1
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Ajayi T, Hosseinian S, Schaefer AJ, Fuller CD. Combination Chemotherapy Optimization with Discrete Dosing. INFORMS JOURNAL ON COMPUTING 2024; 36:434-455. [PMID: 38883557 PMCID: PMC11178284 DOI: 10.1287/ijoc.2022.0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Chemotherapy drug administration is a complex problem that often requires expensive clinical trials to evaluate potential regimens; one way to alleviate this burden and better inform future trials is to build reliable models for drug administration. This paper presents a mixed-integer program for combination chemotherapy (utilization of multiple drugs) optimization that incorporates various important operational constraints and, besides dose and concentration limits, controls treatment toxicity based on its effect on the count of white blood cells. To address the uncertainty of tumor heterogeneity, we also propose chance constraints that guarantee reaching an operable tumor size with a high probability in a neoadjuvant setting. We present analytical results pertinent to the accuracy of the model in representing biological processes of chemotherapy and establish its potential for clinical applications through a numerical study of breast cancer.
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Affiliation(s)
| | | | - Andrew J. Schaefer
- Department of Computational Applied Mathematics and Operations Research, Rice University, Houston, Texas 77005
| | - Clifton D. Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
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2
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Weiss J, Reneau J, Wilcox RA. PTCL, NOS: An update on classification, risk-stratification, and treatment. Front Oncol 2023; 13:1101441. [PMID: 36845711 PMCID: PMC9947853 DOI: 10.3389/fonc.2023.1101441] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
The peripheral T-cell lymphomas (PTCL) are relatively rare, heterogeneous, and therapeutically challenging. While significant therapeutic gains and improved understanding of disease pathogenesis have been realized for selected PTCL subtypes, the most common PTCL in North America remains "not otherwise specified (NOS)" and is an unmet need. However, improved understanding of the genetic landscape and ontogeny for the PTCL subtypes currently classified as PTCL, NOS have been realized, and have significant therapeutic implications, which will be reviewed here.
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Affiliation(s)
- Jonathan Weiss
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, United States
| | - John Reneau
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States
| | - Ryan A. Wilcox
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, United States
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3
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Li C, Zhang W, Zhao D, Yang P, Wan W, Liu S, Jing H. Development of a new risk scoring system based on spleen involvement and the lymphocyte/monocyte ratio for follicular lymphoma patients. Leuk Res 2022; 123:106980. [DOI: 10.1016/j.leukres.2022.106980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/15/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
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4
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Mozhgani SH, Zarei Ghobadi M, Norouzi M, Rahimi H, Valizadeh N, Teymoori-Rad M, Tarokhian H, Ostadali M, Farajifard H, Rezaee SA. Signaling factors potentially associated to the pathogenesis of Adult T-cell leukemia /lymphoma: A network-analysis and novel findings assessment. Virus Res 2022; 319:198875. [PMID: 35868352 DOI: 10.1016/j.virusres.2022.198875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/19/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022]
Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a human T-cell leukemia virus (HTLV) type 1-associated disease of TCD4+ cell transformation. Despite extensive studies on ATLL development and progression, the fundamental processes of HTLV-1 oncogenicity are yet to be understood. This study aimed to integrate high-throughput microarray datasets to find novel genes involved in the mechanism of ATLL progression. For this purpose, five microarray datasets were downloaded from the Gene Expression Omnibus database and then profoundly analyzed. Differentially expressed genes and miRNAs were determined using the MetaDE package in the R software and the GEO2R web tool. The STRING database was utilized to construct the protein-protein interaction network and explore hub genes. Gene ontology and pathway enrichment analysis were carried out by employing the EnrichR web tool. Furthermore, flow cytometry was employed to assess the CD4/CD8 ratio, and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to confirm the high-throughput data analysis results. Four miRNAs, including hsa-mir-146, hsa-mir-451, hsa-mir-31, and hsa-mir-125, were among the statistically significant differentially expressed miRNAs between healthy individuals and ATLL patients. Moreover, 924 differentially expressed genes were identified between normal and ATLL samples. Further network analysis highlighted 59 hub genes mainly regulating pathways implicated in viral interferences, immunological processes, cancer, and apoptosis pathways. Among the identified hub genes, RhoA and PRKACB were most considerable in the high-throughput analysis and were further validated by qRT-PCR. The RhoA and PRKACB expression were significantly down-regulated in ATLL patients compared to asymptomatic carriers (p<0.0001 and p=0.004) and healthy subjects (p=0.043 and p=0.002). Therefore, these corresponding miRNAs and proteins could be targeted for diagnosis purposes and designing effective treatments.
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Affiliation(s)
- Sayed-Hamidreza Mozhgani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohadeseh Zarei Ghobadi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Norouzi
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Rahimi
- Hematology and Oncology Ward, Internal Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Valizadeh
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Teymoori-Rad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh Tarokhian
- Department of Immunology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammadreza Ostadali
- Hematology-Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Farajifard
- Pediatric cell and gene therapy research center, Tehran university of medical sciences, Tehran, Iran
| | - Seyed Abdolrahim Rezaee
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran.
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5
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Zhang Y, Shi Y, Shen H, Shou L, Fang Q, Zheng X, Zhu M, Huang X, Huang J, Li L, Zhou D, Zhu L, Zhu J, Ye X, Jin J, Xie W. The value of a new prognostic model developed by lymphocyte-monocyte ratio and platelet-monocyte ratio in peripheral T-cell lymphoma. Cancer Cell Int 2021; 21:573. [PMID: 34715862 PMCID: PMC8555175 DOI: 10.1186/s12935-021-02275-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
Peripheral T-cell lymphoma(PTCL) is a group of lymphoproliferative tumors originated from post-thymic T cells or mature natural killer (NK) cells. It shows highly aggressive clinical behaviour, resistance to conventional chemotherapy, and a poor prognosis. Although a few prognostic models of PTCL have been established in retrospective studies, some high-risk patients still can not be screened out. Therefor we retrospectively studied 347 newly diagnosed PTCL patients and assessed the prognostic role of lymphocyte-monocyte ratio (LMR) and platelet-monocyte ratio (PMR) in the complete response (CR) and survival of PTCL patients. Patients with LMR ≤ 1.68 and PMR ≤ 300 achieved a lower CR rate and a poor survival. In multivariate analysis, LMR ≤ 1.68 (HR = 1.751, 95% CI 1.158-2.647, p < 0.05) and PMR ≤ 300 (HR = 1.762, 95% CI 1.201-2.586, p < 0.05) were independently associated with short survival. On this basis, a new prognostic model of PTCL was established to screen out high-risk patients. In our "Peripheral Blood Score (PBS)" model, three groups were identified at low risk (178 patients, 51.3%, score 0), intermediate risk (85 patients, 24.5%, score 1), and high risk (84 patients, 24.2%, score 2), having a 1-year OS of 86%, 55.3% and 22.6% (p < 0.05), and a 3-year OS of 43.4%, 20% and 13.1% (p < 0.05), respectively. Optimal strategies for identifying high-risk patients with PTCL are urgently needed. Our new PBS model is simple, inexpensive and widely available to screen out the high risk patients.
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Affiliation(s)
- Yan Zhang
- Department of Hematology, College of Medicine, Affiliated Huzhou Hospital, Zhejiang University, No. 1558 North Third Ring Road, Huzhou, 313000, Zhejiang, China.,Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Yuanfei Shi
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Huafei Shen
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Lihong Shou
- Department of Hematology, College of Medicine, Affiliated Huzhou Hospital, Zhejiang University, No. 1558 North Third Ring Road, Huzhou, 313000, Zhejiang, China
| | - Qiu Fang
- Department of Hematology, College of Medicine, Affiliated Huzhou Hospital, Zhejiang University, No. 1558 North Third Ring Road, Huzhou, 313000, Zhejiang, China
| | - Xiaolong Zheng
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Mingyu Zhu
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Xin Huang
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.,Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, 310003, Zhejiang, China
| | - Jiansong Huang
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.,Key Laboratory of Hematologic Malignancies, Diagnosis and Treatment, Hangzhou, 310003, Zhejiang, China
| | - Li Li
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - De Zhou
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Lixia Zhu
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Jingjing Zhu
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Xiujin Ye
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Jie Jin
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Wanzhuo Xie
- Department of Hematology, College of Medicine, the First Affiliated Hospital, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
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6
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Guo Z, Zhang Z, Prajapati M, Li Y. Lymphopenia Caused by Virus Infections and the Mechanisms Beyond. Viruses 2021; 13:v13091876. [PMID: 34578457 PMCID: PMC8473169 DOI: 10.3390/v13091876] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 02/07/2023] Open
Abstract
Viral infections can give rise to a systemic decrease in the total number of lymphocytes in the blood, referred to as lymphopenia. Lymphopenia may affect the host adaptive immune responses and impact the clinical course of acute viral infections. Detailed knowledge on how viruses induce lymphopenia would provide valuable information into the pathogenesis of viral infections and potential therapeutic targeting. In this review, the current progress of viruses-induced lymphopenia is summarized and the potential mechanisms and factors involved are discussed.
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Affiliation(s)
- Zijing Guo
- State Key Laboratory on Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou 730030, China;
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu 610041, China; (Z.Z.); (M.P.)
| | - Zhidong Zhang
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu 610041, China; (Z.Z.); (M.P.)
| | - Meera Prajapati
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu 610041, China; (Z.Z.); (M.P.)
- National Animal Health Research Centre, Nepal Agricultural Research Council, Lalitpur 44700, Nepal
| | - Yanmin Li
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu 610041, China; (Z.Z.); (M.P.)
- Correspondence: ; Tel.: +28-85528276
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7
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Junlén HR, Lockmer S, Kimby E, Wahlin BE. Absolute B cell counts in blood predict long-term response in follicular lymphoma patients treated with rituximab without chemotherapy. Ann Hematol 2020; 99:2357-2366. [PMID: 32808106 PMCID: PMC7481163 DOI: 10.1007/s00277-020-04208-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Rituximab monotherapy is widely used for follicular lymphoma. However, there are no established predictors for response or response duration. We analyzed the long-term prognostic relevance of pre-treatment absolute blood counts of lymphocytes with subsets and monocytes in 265 follicular lymphoma patients, uniformly treated with rituximab without chemotherapy, in two Nordic Lymphoma Group trials. There were 265 previously untreated, stage II–IV follicular lymphoma patients with a median follow-up of over 10 years. Absolute B cell counts ≥ median (0.09 × 109/L) were an independent predictor for shorter time to next treatment or death (multivariable analysis P = 0.010). In univariate analysis, absolute monocyte counts ≥ median (0.5 × 109/L) did not correlate with time to next treatment or death, but with inferior overall survival (P = 0.034). Absolute T cell or T cell subset counts were not predictive for outcome. High absolute B cell counts, possibly reflecting circulating lymphoma cells, have an unfavorable impact on time to next treatment or death in patients treated with rituximab without chemotherapy.
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Affiliation(s)
- Henna-Riikka Junlén
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Lockmer
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Kimby
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden. .,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden.
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8
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Zhao Y, Shi Y, Shen H, Zhou D, Li L, Zhu J, Yang X, Zheng Y, Zhu L, Ye X, Xie W. The prognostic value of platelet-lymphocyte ratio and neutrophil-lymphocyte ratio in the treatment response and survival of patients with peripheral T-cell lymphoma. Leuk Lymphoma 2019; 61:623-630. [PMID: 31809624 DOI: 10.1080/10428194.2019.1700244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Peripheral T-cell lymphoma (PTCL) is a rare and highly heterogeneous non-Hodgkin lymphoma (NHL). Although a few prognostic models have been put forward to predict the prognosis of PTCL, some patients with poor prognosis remain unidentified. Therefore, we conducted a retrospective study of 213 adult PTCL patients and assessed the prognostic role of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in the complete response (CR) and survival of PTCL patients. Patients with PLR ≥ 232.5 achieved a lower CR rate than patients with PLR < 232.5 (18.5% vs. 56.6%, p < .001). Moreover, there was a statistical significance in CR rate between patients with NLR ≥ 3.7 and < 3.7 (31.7% vs. 60.7%, p < .001). The univariable analysis indicated that both PLR and NLR were related with worse OS. However, only PLR remained an independent prognostic indicator of OS (p = .002) by multivariable analysis.
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Affiliation(s)
- Yanchun Zhao
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Yuanfei Shi
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Huafei Shen
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - De Zhou
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Li Li
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Jingjing Zhu
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Xiudi Yang
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Yanlong Zheng
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Lixia Zhu
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Xiujin Ye
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
| | - Wanzhuo Xie
- Senior Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China
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9
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Jiang T, Wang L, Zhao WL. Use of Complete Blood Count for Prognostic Evaluation of Peripheral T-Cell Lymphoma. Acta Haematol 2019; 143:93-95. [PMID: 31401623 DOI: 10.1159/000501353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/05/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Tao Jiang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Hematology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Li Wang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Li Zhao
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
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10
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Ménétrier-Caux C, Ray-Coquard I, Blay JY, Caux C. Lymphopenia in Cancer Patients and its Effects on Response to Immunotherapy: an opportunity for combination with Cytokines? J Immunother Cancer 2019; 7:85. [PMID: 30922400 PMCID: PMC6437964 DOI: 10.1186/s40425-019-0549-5] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/27/2019] [Indexed: 12/12/2022] Open
Abstract
Quantitative lymphocyte alterations are frequent in patients with cancer, and strongly impact prognosis and survival. The development of cancers in immunosuppressed patients has demonstrated the contribution of different T cell populations, including CD4+ cells, in the control of cancer occurrence.Whereas absolute numbers of neutrophils, platelets and red blood cells are routinely monitored in clinic following treatments, because of possible short-term complications, absolute lymphocyte counts (ALC), their subpopulations or diversity (phenotype, TCR) are rarely analyzed and never used to choose therapy or as prognostic criteria. The recent identification of immune checkpoint inhibitors (ICPi) as powerful therapeutic agents has revitalized immunotherapy of cancer in a broader group of diseases than anticipated. The status of the immune system is now recognized as an important biomarker for response to these novel treatments. Blood ALC values, along with tumor infiltration by CD8+T cells, and ICPi and ICPi-ligand expression, are likely to be a potential marker of sensitivity to anti-ICPi therapy.In this article, we review the current knowledge on the incidence and significance of lymphopenia in cancer patients, and discuss therapeutic strategies to restore lymphocyte numbers.
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Affiliation(s)
- Christine Ménétrier-Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France. .,Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Centre Léon Bérard, F-69008, Lyon, France.
| | | | - Jean-Yves Blay
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France.,Medical Oncology department, Centre Léon Bérard, F-69008, Lyon, France
| | - Christophe Caux
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Cancer Research Center of Lyon (CRCL), Centre Léon Bérard, F-69008, Lyon, France.,Innovation in Immuno-monitoring and Immunotherapy Platform (PI3), Centre Léon Bérard, F-69008, Lyon, France
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11
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Zhong H, Chen J, Cheng S, Chen S, Shen R, Shi Q, Xu P, Huang H, Zhang M, Wang L, Wu D, Zhao W. Prognostic nomogram incorporating inflammatory cytokines for overall survival in patients with aggressive non-Hodgkin's lymphoma. EBioMedicine 2019; 41:167-174. [PMID: 30827933 PMCID: PMC6443577 DOI: 10.1016/j.ebiom.2019.02.048] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/13/2019] [Accepted: 02/20/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association of pre-treatment inflammatory status with survival time and to develop a prognostic nomogram incorporating inflammatory cytokines in non-Hodgkin's lymphoma. METHODS A total of 228 patients with diffuse large B-cell lymphoma (DLBCL) received R-CHOP-based regimens from a prospective randomized study (NCT01852435) were included as a training cohort. Other cohorts of 886 lymphoma patients were served as validation cohorts. Lymphocyte-monocyte ratio (LMR), serum levels of soluble interleukin s(IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor-α (TNF-α), were assessed before treatment. Least absolute shrinkage and selection operator (LASSO) regression were used to select variables for nomogram of overall survival (OS). The predictive accuracy of the nomogram was determined by concordance index (C-index). FINDINGS The nomogram included lactate dehydrogenase (LDH), sIL-2R, TNF-α and decreased LMR. The C-index of the nomogram for OS prediction were range from 0.61 to 0.86 for training cohort of DLBCL and validation cohorts of DLBCL, PTCL, NKTCL and ASCT, which were superior to the predictive power of International Prognostic Index (IPI, 0.67 to 0.84) or NCCN-IPI (0.59 to 0.78), but not in those of indolent lymphoma like FL and MALT. INTERPRETATIONS The nomogram incorporating inflammatory cytokines provides a useful tool for risk stratification in aggressive non-Hodgkin's lymphomas. FUND: National Natural Science Foundation of China, the Shanghai Commission of Science and Technology, Multicenter Clinical Research Project by Shanghai Jiao Tong University School of Medicine, Clinical Research Plan of SHDC, and Chang Jiang Scholars Program.
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Affiliation(s)
- Huijuan Zhong
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Jia Chen
- Jiangsu Institute of Hematology, Institute of Blood and Marrow Transplantation, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Shu Cheng
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Suning Chen
- Jiangsu Institute of Hematology, Institute of Blood and Marrow Transplantation, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Rong Shen
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Qing Shi
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Pengpeng Xu
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Hengye Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, China
| | - Muchen Zhang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China
| | - Li Wang
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China; Pôle de Recherches Sino-Français en Science du Vivant et Génomique, Laboratory of Molecular Pathology, Shanghai, China
| | - Depei Wu
- Jiangsu Institute of Hematology, Institute of Blood and Marrow Transplantation, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
| | - Weili Zhao
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Er Road, Shanghai, China; Pôle de Recherches Sino-Français en Science du Vivant et Génomique, Laboratory of Molecular Pathology, Shanghai, China.
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12
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Choi M, Lee JO, Jung J, Lee JY, Lee E, Lee H, Bang SM, Eom HS, Lee JS. Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma. Acta Haematol 2019; 141:176-186. [PMID: 30814469 DOI: 10.1159/000495337] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 11/08/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Peripheral T cell lymphoma (PTCL) is a heterogeneous entity with poor survival. We evaluated the neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC), and platelet count as new prognostic factors for PTCL. PATIENTS AND METHODS We retrospectively analyzed 77 patients with PTCL initially treated with anthracycline-based chemotherapy. Survival curves were compared between groups with different initial NLR (iNLR), end-point NLR (eNLR), initial ALC, and platelet counts. Cox regression was used to analyze the risk factor for survival. RESULTS Patients with a higher eNLR (≥3), lymphopenia (< 1,000/μL), and thrombocytopenia (< 150 K/μL) had an inferior progression-free survival (PFS) and overall survival (OS) compared to their counterparts, while a higher iNLR (≥3) was predictive of a shorter OS but not PFS. Among these, thrombocytopenia was an independent poor prognostic factor for both PFS and OS, with a hazard ratio of 2.42 (p = 0.012) for PFS and 4.21 (p = 0.006) for OS. The presence of thrombocytopenia further stratified patients with a worse prognosis within overlapping risk-groups by the prognostic index for PTCL. CONCLUSIONS Our study showed that thrombocytopenia at diagnosis was an independent prognostic factor for survival in patients with PTCL.
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Affiliation(s)
- Mihong Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea,
| | - Jongheon Jung
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Ji Yun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunyoung Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Hyewon Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Soo-Mee Bang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Seok Eom
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Jong Seok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Niu JY, Zhu HY, Wang L, Fan L, Liang JH, Cao L, Wu W, Xia Y, Wu JZ, Li JY, Xu W. [Prognostic value of lymphocyte-to-monocyte ratio in angioimmunoblastic T cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 39:265-270. [PMID: 29779318 PMCID: PMC7342139 DOI: 10.3760/cma.j.issn.0253-2727.2018.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
目的 探究淋巴细胞/单核细胞比值(LMR)在血管免疫母细胞性T细胞淋巴瘤(AITL)患者中的预后价值。 方法 回顾性分析2009年6月至2017年7月南京医科大学第一附属医院收治的64例初诊AITL患者资料。采用ROC曲线计算LMR临界值,并以此将患者分为高LMR和低LMR组,采用Pearson卡方检验及Fisher精确概率法进行组间比较。采用Kaplan-Meier法和Cox回归分析影响无进展生存(PFS)和总生存(OS)的预后因素。 结果 64例患者中,男39例,女25例,中位年龄63(29~89)岁。LMR临界值为3.07。中位随访33(5~103)个月,低LMR与高LMR组比较,患者的PFS时间(9对13个月,P=0.044)和OS时间(16个月对未达到,P=0.014)差异均有统计学意义。多因素分析显示低LMR是影响患者PFS(HR=0.48, 95% CI 0.26~0.92,P=0.027)和OS(HR=0.38,95% CI 0.18~0.82,P=0.013)的独立预后不良因素。亚组分析结果显示,在中高危至高危[非特指型预后指数(PIT)评分2~4分]患者中,低LMR者有更短的PFS和OS时间(P值分别为0.013、0.031),而在低危至中低危(PIT评分0~1分)患者中其差异均无统计学意义(P值分别为0.949、0.238)。 结论 可根据PIT评分及LMR的状态初步评估患者的疾病风险。低LMR提示患者具有更差的预后。
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Affiliation(s)
- J Y Niu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
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Utility of PET-CT for Evaluation of Patients With Peripheral T-cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:687-691. [PMID: 30017596 DOI: 10.1016/j.clml.2018.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/19/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Fluorine-18 fluorodeoxyglucose (FDG) avidity varies in peripheral T-cell lymphoma (PTCL). We evaluated FDG avidity of pretreatment positron emission tomography/computed tomography (P-PET/CT), to appraise the prognostic significance of interim PET/CT (I-PET/CT) and end of treatment PET/CT (E-PET/CT) in PTCL. PATIENTS AND METHODS We performed a retrospective cohort study of patients with newly diagnosed or relapsed PTCL who had received any chemotherapy regimen from 2008 to 2015 in a tertiary center. P-PET/CT, I-PET/CT, and E-PET/CT studies were centrally reviewed. The primary outcomes were the prognostic role of I-PET/CT and E-PET/CT on progression-free survival (PFS) and overall survival (OS). The secondary outcomes were P-PET/CT avidity, the prognostic role of other baseline characteristics, and the correlation between the PET/CT and bone marrow biopsy findings. RESULTS We included 40 patients in the present analysis. The median OS and PFS for the whole cohort was 39 and 16 months, respectively. Of the 40 patients, 36 had positive P-PET/CT findings. A total of 23 patients underwent I-PET/CT, with positive findings for 10. Of the 40 patients, 34 underwent E-PET/CT, 26 of which had positive findings. The sensitivity, specificity, and negative predictive value of P-PET/CT for bone marrow involvement was 40%, 83%, and 89%, respectively. The factors significantly associated with PFS and OS on univariate analysis included elevated lactate dehydrogenase, and low lymphocyte, hemoglobin, and albumin levels. On multivariate analysis, only lymphopenia remained prognostic for PFS and OS. The E-PET/CT and I-PET/CT results were not prognostic for PFS or OS. CONCLUSION Our study has shown that 90% of PTCL cases will be FDG avid. However, PET/CT was not predictive for PFS or OS at any point. The only predictive factor was the presence of lymphopenia.
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The impact of the neutrophil:lymphocyte ratio in response and survival of patients with de novo diffuse large B-cell lymphoma. Leuk Res 2018; 67:82-85. [DOI: 10.1016/j.leukres.2018.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/09/2018] [Accepted: 02/13/2018] [Indexed: 12/15/2022]
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A new prognostic score comprising lactate dehydrogenase, albumin and neutrophil to lymphocyte ratio to predict sensitivity to first-line chemotherapy in patients with peripheral T-cell lymphomas. Int J Hematol 2017; 107:451-459. [PMID: 29103138 DOI: 10.1007/s12185-017-2362-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 12/18/2022]
Abstract
No standard therapy for peripheral T-cell lymphomas (PTCLs) has been established, and treatment outcomes are poor. Upfront stem cell transplantation has been investigated in several studies, some of which have reported promising outcomes. However, some patients maintain long-term remission after chemotherapy alone. It is thus important to predict sensitivity to first-line chemotherapy to optimize treatment strategies. In the present study, we retrospectively analyzed time to treatment failure (TTF) of first-line chemotherapy in 59 patients with PTCLs. On multivariate analysis for TTF, elevated lactate dehydrogenase level, hypoalbuminemia, and high neutrophil-to-lymphocyte ratio were significant prognostic factors. Using these three factors, we also developed a new model that effectively distinguished patient outcomes. The TTF rate at 1 year from diagnosis was 71.4% in patients with score 0 (0 factor), 31.8% with score 1 (1 factor) and 4.5% with score 2 (2-3 factors) (P < 0.001). The prognostic power was superior to that of the Prognostic Index for PTCL-unspecified score. Patients with scores of 1 and 2 had poor TTF, and may be candidates for upfront stem cell transplantation if they respond to first-line chemotherapy. Further investigation in a larger cohort is warranted to determine the general applicability of this score.
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Li N, Zhang L, Song HL, Zhang J, Weng HW, Zou LQ. Prognostic impact of absolute lymphocyte count/absolute monocyte count ratio and prognostic score in patients with nasal-type, extranodal natural killer/T-cell lymphoma. Tumour Biol 2017; 39:1010428317705503. [PMID: 28475009 DOI: 10.1177/1010428317705503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Nasal-type, extranodal natural killer/T-cell lymphoma is a heterogeneous disorder with poor prognosis, requiring risk stratification in this population. The combined value of baseline absolute lymphocyte count and absolute monocyte count provided prognostic information in some malignancies. However, the evidence requires validation in extranodal natural killer/T-cell lymphoma. Aiming to investigate the prognostic significance of absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score for extranodal natural killer/T-cell lymphoma, a retrospective research was carried out. A total of 264 patients with newly diagnosed extranodal natural killer/T-cell lymphoma were analyzed in this study. The patients' absolute lymphocyte count and absolute monocyte count tested at initial diagnosis were collected. Receiver operating curve analysis showed that the optimal cut-off values for absolute lymphocyte count and absolute monocyte count were 1.0 × 109 and 0.5 × 109L-1, respectively, and for absolute lymphocyte count/absolute monocyte count ratio was 2.85. After a median follow-up of 27 months (range 1-87 months), the 3-year overall survival and progression-free survival was 75.4% and 67.6%, respectively. Patients with absolute lymphocyte count/absolute monocyte count ratio ≥ 2.85 had better 3-year overall survival and progression-free survival than those with absolute lymphocyte count/absolute monocyte count ratio <2.85 (p < 0.001). According to absolute lymphocyte count/absolute monocyte count prognostic score, significant difference has been noticed in 3-year overall survival and progression-free survival (p < 0.001) and high absolute lymphocyte count/absolute monocyte count prognostic score was associated with poorer survival. The International Prognostic Index and Korean Prognostic Index were used for prognosis and showed no significant difference. When adding absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score to the International Prognostic Index and Korean Prognostic Index model, additional prognostic information was found. These results suggest that absolute lymphocyte count/absolute monocyte count ratio and absolute lymphocyte count/absolute monocyte count prognostic score might be useful prognostic factors in extranodal natural killer/T-cell lymphoma.
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Affiliation(s)
- Na Li
- 1 Department of Medical Oncology of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- 1 Department of Medical Oncology of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Hao-Lan Song
- 2 Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhang
- 1 Department of Medical Oncology of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Hua-Wei Weng
- 1 Department of Medical Oncology of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Li-Qun Zou
- 1 Department of Medical Oncology of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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Yang H, Fu G, Liu J, Da Z, Cheng X, Chen C, Li Y, Fu B, Li X. Clinical analysis of 42 cases of EBV-positive mature T/NK-cell neoplasms. Exp Ther Med 2017; 14:567-574. [PMID: 28672968 PMCID: PMC5488386 DOI: 10.3892/etm.2017.4531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/31/2017] [Indexed: 12/22/2022] Open
Abstract
The pathogenesis of Epstein-Barr virus-positive (EBV+) mature T-cell and natural killer (NK)-cell neoplasms is challenging to understand. The clinical features are diverse, with no typical manifestation. Therefore, it is important to analyze the association of the clinical characteristics and prognoses of patients with various factors associated with EBV+ T/NK-cell neoplasms, particularly extranodal NK/T cell lymphoma, systemic EBV+ T/NK cell lymphoproliferative disorders, aggressive NK cell leukemia and EBV+ peripheral T-cell lymphoma. Therefore, 42 cases of EBV+ T/NK-cell neoplasms with information on age, gender, fever, LDH level, complete blood count (CBC) and immunophenotype (CD5/CD20) were retrospectively analyzed to examine the clinical features, prognoses and related factors. It was found that patients ≤60 years old accounted for 86% of cases. The frequency of stage III/IV disease was higher in groups with pancytopenia (P=0.005), high LDH level (P=0.020), CD5-expression status (P=0.031) and fever (P=0.024). There were significant differences in the mean International Prognostic Index (IPI) scores according to the presence or absence of fever (P=0.022), elevated or normal lactose dehydrogenase (LDH) levels (P=0.001), and pancytopenia or normal complete blood count (CBC; P=0.046). Analysis of overall survival showed that CD5 expression, CBC, IPI scores and LDH levels were factors associated with OS. CD5 expression (P=0.003), CBC (P=0.003) and IPI scores (P=0.017) were identified to be important risk factors on the basis of Cox regression analysis. The mean survival time was longer in the CD5+, CD20+ and normal CBC groups, and there was no clear difference in survival time according to LDH level or fever. In summary, CD5 and CD20 may be prognostic factors in EBV+ T/NK lymphoid neoplasms, and CBC and fever are most likely to influence the IPI score and Ann Arbor stage.
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Affiliation(s)
- Haiyan Yang
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Gan Fu
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Jia Liu
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Zhenzhen Da
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Xiaoye Cheng
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Cong Chen
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Yan Li
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Bin Fu
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Xiaolin Li
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
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Bellei M, Nabhan C, Pesce EA, Conte L, Vose JM, Foss F, Federico M. The Value and Relevance of the T Cell Lymphoma Registries and International Collaborations: the Case of COMPLETE and the T-Cell Project. Curr Hematol Malig Rep 2016; 10:448-55. [PMID: 26449717 DOI: 10.1007/s11899-015-0291-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Peripheral T cell lymphomas (PTCLs) are a heterogeneous group of lymphoid malignancies that portend a poor prognosis and have an undefined optimal therapeutic strategy. Data on best practices stem from prior studies that have generally included B cell lymphomas. However, the enhanced ability to diagnose PTCLs, the development of newer agents specific for PTCLs, and its increased incidence have called the scientific community to develop better strategies to combat these neoplasms. To that end, T cell lymphoma registries were developed in an attempt to answer relevant questions on the prognosis and management of PTCLs. The largest registries currently enrolling patients are the Comprehesive Oncology Measures for PeripheraL T-cEll Lymphoma TrEatment (COMPLETE) and the T-Cell Project. Despite the inherent limitations of these studies, valuable information are being collected to refine our management approaches and to aid in designing future clinical trials. This review illustrates the value of these registries and describes the critical questions that need to be answered.
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Affiliation(s)
- Monica Bellei
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Centro Oncologico Modenese, Via del Pozzo 71, 41124, Modena, MO, Italy.
| | - Chadi Nabhan
- Section of Hematology and Oncology, Medical Director, Clinical Outpatient Cancer Center, The University of Chicago, 5841 South Maryland Ave MC2115, Chicago, IL, 60637, USA.
| | - Emanuela Anna Pesce
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Centro Oncologico Modenese, Via del Pozzo 71, 41124, Modena, MO, Italy.
| | - Luana Conte
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), University of Salento at the Hospital "V. FAZZI", Piazza F. Muratore n.1, Palazzina Direzione Amministrativa, I Piano DReAM, 73100, Lecce, LE, Italy.
| | - Julie M Vose
- Division of Hematology/Oncology, University of Nebraska Medical Center
- , Omaha, NE, 68198-7680, USA.
| | - Francine Foss
- Yale Medical Oncology, Smilow Cancer Hospital at Yale-New Haven, South Frontage Road and Park Street, 7th Floor Multispecialty Care Center, New Haven, CT, 0651, USA.
| | - Massimo Federico
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Centro Oncologico Modenese, Via del Pozzo 71, 41124, Modena, MO, Italy.
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Kawasaki T, Wasano K, Suzuki N, Yamamoto S, Ogawa K. [Usefulness of Clinicobiological Data Obtained Prior to Cervical Lymph Node Biopsy]. ACTA ACUST UNITED AC 2015; 118:206-12. [PMID: 26349336 DOI: 10.3950/jibiinkoka.118.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION We commonly use data obtained prior to cervical lymph node biopsy for the diagnosis of malignant lymphoma. Based on such data, we can confirm whether a biopsy should be performed in some cases. Currently, the parameters used to indicate a presurgery examination prior to biopsy have been very few. So, we retrospectively analyzed cases of cervical lymph node biopsy. Moreover, we examined the usefulness of clinicobiological data obtained prior to cervical lymph node biopsy to evaluate various factors related to the diagnosis of malignant lymphoma. METHODS This study included 77 patients for whom the initial diagnostic impression was malignant lymphoma before surgery. Of the 77 cases, 40 were diagnosed as having malignant lymphoma and 37 were diagnosed as having non-malignant lymphoma. We performed a case-controlled study to evaluate the differences in clinicobiological data between malignant and non-malignant lymphoma in terms of the following parameters: (1) age, (2) sex, (3) number of white blood cells, (4) white blood cell lymphocyte count, (5) percentage of white blood cell lymphocytes, (6) percentage of eosinophils (%), (7) percentage of monocytes (%), (8) atypical lymphocytes (%), (9) hemoglobin level, (10) lactate dehydrogenase level, (11) C-reactive protein level, (12) soluble interleukin-2 receptor (IL-2R) level, and (13) cytological findings. We used multivariate and univariate analyses to study the data statistically. RESULTS The following 5 factors were found to be significant in a Wilcoxon t-test for malignant lymphoma: percentage of white blood cell lymphocytes, sIL-2R level, age, white blood cell lymphocyte count, and cytological findings; these factors were also significant when examined using a Pearson χ2 test. The other factors did not differ significantly between the malignant and non-malignant lymphomas. The percentage of white blood cell lymphocytes and the cytological findings were identified as significant independent factors for the diagnosis of malignant lymphoma in a multivariate analysis, whereas the other factors were not found to be significant. CONCLUSION Based on the results of the univariate and multivariate analyses performed in the present study, the decline in the percentage of white blood cell lymphocytes and the cytological findings obtained prior to cervical lymph node biopsy are significant indicators of malignant lymphoma.
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Lymphopenia in early arthritis: Impact on diagnosis and 3-year outcomes (ESPOIR cohort). Joint Bone Spine 2015; 82:417-22. [PMID: 26184529 DOI: 10.1016/j.jbspin.2015.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/17/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES In patients with early arthritis naive to disease-modifying antirheumatic drugs, we evaluated the prevalence of initial and persistent lymphopenia, underlying diagnoses, and risk of infection or malignancy. METHODS Eight hundred and thirteen patients with early arthritis included in the ESPOIR cohort had a clinical examination, laboratory tests (viral serology, immunological tests, and cytokine profile), and radiographs. We determined the prevalence of lymphopenia at baseline and after 3 years, associated factors, diagnoses, and risk of infection or malignancy. RESULTS At baseline, 50/813 (6.2%) patients had lymphopenia. Lymphopenia was associated with positive rheumatoid factor (P=0.02), cytopenia (P≤0.05), hepatitis C (P=0.05), higher C-reactive protein and DAS28 (P≤0.05 for both). Cytokine profile and radiological progression were not significantly different between patients with and without lymphopenia. Suspected diagnoses at inclusion were rheumatoid arthritis (RA, n=27), unclassified arthritis (n=15), systemic lupus erythematosus (SLE, n=3), spondyloarthritis (n=2), Sjögren's syndrome (n=1), hematologic disease (n=1), and fibromyalgia (n=1). Fifteen patients out of 42 (35.7%) with initial lymphopenia had persistent lymphopenia after 3 years, including 5 with documented causes (lupus, hepatitis C, undernutrition, azathioprine, and tamoxifen); none had PVB19, HIV, or HBV infection and none experienced infections, solid or hematologic malignancies during follow-up. Final diagnoses in these 15 patients were RA (n=6), unclassified arthritis (n=6), SLE (n=1), spondyloarthritis (n=1), and fibromyalgia (n=1). CONCLUSIONS Lymphopenia is rare in early arthritis. The most common rheumatic cause is RA, in which marked inflammation and other cytopenias are common. Lymphopenia in early arthritis is often short-lived, even when methotrexate is prescribed.
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Porrata LF, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Hogan WJ, Markovic SN. Infused autograft lymphocyte-to-monocyte ratio and survival in T-cell lymphoma post-autologous peripheral blood hematopoietic stem cell transplantation. J Hematol Oncol 2015; 8:80. [PMID: 26138828 PMCID: PMC4490710 DOI: 10.1186/s13045-015-0178-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 06/24/2015] [Indexed: 12/16/2022] Open
Abstract
Background The infused autograft lymphocyte-to-monocyte ratio (A-LMR) is a prognostic factor for survival in B-cell lymphomas post-autologous peripheral hematopoietic stem cell transplantation (APHSCT). Thus, we set out to investigate if the A-LMR is also a prognostic factor for survival post-APHSCT in T-cell lymphomas. Methods From 1998 to 2014, 109 T-cell lymphoma patients that underwent APHSCT were studied. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to identify the optimal cut-off value of A-LMR for survival analysis and k-fold cross-validation model to validate the A-LMR cut-off value. Univariate and multivariate Cox proportional hazard models were used to assess the prognostic discriminator power of A-LMR. Results ROC and AUC identified an A-LMR ≥ 1 as the best cut-off value and was validated by k-fold cross-validation. Multivariate analysis showed A-LMR to be an independent prognostic factor for overall survival (OS) and progression-free survival (PFS). Patients with an A-LMR ≥ 1.0 experienced a superior OS and PFS versus patients with an A-LMR < 1.0 [median OS was not reached vs 17.9 months, 5-year OS rates of 87 % (95 % confidence interval (CI), 75–94 %) vs 26 % (95 % CI, 13–42 %), p < 0.0001; median PFS was not reached vs 11.9 months, 5-year PFS rates of 72 % (95 % CI, 58–83 %) vs 16 % (95 % CI, 6–32 %), p < 0.0001]. Conclusions A-LMR is also a prognostic factor for clinical outcomes in patients with T-cell lymphomas undergoing APHSCT.
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Affiliation(s)
- Luis F Porrata
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA.
| | - David J Inwards
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
| | - Stephen M Ansell
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
| | - Ivana N Micallef
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
| | - Patrick B Johnston
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
| | - William J Hogan
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
| | - Svetomir N Markovic
- Division of Hematology, Department of Medicine, Mayo Clinic, 200 first St. SW, Rochester, MN, 55905, USA
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Beltran BE, Aguilar C, Quiñones P, Morales D, Chavez JC, Sotomayor EM, Castillo JJ. The neutrophil-to-lymphocyte ratio is an independent prognostic factor in patients with peripheral T-cell lymphoma, unspecified. Leuk Lymphoma 2015; 57:58-62. [PMID: 25926063 DOI: 10.3109/10428194.2015.1045897] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Peripheral T-cell lymphoma (PTCL) encompasses a group of rare and aggressive lymphomas. PTCL, unspecified (PTCLU) is the most common subtype of PTCL, and carries a poor prognosis. The International Prognostic Index (IPI) and the Prognostic Index for PTCLU (PIT) scoring systems are powerful risk-stratification tools in patients with PTCL. The aim of this study was to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in PTCLU. We retrospectively studied 83 patients with diagnosis of PTCLU. In the univariate analysis, NLR ≥ 4 was associated with worse overall survival (HR 3.96, 95% CI 1.92-8.17; p < 0.001). In the multivariate analysis, NLR ≥ 4 was independently associated with worse overall survival after adjustment for the PIT score (HR 4.30, 95% CI 1.90-9.69; p < 0.001), and for the IPI score (HR 2.60, 95% CI 1. 12-6.04; p = 0.03). Our study suggests the NLR could be helpful in refining the survival prognostication in patients with PTCLU.
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Affiliation(s)
| | | | - Pilar Quiñones
- b Department of Pathology , Hospital Nacional Edgardo Rebagliati Martins , Lima , Peru
| | - Domingo Morales
- b Department of Pathology , Hospital Nacional Edgardo Rebagliati Martins , Lima , Peru
| | - Julio C Chavez
- c Division of Malignant Hematology, Moffitt Cancer and Research Institute, University of South Florida , Tampa , FL , USA
| | - Eduardo M Sotomayor
- c Division of Malignant Hematology, Moffitt Cancer and Research Institute, University of South Florida , Tampa , FL , USA
| | - Jorge J Castillo
- d Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School Boston , MA , USA
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Wang SS, Flowers CR, Kadin ME, Chang ET, Hughes AM, Ansell SM, Feldman AL, Lightfoot T, Boffetta P, Melbye M, Lan Q, Sampson JN, Morton LM, Zhang Y, Weisenburger DD. Medical history, lifestyle, family history, and occupational risk factors for peripheral T-cell lymphomas: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:66-75. [PMID: 25174027 DOI: 10.1093/jncimonographs/lgu012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Accounting for 10%-15% of all non-Hodgkin lymphomas in Western populations, peripheral T-cell lymphomas (PTCL) are the most common T-cell lymphoma but little is known about their etiology. Our aim was to identify etiologic risk factors for PTCL overall, and for specific PTCL subtypes, by analyzing data from 15 epidemiologic studies participating in the InterLymph Consortium. METHODS A pooled analysis of individual-level data for 584 histologically confirmed PTCL cases and 15912 controls from 15 case-control studies conducted in Europe, North America, and Australia was undertaken. Data collected from questionnaires were harmonized to permit evaluation of a broad range of potential risk factors. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression. RESULTS Risk factors associated with increased overall PTCL risk with a P value less than .05 included: a family history of hematologic malignancies (OR = 1.92, 95% CI = 1.30 to 2.84); celiac disease (OR = 17.8, 95% CI = 8.61 to 36.79); eczema (OR = 1.41, 95% CI = 1.07 to 1.85); psoriasis (OR = 1.97, 95% CI = 1.17 to 3.32); smoking 40 or more years (OR = 1.92, 95% CI = 1.41 to 2.62); and employment as a textile worker (ever) (OR = 1.58, 95% CI = 1.05 to 2.38) and electrical fitter (ever) (OR = 2.89, 95% CI = 1.41 to 5.95). Exposures associated with reduced overall PTCL risk included a personal history of allergies (OR = 0.69, 95% CI = 0.54 to 0.87), alcohol consumption (ever) (OR = 0.64, 95% CI = 0.49 to 0.82), and having ever lived or worked on a farm (OR = 0.72, 95% CI = 0.55% to 0.95%). We also observed the well-established risk elevation for enteropathy-type PTCL among those with celiac disease in our data. Conclusions Our pooled analyses identified a number of new potential risk factors for PTCL and require further validation in independent series.
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Affiliation(s)
- Sophia S Wang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
| | - Christopher R Flowers
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Marshall E Kadin
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Ellen T Chang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Ann Maree Hughes
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Stephen M Ansell
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Andrew L Feldman
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Tracy Lightfoot
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Paolo Boffetta
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Mads Melbye
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Qing Lan
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Joshua N Sampson
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Lindsay M Morton
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Yawei Zhang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Dennis D Weisenburger
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
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Kim SJ, Ryu KJ, Hong M, Ko YH, Kim WS. The serum CXCL13 level is associated with the Glasgow Prognostic Score in extranodal NK/T-cell lymphoma patients. J Hematol Oncol 2015; 8:49. [PMID: 25966773 PMCID: PMC4437674 DOI: 10.1186/s13045-015-0142-4] [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] [Received: 01/30/2015] [Accepted: 04/21/2015] [Indexed: 12/20/2022] Open
Abstract
Background The Glasgow Prognostic Score (GPS) measures inflammation and proves its prognostic value in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL) which is commonly combined with inflammatory lesion. Given inflammatory chemokines play an important role in tumor progression, we hypothesized that chemokines might influence ENKTL aggressiveness through interaction with their receptors in the tumor tissue. Methods We measured the serum levels of C-X-C motif ligand 13 (CXCL13) in 69 patients with ENKTL who received non-anthracycline-based chemotherapy and/or concurrent chemoradiotherapy because CXCL13 is thought to have a pro-tumor effect through interaction with its receptor, the C-X-C chemokine receptor 5 (CXCR5). We analyzed the association of serum CXCL13 with the GPS, and their prognostic relevance. The levels of CXCL13 were measured using a multiplex chemokine assay on archived frozen serum samples. Results Patients were categorized into high and low CXCL13 groups if they had CXCL13 levels above or below the median value of 29.1 pg/mL, respectively. The high CXCL13 group and grouping by the GPS showed a significant association with poor progression-free survival. The elevated serum levels of CXCL13 were also significantly associated with a high score of the GPS. High CXCL13 levels and GPS were significantly associated with high tumor burden predicting poor prognosis including stages III/IV, extranasal presentation, bone marrow invasion, and presence of Epstein-Barr virus (EBV) DNA in blood. Furthermore, serum CXCL13 and GPS discriminated patients at risk of treatment failure among patients with low tumor burden (stage I/II) and non-detectable EBV DNA. Conclusions Serum levels of CXCL13 were associated with the prognostic value of GPS. Grouping by the serum CXCL13 might predict survival outcomes in patients with ENKTL, suggesting that it is a potential therapeutic target.
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Affiliation(s)
- Seok Jin Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. .,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Kyung Ju Ryu
- Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea.
| | - Mineui Hong
- Department of Pathology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
| | - Young Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Han X, Wang J, Zhang N, Yao J, Feng Y, Li D, Liu P, Yang J, Zhou S, Qin Y, Yang S, Gui L, He X, Shi Y. The prognostic utility and the association of serum light chains (free and total) and absolute lymphocyte count in patients with newly diagnosed diffuse large B-cell lymphoma. Leuk Res 2014; 38:1291-8. [PMID: 25287608 DOI: 10.1016/j.leukres.2014.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/11/2014] [Accepted: 09/13/2014] [Indexed: 12/01/2022]
Abstract
In this study, serum free and total light chains (sFLC/sTLC) were measured in 108 serum samples of therapy-naïve patients with DLBCL. Clinicopathologic data and survival outcomes were analyzed according to the results of sFLC/sTLC measurements. Moreover, the association of sFLC/sTLC with absolute monocyte count (AMC) and absolute lymphocyte count (ALC) was evaluated. Elevated sFLC and abnormal κ/λ ratio was present in 42.6% (51/108) and 4.6% (5/108) of patients, respectively. sTLC was successfully measured in 107 serum samples, abnormal sTLC and abnormal κ/λ ratio was found in 28.0% (30/107) and 26.2% (28/107) of patients, respectively. Patients with elevated sFLC more frequently displayed adverse clinical characteristics, including age (P=0.001), B symptoms (P=0.022), low ALC (P=0.024) and hyperglobulinemia (P=0.012). Patients with elevated sFLC had an inferior overall survival (OS) (P=0.012) and tended to have shorter progression-free survival (PFS) (P=0.061) compared to patients with normal sFLC. Abnormal sTLC or abnormal sTLC ratio showed no significant association with clinical outcomes, with exception of abnormal concurrent κ and λ. Only association of sFLC and ALC with survival remained significant after adjusting for the International Prognostic Index (IPI). The measurement of sFLC and ALC at diagnosis might be useful for the prognostic stratification of patients and sTLC measurement was of little prognostic utility in DLBCL.
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Affiliation(s)
- Xiaohong Han
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Jianfei Wang
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Ningning Zhang
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Jiarui Yao
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Yun Feng
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Dan Li
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Peng Liu
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Jianliang Yang
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Shengyu Zhou
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Yan Qin
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Sheng Yang
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Lin Gui
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Xiaohui He
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
| | - Yuankai Shi
- Department of Medical Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China.
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28
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Analysis of prognostic factors and comparison of prognostic scores in peripheral T cell lymphoma, not otherwise specified: a single-institution study of 105 Chinese patients. Ann Hematol 2014; 94:239-47. [PMID: 25193354 DOI: 10.1007/s00277-014-2188-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 08/06/2014] [Indexed: 10/24/2022]
Abstract
Peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) is a heterogeneous subtype of non-Hodgkin's lymphoma. This study aims to better define the prognostic factors and compare the predictive value of the prognostic scores in Chinese patients with PTCL-NOS. One hundred and five patients diagnosed as PTCL-NOS from our institution were retrospectively studied and grouped according to four previously described prognostic scores [International Prognostic Index (IPI), Prognostic Index for PTCL-NOS (PIT), modified PIT (m-PIT), and International PTCL Project (IPTCLP)]. In addition to clinical parameters, peripheral lymphopenia and thrombocytopenia, serum Epstein-Barr virus positivity, and tumor Ki-67 were significantly associated with poor disease outcome. Multivariate analysis revealed that age >60 years, poor performance status, elevated lactic dehydrogenase, and bone marrow involvement were independent adverse variables for survival. All prognostic scores were successful for survival estimation. Risk subgroups in IPI and PIT could be further discriminated by platelet count (IPTCLP factor) and Ki-67 (m-PIT factor), respectively. Together, patient- and tumor-specific characteristics may be incorporated in risk stratification of PTCL-NOS patients. The prognostic scores could be mutually active to improve their predictive value of disease outcome.
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Bari A, Tadmor T, Sacchi S, Marcheselli L, Cox C, Liardo EV, Pozzi S, Benyamini N, Avivi I, Ferrari A, Baldini L, Falorio S, Gobbi P, Federico M, Polliack A. Defining the best cut-off value for lymphopenia in diffuse large B cell lymphoma treated with immuno-chemotherapy. Br J Haematol 2014; 167:133-6. [DOI: 10.1111/bjh.12930] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alessia Bari
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Tamar Tadmor
- Haematology - Oncology Unit; Bnai Zion Medical Centre; Haifa Israel
- Bruce Rappaport Faculty of Medicine; Technion-Israel Institute of Technology; Haifa Israel
| | - Stefano Sacchi
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Luigi Marcheselli
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Christina Cox
- Department of Haematology; AO Sant'Andrea; La Sapienza University; Rome Italy
| | - Eliana V. Liardo
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Samantha Pozzi
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Noam Benyamini
- Department of Haematology & Bone Marrow Transplantation; Rambam Health Care Campus; Haifa Israel
| | - Irit Avivi
- Bruce Rappaport Faculty of Medicine; Technion-Israel Institute of Technology; Haifa Israel
- Department of Haematology & Bone Marrow Transplantation; Rambam Health Care Campus; Haifa Israel
| | - Angela Ferrari
- Haematology Unit; Arcispedale Santa Maria Nuova; Istituto di Ricovero e Cura a Carattere Scientifico; Reggio Emilia Italy
| | - Luca Baldini
- Fondazione IRCCS Cà Granda; Ospedale Maggiore Policlinico; UO Ematologia I/CTMO; Università degli Studi di Milano; Milan Italy
| | - Simona Falorio
- Dipartimento di Ematologia; Centro Diagnosi e Cura dei Linfomi; USL di Pescara; Ospedale Santo Spirito; Pescara Italy
| | - Paolo Gobbi
- Medicina Interna, Gatroenterologia; Fondazione IRCCS Policlinico S. Matteo; Università di Pavia; Pavia Italy
| | - Massimo Federico
- Department of Diagnostic, Clinical, and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Aaron Polliack
- Department of Haematology; Hadassah University Hospital and Hebrew University Medical School; Jerusalem Israel
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Shet T, Suryawanshi P, Epari S, Sengar M, Rangarajan V, Menon H, Laskar S. Extranodal natural killer/T cell lymphomas with extranasal disease in non-endemic regions are disseminated or have nasal primary: a study of 84 cases from India. Leuk Lymphoma 2014; 55:2748-53. [PMID: 24597982 DOI: 10.3109/10428194.2014.894188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract We report a study of 84 extranodal natural killer/T cell lymphomas (ENKTCLs) from India to understand the disease pattern. Sixty-one patients had nasal disease and three had Waldeyer's ring tumors, while 20 had extranasal sites of presentation, namely: cervix (n = 1), oral cavity (n = 3), orbit (n = 3), liver (n = 1), ileum (n = 1), and soft tissue and lymph nodes (n = 9). Staging of patients with extranasal disease revealed that either they had disseminated disease or the nasal mass was missed during the initial staging. Extranasal presentation, performance status (PS), international prognostic index (IPI), Korean prognostic index, marrow involvement, radiotherapy and type of chemotherapy affected overall survival, while lymphopenia, performance status, radiotherapy and type of chemotherapy impacted disease-free survival. In the multivariate analysis, IPI and response to chemotherapy emerged as significant prognostic factors. Thus most patients with extranasal ENKTCL have a nasal lesion or disseminated disease and pure extranasal disease is uncommon in non-endemic regions.
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Affiliation(s)
- Tanuja Shet
- Department of Pathology, Tata Memorial Hospital , Mumbai , India
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31
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Trebouet A, Marchand T, Lemal R, Gyan E, Broussais-Guillaumot F, Guillermin Y, Monjanel H, Salles G, Le Gouill S, Godmer P, Fruchart C, Damaj G, Feugier P, Thieblemont C, Maynadié M, Monnereau A, Troussard X, Rossille D, Lamy T, Houot R. Lymphoma occurring in patients over 90 years of age: characteristics, outcomes, and prognostic factors. A retrospective analysis of 234 cases from the LYSA. Ann Oncol 2013; 24:2612-2618. [PMID: 23970017 DOI: 10.1093/annonc/mdt282] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Lymphoma occurring in patients aged 90 or older is not uncommon, and its incidence is expected to increase over time. Management of these patients is difficult given their underlying fragility and the lack of information regarding this population. PATIENTS AND METHODS We retrospectively analyzed 234 patients diagnosed with lymphoma at the age of 90 years or older (90+) between 1990 and 2012 to describe their characteristics, management, outcomes and prognostic factors. RESULTS The median age was 92 years; 88% were B-cell lymphomas consisting mainly in diffuse large B-cell lymphoma. The median overall survival (OS) was 7.2 months (range, 0-92 months) for the 227 patients with non-Hodgkin Lymphoma (NHL), with a significant difference between aggressive and indolent NHL (5.2 months versus 19.4 months, respectively). We further analyzed 166 NHL patients for whom detailed characteristics were available. Among these patients, 63.5% received a treatment, either local (7.5%) or systemic (56%). Lymphoma was reported as the main cause of death (40%). Treatment administration was associated with improved OS in patients with aggressive (P < 0.001) but not indolent NHL (P = 0.96). In patients with aggressive NHL, hypoalbuminemia appeared as a strong and independent negative prognostic factor. CONCLUSIONS The median OS is short in 90+ patients diagnosed with lymphoma but some patients experience prolonged survival. Lymphoma represents the main cause of death in these patients. Treatment may improve survival of selected patients with aggressive but not indolent NHL. Management of these patients may be guided by prognostic factors identified in this study, notably serum albumin.
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Affiliation(s)
- A Trebouet
- Department of Hematology, Centre Hospitalier Universitaire de Rennes, INSERM U917, Rennes
| | - T Marchand
- Department of Hematology, Centre Hospitalier Universitaire de Rennes, INSERM U917, Rennes
| | - R Lemal
- Department of Hematology, Centre Hospitalier Universitaire de Clermont-Ferrand Hôpital Estaing, Université d'Auvergne CREaT - EA 7283, Inserm CIC-501, Clermont-Ferrand
| | - E Gyan
- Department of Hematology, Centre Hospitalier Universitaire de Tours, CIC INSERM U202, Tours
| | | | - Y Guillermin
- Department of Hematology, Centre Léon Bérard, Université Lyon 1, Lyon
| | - H Monjanel
- Department of Hematology, AP-HP, Hôpital Saint Louis, Université Paris 7, INSERM U728, Paris
| | - G Salles
- Department of Hematology, Hospices Civils de Lyon, Université Lyon-1, Pierre-Bénite
| | - S Le Gouill
- Department of Hematology, Centre Hospitalier Universitaire de Nantes, Nantes
| | - P Godmer
- Department of Hematology, Centre Hospitalier de Bretagne Atlantique, Vannes
| | - C Fruchart
- Department of Hematology, Centre de lutte contre le Cancer François Baclesse, Caen
| | - G Damaj
- Department of Hematology, Centre Hospitalier Universitaire d'Amiens, Amiens
| | - P Feugier
- Department of Hematology, Centre Hospitalier Universitaire de Nancy, Nancy
| | - C Thieblemont
- Department of Hematology, AP-HP, Hôpital Saint Louis, Université Paris 7, INSERM U728, Paris
| | - M Maynadié
- Hematological Cancer Registry of Côte d'Or, UCOG de Bourgogne, EA4184, Université de Bourgogne, Dijon
| | - A Monnereau
- Hematological Cancer Registry of Gironde, Institut Bergonié, Bordeaux
| | - X Troussard
- Hematological Cancer Registry of Basse Normandie, Centre Hospitalier Universitaire de Caen, Caen
| | - D Rossille
- Department of Biology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - T Lamy
- Department of Hematology, Centre Hospitalier Universitaire de Rennes, INSERM U917, Rennes
| | - R Houot
- Department of Hematology, Centre Hospitalier Universitaire de Rennes, INSERM U917, Rennes.
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Tadmor T, Bari A, Sacchi S, Marcheselli L, Liardo EV, Avivi I, Benyamini N, Attias D, Pozzi S, Cox MC, Baldini L, Brugiatelli M, Federico M, Polliack A. Monocyte count at diagnosis is a prognostic parameter in diffuse large B-cell lymphoma: results from a large multicenter study involving 1191 patients in the pre- and post-rituximab era. Haematologica 2013; 99:125-30. [PMID: 23935023 DOI: 10.3324/haematol.2013.088161] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In this study we assessed the prognostic significance of absolute monocyte count and selected the best cut-off value at diagnosis in a large cohort of patients with diffuse large B-cell lymphoma. Data were retrieved for therapy-naïve patients with diffuse large B-cell lymphoma followed in Israel and Italy during 1993-2010. A final cohort of 1017 patients was analyzed with a median follow up of 48 months and a 5-year overall survival rate of 68%. The best absolute monocyte count cut-off level was 630/mm(3) and the 5-year overall survival for patients with counts below this cut-off was 71%, whereas it was 59% for those with a count >630 mm(3) (P=0.0002). Of the 1017 patients, 521 (51%) were treated with chemo-immunotherapy, and in this cohort, using multivariate analysis, elevated monocyte count retained a negative prognostic value even when adjusted for International Prognostic Index (HR1.54, P=0.009). This large study shows that a simple parameter such as absolute monocyte count (>630/mm(3)) can easily be used routinely in the evaluation of newly diagnosed diffuse large B-cell lymphoma to identify high-risk patients with a worse survival in the rituximab era.
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William BM, Armitage JO. International analysis of the frequency and outcomes of NK/T-cell lymphomas. Best Pract Res Clin Haematol 2013; 26:23-32. [DOI: 10.1016/j.beha.2013.04.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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34
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Bari A, Tadmor T, Sacchi S, Marcheselli L, Liardo EV, Pozzi S, Luminari S, Baldini L, Marmiroli S, Federico M, Polliack A. Monocytosis has adverse prognostic significance and impacts survival in patients with T-cell lymphomas. Leuk Res 2013; 37:619-23. [PMID: 23395384 DOI: 10.1016/j.leukres.2013.01.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 01/10/2013] [Accepted: 01/14/2013] [Indexed: 11/29/2022]
Abstract
In this retrospective study we evaluated the prognostic impact of peripheral blood monocytosis in patients with T-cell non Hodgkin lymphomas with "aggressive-typically nodal presentation". In this dataset monocytes >0.8 × 10(9)/L had a strong and statistically significant negative impact on overall survival (OS). In univariate analysis several parameters, including age >60 years, advanced stage, bone marrow involvement, ECOG PS >1, high LDH level, monocytes >0.8 × 10(9)/L, hemoglobin<120 g/L, albumin<35 g/L) had a negative influence on outcome, but in multivariate analysis, monocytosis alone had a stronger association with poor OS.
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Affiliation(s)
- Alessia Bari
- Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Hong J, Yoon HH, Ahn HK, Sym SJ, Park J, Park PW, Ahn JY, Park S, Cho EK, Shin DB, Lee JH. Prognostic role of serum lactate dehydrogenase beyond initial diagnosis: a retrospective analysis of patients with diffuse large B cell lymphoma. Acta Haematol 2013; 130:305-11. [PMID: 24008775 DOI: 10.1159/000353127] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 04/30/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Baseline serum lactate dehydrogenase (LDH) level is a well-known prognostic factor in patients with non-Hodgkin's lymphoma; however, its role beyond initial diagnosis has not yet been defined. METHODS This study was conducted as a retrospective analysis of patients with diffuse large B cell lymphoma (DLBCL) treated with R-CHOP21, who had undergone regular checks for LDH during immunochemotherapy (n = 119) and during the posttreatment follow-up period after complete remission (CR; n = 100). The 119 patients were classified into 4 groups according to their baseline and change in LDH level during treatment, and an analysis of tumor response and survival was performed. The value of LDH as a predictor for relapse was evaluated among the patients with regular follow-up visits after achieving CR. RESULTS An increased LDH level during immunochemotherapy had no impact on tumor response or survival, and only the LDH status 'before' treatment was a prognostic marker. The sensitivity, specificity, positive predictive value and negative predictive value of serum LDH for detecting relapse after CR were 47.4, 86.5, 9.3 and 98.3%, respectively. CONCLUSION The measurement of LDH level beyond initial diagnosis has no clear benefit in predicting disease progression or relapse in patients with DLBCL treated with R-CHOP21.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Female
- Humans
- L-Lactate Dehydrogenase/blood
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Non-Hodgkin/diagnosis
- Male
- Middle Aged
- Prednisone/administration & dosage
- Prognosis
- Retrospective Studies
- Rituximab
- Treatment Outcome
- Vincristine/administration & dosage
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Affiliation(s)
- Junshik Hong
- Department of Internal Medicine, Gachon University School of Medicine, Incheon, Republic of Korea
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