1
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Hurt CN, Kaiser K, Shaunfield S, Webster KA, Keating K, Boyken L, Duffey S, Garcia J, Cella D. Content validation of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Lymphoma Symptom Index-18 (NFLymSI-18) in indolent B-cell non-Hodgkin's lymphoma. J Patient Rep Outcomes 2024; 8:68. [PMID: 38980533 PMCID: PMC11233475 DOI: 10.1186/s41687-024-00752-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND The NFLymSI-18 is a patient-reported outcome measure comprised of the highest priority symptoms, emotional concerns, treatment side effects, and other concerns identified by lymphoma patients and oncologists. This study assessed the content validity of the NFLymSI-18 for patients with indolent B-cell non-Hodgkin's lymphoma (iNHL), with a focus on the Disease-Related Symptoms Physical (DRS-P) subscale. METHODS Patients with a confirmed iNHL diagnosis who had received one or more lines of treatment were recruited during clinic visits. Patients described their symptoms, treatment side effects, and emotional concerns related to iNHL in a semi-structured interview. Qualitative data were analyzed using NVivo10. RESULTS Data saturation was obtained by the 18th interview. Most participants (67%) had follicular lymphoma. 28% of participants had marginal zone lymphoma, and one participant had lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia. Mean age of the 18 participants was 67 years. 56% of the sample was male. Most participants (67%) had a college or advanced degree. When asked to describe their iNHL symptoms, patients most often discussed swelling (n = 14), fatigue (n = 11), and pain (n = 8). The following symptoms were mentioned by three patients each: anxiety, appetite loss, rash, sleep disruption, trouble breathing, and malaise. Mapping of NFLymSI-18 content to these concerns showed the instrument includes all those most frequently mentioned symptoms. CONCLUSIONS This study supports the content validity of the NFLymSI-18, including its DRS-P Subscale, for patients with iNHL. The instrument shows strong validity for the most referenced symptoms of swelling, fatigue, and pain. The diversity of additional symptoms reported by patients is consistent with the heterogeneous symptomology of iNHL.
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Affiliation(s)
- Courtney N Hurt
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Karen Kaiser
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara Shaunfield
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kimberly A Webster
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Lara Boyken
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara Duffey
- Lurie Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jessica Garcia
- Lurie Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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2
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Yurttaş NÖ, Eşkazan AE. Clinical Application of Biomarkers for Hematologic Malignancies. Biomark Med 2022. [DOI: 10.2174/9789815040463122010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Over the last decade, significant advancements have been made in the
molecular mechanisms, diagnostic methods, prognostication, and treatment options in
hematologic malignancies. As the treatment landscape continues to expand,
personalized treatment is much more important.
With the development of new technologies, more sensitive evaluation of residual
disease using flow cytometry and next generation sequencing is possible nowadays.
Although some conventional biomarkers preserve their significance, novel potential
biomarkers accurately detect the mutational landscape of different cancers, and also,
serve as prognostic and predictive biomarkers, which can be used in evaluating therapy
responses and relapses. It is likely that we will be able to offer a more targeted and
risk-adapted therapeutic approach to patients with hematologic malignancies guided by
these potential biomarkers. This chapter summarizes the biomarkers used (or proposed
to be used) in the diagnosis and/or monitoring of hematologic neoplasms.;
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Affiliation(s)
- Nurgül Özgür Yurttaş
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine,
Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Emre Eşkazan
- Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine,
Istanbul University-Cerrahpasa, Istanbul, Turkey
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3
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Genuardi E, Alessandria B, Civita AM, Ferrero S. Targeted Locus Amplification as Marker Screening Approach to Detect Immunoglobulin (IG) Translocations in B-Cell Non-Hodgkin Lymphomas. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2022; 2453:119-132. [PMID: 35622324 DOI: 10.1007/978-1-0716-2115-8_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although MRD monitoring by the classic polymerase chain reaction (PCR) approach is a powerful outcome predictor, about 20% of mantle cell lymphoma (MCL) and 50% of follicular lymphoma (FL) patients still lack a molecular marker and are thus resulting not eligible for MRD monitoring. Targeted locus amplification (TLA), a new NGS technology, has been revealed as a feasible marker screening approach able to identify uncommon B-cell leukemia/lymphoma 1 (BCL1) and B-cell leukemia/lymphoma 2 (BCL2) rearrangements in MCL and FL cases defined as having "no marker" by the classic PCR approach.
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Affiliation(s)
- Elisa Genuardi
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Beatrice Alessandria
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Aurora Maria Civita
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy
| | - Simone Ferrero
- Hematology Division, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Torino, Italy. .,Hematology Division, AOU "Città della Salute e della Scienza di Torino", Torino, Italy.
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4
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Genuardi E, Klous P, Mantoan B, Drandi D, Ferrante M, Cavallo F, Alessandria B, Dogliotti I, Grimaldi D, Ragaini S, Clerico M, Lo Schirico M, Saraci E, Yilmaz M, Zaccaria GM, Cortelazzo S, Vitolo U, Luminari S, Federico M, Boccadoro M, van Min M, Splinter E, Ladetto M, Ferrero S. Targeted locus amplification to detect molecular markers in mantle cell and follicular lymphoma. Hematol Oncol 2021; 39:293-303. [PMID: 33742718 PMCID: PMC8451873 DOI: 10.1002/hon.2864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/22/2021] [Accepted: 03/06/2021] [Indexed: 11/16/2022]
Abstract
Minimal residual disease (MRD) monitoring by PCR methods is a strong and standardized predictor of clinical outcome in mantle cell lymphoma (MCL) and follicular lymphoma (FL). However, about 20% of MCL and 40% of FL patients lack a reliable molecular marker, being thus not eligible for MRD studies. Recently, targeted locus amplification (TLA), a next‐generation sequencing (NGS) method based on the physical proximity of DNA sequences for target selection, identified novel gene rearrangements in leukemia. The aim of this study was to test TLA in MCL and FL diagnostic samples lacking a classical, PCR‐detectable, t(11; 14) MTC (BCL1/IGH), or t(14; 18) major breakpoint region and minor cluster region (BCL2/IGH) rearrangements. Overall, TLA was performed on 20 MCL bone marrow (BM) or peripheral blood (PB) primary samples and on 20 FL BM, identifying a novel BCL1 or BCL2/IGH breakpoint in 16 MCL and 8 FL patients (80% and 40%, respectively). These new breakpoints (named BCL1‐TLA and BCL2‐TLA) were validated by ASO primers design and compared as MRD markers to classical IGH rearrangements in eight MCL: overall, MRD results by BCL1‐TLA were superimposable (R Pearson = 0.76) to the standardized IGH‐based approach. Moreover, MRD by BCL2‐TLA reached good sensitivity levels also in FL and was predictive of a primary refractory case. In conclusion, this study offers the proof of principle that TLA is a promising and reliable NGS‐based technology for the identification of novel molecular markers, suitable for further MRD analysis in previously not traceable MCL and FL patients.
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Affiliation(s)
- Elisa Genuardi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | | | - Barbara Mantoan
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Daniela Drandi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Martina Ferrante
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Federica Cavallo
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Beatrice Alessandria
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | - Irene Dogliotti
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Daniele Grimaldi
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Simone Ragaini
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Michele Clerico
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | - Mariella Lo Schirico
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | | | | | - Gian Maria Zaccaria
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy
| | | | - Umberto Vitolo
- Department of Oncology, Division of Hematology, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda USL IRCCS di Reggio Emilia, Reggio Emilia, Modena, Italy.,Medical Oncology, CHIMOMO department, University of Modena and Reggio Emilia, Modena, Italy
| | - Massimo Federico
- Medical Oncology, CHIMOMO department, University of Modena and Reggio Emilia, Modena, Italy
| | - Mario Boccadoro
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
| | | | | | - Marco Ladetto
- Division of Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Simone Ferrero
- Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of Torino, Torino, Italy.,Division of Hematology 1, AOU "Città della Salute e della Scienza di Torino", Torino, Italy
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5
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Dada R, Al-Mansour M, Alhashmi H, Kandil M, Alhejazi A, Sagheir A, Alzahrani M, Motabi I. Follicular Lymphoma: Saudi Lymphoma Group's Clinical Practice Guidelines for Diagnosis, Management and Follow-up. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2019; 7:214-218. [PMID: 31543747 PMCID: PMC6734728 DOI: 10.4103/sjmms.sjmms_101_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 05/06/2019] [Accepted: 07/24/2019] [Indexed: 12/04/2022]
Affiliation(s)
- Reyad Dada
- Department of Oncology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
- College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
| | - Mubarak Al-Mansour
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Adult Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah, Saudi Arabia
| | - Hani Alhashmi
- Adult Hematology and Stem Cell Transplantation Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Magdy Kandil
- Oncology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
- Clinical Oncology Department, Cairo University, Giza, Egypt
| | - Ayman Alhejazi
- Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Central Region, Riyadh, Saudi Arabia
| | - Ahmed Sagheir
- Oncology Institute, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Musa Alzahrani
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ibraheem Motabi
- Department of Adult Hematology and BMT, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
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6
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Pulsoni A, Della Starza I, Cappelli LV, Tosti ME, Annechini G, Cavalli M, De Novi LA, D’Elia GM, Grapulin L, Guarini A, Del Giudice I, Foà R. Minimal residual disease monitoring in early stage follicular lymphoma can predict prognosis and drive treatment with rituximab after radiotherapy. Br J Haematol 2019; 188:249-258. [DOI: 10.1111/bjh.16125] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/21/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Alessandro Pulsoni
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Irene Della Starza
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Luca V. Cappelli
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Maria E. Tosti
- National Centre for Global Health Istituto Superiore di Sanità RomeItaly
| | - Giorgia Annechini
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Marzia Cavalli
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Lucia A. De Novi
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Gianna M. D’Elia
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Lavinia Grapulin
- Department of Radiology and Radiotherapy Sapienza University RomeItaly
| | - Anna Guarini
- Department of Molecular Medicine Sapienza University Rome Italy
| | - Ilaria Del Giudice
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
| | - Robin Foà
- Haematology, Department of Translational and Precision Medicine Sapienza University RomeItaly
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7
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Pirozzi A, Cartenì G, Scagliarini S, Fusco M, Riccardi F. Incidental finding of non-Hodgkin's lymphoma in a patient affected by castration-sensitive prostate cancer: A case report. Medicine (Baltimore) 2019; 98:e14805. [PMID: 30882658 PMCID: PMC6426560 DOI: 10.1097/md.0000000000014805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
RATIONALE This article describes the case of a patient with 2 simultaneous malignant diseases: Follicular lymphoma and 'castration sensitive prostate cancer. Patients with multiple cancers are not easy to manage and it is difficult to find the appropriate approach and resources to use with them. We focused our attention on how to choose the correct strategy to face 2 different neoplasms and control the adverse reactions related to the corresponding treatments. PATIENT CONCERNS We present a case of a 71-year-old man who came to us complaining about an abnormal difficulty in urinating associated with an interrupted flow and excessive urination at night. Clinical examination detected multiple enlarged superior and inferior diaphragmatic lymph nodes. DIAGNOSIS Prostate biopsy revealed an acinar adenocarcinoma (Gleason 4+3, Grade group 3). Clinical staging by bone scan was negative but computed tomography scan (CT) detected multiple enlarged superior and inferior diaphragmatic, and inguinal lymph nodes. This type of lymph node involvement pattern is unusual for an acinar adenocarcinoma prostate cancer therefore we suspected the simultaneous presence of a lymphatic neoplasm. Fluorodeoxyglucose positron emission tomography scan. The exam showed one of the left inguinal lymph nodes had the highest standardized uptake value (13.0) so a biopsy was taken. The sample analysis confirmed the diagnosis of a follicular non-Hodgkin lymphoma of Grade 3a. INTERVENTIONS We used a multidisciplinary clinical approach based on Rituximab+CHOP administered every 21 days. Simultaneously, the patient underwent androgen deprivation therapy with triptorelin monthly and bicalutamide administered just during the first month of treatment. When we obtained a complete response for the lymphoma, the patient continued the therapy with Rituximab once every 2 months for the next 2 years. Then we added volumetric modulated arc therapy (VMAT) radiotherapy with simultaneous integrated boost (SIB) to androgen deprivation therapy for the duration of 1 month. OUTCOMES After 1 year and 6 months since the conclusion of therapy for prostate cancer and Follicular lymphoma, patient's conditions are good and he is in complete remission for both diseases. Gut toxicity is reduced with a mean number of 2 to 3 discharges daily and an increased body weight. LESSONS The presence of diffuse lymphadenopathy and urinary symptoms in the same patients must induce the suspect of 2 contemporary cancer diseases. Parallel treatments of follicular lymphoma and prostate cancer should consider the increased risk of severe adverse effects related to the treatment and their management. We describe our therapeutic strategy to highlight the importance to balance benefits and disadvantages to get the best possible response and maintain a good quality of life in this complex setting.
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Affiliation(s)
- Angelo Pirozzi
- Department of Clinical Medicine and Surgery, University Federico II of Naples
| | - Giacomo Cartenì
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Sarah Scagliarini
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
| | - Mario Fusco
- Registro Tumori Regione Campania, ASL Napoli 3 Sud, Brusciano, Italy
| | - Ferdinando Riccardi
- Department of Medical Oncology, Azienda Ospedaliero-Universitaria “A. Cardarelli”, Naples
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Kim J, Lim JH, Jeong J, Lee SH, Jo JC, Park SH. Low-grade follicular lymphoma involvement of the bone marrow with a mixed paratrabecular, diffuse, and massive pattern expressing typical mantle cell lymphoma immunophenotype CD23-/FMC7+: a case report. Blood Res 2018; 53:261-263. [PMID: 30310797 PMCID: PMC6170308 DOI: 10.5045/br.2018.53.3.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/02/2018] [Accepted: 08/05/2018] [Indexed: 12/02/2022] Open
Affiliation(s)
- Jaewook Kim
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Ji-Hun Lim
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Joseph Jeong
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Seon-Ho Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Jae-Cheol Jo
- Department of Hematology and Cellular Therapy, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Sang Hyuk Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
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9
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Sun RF, Yu QQ, Young KH. Critically dysregulated signaling pathways and clinical utility of the pathway biomarkers in lymphoid malignancies. Chronic Dis Transl Med 2018; 4:29-44. [PMID: 29756121 PMCID: PMC5938286 DOI: 10.1016/j.cdtm.2018.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Indexed: 12/15/2022] Open
Abstract
Accumulating evidence confirmed that many dysregulated signaling pathways and aberrant genetic alterations contribute to the oncogenesis and heterogeneity of lymphoid malignancies. Therapeutically targeting dysregulating signaling pathways and their hidden oncogenic biomarkers are becoming available, but did not show desired therapeutic effect in current clinical practice. It is meaningful to further understand the underlying mechanisms of the dysregulated signaling pathways and to address the potential utility of pathway-related biomarkers. To precisely identify the dysregulation of signaling pathways and the “driver” oncogenic biomarkers, as well as to develop reliable and reproducible risk-stratification based on biomarkers will be challenging. Nevertheless, pathway-based targeted therapy will raise the hope to improve the outcomes of the patients with lymphoid malignancies, especially with aggressive types, and the efficient utility of pathway-related biomarkers in diagnosis, prognosis, prediction of lymphoid malignancies may also be able to power precision medicine.
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Affiliation(s)
- Rui-Fang Sun
- Tumor Biobank, Department of Pathology, Shanxi Cancer Hospital, Taiyuan, Shanxi 030013, China
| | - Qian-Qian Yu
- Tumor Biobank, Department of Pathology, Shanxi Cancer Hospital, Taiyuan, Shanxi 030013, China
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77025, USA
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10
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AlJohani N, Choi SJ, Day AG, Alhejaily A, Virk S, Baetz T, LeBrun DP. Abundant expression of BMI1 in follicular lymphoma is associated with reduced overall survival. Leuk Lymphoma 2017; 59:2211-2219. [PMID: 29251058 DOI: 10.1080/10428194.2017.1410883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Although generally indolent, follicular lymphoma (FL) sometimes pursues a more aggressive course leading to early death. B-cell-specific Mo-MLV insertion site-1 (BMI1) is a member of the polycomb group (PcG) proteins that confer stem cell properties through gene silencing. We used multi-channel immunofluorescence and automated image analysis to quantify BMI1 selectively in the nuclei of FL-derived B-cells in routine biopsy specimens. Applying this assay to 109 pretreatment FL biopsy samples demonstrates a significant association between abundant BMI1 and reduced overall survival (p = .001); the statistically significant association with mortality persists in a Cox proportional hazards model that includes Follicular Lymphoma International Prognostic Index (FLIPI) score, histological grade, and the presence of a component of diffuse large B-cell lymphoma in the biopsy sample. Ascertaining BMI1 over-expression may be useful in identifying patients who might benefit from novel therapies directed at reversing the chromatin-modifying functions of BMI1.
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Affiliation(s)
- Naif AlJohani
- a Division of Hematology, Department of Medicine , Queen's University , Kingston , Canada
| | - Suk-Jin Choi
- b Department of Pathology and Molecular Medicine , Queen's University , Kingston , Canada.,c Department of Pathology , Inha University Hospital , Jung-gu , Korea
| | - Andrew G Day
- d Kingston General Health Research Institute , Kingston General Hospital , Kingston , Canada
| | - Abdulmohsen Alhejaily
- b Department of Pathology and Molecular Medicine , Queen's University , Kingston , Canada.,e King Fahad Medical City , Riyadh , Saudi Arabia
| | - Shakeel Virk
- b Department of Pathology and Molecular Medicine , Queen's University , Kingston , Canada
| | - Tara Baetz
- f Cancer Centre of Southeastern Ontario, Kingston General Hospital , Kingston , Canada
| | - David P LeBrun
- b Department of Pathology and Molecular Medicine , Queen's University , Kingston , Canada
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11
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Xin L, Yan Z, Zhang X, Zang Y, Ding Z, Xue H, Zhao C. Parameters for Contrast-Enhanced Ultrasound (CEUS) of Enlarged Superficial Lymph Nodes for the Evaluation of Therapeutic Response in Lymphoma: A Preliminary Study. Med Sci Monit 2017; 23:5430-5438. [PMID: 29138385 PMCID: PMC5700665 DOI: 10.12659/msm.907293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aims of this preliminary study were to evaluate contrast-enhanced ultrasound (CEUS) imaging and the therapeutic response of enlarged superficial lymph nodes in patients with lymphoma before and after chemotherapy and to determine the most useful CEUS response parameters. MATERIAL AND METHODS Forty-three patients with lymphoma, with 43 enlarged superficial lymph nodes, underwent CEUS and conventional ultrasound (US), before treatment and after the first three cycles of chemotherapy. Clinical responses included overall response (OR) and no response (NR). Imaging parameters by time-intensity curve (TIC) included basic intensity (B), wash-out slope and/or decent slope (K), wash-in slope or rise slope (C), time to peak (TTP), area under the gamma curve (Area), arrive time(ATM), peak intensity (PI), change of peak intensity (I) were compared. And receiver operating characteristic (ROC) curve analysis was operated. RESULTS Quantitative parameters of CEUS before and after the first three cycles of chemotherapy showed a significant difference in the AreaΔ, PID, and IΔ in the OR group compared with NR group (P<0.05). There was a significant difference in the Cpre, Areain, PIin, Iin, AreaΔ, PIΔ, and IΔ in the OR group compared with NR group (P<0.05). The effectiveness of the therapeutic response was predicted by the CEUS parameters of IΔ (P<0.05). And ΔArea has the highest diagnostic performance of ineffectiveness. CONCLUSIONS The findings of this study have shown that quantitative analysis by CEUS may be a useful, and objective, imaging method for the evaluation of the therapeutic response of enlarged superficial lymph nodes in lymphoma before and after chemotherapy.
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Affiliation(s)
- Lei Xin
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Zhimei Yan
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Xiaojuan Zhang
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Yichen Zang
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Zhaoyan Ding
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Hongwei Xue
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, P.R. China
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12
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Sites of extranodal involvement are prognostic in patients with stage 1 follicular lymphoma. Oncotarget 2017; 8:78410-78418. [PMID: 29108238 PMCID: PMC5667971 DOI: 10.18632/oncotarget.19240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/19/2017] [Indexed: 12/12/2022] Open
Abstract
Objectives Follicular lymphoma (FL) is the most common indolent B cell lymphoma in the United States and a quarter of patients present with stage I disease. The objective of this study was to examine if primary site of disease influences survival in early stage lymphoma. Results The most common extranodal primary sites were the integumentary system (8%), followed by the GI tract (6.4%) and head & neck (5.6%). We stratified patients into a pre-rituximab era (1983-1998) and the rituximab era (1999-2011). In multivariable analysis, integumentary disease was associated with better overall survival (Hazard Ratio [HR], 0.77; Confidence Interval [CI], 0.66-0.9) while primary site FL of the nervous system (HR, 2.40; CI, 1.72-3.38) and the musculoskeletal system (HR, 2.14; CI, 1.44-3.18) were associated with worse overall survival when compared to primary nodal FL. Treatment in the pre-rituximab era, male gender and older age at diagnosis were associated with worse survival. Methods We queried the SEER database from 1983 to 2011. We included all adult patients (>18 years) with histologically confirmed stage I FL, active follow-up, and a single primary tumor. A total of 9,865 patients met eligibility criteria, with 2520 (25%) having an extranodal primary site. We classified the primary sites by organ or anatomic location into 11 sites. Conclusion Primary site of disease is a prognostic factor for patients with early stage FL and may help identify subsets of patients that could benefit from early, aggressive treatment.
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13
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Nic Dhonncha E, Fadalla K, Moriarty B, Gibbons D, Collins CD, Fabre A, Collins P. High grade follicular lymphoma in a patient receiving adalimumab and methotrexate for pityriasis rubra pilaris. J DERMATOL TREAT 2017; 28:764-765. [DOI: 10.1080/09546634.2017.1303572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eilis Nic Dhonncha
- The Charles Centre, Department of Dermatology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Kamal Fadalla
- Department of Haematology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Blaithin Moriarty
- The Charles Centre, Department of Dermatology, St. Vincent’s University Hospital, Dublin, Ireland
| | - David Gibbons
- Department of Histopathology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Conor D. Collins
- Department of Radiology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Aurelie Fabre
- Department of Histopathology, St. Vincent’s University Hospital, Dublin, Ireland
| | - Paul Collins
- The Charles Centre, Department of Dermatology, St. Vincent’s University Hospital, Dublin, Ireland
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14
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Matsuo T, Tanaka T, Fujii N. Orbital MALT Lymphoma after Autologous Stem Cell Transplantation for Follicular Lymphoma as Relapse of Diffuse Large B-Cell Lymphoma. J Clin Exp Hematop 2017; 56:170-175. [PMID: 28331132 DOI: 10.3960/jslrt.56.170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We report a patient who developed orbital MALT lymphoma after autologous peripheral blood stem cell transplantation for follicular lymphoma as relapse of diffuse large B-cell lymphoma. A 54-year-old woman with systemic lymphadenopathy was diagnosed with diffuse large B-cell lymphoma by left supraclavicular lymph node biopsy, and underwent 6 courses of R-CHOP chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, leading to complete response. Five years later in the follow-up, an abdominal mass with abnormal uptake was found by whole-body 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography, and computed tomography-guided biopsy demonstrated follicular lymphoma. She underwent 4 courses of R-IDEA chemotherapy with rituximab, ifosfamide, dexamethasone, etoposide, and cytarabine, resulting in partial response, and then, underwent autologous peripheral blood stem cell transplantation with myeloablative conditioning with R-MCEC chemotherapy (rituximab, ranimustine, cyclophosphamide, etoposide, and carboplatin). She was well for the following 3 years with no treatment until the development of a right orbital mass. The excisional biopsy this time revealed MALT lymphoma. She underwent 3 courses with rituximab monotherapy and local orbital radiation at the total dose of 30 Gy. She had no relapse for the following three years. Relapse as MALT lymphoma after hematopoietic stem cell transplantation for relapsed and refractory lymphoma may not be a poor prognostic sign.
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Affiliation(s)
- Toshihiko Matsuo
- Department of Ophthalmology, Okayama University Hospital and Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
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15
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Sorigue M, Mercadal S, Alonso S, Fernández-Álvarez R, García O, Moreno M, Pomares H, Alcoceba M, González-García E, Motlló C, González-Barca E, Martin A, Sureda A, Caballero D, Ribera JM, Sancho JM. Refractoriness to immunochemotherapy in follicular lymphoma: Predictive factors and outcome. Hematol Oncol 2017; 35:520-527. [PMID: 28156010 DOI: 10.1002/hon.2378] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 11/17/2016] [Accepted: 11/28/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Marc Sorigue
- Department of Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerce Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
| | - Santiago Mercadal
- Department of Hematology. ICO-Duran y Reynals; Hospitalet de Llobregat; Bacelona Spain
| | - Sara Alonso
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | | | - Olga García
- Department of Clinical Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
| | - Miriam Moreno
- Department of Clinical Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
| | - Helena Pomares
- Department of Hematology. ICO-Duran y Reynals; Hospitalet de Llobregat; Bacelona Spain
| | - Miguel Alcoceba
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | | | - Cristina Motlló
- Department of Clinical Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
| | - Eva González-Barca
- Department of Hematology. ICO-Duran y Reynals; Hospitalet de Llobregat; Bacelona Spain
| | - Alejandro Martin
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - Anna Sureda
- Department of Hematology. ICO-Duran y Reynals; Hospitalet de Llobregat; Bacelona Spain
| | - Dolores Caballero
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - Josep-María Ribera
- Department of Clinical Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
| | - Juan-Manuel Sancho
- Department of Clinical Hematology. ICO-Badalona, Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras; Universitat Autònoma de Barcelona; Badalona Spain
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16
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Sun R, Wang J, Young KH. Oncogenic Signaling Pathways and Pathway-Based Therapeutic Biomarkers in Lymphoid Malignancies. Crit Rev Oncog 2017; 22:527-557. [PMID: 29604930 PMCID: PMC5961736 DOI: 10.1615/critrevoncog.2017020816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lymphoma is characterized by heterogeneous biology, pathologic features, and clinical outcome. This has been proven by accumulating pathologic and molecular evidence attributed to underlying aberrant alterations at genetic, epigenetic, transcriptional, protein, microenvironmental levels, and dysregulated oncogenic signaling pathways. In the era of precision medicine, targeting oncogenic pathways to design drugs and to optimize treatment regimens for the lymphoma patients is feasible and clinically significant. As such, further understanding of the biology and the mechanisms behind lymphoma development and identification of oncogenic pathway activation and pathway-based biomarkers to better design precise therapies are challenging but hopeful. Furthermore, pathway-based targeted therapies in combination with traditional chemotherapy, single specific targeted antibody therapy, and immunotherapy might raise the hope for the patients with lymphoma, especially for relapsed and refractory lymphoma patients.
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Affiliation(s)
- Ruifang Sun
- Department of Pathology, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
- Tumor Biobank, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Jinfen Wang
- Department of Pathology, Shanxi Cancer Hospital, Taiyuan, Shanxi, China
| | - Ken H. Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Graduate School of Biomedical Sciences, The University of Texas Health Science Center, Houston, TX, USA
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17
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Basic Molecular Pathology and Cytogenetics for Practicing Pathologists: Correlation With Morphology and With a Focus on Aspects of Diagnostic or Therapeutic Utility. Adv Anat Pathol 2016; 23:368-380. [PMID: 27740961 DOI: 10.1097/pap.0000000000000124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Morphology, as confronted in the everyday practice, often correlates with specific molecular features, which have important implications not only in pathogenesis and in diagnosis but also in prognosis and therapy. Thus, it is important that the classical pathology includes a sound knowledge of molecular aspects of disease. These molecular concepts are complex and not easily understood by all engaged in the routine practice of histopathology. Thus, the aim of this review is to present a summary of most of the necessary concepts for pathologists involving molecular pathology and genetics, beginning from basic definitions and mechanisms to major abnormalities and the methodology to detect them, correlating at the same time, the specific morphologic features associated with every abnormality.
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18
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Sun R, Medeiros LJ, Young KH. Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine. Mod Pathol 2016; 29:1118-42. [PMID: 27363492 DOI: 10.1038/modpathol.2016.92] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 02/07/2023]
Abstract
Lymphomas are a group of hematological malignancies derived from lymphocytes. Lymphomas are clinically and biologically heterogeneous and have overlapping diagnostic features. With the advance of new technologies and the application of efficient and feasible detection platforms, an unprecedented number of novel biomarkers have been discovered or are under investigation at the genetic, epigenetic, and protein level as well as the tumor microenvironment. These biomarkers have enabled new clinical and pathological insights into the mechanisms underlying lymphomagenesis and also have facilitated improvements in the diagnostic workup, sub-classification, outcome stratification, and personalized therapy for lymphoma patients. However, integrating these biomarkers into clinical practice effectively and precisely in daily practice is challenging. More in-depth studies are required to further validate these novel biomarkers and to assess other parameters that can affect the reproducibility of these biomarkers such as the selection of detection methods, biological reagents, interpretation of data, and cost efficiency. Despite these challenges, there are many reasons to be optimistic that novel biomarkers will facilitate better algorithms and strategies as we enter a new era of precision medicine to better refine diagnosis, prognostication, and rational treatment design for patients with lymphomas.
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Affiliation(s)
- Ruifang Sun
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Pathology, Shanxi Cancer Hospital, Shanxi, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Science, Houston, TX, USA
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19
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Limited Stage Follicular Lymphoma: Current Role of Radiation Therapy. Mediterr J Hematol Infect Dis 2016; 8:e2016041. [PMID: 27648204 PMCID: PMC5016012 DOI: 10.4084/mjhid.2016.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/18/2016] [Indexed: 12/04/2022] Open
Abstract
Radiation therapy (RT) alone has been considered for a long time as the standard therapeutic option for limited stage FL, due to its high efficacy in terms of local disease control with a quite significant proportion of “cured” patients (without further relapses at 10–15 years). Multiple therapeutic choices are currently accepted for the management of early stage FL at diagnosis, and better staging procedures as well as better systemic therapy partially modified the role of RT in this setting. RT has also changed in terms of prescribed dose as well as treatment volumes. In this review, we present and discuss the current role of RT for limited stage FL in light of the historical data and the modern RT concepts along with the possible combination with systemic therapy.
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20
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Mensali N, Ying F, Sheng VOY, Yang W, Walseng E, Kumari S, Fallang LE, Kolstad A, Uckert W, Malmberg KJ, Wälchli S, Olweus J. Targeting B-cell neoplasia with T-cell receptors recognizing a CD20-derived peptide on patient-specific HLA. Oncoimmunology 2016; 5:e1138199. [PMID: 27467957 DOI: 10.1080/2162402x.2016.1138199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 12/22/2022] Open
Abstract
T cells engineered to express chimeric antigen receptors (CARs) targeted to CD19 are effective in treatment of B-lymphoid malignancies. However, CARs recognize all CD19 positive (pos) cells, and durable responses are linked to profound depletion of normal B cells. Here, we designed a strategy to specifically target patient B cells by utilizing the fact that T-cell receptors (TCRs), in contrast to CARs, are restricted by HLA. Two TCRs recognizing a peptide from CD20 (SLFLGILSV) in the context of foreign HLA-A*02:01 (CD20p/HLA-A2) were expressed as 2A-bicistronic constructs. T cells re-directed with the A23 and A94 TCR constructs efficiently recognized malignant HLA-A2(pos) B cells endogenously expressing CD20, including patient-derived follicular lymphoma and chronic lymphocytic leukemia (CLL) cells. In contrast, a wide range of HLA-A2(pos)CD20(neg) cells representing different tissue origins, and HLA-A2(neg)CD20(pos) cells, were not recognized. Cytotoxic T cells re-directed with CD20p/HLA-A2-specific TCRs or CD19 CARs responded with similar potencies to cells endogenously expressing comparable levels of CD20 and CD19. The CD20p/HLA-A2-specific TCRs recognized CD20p bound to HLA-A2 with high functional avidity. The results show that T cells expressing CD20p/HLA-A2-specific TCRs efficiently and specifically target B cells. When used in context of an HLA-haploidentical allogeneic stem cell transplantation where the donor is HLA-A2(neg) and the patient HLA-A2(pos), these T cells would selectively kill patient-derived B cells and allow reconstitution of the B-cell compartment with HLA-A2(neg) donor cells. These results should pave the way for clinical testing of T cells genetically engineered to target malignant B cells without permanent depletion of normal B cells.
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Affiliation(s)
- Nadia Mensali
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fan Ying
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Vincent Oei Yi Sheng
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Weiwen Yang
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Even Walseng
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet , Oslo, Norway
| | - Shraddha Kumari
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars-Egil Fallang
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet , Oslo, Norway
| | - Arne Kolstad
- K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital Radiumhospitalet, Oslo, Norway
| | - Wolfgang Uckert
- Max Delbrück Center for Molecular Medicine and Institute of Biology, Humboldt University , Berlin, Germany
| | - Karl Johan Malmberg
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sébastien Wälchli
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; Department of Cell Therapy, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Johanna Olweus
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital Radiumhospitalet, Oslo, Norway; K.G Jebsen Center for Cancer Immunotherapy, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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21
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Le KS, Thibult ML, Just-Landi S, Pastor S, Gondois-Rey F, Granjeaud S, Broussais F, Bouabdallah R, Colisson R, Caux C, Ménétrier-Caux C, Leroux D, Xerri L, Olive D. Follicular B Lymphomas Generate Regulatory T Cells via the ICOS/ICOSL Pathway and Are Susceptible to Treatment by Anti-ICOS/ICOSL Therapy. Cancer Res 2016; 76:4648-60. [PMID: 27246829 DOI: 10.1158/0008-5472.can-15-0589] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/09/2016] [Indexed: 11/16/2022]
Abstract
The prognosis of follicular lymphoma (FL) patients is suspected to be influenced by tumor-infiltrating regulatory T cells (Treg). The mechanism of Treg enrichment in FL and their impact on malignant FL B cells remains to be elucidated. We analyzed 46 fresh lymph node biopsy samples, including FL (n = 20), diffuse large B-cell lymphoma (n = 10), classical Hodgkin lymphoma (n = 9), and reactive lymphadenitis (n = 7). Using multicolor flow cytometry and cell sorting, we observed an accumulation of CD25(high)CD127(low/neg) Tregs in FL tissues. These Tregs comprised activated ICOS(+) Tregs that were able to suppress not only conventional T cells, but also FL B cells. These FL B cells were able to express ICOSL in vitro and to generate CD25(high)FoxP3(high) Tregs expressing ICOS. Treg generation was associated with ICOS/ICOSL engagement and was abrogated by antagonist anti-ICOS and anti-ICOSL antibodies. Interactions between Tregs and FL B cells resulted in ICOSL downregulation on FL B cells. Our results highlight a key role for Tregs in FL pathogenesis and suggest that targeting the ICOS/ICOSL pathway may be a promising immunotherapy for FL treatment. Cancer Res; 76(16); 4648-60. ©2016 AACR.
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Affiliation(s)
- Kieu-Suong Le
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France
| | - Marie-Laure Thibult
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Institut Paoli - Calmettes, Marseille, France
| | | | - Sonia Pastor
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | - Françoise Gondois-Rey
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | - Samuel Granjeaud
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France
| | | | | | - Renaud Colisson
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052/CNRS 5286, Lyon, France
| | - Christophe Caux
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052/CNRS 5286, Lyon, France
| | | | | | - Luc Xerri
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France. Institut Paoli - Calmettes, Marseille, France
| | - Daniel Olive
- Centre de recherche en Cancérologie de Marseille, Inserm U1068/CNRS U7258, Marseille, France. Aix Marseille Université, Marseille, France. Institut Paoli - Calmettes, Marseille, France.
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22
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Li Y, Bouchlaka MN, Wolff J, Grindle KM, Lu L, Qian S, Zhong X, Pflum N, Jobin P, Kahl BS, Eickhoff JC, Wuerzberger-Davis SM, Miyamoto S, Thomas CJ, Yang DT, Capitini CM, Rui L. FBXO10 deficiency and BTK activation upregulate BCL2 expression in mantle cell lymphoma. Oncogene 2016; 35:6223-6234. [PMID: 27157620 DOI: 10.1038/onc.2016.155] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/29/2016] [Accepted: 03/11/2016] [Indexed: 12/17/2022]
Abstract
Targeting Bruton tyrosine kinase (BTK) by ibrutinib is an effective treatment for patients with relapsed/refractory mantle cell lymphoma (MCL). However, both primary and acquired resistance to ibrutinib have developed in a significant number of these patients. A combinatory strategy targeting multiple oncogenic pathways is critical to enhance the efficacy of ibrutinib. Here, we focus on the BCL2 anti-apoptotic pathway. In a tissue microarray of 62 MCL samples, BCL2 expression positively correlated with BTK expression. Increased levels of BCL2 were shown to be due to a defect in protein degradation because of no or little expression of the E3 ubiquitin ligase FBXO10, as well as transcriptional upregulation through BTK-mediated canonical nuclear factor-κB activation. RNA-seq analysis confirmed that a set of anti-apoptotic genes (for example, BCL2, BCL-XL and DAD1) was downregulated by BTK short hairpin RNA. The downregulated genes also included those that are critical for B-cell growth and proliferation, such as BCL6, MYC, PIK3CA and BAFF-R. Targeting BCL2 by the specific inhibitor ABT-199 synergized with ibrutinib in inhibiting growth of both ibrutinib-sensitive and -resistant cancer cells in vitro and in vivo. These results suggest co-targeting of BTK and BCL2 as a new therapeutic strategy in MCL, especially for patients with primary resistance to ibrutinib.
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Affiliation(s)
- Y Li
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - M N Bouchlaka
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J Wolff
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - K M Grindle
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - L Lu
- Wisconsin Institute for Discovery and Laboratory of Genetics, University of Wisconsin, Madison, WI, USA
| | - S Qian
- Wisconsin Institute for Discovery and Laboratory of Genetics, University of Wisconsin, Madison, WI, USA
| | - X Zhong
- Wisconsin Institute for Discovery and Laboratory of Genetics, University of Wisconsin, Madison, WI, USA
| | - N Pflum
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - P Jobin
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - B S Kahl
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - J C Eickhoff
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - S M Wuerzberger-Davis
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - S Miyamoto
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C J Thomas
- Division of Preclinical Innovation, National Institutes of Health Chemical Genomics Center, National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - D T Yang
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - C M Capitini
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - L Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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23
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Thomas R, Demeter Z, Kennedy KA, Borst L, Singh K, Valli VE, Le Boedec K, Breen M. Integrated immunohistochemical and DNA copy number profiling analysis provides insight into the molecular pathogenesis of canine follicular lymphoma. Vet Comp Oncol 2016; 15:852-867. [PMID: 27135201 DOI: 10.1111/vco.12227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 12/16/2022]
Abstract
Follicular lymphomas (FLs) typically exhibit a chromosome translocation that induces constitutive expression of the anti-apoptotic bcl2 protein and accumulation of additional molecular defects. This rearrangement offers a promising therapeutic target, but its nature as a fundamental driver of FL pathogenesis remains unclear as 15% of cases lack the translocation. We performed an integrated immunohistochemical and genomic investigation of 10 naturally occurring FL cases from domestic dogs, showing that, as with human tumours, they exhibit marked heterogeneity in the frequency and intensity of bcl2 protein expression. Genomic copy number aberrations were infrequent and broadly consistent with those of other canine B-cell lymphoma subtypes. None of the canine FL specimens exhibited a rearrangement consistent with the hallmark translocation of human FL, despite their remarkable histomorphologic similarity. Parallel exploration of canine and human cases may reveal alternative tumour-initiating mechanisms other than BCL2 disruption, yielding a more complete definition of the molecular pathogenesis of FL.
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Affiliation(s)
- R Thomas
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA
| | - Z Demeter
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.,IDEXX Reference Laboratories Inc., West Sacramento, CA, USA
| | - K A Kennedy
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - L Borst
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - K Singh
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - V E Valli
- Visalia Pathology Medical Group, Visalia, CA, USA
| | - K Le Boedec
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - M Breen
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, NC, USA.,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.,University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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24
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Oh DH, Li H, Duan Q, Villa D, Peters A, Chua N, Owen CJ, Connors JM, Stewart DA. Quantifying Benefit of Autologous Transplantation for Relapsed Follicular Lymphoma Patients via Instrumental Variable Analysis. Biol Blood Marrow Transplant 2016; 22:941-8. [DOI: 10.1016/j.bbmt.2016.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/10/2016] [Indexed: 10/22/2022]
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25
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Fenske TS, Hamadani M, Cohen JB, Costa LJ, Kahl BS, Evens AM, Hamlin PA, Lazarus HM, Petersdorf E, Bredeson C. Allogeneic Hematopoietic Cell Transplantation as Curative Therapy for Patients with Non-Hodgkin Lymphoma: Increasingly Successful Application to Older Patients. Biol Blood Marrow Transplant 2016; 22:1543-1551. [PMID: 27131863 DOI: 10.1016/j.bbmt.2016.04.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 04/21/2016] [Indexed: 12/31/2022]
Abstract
Non-Hodgkin lymphoma (NHL) constitutes a collection of lymphoproliferative disorders with widely varying biological, histological, and clinical features. For the B cell NHLs, great progress has been made due to the addition of monoclonal antibodies and, more recently, other novel agents including B cell receptor signaling inhibitors, immunomodulatory agents, and proteasome inhibitors. Autologous hematopoietic cell transplantation (auto-HCT) offers the promise of cure or prolonged remission in some NHL patients. For some patients, however, auto-HCT may never be a viable option, whereas in others, the disease may progress despite auto-HCT. In those settings, allogeneic HCT (allo-HCT) offers the potential for cure. Over the past 10 to 15 years, considerable progress has been made in the implementation of allo-HCT, such that this approach now is a highly effective therapy for patients up to (and even beyond) age 75 years. Recent advances in conventional lymphoma therapy, peritransplantation supportive care, patient selection, and donor selection (including the use of alternative hematopoietic cell donors), has allowed broader application of allo-HCT to patients with NHL. As a result, an ever-increasing number of NHL patients over age 60 to 65 years stand to benefit from allo-HCT. In this review, we present data in support of the use of allo-HCT for patients with diffuse large B cell lymphoma, follicular lymphoma, and mantle cell lymphoma. These histologies account for a large majority of allo-HCTs performed for patients over age 60 in the United States. Where possible, we highlight available data in older patients. This body of literature strongly supports the concept that allo-HCT should be offered to fit patients well beyond age 65 and, accordingly, that this treatment should be covered by their insurance carriers.
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Affiliation(s)
- Timothy S Fenske
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Mehdi Hamadani
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin
| | - Jonathon B Cohen
- Department of Hematology and Medical Oncology, Emory University, Winship Cancer Institute, Atlanta, Georgia
| | - Luciano J Costa
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brad S Kahl
- Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew M Evens
- Division of Hematology/Oncology, Tufts Medical Center, Boston, Massachusetts
| | - Paul A Hamlin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, and Department of Medicine, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, New York
| | - Hillard M Lazarus
- Division of Hematology-Oncology, Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Effie Petersdorf
- Division of Medical Oncology, University of Washington School of Medicine, and Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Christopher Bredeson
- Blood and Marrow Transplant Program, Ottawa Hospital Research Institute at University of Ottawa, Ottawa, Ontario, Canada
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26
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Laport GG, Wu J, Logan B, Bachanova V, Hosing C, Fenske T, Longo W, Devine SM, Nademanee A, Gersten I, Horowitz M, Lazarus HM, Riches ML. Reduced-Intensity Conditioning with Fludarabine, Cyclophosphamide, and High-Dose Rituximab for Allogeneic Hematopoietic Cell Transplantation for Follicular Lymphoma: A Phase Two Multicenter Trial from the Blood and Marrow Transplant Clinical Trials Network. Biol Blood Marrow Transplant 2016; 22:1440-1448. [PMID: 27118571 DOI: 10.1016/j.bbmt.2016.04.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
Allogeneic (allo) hematopoietic cell transplantation (HCT) can induce long-term remissions in chemosensitive relapsed follicular lymphoma (FL). The Blood and Marrow Transplant Clinical Trials Network conducted a multicenter phase 2 trial to examine the efficacy of alloHCT using reduced-intensity conditioning with rituximab (RTX) in multiply relapsed, chemosensitive FL. The primary endpoint was 2-year progression-free survival (PFS). The conditioning regimen consisted of fludarabine, cyclophosphamide, and high-dose RTX (FCR), in which 3 of the 4 doses of RTX were administered at a dose of 1 gm/m(2). Graft-versus-host disease (GVHD) prophylaxis was with tacrolimus and methotrexate. Sixty-five patients were enrolled and 62 were evaluable. Median age was 55 years (range, 29 to 74). This group was heavily pretreated: 77% had received ≥ 3 prior regimens, 32% had received ≥ 5 prior regimens, and 11% had received prior autologous HCT. Donors were HLA-matched siblings (n = 33) or HLA-matched unrelated adults (n = 29). No graft failures occurred. The overall response rate after HCT was 94% with 90% in complete remission (CR), including 24 patients not in CR before alloHCT. With a median follow-up of 47 months (range, 30 to 73), 3-year PFS and overall survival rates were 71% (95% confidence interval, 58% to 81%) and 82% (95% confidence interval, 70% to 90%), respectively. Three-year cumulative incidences of relapse/progression and nonrelapse mortality were 13% and 16%, respectively. Two-year cumulative incidences of grades 2 to 4 and grades 3 or 4 acute GVHD were 27% and 10%, respectively, and extensive chronic GVHD incidence was 55%. Serum RTX concentrations peaked at day +28 and remained detectable as late as 1 year in 59% of patients with available data. In conclusion, alloHCT with FCR conditioning confers high CR rates, a low incidence of relapse/progression, and excellent survival probabilities in heavily pretreated FL patients.
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Affiliation(s)
- Ginna G Laport
- Stanford University Medical Center, Stanford, California
| | - Juan Wu
- The EMMES Corporation, Rockville, Maryland
| | - Brent Logan
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Chitra Hosing
- University of Texas/MD Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | | | | | - Marcie L Riches
- Division of Hematology/Oncology, University of North Carolina, Chapel Hill, North Carolina.
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27
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Thakkar K, Ghaisas SM, Singh M. Lymphadenopathy: Differentiation between Tuberculosis and Other Non-Tuberculosis Causes like Follicular Lymphoma. Front Public Health 2016; 4:31. [PMID: 26942176 PMCID: PMC4766275 DOI: 10.3389/fpubh.2016.00031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/12/2016] [Indexed: 11/25/2022] Open
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28
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Wu R, Nijland M, Rutgers B, Veenstra R, Langendonk M, van der Meeren LE, Kluin PM, Li G, Diepstra A, Chiu JF, van den Berg A, Visser L. Proteomics Based Identification of Proteins with Deregulated Expression in B Cell Lymphomas. PLoS One 2016; 11:e0146624. [PMID: 26752561 PMCID: PMC4708982 DOI: 10.1371/journal.pone.0146624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/18/2015] [Indexed: 02/05/2023] Open
Abstract
Follicular lymphoma and diffuse large B cell lymphomas comprise the main entities of adult B cell malignancies. Although multiple disease driving gene aberrations have been identified by gene expression and genomic studies, only a few studies focused at the protein level. We applied 2 dimensional gel electrophoresis to compare seven GC B cell non Hodgkin lymphoma (NHL) cell lines with a lymphoblastoid cell line (LCL). An average of 130 spots were at least two folds different in intensity between NHL cell lines and the LCL. We selected approximately 38 protein spots per NHL cell line and linked them to 145 unique spots based on the location in the gel. 34 spots that were found altered in at least three NHL cell lines when compared to LCL, were submitted for LC-MS/MS. This resulted in 28 unique proteins, a substantial proportion of these proteins were involved in cell motility and cell metabolism. Loss of expression of B2M, and gain of expression of PRDX1 and PPIA was confirmed in the cell lines and primary lymphoma tissue. Moreover, inhibition of PPIA with cyclosporine A blocked cell growth of the cell lines, the effect size was associated with the PPIA expression levels. In conclusion, we identified multiple differentially expressed proteins by 2-D proteomics, and showed that some of these proteins might play a role in the pathogenesis of NHL.
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Affiliation(s)
- Rui Wu
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- Department of Biochemistry, Open laboratory for Tumor Molecular Biology, Shantou University Medical College, Shantou, China
| | - Marcel Nijland
- Department of Hematology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Bea Rutgers
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Rianne Veenstra
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Myra Langendonk
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Lotte E. van der Meeren
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Philip M. Kluin
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Guanwu Li
- Department of Biochemistry, Open laboratory for Tumor Molecular Biology, Shantou University Medical College, Shantou, China
| | - Arjan Diepstra
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Jen-Fu Chiu
- Department of Biochemistry, Open laboratory for Tumor Molecular Biology, Shantou University Medical College, Shantou, China
| | - Anke van den Berg
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Lydia Visser
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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29
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Jeong G, Kim J, Han S, Lee J, Park K, Pak C, Lim JH, Cha HJ, Kim H, Jo JC. Coexistence of follicular lymphoma and an unclassifiable myeloproliferative neoplasm in a treatment-naïve patient: A case report. Oncol Lett 2015; 11:1469-1473. [PMID: 26893762 DOI: 10.3892/ol.2015.4040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 06/16/2015] [Indexed: 12/16/2022] Open
Abstract
Myeloproliferative neoplasms are associated with lymphoproliferative diseases following the administration of cytotoxic drugs or exposure to radiation, but are rare prior to therapy. The present study reports the case of a 61-year-old female with a history of transient ischemic attack. The patient, who presented with a palpable mass in the epitrochlear area of the left arm, was simultaneously diagnosed with follicular lymphoma and an unclassifiable myeloproliferative neoplasm. Excisional lymph node biopsy revealed stage I follicular lymphoma (grade 1). Laboratory findings demonstrated leukocytosis, erythrocytosis, thrombocytosis and decreased erythropoietin. Biopsy of the bone marrow revealed hypercellularity, with predominance of erythroid cells, and large polylobated megakaryocytes with increased mitotic figures, but no evidence of lymphomatous infiltration. The janus kinase 2 V617F mutation was also detected in the cells derived from the bone marrow specimen. Following local excision of the lymph node in the left epitrochlear area, radiation was delivered to the involved field, at a dose of 24 Gy in 12 fractions. The patient was started on hydroxyurea (1 g twice per day, orally) 2 weeks subsequent to radiotherapy, and was administered 500 mg twice per day as maintenance therapy. At the six-month follow-up, the white blood cell count, hemoglobin levels and platelet count had reduced, and the patient was in a healthy condition. A computed tomography scan of the neck, chest and abdomen indicated no abnormalities. To the best of our knowledge, the present study is the first case report of follicular lymphoma coexisting with an unclassifiable myeloproliferative neoplasm in a previously healthy patient. Molecular and genetic studies are required to further evaluate this infrequent disease association.
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Affiliation(s)
- Gyeongmin Jeong
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Jinhyong Kim
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Seeun Han
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Jongmin Lee
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Kyunghye Park
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Chuiyong Pak
- Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Ji-Hun Lim
- Department of Laboratory Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Hee Jeong Cha
- Department of Pathology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Hawk Kim
- Department of Hematology and Oncology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
| | - Jae-Cheol Jo
- Department of Hematology and Oncology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 682-714, Republic of Korea
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30
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Ruella M, Filippi AR, Bruna R, Di Russo A, Magni M, Caracciolo D, Passera R, Matteucci P, Di Nicola M, Corradini P, Parvis G, Gini G, Olivieri A, Ladetto M, Ricardi U, Tarella C, Devizzi L. Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study. Int J Radiat Oncol Biol Phys 2015; 94:783-91. [PMID: 26972651 DOI: 10.1016/j.ijrobp.2015.12.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/28/2015] [Accepted: 12/02/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. METHODS AND MATERIALS Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab courses (375 mg/m(2), days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. RESULTS At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. CONCLUSIONS This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.
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Affiliation(s)
- Marco Ruella
- Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino, Italy; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Riccardo Bruna
- Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino, Italy
| | - Anna Di Russo
- Radiation Oncology, Istituto Nazionale Tumori, Milano, Italy
| | - Michele Magni
- Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano, Italy
| | - Daniele Caracciolo
- Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino, Italy
| | - Roberto Passera
- Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino, Italy
| | - Paola Matteucci
- Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano, Italy
| | - Massimo Di Nicola
- Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano, Italy
| | - Paolo Corradini
- Division of Haematology, Istituto Nazionale Tumori, and University of Milano, Milano, Italy
| | - Guido Parvis
- Division of Haematology, San Luigi Gonzaga Hospital, Orbassano, Torino, Italy
| | - Guido Gini
- Division of Haematology, Ospedali Riuniti, Ancona, Italy
| | | | - Marco Ladetto
- Division of Haematology, San Giovanni Battista Hospital and University of Torino, Torino, Italy
| | - Umberto Ricardi
- Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy
| | - Corrado Tarella
- Division of Haematology and Cell Therapy, Mauriziano Hospital and University of Torino, Torino, Italy; Hemato-Oncology Division, European Institute of Oncology, Milano, Italy.
| | - Liliana Devizzi
- Division of Medical Oncology, Istituto Nazionale Tumori, and University of Milano, Milano, Italy
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31
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Luminari S, Galimberti S, Versari A, Biasoli I, Anastasia A, Rusconi C, Ferrari A, Petrini M, Manni M, Federico M. Positron emission tomography response and minimal residual disease impact on progression-free survival in patients with follicular lymphoma. A subset analysis from the FOLL05 trial of the Fondazione Italiana Linfomi. Haematologica 2015; 101:e66-8. [PMID: 26471485 DOI: 10.3324/haematol.2015.132811] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Stefano Luminari
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Italy
| | - Sara Galimberti
- Department of Internal and Experimental Medicine, University of Pisa, UO Hematology, Italy
| | - Annibale Versari
- Department of Nuclear Medicine, Arcispedale S. Maria Nuova - IRCCS of Reggio Emilia, Italy
| | - Irene Biasoli
- Department of Medicine, University Hospital and School of Medicine, Universidade Federal do Rio de Janeiro, Brazil
| | | | - Chiara Rusconi
- Division of Hematology, Department of Hematology and Oncology, Niguarda Hospital, Milan, Italy
| | - Angela Ferrari
- Hematology Unit, Arcispedale Santa Maria Nuova, IRCCS of Reggio Emilia, Italy
| | - Mario Petrini
- Department of Internal and Experimental Medicine, University of Pisa, UO Hematology, Italy
| | - Martina Manni
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Italy
| | - Massimo Federico
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Italy
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32
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Rosario M, Liu B, Kong L, Collins LI, Schneider SE, Chen X, Han K, Jeng EK, Rhode PR, Leong JW, Schappe T, Jewell BA, Keppel CR, Shah K, Hess B, Romee R, Piwnica-Worms DR, Cashen AF, Bartlett NL, Wong HC, Fehniger TA. The IL-15-Based ALT-803 Complex Enhances FcγRIIIa-Triggered NK Cell Responses and In Vivo Clearance of B Cell Lymphomas. Clin Cancer Res 2015; 22:596-608. [PMID: 26423796 DOI: 10.1158/1078-0432.ccr-15-1419] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/15/2015] [Indexed: 12/30/2022]
Abstract
PURPOSE Anti-CD20 monoclonal antibodies (mAb) are an important immunotherapy for B-cell lymphoma, and provide evidence that the immune system may be harnessed as an effective lymphoma treatment approach. ALT-803 is a superagonist IL-15 mutant and IL-15Rα-Fc fusion complex that activates the IL-15 receptor constitutively expressed on natural killer (NK) cells. We hypothesized that ALT-803 would enhance anti-CD20 mAb-directed NK-cell responses and antibody-dependent cellular cytotoxicity (ADCC). EXPERIMENTAL DESIGN We tested this hypothesis by adding ALT-803 immunostimulation to anti-CD20 mAb triggering of NK cells in vitro and in vivo. Cell lines and primary human lymphoma cells were utilized as targets for primary human NK cells. Two complementary in vivo mouse models were used, which included human NK-cell xenografts in NOD/SCID-γc (-/-) mice. RESULTS We demonstrate that short-term ALT-803 stimulation significantly increased degranulation, IFNγ production, and ADCC by human NK cells against B-cell lymphoma cell lines or primary follicular lymphoma cells. ALT-803 augmented cytotoxicity and the expression of granzyme B and perforin, providing one potential mechanism for this enhanced functionality. Moreover, in two distinct in vivo B-cell lymphoma models, the addition of ALT-803 to anti-CD20 mAb therapy resulted in significantly reduced tumor cell burden and increased survival. Long-term ALT-803 stimulation of human NK cells induced proliferation and NK-cell subset changes with preserved ADCC. CONCLUSIONS ALT-803 represents a novel immunostimulatory drug that enhances NK-cell antilymphoma responses in vitro and in vivo, thereby supporting the clinical investigation of ALT-803 plus anti-CD20 mAbs in patients with indolent B-cell lymphoma.
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MESH Headings
- Animals
- Antibody-Dependent Cell Cytotoxicity/drug effects
- Antineoplastic Agents/pharmacology
- Cell Line, Tumor
- Cytotoxicity, Immunologic/drug effects
- Disease Models, Animal
- Drug Synergism
- Gene Expression Regulation, Neoplastic/drug effects
- Granzymes/genetics
- Granzymes/metabolism
- Humans
- Interferon-gamma/biosynthesis
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/metabolism
- Lymphoma, B-Cell/pathology
- Mice
- Mice, Knockout
- Perforin/genetics
- Perforin/metabolism
- Proteins/pharmacology
- Receptors, IgG/metabolism
- Recombinant Fusion Proteins
- Rituximab/pharmacology
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Maximillian Rosario
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri. Department of Pathology/Immunology, Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Bai Liu
- Altor BioScience Corporation, Miramar, Florida
| | - Lin Kong
- Altor BioScience Corporation, Miramar, Florida
| | - Lynne I Collins
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Stephanie E Schneider
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | | | - Kaiping Han
- Altor BioScience Corporation, Miramar, Florida
| | | | | | - Jeffrey W Leong
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Timothy Schappe
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Brea A Jewell
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Catherine R Keppel
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Keval Shah
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Brian Hess
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Rizwan Romee
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - David R Piwnica-Worms
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri. Department of Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amanda F Cashen
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Nancy L Bartlett
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Hing C Wong
- Altor BioScience Corporation, Miramar, Florida
| | - Todd A Fehniger
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
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33
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Davies A. Idelalisib for relapsed/refractory indolent B-cell non-Hodgkin’s lymphoma: an overview of pharmacokinetics and clinical trial outcomes. Expert Rev Hematol 2015; 8:581-93. [DOI: 10.1586/17474086.2015.1071663] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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34
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Neshatian L, Katzka DA. A Hidden Cause of Dysphagia. Primary Esophageal Lymphoma. Gastroenterology 2015; 149:549-50. [PMID: 26231599 DOI: 10.1053/j.gastro.2015.05.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 04/22/2015] [Accepted: 05/06/2015] [Indexed: 12/02/2022]
Affiliation(s)
- Leila Neshatian
- Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota
| | - David A Katzka
- Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota
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Andrade-Campos MM, Montes-Limón AE, Soro-Alcubierre G, Lievano P, López-Gómez L, Baringo T, Giraldo P. Patients Older Than 65 Years With Non-Hodgkin Lymphoma Are Suitable for Treatment With 90Yttrium-Ibritumumab Tiuxetan: A Single-Institution Experience. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:464-71. [DOI: 10.1016/j.clml.2015.02.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 02/26/2015] [Indexed: 11/30/2022]
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Kouroukis C, Crump M, MacDonald D, Larouche J, Stewart D, Johnston J, Sauvageau S, Beausoleil E, Sage P, Dubois S, Christofides A, Di Clemente S, Sehn L. An open-label expanded-access trial of bendamustine in patients with rituximab-refractory indolent non-Hodgkin lymphoma or previously untreated chronic lymphocytic leukemia: BEND-ACT. Curr Oncol 2015; 22:260-71. [PMID: 26300664 PMCID: PMC4530811 DOI: 10.3747/co.22.2431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Bendamustine is a bifunctional alkylating agent with unique properties that distinguish it from other agents in its class. Bendamustine is used as monotherapy or in combination with other agents to treat patients with non-Hodgkin lymphoma (nhl) and chronic lymphocytic leukemia (cll). METHODS The prospective interventional open-label bend-act trial evaluated bendamustine in patients with rituximab-refractory indolent nhl (inhl) and previously untreated cll. Study objectives were to assess the safety and tolerability of bendamustine monotherapy and to provide patients with access to bendamustine before Health Canada approval. The study aimed to enrol up to 100 patients. All patients with inhl received an intravenous dose of bendamustine 120 mg/m(2) over 60 minutes on days 1 and 2 for up to eight 21- or 28-day treatment cycles. All patients with cll received an intravenous dose of bendamustine 100 mg/m(2) over 30 minutes on days 1 and 2 for up to six 28-day treatment cycles. RESULTS Of 90 patients treated on study (16 with cll and 74 with inhl), 35 completed the study (4 with cll and 31 with inhl). The most common treatment-emergent adverse events (teaes) were nausea (70%), fatigue (57%), vomiting (40%), and diarrhea (33%)-mostly grades 1 and 2. Ondansetron was the most common supportive medication used in the patients (63.5% of those with inhl and 68.8% of those with cll). Neutropenia (32%), anemia (23%), and thrombocytopenia (21%) were the most frequent hematologic teaes, with neutropenia being the most common grade 3 or 4 teae leading to dose modification. Dose delays occurred in 28 patients (31.3%) because of grade 3 or 4 teaes, with a higher incidence of dose delays being observed in inhl patients on the 21-day treatment cycle than in those on the 28-day treatment cycle (50.0% vs. 24.1%). During the study, 33 patients (36.7%) experienced at least 1 serious adverse event, and 4 deaths were reported (all in patients with inhl). CONCLUSIONS The type and frequency of the teaes reported accorded with observations in earlier clinical trials and post-marketing experiences, thus confirming the acceptable and manageable safety profile of bendamustine.
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Affiliation(s)
- C.T. Kouroukis
- Department of Oncology, McMaster University, and Juravinski Cancer Centre and Hospital, Hamilton, ON
| | - M. Crump
- Department of Medical Oncology and Hematology, University of Toronto, Toronto, ON
| | - D. MacDonald
- Dalhousie University and QEII Health Sciences Centre, Halifax, NS
| | - J.F. Larouche
- Hematology–Oncology, CHU de Québec, Hôpital Enfant-Jésus, Montreal, QC
| | - D.A. Stewart
- Department of Oncology and Medicine, University of Calgary, and Tom Baker Cancer Centre, Calgary, AB
| | - J. Johnston
- Department of Internal Medicine, University of Manitoba, and Cancer Care Manitoba, Winnipeg, MB
| | | | | | - P. Sage
- Lundbeck Canada Inc., Montreal, QC
| | | | | | | | - L. Sehn
- University of British Columbia and BC Cancer Agency, Vancouver, BC
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Smolewski P, Robak T. The preclinical discovery of rituximab for the treatment of non-Hodgkin’s lymphoma. Expert Opin Drug Discov 2015; 10:791-808. [DOI: 10.1517/17460441.2015.1045295] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Adams HJA, Nievelstein RAJ, Kwee TC. Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma. Blood Rev 2015; 29:417-25. [PMID: 26113144 DOI: 10.1016/j.blre.2015.06.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 12/17/2022]
Abstract
Bone marrow involvement in lymphoma may have prognostic and therapeutic consequences. Bone marrow biopsy (BMB) is the established method for the evaluation of the bone marrow. (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) plays an important role in lymphoma staging, but its value in the assessment of the bone marrow and whether it can replace BMB is still a topic of debate and investigation. The purpose of this scientific communication is to provide an evidence-based overview about the opportunities and limitations of BMB and FDG-PET in the evaluation of the bone marrow in patients with lymphoma. This article first reviews the basic properties, opportunities and limitations of BMB and bone marrow FDG-PET, and then focuses on the clinical utility of BMB and bone marrow FDG-PET in three major lymphoma subtypes including Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma.
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Affiliation(s)
- Hugo J A Adams
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Thomas C Kwee
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
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Miller BW, Przepiorka D, de Claro RA, Lee K, Nie L, Simpson N, Gudi R, Saber H, Shord S, Bullock J, Marathe D, Mehrotra N, Hsieh LS, Ghosh D, Brown J, Kane RC, Justice R, Kaminskas E, Farrell AT, Pazdur R. FDA approval: idelalisib monotherapy for the treatment of patients with follicular lymphoma and small lymphocytic lymphoma. Clin Cancer Res 2015; 21:1525-9. [PMID: 25645861 DOI: 10.1158/1078-0432.ccr-14-2522] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/12/2015] [Indexed: 11/16/2022]
Abstract
On July 23, 2014, the FDA granted accelerated approval to idelalisib (Zydelig tablets; Gilead Sciences, Inc.) for the treatment of patients with relapsed follicular B-cell non-Hodgkin lymphoma or relapsed small lymphocytic lymphoma (SLL) who have received at least two prior systemic therapies. In a multicenter, single-arm trial, 123 patients with relapsed indolent non-Hodgkin lymphomas received idelalisib, 150 mg orally twice daily. In patients with follicular lymphoma, the overall response rate (ORR) was 54%, and the median duration of response (DOR) was not evaluable; median follow-up was 8.1 months. In patients with SLL, the ORR was 58% and the median DOR was 11.9 months. One-half of patients experienced a serious adverse reaction of pneumonia, pyrexia, sepsis, febrile neutropenia, diarrhea, or pneumonitis. Other common adverse reactions were abdominal pain, nausea, fatigue, cough, dyspnea, and rash. Common treatment-emergent laboratory abnormalities were elevations in alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, absolute lymphocytes, and triglycerides. Continued approval may be contingent upon verification of clinical benefit in confirmatory trials.
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Affiliation(s)
- Barry W Miller
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
| | - Donna Przepiorka
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - R Angelo de Claro
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Kyung Lee
- Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Lei Nie
- Office of Biostatistics, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Natalie Simpson
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Ramadevi Gudi
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Haleh Saber
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Stacy Shord
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Julie Bullock
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Dhananjay Marathe
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Nitin Mehrotra
- Office of Clinical Pharmacology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Li Shan Hsieh
- Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Debasis Ghosh
- Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Janice Brown
- Office of Pharmaceutical Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Robert C Kane
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Robert Justice
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Edvardas Kaminskas
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Ann T Farrell
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Richard Pazdur
- Office of Hematology and Oncology Products, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland
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Wang F, Xu D, Cui W. Leukocyte common antigen (CD45) negative follicular lymphoma, a rare immunophenotypic presentation. Clin Chim Acta 2015; 442:46-8. [DOI: 10.1016/j.cca.2014.12.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 12/26/2014] [Accepted: 12/29/2014] [Indexed: 01/13/2023]
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Abstract
Follicular lymphoma (FL) is the most common indolent lymphoma. The vast majority of cases are associated with the chromosome translocation t(14;18), a somatic rearrangement that leads to constitutive expression of the anti-apoptotic BCL2 protein. Although t(14;18) clearly represents an important early event in FL pathogenesis, abundant evidence indicates that it is not sufficient. In particular, the recent application of next-generation DNA sequencing technology has uncovered numerous recurrent somatic genomic alterations associated with FL, most of which affect tumor suppressor genes (TSGs). In this article we review the existing literature on TSGs involved in the development and progression of FL. We consider the genes that are most frequently targeted by deleterious mutation, deletion or epigenetic silencing, along with strategies for developing new treatments that exploit the susceptibilities that may be conferred on lymphoma cells by the loss of particular TSGs.
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Rossi G, Marcheselli L, Dondi A, Bottelli C, Tucci A, Luminari S, Arcaini L, Merli M, Pulsoni A, Boccomini C, Puccini B, Micheletti M, Martinelli G, Rossi A, Zilioli VR, Bozzoli V, Balzarotti M, Bolis S, Cabras MG, Federico M. The use of anthracycline at first-line compared to alkylating agents or nucleoside analogs improves the outcome of salvage treatments after relapse in follicular lymphoma The REFOLL study by the Fondazione Italiana Linfomi. Am J Hematol 2015; 90:56-61. [PMID: 25327841 DOI: 10.1002/ajh.23872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 11/12/2022]
Abstract
Follicular lymphoma (FL) patients experience multiple remissions and relapses and commonly receive multiple treatment lines. A crucial question is whether anthracyclines should be used at first-line or whether they would be better "reserved" for relapse and whether FL outcome can be optimized by definite sequences of treatments. Randomized trials can be hardly designed to address this question. In this retrospective multi-institutional study, time-to-next-treatment after first relapse was analyzed in 510 patients who had received either alkylating agents- or anthracycline- or nucleoside analogs-based chemotherapy with/without rituximab at first-line and different second-line therapies. After a median of 42 months, median time-to-next-treatment after relapse was 41 months (CI95%:34-47 months). After adjustment for covariates, first-line anthracycline-based chemotherapy with/without rituximab was associated with better time-to-next-treatment after any salvage than alkylating agents-based chemotherapy with/without rituximab or nucleoside analogs-based chemotherapy with/without rituximab (HR:0.74, P = 0.027). The addition of rituximab to first-line chemotherapy had no significant impact (HR:1.22, P = 0.140). Autologs stem cell transplantation performed better than any other salvage treatment (HR:0.53, P < 0.001). First-line anthracycline-based chemotherapy significantly improved time-to-next-treatment even in patients receiving salvage autologs stem cell transplantation (P = 0.041). This study supports the concept that in FL previous treatments significantly impact on the outcome of subsequent therapies. The outcome of second-line treatments, either with salvage chemoimmunotherapy or with autologs stem cell transplantation, was better when an anthracycline-containing regimen was used at first-line.
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Affiliation(s)
| | - Luigi Marcheselli
- Department of Diagnostic; Clinical; and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Alessandra Dondi
- Department of Diagnostic; Clinical; and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | | | | | - Stefano Luminari
- Department of Diagnostic; Clinical; and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Luca Arcaini
- Department of Hematology Oncology; Fondazione IRCCS Policlinico San Matteo; University of Pavia; Pavia Italy
| | - Michele Merli
- Hematology Division; Department of Internal Medicine; Circolo e Fondazione Macchi; Varese Italy
| | | | - Carola Boccomini
- Department of Hematology; Città della Salute e della Scienza; Torino Italy
| | - Benedetta Puccini
- Department of Hematology; Azienda Ospedaliero Universitaria Careggi; Firenze Italy
| | | | | | - Andrea Rossi
- Department of Hematology; Ospedali Riuniti; Bergamo Italy
| | | | - Valentina Bozzoli
- Department of Hematology; University Cattolica Sacro Cuore; Roma Italy
| | | | - Silvia Bolis
- Hematology Unit; Ospedale San Gerardo; Monza Italy
| | | | - Massimo Federico
- Department of Diagnostic; Clinical; and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
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Autologous hematopoietic stem cell transplantation for relapsed follicular lymphoma: safety profile and clinical outcome in a single-center experience. Med Oncol 2014; 31:310. [PMID: 25373321 PMCID: PMC4221626 DOI: 10.1007/s12032-014-0310-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 10/28/2014] [Indexed: 11/03/2022]
Abstract
Autologous hematopoietic stem cell transplantation (AHSCT) is a treatment option for relapsed and recurrent follicular lymphoma (R/R FL); however, its value in the rituximab era remains to be elucidated. To evaluate the safety and clinical outcome of AHSCT for relapsed FL, we present a retrospective series of AHSCT for 30 FL patients (17 male and 13 female) at median age of 49 years. Patients were transplanted in second or subsequent complete or partial response after at least one therapeutic line including chemotherapy and rituximab. Overall, seven patients achieved second or higher complete response (CR) at AHSCT, whereas 23 were transplanted in partial response. Median overall survival (OS) was not reached, whereas progression-free survival (PFS) was 4.8 years. The estimated 10-year OS and PFS were found to be 60 and 33%, respectively. There was no significant difference in OS and PFS in terms of FLIPI score and disease status at transplant. Median follow-ups from diagnosis and from AHSCT were 4.9 years (range 1.5-18.4 years) and 1.7 years (range 0.03-16.5 years), respectively. Fifteen patients relapsed, and 11 out of them (73%) died of disease recurrence and chemoresistance. At the last contact, 19 patients are alive: 12 are in CR, whereas seven patients receive salvage regimens due to active lymphoma. AHSCT for relapsed FL patients who were pretreated with rituximab remains a safe procedure with low transplant-related mortality and long-term progression-free survival in about one-third of transplanted patients.
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Baecklund F, Foo JN, Bracci P, Darabi H, Karlsson R, Hjalgrim H, Rosenquist R, Adami HO, Glimelius B, Melbye M, Conde L, Liu J, Humphreys K, Skibola CF, Smedby KE. A comprehensive evaluation of the role of genetic variation in follicular lymphoma survival. BMC MEDICAL GENETICS 2014; 15:113. [PMID: 25294155 PMCID: PMC4411784 DOI: 10.1186/s12881-014-0113-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 09/29/2014] [Indexed: 12/30/2022]
Abstract
Background Survival in follicular lymphoma (FL) is highly variable, even within prognostic groups defined by tumor grade and the Follicular Lymphoma International Prognostic Index. Studies suggest that germline single nucleotide polymorphisms (SNPs) may hold prognostic information but further investigation is needed. Methods We explored the association between SNPs and FL outcome using two approaches: 1) Two independent genome-wide association studies (GWAS) of ~300.000 SNPs followed by a meta-analysis encompassing 586 FL patients diagnosed in Denmark/Sweden 1999–2002 and in the United States 2001–2006; and 2) Investigation of 22 candidate-gene variants previously associated with FL outcome in the Danish/Swedish cohort (N = 373). We estimated time to lymphoma-specific death (approach 1 and 2) and lymphoma progression (approach 2) with hazard ratios (HR) and 95% confidence intervals (CI) in a multivariable Cox regression model. Results In the GWAS meta-analysis, using a random effects model, no variants were associated with lymphoma-specific death at a genome-wide significant level (p < 5.0 ×10−8). The strongest association was observed for tightly linked SNPs on 17q24 near the ABCA10 and ABCA6 genes (rs10491178 HRrandom = 3.17, 95% CI 2.09-4.79, prandom = 5.24 ×10−8). The ABCA10 and ABCA6 genes belong to a family of genes encoding for ABC transporter proteins, implicated in multidrug resistance. In line with a previous study, rs2466571 in CD46 (HR = 0.73, 95% CI 0.58-0.91, p = 0.006) showed nominal association with lymphoma progression, as did two highly linked SNPs in IL8 (rs4073 HR = 0.78, 95% CI 0.62-0.97, p = 0.02; rs2227307 HR = 0.75, 95% CI 0.60-0.94, p = 0.01) previously associated with overall survival. Conclusions The results suggest a possible role for multidrug resistance in FL survival and add to the evidence that genetic variation in CD46 and IL8 may have prognostic implications in FL. Our findings need further confirmation in other independent populations or in a larger multicenter GWAS. Electronic supplementary material The online version of this article (doi:10.1186/s12881-014-0113-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fredrik Baecklund
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden. .,Department of Oncology, Karolinska University Hospital Solna, Stockholm, Sweden.
| | - Jia-Nee Foo
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore, Singapore.
| | - Paige Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
| | - Hatef Darabi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. .,Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
| | - Bengt Glimelius
- Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden. .,Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
| | - Mads Melbye
- Division of National Health Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark.
| | - Lucia Conde
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore, Singapore.
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Christine F Skibola
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden. .,Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden.
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Mohite SS, Nastoupil LJ. Rituximab in follicular lymphoma: the first chapter of the new era? Int J Hematol Oncol 2014. [DOI: 10.2217/ijh.14.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Follicular lymphoma is the most common indolent B-cell lymphoma. Although there is no current standard of care adopted for all patients, clinical outcomes for patients with follicular lymphoma have significantly improved over the past few decades, which can be largely attributed to the incorporation of immunotherapy. Rituximab, a monoclonal antibody to the CD20 antigen, has been widely adopted in the treatment of B-cell lymphomas, resulting from improvements in remission duration and overall survival. We provide an evidence-based discussion of the clinical success and incorporation of immunotherapy, rituximab in the treatment of follicular lymphoma, the prototypical indolent B-cell lymphoma. This shift in the treatment paradigm has opened the door to novel, nonchemotherapy approaches in the treatment of patients with indolent B-cell lymphoma.
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Affiliation(s)
- Satyajit S Mohite
- University of Texas Health Science Center, School of Public Health, Houston, TX, USA
| | - Loretta J Nastoupil
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX 77030, USA
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