As miR-155-3p targets LT-β, which is an upstream activator of the non-canonical NF-kB signaling, miR-155-3p methylation is potentially important in lymphomagenesis.
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Affiliation(s)
- Rita Lh Yim
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Kwan Yeung Wong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Yok Lam Kwong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | | | | | - Raymond Chu
- Department of Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | | | - Pak Kwan Hui
- Department of Pathology, Kwong Wah Hospital, Hong Kong
| | - Raymond Lai
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | - Chor Sang Chim
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
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Wang Y, Ma S. Racial differences in mantle cell lymphoma in the United States. BMC Cancer 2014; 14:764. [PMID: 25315847 PMCID: PMC4210548 DOI: 10.1186/1471-2407-14-764] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 10/09/2014] [Indexed: 01/19/2023] Open
Abstract
Background MCL (mantle cell lymphoma) is a rare subtype of NHL (non-Hodgkin lymphoma) with mostly poor prognosis. Different races have different etiology, presentation, and progression patterns. Methods Data were analyzed on MCL patients in the United States reported to the SEER (Surveillance, Epidemiology, and End Results) database between 1992 and 2009. SEER contains the most comprehensive population-based cancer information in the U.S., covering approximately 28% of the population. Racial groups analyzed included non-Hispanic whites, Hispanic whites, blacks, and Asians/PIs (Pacific Islanders). Patient characteristics, age-adjusted incidence rate, and survival rate were compared across races. Stratification by age, gender, and stage at diagnosis was considered. Multivariate analysis was conducted on survival. Results In the analysis of patients’ characteristics, distributions of gender, marital status, age at diagnosis, stage, and extranodal involvement were significantly different across races. For all three age groups and both male and female, non-Hispanic whites have the highest incidence rates. In the analysis of survival, for cancers diagnosed in the period of 1992–2004, no significant racial difference is observed. For cancers diagnosed in the period of 1999–2004, significant racial differences exist for the 40–64 age group and stage III and IV cancers. Conclusions Racial differences exist among MCL patients in the U.S. in terms of patients’ characteristics, incidence, and survival. More extended data collection and analysis are needed to more comprehensively describe and understand the racial differences. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-764) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Shuangge Ma
- School of Public Health, Yale University, 60 College ST, New Haven, CT 06520, USA.
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Kang BW, Sohn SK, Moon JH, Chae YS, Kim JG, Lee SJ, Kim WS, Lee JJ, Lee SR, Park KU, Lee HS, Lee WS, Won JH, Park MR, Kwak JY, Kim MK, Kim HJ, Oh SY, Kang HJ, Suh C. Clinical features and treatment outcomes in patients with mantle cell lymphoma in Korea: Study by the Consortium for Improving Survival of Lymphoma. Blood Res 2014; 49:15-21. [PMID: 24724062 PMCID: PMC3974951 DOI: 10.5045/br.2014.49.1.15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/05/2013] [Accepted: 02/19/2014] [Indexed: 12/11/2022] Open
Abstract
Background We investigated the clinical features and treatment outcomes of patients with mantle cell lymphoma (MCL) in Korea. Methods We retrospectively analyzed the clinical characteristics and prognosis of 131 patients diagnosed with MCL between January 2004 and December 2009 at 15 medical centers in Korea; all patients received at least 1 chemotherapeutic regimen for MCL. Results The median age for the patients was 63 years (range, 26-78 years), and 77.9% were men. A total of 105 patients (80.1%) had stage III or IV MCL at diagnosis. Fifty-two patients (39.7%) were categorized with high- or high-intermediate risk MCL according to the International Prognostic Index (IPI). Eighteen patients (13.7%) were in the high-risk group according to the simplified MCL-IPI (MIPI). The overall incidence of extranodal involvement was 69.5%. The overall incidence of bone marrow and gastrointestinal involvements at diagnosis was 41.2% and 35.1%, respectively. Cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab were used frequently as the first-line treatment (41.2%). With a median follow-up duration of 20.0 months (range, 0.2-77.0 months), the overall survival (OS) at 2 years was 64.7%, while the event-free survival (EFS) was 39.7%. Multivariate analysis showed that the simplified MIPI was significantly associated with OS. However, the use of a rituximab-containing regimen was not associated with OS and EFS. Conclusion Similar to results from Western countries, the current study found that simplified MIPI was an important prognostic factor in Korean patients with MCL.
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Affiliation(s)
- Byung Woog Kang
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Sang Kyun Sohn
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Joon Ho Moon
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Yee Soo Chae
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jong Gwang Kim
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Soo Jung Lee
- Department of Hematology/Oncology, Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Won Seog Kim
- Department of Hematology/Oncology, Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Je-Jung Lee
- Department of Hematology/Oncology, Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Se Ryeon Lee
- Department of Hematology/Oncology, Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Keon Uk Park
- Department of Hematology/Oncology, Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ho Sup Lee
- Department of Hematology/Oncology, Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
| | - Won Sik Lee
- Department of Hematology/Oncology, Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Jong-Ho Won
- Department of Hematology/Oncology, Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea
| | - Moo-Rim Park
- Department of Hematology/Oncology, Internal Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Jae-Yong Kwak
- Department of Hematology/Oncology, Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea
| | - Min Kyoung Kim
- Department of Hematology/Oncology, Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Hyo Jung Kim
- Department of Hematology/Oncology, Internal Medicine, Hallym University Scared Heart Hospital, Anyang, Korea
| | - Sung Yong Oh
- Department of Hematology/Oncology, Internal Medicine, Dong-A University Hospital, Busan, Korea
| | - Hye Jin Kang
- Department of Hematology/Oncology, Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea
| | - Cheolwon Suh
- Department of Hematology/Oncology, Internal Medicine, Asan Medical Center, Seoul, Korea
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Yim RLH, Kwong YL, Wong KY, Chim CS. DNA Methylation of Tumor Suppressive miRNAs in Non-Hodgkin's Lymphomas. Front Genet 2012; 3:233. [PMID: 23162567 PMCID: PMC3492703 DOI: 10.3389/fgene.2012.00233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 10/15/2012] [Indexed: 11/13/2022] Open
Abstract
DNA methylation is an epigenetic alteration leading to heritable phenotypic changes of cells with functional consequences. It is important in early embryonic development, stem cell differentiation, and tissue-specific gene expression. In normal cells, promoter-associated CpG islands (CGI) are generally unmethylated except in X-chromosome inactivation or genomic imprinting. In cancer, tumor cells are characterized by global hypomethylation but locus-specific hypermethylation of promoter-associated CGI, resulting in gene silencing. MicroRNAs (miRNAs) are short, non-coding RNA sequences of 18-25 nucleotides, which can repress the translational of multiple protein-coding mRNAs by sequence-specific binding to the 3'untranslated region. Depending on the genes targeted, miRNA can be tumor suppressive if an oncogene is repressed, or it can be oncogenic when a tumor suppressive gene is repressed. Recently, aberrant methylation of tumor suppressive miRNAs has been reported in different types of cancers including lymphomas. Herein, we review the recent literature of methylation of tumor suppressive miRNAs in different histopathologic subtypes of lymphomas, and discuss its potential diagnostic, prognostic, and therapeutic significance.
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Affiliation(s)
- Rita Lok-Hay Yim
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong Hong Kong, China
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Hon C, Chan RTT, Ma ESK, Shek TW, Yau K, Au WY. Lymphomatous proptosis as a novel feature of mantle cell lymphoma. Leuk Lymphoma 2009; 47:71-5. [PMID: 16321830 DOI: 10.1080/10428190500301058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We describe eight cases of acute proptosis due to mantle cell lymphoma (MCL), among 26 consecutive MCL cases. The median time of onset was 29 months (range 0-102) from diagnosis. Two cases presented initially with orbital masses while five as sudden disease progression after multiple courses of chemotherapy. In each case, there was dramatic loss of vision and severe proptosis, which uniformly responded to radiotherapy and/or further chemotherapy. Unilateral blindness only occurred in two cases, with recurrent orbital relapse and repeated retinal irradiation and retro-orbital optic nerve involvement, respectively. The high incidence, as well as bilateral and recurrent nature, of orbital involvement suggested a homing mechanism of MCL to this site. Despite the absence of central nervous system involvement, most cases died of refractory disease. Apart from lymphomatous polyposis of the gut, MCL cells also show predilection to ocular presentation, and must be considered as a differential diagnosis to maltoma in the two anatomical sites.
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Affiliation(s)
- Charmaine Hon
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin, Hong Kong.
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Chim CS, Wong KY, Loong F, Lam WW, Srivastava G. Frequent epigenetic inactivation of Rb1 in addition to p15 and p16 in mantle cell and follicular lymphoma. Hum Pathol 2007; 38:1849-57. [PMID: 17900658 DOI: 10.1016/j.humpath.2007.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 05/03/2007] [Accepted: 05/03/2007] [Indexed: 10/22/2022]
Abstract
Dysregulation of cell cycle control is an important mechanism in carcinogenesis. Gene promoter hypermethylation is an alternative mechanism of gene inactivation. We analyzed the methylation status of the tumor suppressor components of the INK4/Rb pathway in mantle cell lymphoma and follicular lymphoma by methylation-specific polymerase chain reaction for p15, p16, p18, and Rb1 in 23 mantle cell lymphoma and 30 follicular lymphoma cases and lymphoma cell lines. The methylation-specific polymerase chain reaction results showed that in mantle cell lymphoma, frequent p16 (82%) but infrequent p15 (8.7%) or Rb1 (17.4%) hypermethylation occurred, with p16 and Rb1 hypermethylation being mutually exclusive (P=.01). In follicular lymphoma, frequent hypermethylation of p15 (36.7%), p16 (56.7%), and Rb1 (43.3%) occurred, with p15 and Rb1 hypermethylation being mutually exclusive (P=.05). Concurrent methylation of p15 and p16 occurred in 26.7% of patients with follicular lymphoma and 8.7% of patients with mantle cell lymphoma. Compared with mantle cell lymphoma, there was more frequent p15 (P=.025) hypermethylation but comparable Rb1 (P=.07) and p16 (P=.07) hypermethylation in follicular lymphoma. In a patient with follicular lymphoma with sequential biopsies, Rb1 was unmethylated and expressed at diagnosis but became methylated and down-regulated at relapse. Moreover, methylation analysis of these 4 genes in an additional 8 patients with grade I follicular lymphoma showed that Rb, but not the other genes, was preferentially methylated in grade II (P=.03). In summary, most patients with mantle cell lymphoma and follicular lymphoma had epigenetic aberrations targeting the INK4/Rb pathway. There is more frequent p16 hypermethylation in mantle cell lymphoma and p15 or Rb1 hypermethylation in follicular lymphoma. The role of Rb methylation in disease or histologic transformation in follicular lymphoma warrants further study.
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Affiliation(s)
- C S Chim
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong.
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Salar A, Juanpere N, Bellosillo B, Domingo-Domenech E, Espinet B, Seoane A, Romagosa V, Gonzalez-Barca E, Panades A, Pedro C, Nieto M, Abella E, Solé F, Ariza A, Fernández-Sevilla A, Besses C, Serrano S. Gastrointestinal involvement in mantle cell lymphoma: a prospective clinic, endoscopic, and pathologic study. Am J Surg Pathol 2006; 30:1274-80. [PMID: 17001159 DOI: 10.1097/01.pas.0000208899.15859.cb] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The frequency of gastrointestinal (GI) tract involvement in mantle cell lymphoma (MCL) at diagnosis is reported to be below 30%. To investigate the actual frequency of GI involvement by MCL, upper and lower endoscopy was prospectively performed on 13 untreated MCL patients at diagnosis. Multiple biopsies from endoscopically normal and abnormal gastric and colonic mucosa were studied with immunohistochemistry (IHC) for CD20, CD5, and cyclin D1, as well as fluorescence in situ hybridization (FISH) for t(11;14) and polymerase chain reaction (PCR) for immunoglobulin heavy chain gene. Abnormal mucosa was identified in 38% of cases by upper endoscopy (mainly mild nonspecific gastritis) and in 54% of cases by lower endoscopy (mostly micropolyps). Histologically, infiltration by MCL was demonstrated in the stomach in 77% of cases and in the colon in 77% of cases. As a whole, 92% of patients showed upper or lower GI tract infiltration by MCL. Histologic evidence of MCL involvement was present in all cases with endoscopically abnormal mucosa, but it was also observed in two-thirds of cases with endoscopically unremarkable mucosa. Positive cyclin D1 IHC was seen in all instances displaying CD20 and CD5-positive lymphoid infiltrates, whereas t(11;14) was demonstrated by FISH in 63.5% and PCR was clonal in 64% of those instances. In conclusion, the great majority of MCL patients showed GI tract involvement at the time of diagnosis, not uncommonly in the form of minute lymphoid infiltrates. IHC for cyclin D1 was significantly more sensitive than FISH t(11;14) or PCR for immunoglobulin heavy chain gene to confirm MCL in this setting.
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Affiliation(s)
- Antonio Salar
- Department of Clinical Hematology, Hospital del Mar, Barcelona, Spain.
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Chuang SS, Huang WT, Hsieh PP, Tseng HH, Campo E, Colomer D, Ye H, Lu CL, Chang HM, Cho CY, Huang SH, Lu YC, Wu JD. Mantle cell lymphoma in Taiwan: clinicopathological and molecular study of 21 cases including one cyclin D1-negative tumor expressing cyclin D2. Pathol Int 2006; 56:440-8. [PMID: 16872438 DOI: 10.1111/j.1440-1827.2006.01986.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mantle cell lymphoma (MCL) is a rare B-cell lymphoma that has never been characterized in Taiwan. The purpose of the present paper was to retrospectively identify 21 cases in male patients, with a median age of 61, involving lymph node (91%), marrow (71%), and peripheral blood (23%). Eighteen (86%) were in stages III/IV with 1 and 5 year survival rates of 78% and 17%, respectively. Mixed nodular and diffuse pattern (45%) was most common while interstitial pattern (92%) predominated in marrow. Eighteen (86%) were of classical morphology, two were pleomorphic and one was blastic. The tumors expressed IgM and bcl-2 (100%), cyclin D1 (95%), CD5 (86%), CD43 and IgD (62%), CD52 (60%), and bcl-6 (5%). Ki-67 index>or=30% (P=0.1834) was associated with a trend toward poorer survival while p21, p27, or p53 expression was not statistically significant for survival. Real-time polymerase chain reaction for cyclin D1 (CCND1) gene mRNA expression showed high levels in nine cyclin D1-positive patients and a low level in the single cyclin D1-negative patient. The latter patient was cyclin D2 positive and negative for immunoglubuin heavy chain gene and CCND1 gene translocation by locus-specific interphase fluorescent in situ hybridization. In conclusion, it is confirmed that the usual morphological variants and aberrant immunophenotype of MCL in the West occur in Taiwan and that this disease carries a poor prognosis.
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Affiliation(s)
- Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan.
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Liu X, Tang Z. BCL-1 rearrangement in acute lymphocytic leukemia and its clinical significance. JOURNAL OF TONGJI MEDICAL UNIVERSITY = TONG JI YI KE DA XUE XUE BAO 2004; 21:283-5. [PMID: 12539548 DOI: 10.1007/bf02886557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BCL-1 rearrangement (BCL-1/IgH gene rearrangement) in acute lymphocytic leukemia and its clinical significance was investigated. In 38 patients with acute lymphocytic leukemia (ALL), the genomic DNA of mononuclear cells isolated from peripheral blood and bone marrow was amplified by using hemi-nested polymerase chain reaction (PCR) technique and the expression of cyclin D1 protein of mononuclear cells was detected by using immunohistochemical method. Ten patients with acute granulocytic leukemia, 2 with chronic granulocytic leukemia and 10 with normal bone marrow served as control group. The results showed that BCL-1 rearrangement was detectable in 3 of 38 ALL patients (7.9%) and cyclin D1 protein positive expression was detected in 4 ALL patients (10.5%). Three ALL patients with BCL-1 rearrangement were all B-cell leukemia (B-ALL) and accompanied by cyclin D1 protein expression. No BCL-1/IgH rearrangement or cyclin D1 protein expression was detected in 12 patients with granulocytic leukemia and 10 cases of normal bone marrow. Leukocyte counts in peripheral blood of B-ALL patients with BCL-1 rearrangement and (or) cyclin D1 protein expression were significantly increased and the patients had bad reaction to chemotherapy. It was concluded that: 1) BCL-1/IgH gene rearrangement were detected in acute B lymphocytic leukemia; 2) B-ALL patients with BCL-1 rearrangement and (or) cyclin D1 protein expression had poor prognosis.
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Affiliation(s)
- X Liu
- Institute of Hematology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022
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Affiliation(s)
- Chor Sang Chim
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
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Chim CS, Loong F, Yau T, Ooi GC, Liang R. Common Malignancies With Uncommon Sites of Presentation. J Clin Oncol 2003; 21:4456-8. [PMID: 14645437 DOI: 10.1200/jco.2003.03.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C S Chim
- University Departments of Medicine, Pathology, and Radiology, Queen Mary Hospital, University of Hong Kong, Hong Kong
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Chim CS, Shek TWH, Chung LP, Liang R. Unusual abdominal tumors: case 3. Multiple lymphomatous polyposis in lymphoma of colon. J Clin Oncol 2003; 21:953-5. [PMID: 12610202 DOI: 10.1200/jco.2003.02.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- C S Chim
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, People's Republic of China
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Romaguera JE, Medeiros LJ, Hagemeister FB, Fayad LE, Rodriguez MA, Pro B, Younes A, McLaughlin P, Goy A, Sarris AH, Dang NH, Samaniego F, Brown HM, Gagneja HK, Cabanillas F. Frequency of gastrointestinal involvement and its clinical significance in mantle cell lymphoma. Cancer 2003; 97:586-91. [PMID: 12548600 DOI: 10.1002/cncr.11096] [Citation(s) in RCA: 161] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The reported frequency of gastrointestinal (GI) tract involvement in patients with mantle cell lymphoma (MCL) is 15-30%. However, this figure most likely is an underestimate because most patients with MCL involving the GI tract previously reported were examined endoscopically only if they had GI tract symptoms. The impact of endoscopic assessment on the management of MCL patients is unknown. METHODS From March 1998 to May 2001 baseline upper and lower endoscopy of the GI tract was performed in consecutive untreated patients with MCL as part of a prospective therapeutic trial. Biopsies were performed on abnormal as well as macroscopically normal mucosa. Endoscopy was repeated during treatment and as part of follow-up evaluations. RESULTS Only 26% of patients presented with GI symptoms at the time of diagnosis. MCL was present histologically in the lower GI tract of 53 of 60 patient (88%) and in the upper GI tract of 28 of 58 patients (43%). Microscopic evidence of MCL was found in 84% of patients with normal visual (macroscopic) findings by lower endoscopy and in 45% of patients with macroscopically normal findings by upper endoscopy. Despite this high frequency of GI tract involvement, the use of upper and lower endoscopy with biopsies in this group of patients resulted in changes in clinical management in only three (4%) patients. CONCLUSIONS Gastrointestinal tract involvement was found to be present in most patients with MCL, usually at a microscopic level involving macroscopically normal mucosa. The use of aggressive staging evaluation of the GI tract was found to have little impact on patient management decisions in the current study.
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Affiliation(s)
- Jorge E Romaguera
- Department of Lymphoma/Myeloma, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
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Chim CS, Choy C, Ooi GC, Liang R. Primary low-grade lymphomas of the intestine. Case 2: primary follicular lymphoma of the colon. J Clin Oncol 1999; 17:3684-8. [PMID: 10550168 DOI: 10.1200/jco.1999.17.11.3684] [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: 11/20/2022] Open
Affiliation(s)
- C S Chim
- University Departments of Medicine, Pathology, and Radiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong
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