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Xu ZF, Chen H, Liu Y, Zhang W, Jin H, Liu J. A retrospective study of prognostic factors and treatment outcome in advanced-stage Mycosis Fungoides and Sezary Syndrome. Hematology 2024; 29:2366631. [PMID: 38975808 DOI: 10.1080/16078454.2024.2366631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/30/2024] [Indexed: 07/09/2024] Open
Abstract
Background: Mycosis fungoides (MF) and Sezary Syndrome (SS) comprise over half of all Cutaneous T-cell lymphoma diagnoses. Current risk stratification is largely based on TNMB staging, few research investigated the prognostic value of clinical exams. Current systemic therapy for advanced disease includes immunomodulatory drugs, chemotherapy, and HADC inhibitors. Few clinical trials or retrospective research compared the efficacy of different drugs.Method: Here, we performed a retrospective analysis of prognostic factors and treatment outcomes of 92 patients diagnosed with MF/SS at the Peking Union Medical College Hospital from 2013-2023.Results: Cox regression analysis identified that age ≥ 50 years, WBC ≥ 8 × 109/L, serum LDH ≥ 250U/L, β2-MG ≥ 4.50 mg/L, and stage IV were associated with reduced overall survival, age ≥ 50 years, serum LDH ≥ 250U/L and stage IV were associated with reduced progression free survival. Kaplan-Meier analysis established that immunomodulatory therapy was associated with longer progression free survival.Conclusion: These results suggested new factors in predicting prognosis and selecting appropriate treatments in patients with advanced MF/SS.
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Affiliation(s)
- Zhuo-Fan Xu
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
- School of Medicine, Tsinghua University, Beijing, People's Republic of China
| | - Hongyun Chen
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Yuehua Liu
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Wei Zhang
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Jie Liu
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
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2
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Ivert LU, Winther AH, Jonsson P, Brauner H. Exploring the educational needs of patients with cutaneous lymphoma using an educational needs assessment tool. Front Oncol 2024; 14:1433821. [PMID: 39169940 PMCID: PMC11335495 DOI: 10.3389/fonc.2024.1433821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Background Cutaneous T-cell lymphomas (CTCL) are a group of rare non-Hodgkin lymphomas characterized by initial localization of malignant T-lymphocytes in the skin. Support and information from nurses and patient support groups have proven useful for patients with CTCL, but little is known about the educational needs of these patients. Objectives To investigate the self-reported educational needs among CTCL patients using an educational needs assessment tool and to explore differences related to sex, age, disease duration, clinical stage, and education. Methods This observational single center study analyzed 70 patients with CTCL in routine dermatological outpatient care. The patients were asked to complete a questionnaire to capture their educational needs in regard to CTCL. The questionnaire was inspired by the educational needs assessment tool, designed and validated for patients with rheumatoid disease. The questionnaire included a general question, "In general, how much information do you want to receive about your lymphoma disease?", and five domains covering information relating to disease process (6 items), treatment (4 items), feelings (2 items), self-management of itch, sleep, and rest (2 items), and support systems (3 items). The domain scores ranged from 0 to 18 and the total score from 0 to 51, with a higher score indicating a greater need for education. Results When asked "In general, how much information do you need?", females wanted to know more compared with males (2.6 vs. 2.1, p=0.006), and patients with higher education wanted to know more than patients with lower education (2.5 vs. 2.0, p=0.025). The domains concerning treatment (80%) and disease process (75%) revealed the greatest needs for education. Patients with a disease duration <2 years reported a greater educational need for the domain support system, compared with patients with longer disease duration. Patients with lower education reported a greater educational need about feelings compared with patients with higher education. Conclusions We found that 65% of the CTCL patients in the cohort, particularly females, expressed a need for education, especially regarding disease process and treatment. A deeper understanding of the educational needs would enable healthcare providers to give personalized information.
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Affiliation(s)
- Lina U. Ivert
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna H. Winther
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Pontus Jonsson
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Hanna Brauner
- Dermatology and Venereology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
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3
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Campbell BA, Dobos G, Haider Z, Bagot M, Evison F, van der Weyden C, McCormack C, Ram-Wolff C, Miladi M, Prince HM, Scarisbrick JJ. Improving disease-specific survival for patients with Sezary syndrome in the modern era of systemic therapies. Br J Haematol 2024. [PMID: 39031983 DOI: 10.1111/bjh.19647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 07/04/2024] [Indexed: 07/22/2024]
Abstract
Traditionally, Sezary syndrome (SS) has been associated with few therapeutic options and poor prognosis, with 5-year disease-specific survival (DSS) less than one-third in historical cohorts. However, newer therapies and combinations are associated with impressive time-to-next-treatment (TTNT), particularly allogeneic stem-cell transplantation (AlloSCT) and combination therapies notably those including extracorporeal photopheresis. In this multicentre, international study, we explored the prognostic outcomes of 178 patients exclusively managed for SS, diagnosed between 2012 and 2020, and treated in the modern therapeutic era. In this cohort, 58 different therapies were delivered, with 13.5% of patients receiving AlloSCT. Long-term survival exceeded historical reports with 5-year DSS and OS of 56.4% and 53.4% respectively. In those receiving AlloSCT, prognosis was excellent: 5-year DSS and OS were 90.5% and 78.0% respectively. Confirming the results from the Cutaneous Lymphoma International Consortium (CLIC), LDH and LCT had significant prognostic impact. Unlike earlier studies, stage did not have prognostic impact; we speculate that greater relative benefit favours patients with extensive lymphomatous nodal disease (Stage IVA2) compared to historical reports. For patients ineligible for AlloSCT, the prognosis remains relatively poor (5-year DSS 51.4% and OS 49.6%), representing ongoing unmet needs for more effective novel agents and investigation of improved therapeutic combinations.
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Affiliation(s)
- Belinda A Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Clinical Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Gabor Dobos
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Zahra Haider
- Beckenham Beacon, Kings College Hospitals NHS Foundation Trust, London, UK
| | - Martine Bagot
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - Felicity Evison
- Health Data Science Team, Research Development and Innovation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Carrie van der Weyden
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Chris McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Caroline Ram-Wolff
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - Maryam Miladi
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - H Miles Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
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4
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Fléchon L, Arib I, Dutta AK, Hasan Bou Issa L, Sklavenitis-Pistofidis R, Tilmont R, Stewart C, Dubois R, Poulain S, Copin MC, Javed S, Nudel M, Cavalieri D, Escure G, Gower N, Chauvet P, Gazeau N, Saade C, Thiam MB, Ouelkite-Oumouchal A, Gaggero S, Cailliau É, Faiz S, Carpentier O, Duployez N, Idziorek T, Mortier L, Figeac M, Preudhomme C, Quesnel B, Mitra S, Morschhauser F, Getz G, Ghobrial IM, Manier S. Genomic profiling of mycosis fungoides identifies patients at high risk of disease progression. Blood Adv 2024; 8:3109-3119. [PMID: 38513135 PMCID: PMC11222946 DOI: 10.1182/bloodadvances.2023012125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 03/23/2024] Open
Abstract
ABSTRACT Mycosis fungoides (MF) is the most prevalent primary cutaneous T-cell lymphoma, with an indolent or aggressive course and poor survival. The pathogenesis of MF remains unclear, and prognostic factors in the early stages are not well established. Here, we characterized the most recurrent genomic alterations using whole-exome sequencing of 67 samples from 48 patients from Lille University Hospital (France), including 18 sequential samples drawn across stages of the malignancy. Genomic data were analyzed on the Broad Institute's Terra bioinformatics platform. We found that gain7q, gain10p15.1 (IL2RA and IL15RA), del10p11.22 (ZEB1), or mutations in JUNB and TET2 are associated with high-risk disease stages. Furthermore, gain7q, gain10p15.1 (IL2RA and IL15RA), del10p11.22 (ZEB1), and del6q16.3 (TNFAIP3) are coupled with shorter survival. Del6q16.3 (TNFAIP3) was a risk factor for progression in patients at low risk. By analyzing the clonal heterogeneity and the clonal evolution of the cohort, we defined different phylogenetic pathways of the disease with acquisition of JUNB, gain10p15.1 (IL2RA and IL15RA), or del12p13.1 (CDKN1B) at progression. These results establish the genomics and clonality of MF and identify potential patients at risk of progression, independent of their clinical stage.
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Affiliation(s)
- Léa Fléchon
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
| | - Inès Arib
- Department of Hematology, Lille Hospital, Lille, France
| | - Ankit K. Dutta
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
- Department of Medical Oncology, Harvard Medical School, Boston, MA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Lama Hasan Bou Issa
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
| | - Romanos Sklavenitis-Pistofidis
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
- Department of Medical Oncology, Harvard Medical School, Boston, MA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Rémi Tilmont
- Department of Hematology, Lille Hospital, Lille, France
| | - Chip Stewart
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Romain Dubois
- Department of Pathology, Lille Hospital, Lille, France
| | - Stéphanie Poulain
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
- Department of Hematology, Biology and Pathology Center, Lille Hospital, Lille, France
| | - Marie-Christine Copin
- Department of Pathology, Angers University, Angers Hospital, INSERM, CRCI2NA, Angers, France
| | - Sahir Javed
- Department of Medical Oncology, Valenciennes Hospital, Valenciennes, France
| | - Morgane Nudel
- Department of Hematology, Lille Hospital, Lille, France
| | | | | | - Nicolas Gower
- Department of Hematology, Lille Hospital, Lille, France
| | - Paul Chauvet
- Department of Hematology, Lille Hospital, Lille, France
| | | | - Cynthia Saade
- Department of Hematology, Lille Hospital, Lille, France
| | | | | | - Silvia Gaggero
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
| | | | - Sarah Faiz
- Department of Pathology and Dermatology, Lille Hospital, Lille, France
| | | | - Nicolas Duployez
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
- Department of Hematology, Biology and Pathology Center, Lille Hospital, Lille, France
| | - Thierry Idziorek
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
| | - Laurent Mortier
- Department of Pathology and Dermatology, Lille Hospital, Lille, France
- OncoThai unit, INSERM UMR-S1189, Lille University, Lille, France
| | - Martin Figeac
- Lille University, Lille Hospital, CNRS, INSERM, Institut Pasteur de Lille, US 41 – UAR 2014 - PLBS, Lille, France
| | - Claude Preudhomme
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
- Department of Hematology, Biology and Pathology Center, Lille Hospital, Lille, France
| | - Bruno Quesnel
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
- Department of Hematology, Lille Hospital, Lille, France
| | - Suman Mitra
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
| | | | - Gad Getz
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
- Cancer Center and Department of Pathology, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Irene M. Ghobrial
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
- Department of Medical Oncology, Harvard Medical School, Boston, MA
- Harvard Medical School, Boston, MA
| | - Salomon Manier
- Canther, ONCOLille, INSERM UMR-S1277, CNRS UMR9020, Lille University, Lille, France
- Department of Hematology, Lille Hospital, Lille, France
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5
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Murphy L, Quigley C, Long A, Barry R, Timoney I, Diong S, O'Gorman S. As serious as Sézary. Clin Exp Dermatol 2024; 49:526-527. [PMID: 38174623 DOI: 10.1093/ced/llae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024]
Abstract
Sézary syndrome is a rare condition, with a very poor prognosis. This case highlights how important it is for clinicians to be cognizant of the impact that this condition and the various treatment regimens can have on patients’ lives.
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Affiliation(s)
| | | | - Amy Long
- St James' Hospital, Dublin, Ireland
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6
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Peeters G, Verhaegen A. Severe insulin resistance in a patient with diabetes after treatment with brentuximab vedotin. BMJ Case Rep 2024; 17:e251867. [PMID: 38569738 PMCID: PMC10989180 DOI: 10.1136/bcr-2022-251867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
A man in his late 60s with a history of well-controlled type 2 diabetes and hepatic cirrhosis presented to the emergency department due to uncontrollable hyperglycaemia following the initial brentuximab vedotin (BV) infusion. BV was initiated as a treatment for mycosis fungoides, a form of cutaneous T-cell lymphoma. The patient was diagnosed with severe hyperglycaemia with ketosis. Empiric treatment with amoxicillin-clavulanic acid, hydration and intravenous insulin infusion was initiated. Hyperglycaemia persisted despite receiving massive amounts of insulin and was corrected only after treatment with high-dose methylprednisolone for suspected type B insulin resistance. Extremely high and difficult-to-treat hyperglycaemia is a rare side effect of BV. Unfortunately, the patient died of upper gastrointestinal bleeding 22 days after discharge. In patients with obesity and/or diabetes mellitus, the blood glucose levels should be carefully monitored when treated with BV.
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Affiliation(s)
- Greet Peeters
- Endocrinology-Diabetology, ZNA Jan Palfijn, Merksem, Belgium
| | - Ann Verhaegen
- Endocrinology-Diabetology, ZNA Jan Palfijn, Merksem, Belgium
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7
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Taş-Aygar G, Ataş H, Gönül M, Kartal SP. Importance of the C-Reactive Protein to Albumin Ratio in the Diagnosis and Prognosis of Mycosis Fungoides. Dermatol Pract Concept 2024; 14:dpc.1402a97. [PMID: 38810087 PMCID: PMC11135996 DOI: 10.5826/dpc.1402a97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION The C-reactive protein to albumin ratio (CAR) lately has demonstrated as a prognostic factor and an indicator of disease activity, severity and prognosis in solid organ malignancies and inflammatory diseases. However, the effects of CAR have not been investigated in mycosis fungoides (MF) patients yet. OBJECTIVES This study aimed to determine the potential role of CAR as a diagnostic and a prognostic indicator in MF. METHODS We retrospectively investigated the electronic medical records of 97 patients with MF admitted to the Dermatology Clinic of Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital between January 2014 and December 2020. In total, 60 patients with MF were enrolled in the study. CAR was evaluated, patient and control group. Also, the other clinicopathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and sedimentation levels were evaluated. RESULTS The median value of CAR was 0.85 (0.10-7.51) in the patient group, whereas it was 0.39 (0.0-1.11) in the control group (P < 0.001). Patients with disease progression (N = 16, 13M, 3 F) had a median value of CAR 0.84 (0.10-7.51) and the median value of CAR (N = 44) was 0.86 (0.12-4.57) in the group of patients with stable disease. The CAR value had no prognostic significance (P > 0.05). CONCLUSIONS There is no association between the CAR and progression in the stage in MF patients. But the CAR is significantly higher in patients with MF than in the control group. The CAR can be a guide for us in cases where we have difficulty in diagnosing.
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Affiliation(s)
- Gamze Taş-Aygar
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Hatice Ataş
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Müzeyyen Gönül
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
| | - Selda Pelin Kartal
- University of Health Sciences, Etlik City Hospital, Dermatology Clinic, Ankara, Turkey
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8
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Vahabi SM, Bahramian S, Esmaeili F, Danaei B, Kalantari Y, Fazeli P, Sadeghi S, Hajizadeh N, Assaf C, Etesami I. JAK Inhibitors in Cutaneous T-Cell Lymphoma: Friend or Foe? A Systematic Review of the Published Literature. Cancers (Basel) 2024; 16:861. [PMID: 38473222 DOI: 10.3390/cancers16050861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/17/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of lymphoid neoplasms with high relapse rates and no curative treatment other than allogeneic stem cell transplantation (allo-SCT). CTCL is significantly influenced by disruption of JAK/STAT signaling. Therefore, Janus kinase (JAK) inhibitors may be promising for CTCL treatment. This study is a systematic review aiming to investigate the role of JAK inhibitors in the treatment of CTCL, including their efficacy and safety. Out of 438 initially searched articles, we present 13 eligible ones. The overall response rate (ORR) in the treatment with JAK inhibitors in clinical trials was 11-35%, although different subtypes of CTCL showed different ORRs. Mycosis fungoides showed an ORR of 14-45%, while subcutaneous-panniculitis-like T-cell lymphoma (SPTCL) displayed an ORR ranging from 75% to 100%. Five cases were reported having a relapse/incident of CTCL after using JAK inhibitors; of these, three cases were de novo CTCLs in patients under treatment with a JAK inhibitor due to refractory arthritis, and two cases were relapsed disease after graft-versus-host disease treatment following allo-SCT. In conclusion, using JAK inhibitors for CTCL treatment seems promising with acceptable side effects, especially in patients with SPTCL. Some biomarkers, like pS6, showed an association with better responses. Caution should be taken when treating patients with an underlying autoimmune disease and prior immunosuppression.
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Affiliation(s)
| | - Saeed Bahramian
- School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Farzad Esmaeili
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Bardia Danaei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran
| | - Yasamin Kalantari
- School of Medicine, Tehran University of Medical Sciences, Tehran 1461884513, Iran
| | | | - Sara Sadeghi
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Nima Hajizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Chalid Assaf
- Department of Dermatology and Venerology, Helios Klinikum Krefeld, 47805 Krefeld, Germany
- Institute for Molecular Medicine, Medical School Hamburg, 20457 Hamburg, Germany
| | - Ifa Etesami
- Departments of Dermatology, Razi Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran 1983969411, Iran
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9
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Choi ME, Lee MY, Won CH, Chang SE, Lee MW, Lee WJ. Spatially Resolved Transcriptomes of CD30+-Transformed Mycosis Fungoides and Cutaneous Anaplastic Large-Cell Lymphoma. J Invest Dermatol 2024; 144:331-340.e2. [PMID: 37544586 DOI: 10.1016/j.jid.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 08/08/2023]
Abstract
Mycosis fungoides with large-cell transformation (MF-LCT) occurs in a minor proportion of aggressive lesions, which express CD30 similar to primary cutaneous anaplastic large-cell lymphoma (pcALCL). We investigated the differences in spatially resolved transcriptome profiles of MF-LCT and pcALCL using CD30 morphology markers and 28 and 24 regions of interest (ROIs) in MF-LCT and pcALCL, respectively. Differentially expressed genes, pathway analysis, and immune-cell deconvolution by selective analysis of CD30-positive tumor cells and CD30-negative extratumoral areas were undertaken. In CD30-positive ROIs of MF-LCT, 190 differentially expressed genes were upregulated (29 were directly or indirectly associated with extracellular matrix remodeling), whereas 255 differentially expressed genes were downregulated, compared with those of pcALCL. Except for cornified envelope formation and keratinization, all six pathways enriched in CD30-positive ROIs of MF-LCT were associated with extracellular matrix remodeling. In CD30-positive ROIs in MF-LCT compared with those in pcALCL, immune-cell deconvolution revealed significantly increased fibroblasts and M2 macrophages (P = 0.012 and P = 0.023, respectively) but decreased M1 macrophages (P = 0.031). In CD30-negative ROIs in MF-LCT compared with those in pcALCL, memory B (P = 0.021), plasma (P = 0.023), and CD8 memory T (P = 0.001) cells significantly decreased, whereas regulatory T cells (P = 0.024) increased. Predomination of extracellular matrix remodeling pathways and immunosuppressive microenvironment in MF-LCT indicates pathophysiological differences between MF-LCT and pcALCL.
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Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Young Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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10
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Abdulrahman N, Leo R, Boumenar HA, Ahmad F, Mateo JM, Jochebeth A, Al-Sowaidi NK, Sher G, Ansari AW, Alam M, Uddin S, Ahmad A, Steinhoff M, Buddenkotte J. Embelin inhibits viability of cutaneous T cell lymphoma cell lines HuT78 and H9 by targeting inhibitors of apoptosis. Leuk Lymphoma 2023; 64:2236-2248. [PMID: 37708450 DOI: 10.1080/10428194.2023.2256909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/15/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
Cutaneous T cell lymphoma (CTCL) is a varied group of neoplasms that affects the skin. Acquired resistance against chemotherapeutic drugs and associated toxic side effects are limitations that warrant search for novel drugs against CTCL. Embelin (EMB) is a naturally occurring benzoquinone derivative that has gained attention owing to its anticancer pharmacological actions and nontoxic nature. We assessed the anticancer activity of EMB against CTCL cell lines, HuT78, and H9. EMB inhibited viability of CTCL cells in a dose-dependent manner. EMB activated extrinsic and intrinsic pathways of apoptosis as shown by the activation of initiator and executioner caspases. EMB-induced apoptosis also involved suppression of inhibitors of apoptosis, XIAP, cIAP1, and cIAP2. PARP cleavage and upregulation of pH2AX indicated DNA damage induced by EMB. In conclusion, we characterized a novel apoptosis-inducing activity of EMB against CTCL cells, implicating EMB as a potential therapeutic agent against CTCL.
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Affiliation(s)
- Nabeel Abdulrahman
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Rari Leo
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Hasna Amal Boumenar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Fareed Ahmad
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Jericha M Mateo
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Anh Jochebeth
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Gulab Sher
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Abdul W Ansari
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Majid Alam
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Shahab Uddin
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Aamir Ahmad
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Martin Steinhoff
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Weill Cornell Medicine, School of Medicine, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Joerg Buddenkotte
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
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11
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Pena J, Cull D, Strowd LC, Vaidya R, Seegars MB, Ahn C, Winkfield KM, Hughes RT. Response and local control in patients treated with low-dose radiotherapy for tumoral mycosis fungoides. Leuk Lymphoma 2023; 64:2202-2207. [PMID: 37671707 PMCID: PMC10873100 DOI: 10.1080/10428194.2023.2254435] [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: 05/03/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/07/2023]
Abstract
Low-dose radiotherapy (LDRT), defined in this study as 2 fractions of 4 Gy delivered on consecutive days, is an effective option for local palliation of mycosis fungoides (MF), but its efficacy for tumoral lesions (TL) needs investigation. We assessed response and local control (LC) rates for patients treated with LDRT for MF and compared these outcomes between TL and non-TL. A total of 73 lesions in 18 patients treated with LDRT between 2013-2020 were analyzed. Response was defined as complete response (CR), partial response (PR), or no response (NR). In the non-TL versus TL groups, CR was observed in 16.7% v. 4.0%, PR in 81.2% v. 80.0%, NR in 2.1% v. 16.0%, respectively. 2-year LC was 100% for non-TL and 61% for TLs (p < 0.01). LDRT yields excellent response and lesion control for non-TLs and is associated with lower response rates and LC for TLs.
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Affiliation(s)
- Joseph Pena
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Deborah Cull
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lindsay C. Strowd
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rakhee Vaidya
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Mary Beth Seegars
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christine Ahn
- Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Karen M. Winkfield
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ryan T. Hughes
- Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC, USA
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12
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Campbell BA, Dobos G, Haider Z, Prince HM, Bagot M, Evison F, van der Weyden C, McCormack C, Ram-Wolff C, Miladi M, Scarisbrick JJ. International study of treatment efficacy in SS shows superiority of combination therapy and heterogeneity of treatment strategies. Blood Adv 2023; 7:6639-6647. [PMID: 37648672 PMCID: PMC10628811 DOI: 10.1182/bloodadvances.2023011041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023] Open
Abstract
Despite increasing availability of therapies, patients with Sezary syndrome (SS) commonly endure multi-line treatment journeys, mostly with partial responses of short duration. Measuring clinical benefit is challenging; time-to-next-treatment (TTNT) provides a robust, objective measurement of efficacy. This international observational study examines patterns of clinical care and therapeutic benefit as measured by TTNT. TTNT was calculated for monotherapies and combination therapies, with consideration to treatment line. 178 patients with SS (73% de novo, 27% secondary) were included, receiving 721 lines of systemic therapy, with median follow-up of 56.9 months. Across all lines, 58 different therapeutic regimens were prescribed (54 were systemic therapies) and classified into 17 treatment groups. The most common first-line treatments were extracorporeal photopheresis (ECP)-containing combination therapy (20%) and retinoid monotherapy (19%). Median TTNT for all first-line therapies was short (5.4 months). First-line, combination therapies had longer median TTNT than monotherapies, 10.0 vs 5.0 months (P = .004), respectively. Later delivery of combination therapies was associated with shorter clinical benefit, with median TTNT reduced to 6.2 and 2.2 months for mid-line (2nd-4th line) and late-line (≥5th line), respectively (P < .001). First-line ECP-containing treatments were associated with longer median TTNT than non-ECP-containing treatments, 9.0 vs 4.9 months (P = .007). For both ECP-monotherapy and ECP-containing combination therapy, significant reductions in TTNT were seen in later lines. These data suggest therapeutic benefit from first-line delivery of combination therapy for SS and favor early inclusion of ECP in the treatment algorithm for those who can access it.
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Affiliation(s)
- Belinda A. Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
- Department of Clinical Pathology, The University of Melbourne, Parkville, Australia
| | - Gabor Dobos
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
- Department of Dermatology and Allergy, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Zahra Haider
- Department of Dermatology, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - H. Miles Prince
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne Australia
| | - Martine Bagot
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - Felicity Evison
- Health Data Science Team, Research Development and Innovation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Carrie van der Weyden
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
- Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne Australia
| | - Chris McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Surgery, The University of Melbourne, Parkville, Australia
| | - Caroline Ram-Wolff
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - Maryam Miladi
- Department of Dermatology, Hôpital Saint Louis, Université Paris Cité, Paris, France
| | - Julia J Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, United Kingdom
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13
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Assaf C, Dobos G, Zech IM, Doess A, May M, Jadasz J. Epidemiologie reifzelliger T- und NK-Zell-Lymphome in Deutschland - Eine repräsentative Querschnittanalyse von GKV-Routinedaten: Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data. J Dtsch Dermatol Ges 2023; 21:1320-1328. [PMID: 37946651 DOI: 10.1111/ddg.15187_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/18/2023] [Indexed: 11/12/2023]
Abstract
ZusammenfassungHintergrundPrimäre kutane Lymphome sind seltene lymphoproliferative Neoplasien und gehören zur heterogenen Gruppe der Non‐Hodgkin‐Lymphome. Sie umfassen ein klinisch und histologisch breites Spektrum an Manifestationsformen, wobei kutane T‐Zell‐Lymphome (CTCL) mit 73% am häufigsten sind. Aufgrund der Seltenheit der Erkrankungen sind bevölkerungsbasierte Untersuchungen zur Versorgungssituation und Epidemiologie kaum vorhanden.Patienten und MethodikAuf Basis anonymisierter, alters‐ und geschlechtsadjustierter GKV‐Routinedaten von circa fünf Millionen gesetzlich Krankenversicherten wurde im Sechsjahreszeitraum (2012–2017) eine retrospektive Analyse zur Bestimmung von Prävalenz, Inzidenz und Letalität von Patienten mit reifzelligen T/NK‐Zell Lymphomen in Deutschland durchgeführt.ErgebnisseInsgesamt 1336 T‐Zell‐Lymphom‐Patienten konnten im Beobachtungszeitraum identifiziert werden. Die Sechsjahres‐Prävalenz liegt demnach zwischen 27,35 und 43,58 pro 100 000 Einwohner. Die Patienten waren zu 65% männlich mit einem durchschnittlichen Alter von 66 Jahren (SD 15). Es verstarben 246 Patienten (circa 20 %) innerhalb der 6 Jahre, pro Jahr bis zu 7 %. Die ermittelte Inzidenz bei 153 identifizierten Patienten im Jahr 2017 liegt bei 3,65 bis 3,92 pro 100 000 Einwohner.SchlussfolgerungenErstmalig in Deutschland wurden mithilfe von Abrechnungsdaten der gesetzlichen Krankenversicherung (GKV‐Routinedaten), valide epidemiologische Erkenntnisse von Patienten mit reifzelligen T‐ und NK‐Zell Lymphomen gewonnen. Weitere Analysen für tiefergehende Einblicke in die Versorgung der Patienten mit dieser seltenen Erkrankung sind wünschenswert.
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Affiliation(s)
- Chalid Assaf
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Krefeld, Krefeld
- Institute for Molecular Medicine, Medical School Hamburg, Hamburg
- Klinik für Dermatologie, HELIOS Klinikum Schwerin, universitärer Campus der Medical School Hamburg, Schwerin
| | - Gabor Dobos
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, gemeinsame Medizinische Fakultät Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
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14
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Assaf C, Dobos G, Zech IM, Doess A, May M, Jadasz J. Epidemiology of mature T/NK-cell lymphomas in Germany - A representative cross-sectional study based on SHI claims data. J Dtsch Dermatol Ges 2023; 21:1320-1327. [PMID: 37845021 DOI: 10.1111/ddg.15187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/18/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Primary cutaneous lymphomas (PCL) are rare skin tumors of lymphoproliferative neoplasms and belong to the heterogeneous group of non-Hodgkin's lymphomas. PCL encompass a broad spectrum of clinical and histologic manifestations, with cutaneous T-cell lymphoma (CTCL) being the most common (73%). Due to the rarity of the diseases, population-based studies of care and epidemiology are limited. PATIENTS AND METHODS Based on anonymized, age- and sex-adjusted SHI (statutory health insurance) claims data of approximately five million SHI-insured patients, a retrospective analysis was conducted over a six-year period (2012-2017) to determine the prevalence, incidence, and lethality in patients with mature-cell T/NK-cell lymphoma in Germany. RESULTS A total of 1,336 patients with T-cell lymphoma were identified during the observation period. The six-year prevalence ranged from 27.35 to 43.58 per 100,000. Patients were 65% male with a mean age of 66 years (SD 15). There were 246 patients (approx. 20%) who died within the 6 years, up to 7% per year. The calculated incidence in 153 identified patients in 2017 is 3.65 to 3.92 per 100,000. CONCLUSIONS For the first time, valid epidemiologic findings of patients with mature T-cell and NK-cell lymphomas were obtained using SHI claims data in Germany. Further analyses are needed to gain a deeper insight into the healthcare reality of patients with this rare disease.
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Affiliation(s)
- Chalid Assaf
- Department of Dermatology and Venerology, HELIOS Klinikum Krefeld, Krefeld, Germany
- Institute for Molecular Medicine, Hamburg Medical School, Hamburg, Germany
- Department of Dermatology, HELIOS Klinikum Schwerin, University Campus of the Hamburg Medical School, Schwerin, Germany
| | - Gabor Dobos
- Clinic for Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Joint Faculty of Medicine of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany
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15
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Gaydosik AM, Stonesifer CJ, Tabib T, Lafyatis R, Geskin LJ, Fuschiotti P. The mycosis fungoides cutaneous microenvironment shapes dysfunctional cell trafficking, antitumor immunity, matrix interactions, and angiogenesis. JCI Insight 2023; 8:e170015. [PMID: 37669110 PMCID: PMC10619438 DOI: 10.1172/jci.insight.170015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023] Open
Abstract
Malignant T lymphocyte proliferation in mycosis fungoides (MF) is largely restricted to the skin, implying that malignant cells are dependent on their specific cutaneous tumor microenvironment (TME), including interactions with non-malignant immune and stromal cells, cytokines, and other immunomodulatory factors. To explore these interactions, we performed a comprehensive transcriptome analysis of the TME in advanced-stage MF skin tumors by single-cell RNA sequencing. Our analysis identified cell-type compositions, cellular functions, and cell-to-cell interactions in the MF TME that were distinct from those from healthy skin and benign dermatoses. While patterns of gene expression were common among patient samples, high transcriptional diversity was also observed in immune and stromal cells, with dynamic interactions and crosstalk between these cells and malignant T lymphocytes. This heterogeneity mapped to processes such as cell trafficking, matrix interactions, angiogenesis, immune functions, and metabolism that affect cancer cell growth, migration, and invasion, as well as antitumor immunity. By comprehensively characterizing the transcriptomes of immune and stromal cells within the cutaneous microenvironment of individual MF tumors, we have identified patterns of dysfunction common to all tumors that represent a resource for identifying candidates with therapeutic potential as well as patient-specific heterogeneity that has important implications for personalized disease management.
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Affiliation(s)
- Alyxzandria M. Gaydosik
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Tracy Tabib
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Robert Lafyatis
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Patrizia Fuschiotti
- Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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16
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Abreu Rocha C, Drummond Borges M, Santos GM, Sousa M, Teixeira T. Itchy Skin: A Challenging Differential Diagnosis Between Mycosis Fungoides and Sézary Syndrome. Cureus 2023; 15:e46427. [PMID: 37927614 PMCID: PMC10621883 DOI: 10.7759/cureus.46427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Primary cutaneous lymphomas represent a diverse spectrum of T-cell and B-cell lymphomas with their primary skin manifestation. Among these, mycosis fungoides (MF) and Sézary syndrome (SS) represent classic forms of cutaneous T-cell lymphomas (CTCLs). This report details the case of a 67-year-old female who presented with longstanding pruritic skin lesions, initially misdiagnosed and managed as eczema. The diagnostic process ultimately revealed the presence of Sézary cells in the peripheral blood smear (PBS). The SS diagnosis was confirmed based on CD4 positivity and CD7 negativity as determined by flow cytometry. The disease was staged as IVA1 (T2N0M1B2). The patient exhibited partial improvement with oral corticosteroid therapy. This report underscores the critical importance of integrating clinical evaluation and blood findings to distinguish between MF and SS. The progression of a circulating clone signals a poor prognosis, requiring surveillance and consideration of targeted therapies to enhance patient outcomes and improve their quality of life. Early detection remains paramount in the management of these rare cutaneous lymphomas, which are associated with unique therapeutic challenges.
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Affiliation(s)
- Cláudia Abreu Rocha
- Family Medicine, Centro de Saúde de Machico, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Madeira Island, PRT
| | - Margarida Drummond Borges
- Family Medicine, Centro de Saúde de Machico, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Madeira Island, PRT
| | - Guida Maria Santos
- Family Medicine, Centro de Saúde do Caniço, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Madeira Island, PRT
| | - Miriam Sousa
- Pathology, Hospital Central do Funchal, Madeira Island, PRT
| | - Tânia Teixeira
- Family Medicine, Centro de Saúde de Machico, Serviço de Saúde da Região Autónoma da Madeira (SESARAM), Madeira Island, PRT
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17
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Datta D, Sarwal T, Kumar R, Bairwa S, Gowda VN, Nalwa A. Interesting Presentation of Mycosis Fungoides in Staging on F-18 FDG PET/CT. Nucl Med Mol Imaging 2023; 57:243-246. [PMID: 37720879 PMCID: PMC10504174 DOI: 10.1007/s13139-023-00794-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/29/2023] Open
Abstract
Mycosis fungoides is the major form of primary cutaneous T cell lymphoma. Its staging is based on the percentage of body surface involvement and biopsy-proven extra cutaneous nodal or visceral involvement. Literature shows F-18 FDG accumulation in disease-involved nodes and viscera with non-specific uptake due to co-existing inflammation limits its specificity. We report an interesting case of mycosis fungoides with bilateral upper limb edema and share its findings on F-18 FDG PET/CT.
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Affiliation(s)
- Deepanksha Datta
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Tanvi Sarwal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Rajesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Sandeep Bairwa
- Department of Medical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vinay N. Gowda
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Aasma Nalwa
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
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18
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Scheffschick A, Nenonen J, Xiang M, Winther AH, Ehrström M, Wahren-Herlenius M, Eidsmo L, Brauner H. Skin infiltrating NK cells in cutaneous T-cell lymphoma are increased in number and display phenotypic alterations partially driven by the tumor. Front Immunol 2023; 14:1168684. [PMID: 37691935 PMCID: PMC10485839 DOI: 10.3389/fimmu.2023.1168684] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/25/2023] [Indexed: 09/12/2023] Open
Abstract
Cutaneous T-cell lymphomas (CTCL) are characterized by focal infiltration of malignant T cell clones in solitary skin lesions. Many CTCL patients experience an indolent disease, but some progress to advanced disease with high fatality. We hypothesized that natural killer (NK) cells participate in local control of tumor growth in CTCL skin. Immunohistochemistry and flow cytometry analysis of the density, localization, phenotype and function of NK cells in twenty-nine fresh or formalin-fixed skin biopsies from twenty-four CTCL patients and twenty-three biopsies from twenty healthy controls highlighted higher numbers of CD56+CD3- NK cells in CTCL skin. A reduced fraction of CTCL skin NK cells expressed the maturation marker CD57, the cytotoxic protein granzyme B and the activation marker CD69, indicating reduced tumor-killing abilities of the NK cells. Retained expression of immune checkpoint proteins or inhibitory proteins including PD1, TIM3, LAG3, CD73 and NKG2A and the activating receptors CD16 and NKp46 indicated maintained effector functions. Indeed, the capacity of NK cells to produce anti-tumor acting IFNγ upon PMA+ionomycin stimulation was similar in cells from CTCL and healthy skin. Co-cultures of primary human NK cells or the NK cell line NKL with CTCL cells resulted in reduced levels of granzyme B and CD69, indicating that close cellular interactions with CTCL cells induced the impaired functional NK cell phenotype. In conclusion, increased numbers of NK cells in CTCL skin exhibit a partially impaired phenotype in terms of activity. Enhancing NK cell activity with NK cell activating cytokines such as IL-15 or immune checkpoint blockade therefore represents a potential immunotherapeutic approach in CTCL.
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Affiliation(s)
- Andrea Scheffschick
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Julia Nenonen
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mengmeng Xiang
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna H. Winther
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - Marcus Ehrström
- Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Wahren-Herlenius
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- The Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Liv Eidsmo
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Hanna Brauner
- Division of Rheumatology, Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
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19
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Levy Yurkovski I, Rokach L, Melamed G, Alapi H, Gazit S, Patalon T, Tadmor T. Clinical Outcomes of COVID-19 in Mycosis Fungoides and Sezary Syndrome. Acta Haematol 2023; 146:496-503. [PMID: 37517402 PMCID: PMC11251663 DOI: 10.1159/000531831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION Haemato-oncologic patients are more susceptible to severe infections with SARS-CoV-2. We aimed to assess the clinical outcomes of SARS-CoV-2 infection among patients with Mycosis Fungoides and Sezary Syndrome (MF/SS). METHODS The data were retrieved from anonymized electronic medical records of Maccabi Healthcare Services (MHS), the second-largest healthcare organization in Israel. Patients diagnosed with MF/SS were included in the study. COVID-19 PCR test results together with sociodemographic and clinical data were extracted and analyzed to evaluate the association of COVID-19 with clinical outcomes. RESULTS In the period of 2020-2022, 1,472 MF/SS patients were included in the study. Among them, 768 (52%) had SARS-CoV-2 infection. The hospitalization rate was 2.9% and infection by the Delta variant was associated with the highest hospitalization rate (7.7%). The hospitalization rate was lower among fully vaccinated patients (p = 0.032) but higher for patients older than 65 (p < 0.001) and patients with SS (vs. MF) (p < 0.001) or COPD (p = 0.024) diagnosis. There was a tendency for decreased hospitalization among patients treated with nirmatrelvir + ritonavir within 5 days of infection, with a 79% risk reduction, although it was not statistically significant (p = 0.164). CONCLUSION Patients with MF/SS do not necessarily have worse COVID-19 outcomes compared to the general population.
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Affiliation(s)
- Ilana Levy Yurkovski
- Hematology Unit, Bnai Zion Medical Center, Haifa, Israel
- Technion Israel Institute of Technology, Haifa, Israel
| | - Lior Rokach
- Department of Information Systems Engineering, Faculty of Engineering Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Guy Melamed
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Hillel Alapi
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Sivan Gazit
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tal Patalon
- Kahn Sagol Maccabi (KSM) Research and Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Tamar Tadmor
- Hematology Unit, Bnai Zion Medical Center, Haifa, Israel
- Technion Israel Institute of Technology, Haifa, Israel
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20
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Gutierrez M, Bladek P, Goksu B, Murga-Zamalloa C, Bixby D, Wilcox R. T-Cell Prolymphocytic Leukemia: Diagnosis, Pathogenesis, and Treatment. Int J Mol Sci 2023; 24:12106. [PMID: 37569479 PMCID: PMC10419310 DOI: 10.3390/ijms241512106] [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: 06/19/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive neoplasm of mature T-cells. Most patients with T-PLL present with lymphocytosis, anemia, thrombocytopenia, and hepatosplenomegaly. Correct identification of T-PLL is essential because treatment for this disease is distinct from that of other T-cell neoplasms. In 2019, the T-PLL International Study Group (TPLL-ISG) established criteria for the diagnosis, staging, and assessment of response to treatment of T-PLL with the goal of harmonizing research efforts and supporting clinical decision-making. T-PLL pathogenesis is commonly driven by T-cell leukemia 1 (TCL1) overexpression and ATM loss, genetic alterations that are incorporated into the TPLL-ISG diagnostic criteria. The cooperativity between TCL1 family members and ATM is seemingly unique to T-PLL across the spectrum of T-cell neoplasms. The role of the T-cell receptor, its downstream kinases, and JAK/STAT signaling are also emerging themes in disease pathogenesis and have obvious therapeutic implications. Despite improved understanding of disease pathogenesis, alemtuzumab remains the frontline therapy in the treatment of naïve patients with indications for treatment given its high response rate. Unfortunately, the responses achieved are rarely durable, and the majority of patients are not candidates for consolidation with hematopoietic stem cell transplantation. Improved understanding of T-PLL pathogenesis has unveiled novel therapeutic vulnerabilities that may change the natural history of this lymphoproliferative neoplasm and will be the focus of this concise review.
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Affiliation(s)
- Marc Gutierrez
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Patrick Bladek
- Department of Pathology, University of Illinois Chicago, Chicago, IL 60607, USA; (P.B.); (B.G.); (C.M.-Z.)
| | - Busra Goksu
- Department of Pathology, University of Illinois Chicago, Chicago, IL 60607, USA; (P.B.); (B.G.); (C.M.-Z.)
| | - Carlos Murga-Zamalloa
- Department of Pathology, University of Illinois Chicago, Chicago, IL 60607, USA; (P.B.); (B.G.); (C.M.-Z.)
| | - Dale Bixby
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 60607, USA;
| | - Ryan Wilcox
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI 60607, USA;
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21
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Kaiser M, Abdin R, Yaghi M, Gaumond SI, Jimenez JJ, Issa NT. Beard Alopecia: An Updated and Comprehensive Review of Etiologies, Presentation and Treatment. J Clin Med 2023; 12:4793. [PMID: 37510908 PMCID: PMC10381635 DOI: 10.3390/jcm12144793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Facial hair is an important social and psychologic aspect of clinical appearance for men. The purpose of this review is to provide a comprehensive overview of the causes of alopecia of the beard including the prevalence, pathophysiology, clinical presentation, and treatment. In this review, we highlight more common causes of beard alopecia including alopecia areata and pseudofolliculitis barbae, infectious causes such as tinea barbae and herpes simplex folliculitis, and rare causes including dermatopathia pigmentosa reticularis and frontal fibrosing alopecia. This review serves as an important resource for clinicians when faced with patients suffering from beard alopecia.
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Affiliation(s)
- Michael Kaiser
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rama Abdin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA
| | - Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Simonetta I Gaumond
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joaquin J Jimenez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Naiem T Issa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Forefront Dermatology, Vienna, VA 22182, USA
- Issa Research and Consulting, LLC, Springfield, VA 22152, USA
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22
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Shimshak S, Dai C, Comfere N, Sokumbi O. Characterization of primary cutaneous T-cell lymphoma following solid organ transplantation. Int J Dermatol 2023; 62:494-500. [PMID: 35687656 DOI: 10.1111/ijd.16300] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/30/2022] [Accepted: 05/13/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Immunosuppression following solid organ transplantation is a known risk factor for the development of posttransplant lymphoproliferative disorders (PTLD). Primary cutaneous T-cell lymphoma (CTCL) occurring in the posttransplant setting is rare, which has made comprehensive understanding of this disease challenging. This study aims to further characterize the spectrum of clinicopathologic features of CTCL in solid organ transplant recipients (SOTR). METHODS A retrospective chart review was performed for SOTR who were diagnosed with CTCL at a multi-site academic medical center from January 1, 1998, to December 31, 2013. Eight patients fulfilled the inclusion criteria and were included in this study. Data collected included patient demographics, transplanted organ, the time between transplant and CTCL diagnosis, clinical presentation and rash morphology, a histological subtype of CTCL, immunosuppression regimens, and patient status. Twelve diagnostic skin biopsies for five patients were examined and reviewed by a board-certified dermatopathologist. RESULTS Six (75%) out of the eight patients were men, two (25%) were women, and the median age was 53 years. The median time from the date of transplant to the diagnosis of CTCL was 8.2 years. Transplanted organs included the liver (4), kidney (3), and heart (1). Clinical presentation varied from papulonodules, comedone-like lesions, intense pruritis, and scaly erythematous eruptions. The most common histologic presentation was folliculotropic mycosis fungoides (FMF) (7/12). Epstein-Barr virus-in situ hybridization (EBV-ISH) was negative in all specimens. CONCLUSIONS We emphasize the rarity of CTCL among SOTR. Although rare in the general population, the FMF subtype appears to be disproportionately seen in SOTR compared with other CTCL.
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Affiliation(s)
| | - Christina Dai
- Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA
| | - Nneka Comfere
- Departments of Dermatology and Laboratory Medicine & Pathology, Mayo Clinic, Rochester, MN, USA
| | - Olayemi Sokumbi
- Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA.,Department of Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL, USA
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23
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Rassek K, Iżykowska K, Żurawek M, Nowicka K, Joks M, Olek-Hrab K, Olszewska B, Sokołowska-Wojdyło M, Biernat W, Nowicki RJ, Przybylski GK. TMEM244 Gene Expression as a Potential Blood Diagnostic Marker Distinguishing Sézary Syndrome from Mycosis Fungoides and Benign Erythroderma. J Invest Dermatol 2023; 143:344-347.e3. [PMID: 36087622 DOI: 10.1016/j.jid.2022.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Karolina Rassek
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | | | - Magdalena Żurawek
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Karina Nowicka
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Monika Joks
- Department of Hematology and Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Karolina Olek-Hrab
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Berenika Olszewska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Małgorzata Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
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24
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Malignant T cells induce skin barrier defects through cytokine-mediated JAK/STAT signaling in cutaneous T-cell lymphoma. Blood 2023; 141:180-193. [PMID: 36122387 DOI: 10.1182/blood.2022016690] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 01/17/2023] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a devastating lymphoid malignancy characterized by the accumulation of malignant T cells in the dermis and epidermis. Skin lesions cause serious symptoms that hamper quality of life and are entry sites for bacterial infection, a major cause of morbidity and mortality in advanced diseases. The mechanism driving the pathological processes that compromise the skin barrier remains unknown. Here, we report increased transepidermal water loss and compromised expression of the skin barrier proteins filaggrin and filaggrin-2 in areas adjacent to TOX-positive T cells in CTCL skin lesions. Malignant T cells secrete mediators (including cytokines such as interleukin 13 [IL-13], IL-22, and oncostatin M) that activate STAT3 signaling and downregulate filaggrin and filaggrin-2 expression in human keratinocytes and reconstructed human epithelium. Consequently, the repression of filaggrins can be counteracted by a cocktail of antibodies targeting these cytokines/receptors, small interfering RNA-mediated knockdown of JAK1/STAT3, and JAK1 inhibitors. Notably, we show that treatment with a clinically approved JAK inhibitor, tofacitinib, increases filaggrin expression in lesional skin from patients with mycosis fungoides. Taken together, these findings indicate that malignant T cells secrete cytokines that induce skin barrier defects via a JAK1/STAT3-dependent mechanism. As clinical grade JAK inhibitors largely abrogate the negative effect of malignant T cells on skin barrier proteins, our findings suggest that such inhibitors provide novel treatment options for patients with CTCL with advanced disease and a compromised skin barrier.
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25
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Giza A, Miklusiak K, Hałubiec P, Jaworek A, Zimowska-Curyło D, Dyduch G, Sacha T. Immediate Response to Brentuximab Vedotin in a Patient with Localized MF-LCT. Case Rep Dermatol 2023; 15:110-116. [PMID: 37497303 PMCID: PMC10368084 DOI: 10.1159/000529576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 07/28/2023] Open
Abstract
The large cell transformation of mycosis fungoides (MF-LCT) is a phenomenon observed in the advanced stages of mycosis fungoides (MF), which is the most common primary cutaneous lymphoma. The diagnostic criteria of MF-LCT are a minimum of 25% of large cells or a formation of microscopic nodules of them in the histological examination of skin samples. The clinical outcomes for MF-LCT are poor, as less than 20% of patients survive 5 years after diagnosis, but the expression of the CD30 antigen is generally considered to be associated with a better prognosis. We present a case of a patient with the diagnosis of MF with LCT, with an ulcerated tumor lesion approximately 30 × 20 cm in size on the right lateral abdominal wall. Brentuximab vedotin (BV) treatment was started due to the presence of the CD30 antigen, with a quick and impressive regression of the cutaneous lesion and tumor mass and good treatment tolerance. After follow-up of 20 months, patient remains in complete remission. A schedule of treatment for MF-LCT is directed mainly by the clinical stage of the disease and the comorbidities; the more severe clinical course of the disease requires systemic treatment. If at least 5% of the cells found in the skin lesions biopsy sample express the CD30 antigen, a beneficial effect of BV treatment could be expected. It may seem that the use of BV is one of the optimal therapeutic options in patients with advanced MF-LCT showing expression of CD30.
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Affiliation(s)
- Agnieszka Giza
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Karol Miklusiak
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
| | - Przemysław Hałubiec
- Student Scientific Group, Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Jaworek
- Department of Dermatology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Grzegorz Dyduch
- Department of Pathomorphology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Medical College, Kraków, Poland
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26
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Paraffin gauze bolus as tissue compensator in photon irradiation for mycosis fungoides – regarding a case study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2023. [DOI: 10.1017/s1460396923000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Abstract
Introduction:
Total skin electron beam therapy is a treatment option in patients with mycosis fungoides (MF) affecting a significant amount of the body surface. For patients with involvement of soles and interdigital folds, however, this approach is ineffective, requiring alternatives such as localised radiotherapy (RT). Although electron beams are well suited for superficial lesions, on irregular surfaces it provides inadequate tumour coverage and excess dose variance, requiring photon irradiation with tissue compensation.
Methods:
We present the case of a patient with extensive cutaneous MF with skin lesions spread over both lower limbs and treated on these affected areas with photon beam RT. Long sheets of paraffin gauze dressings were used to create a 0·5-cm-thick bolus. The patient received a single fraction of 8 Gy. In vivo dosimetry using Gafchromic films was performed.
Results:
After 3 months, a complete response was achieved. In this case, paraffin gauze bolus proved to be an inexpensive, convenient, effective and flexible method for irregular superficial cancer irradiations.
Conclusion:
Paraffin gauze bolus is a suitable option for irregular contours.
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27
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Shimshak S, Sokumbi O, Isaq N, Goyal A, Comfere N. A Practical Guide to the Diagnosis, Evaluation, and Treatment of Cutaneous T-Cell Lymphoma. Dermatol Clin 2023; 41:209-229. [DOI: 10.1016/j.det.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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28
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Hughes MS, Sterling CH, Varadhan R, Ambinder RF, Jones RJ, Sweren RJ, Rozati S, Bolaños-Meade J, Luznik L, Imus PH, Ali SA, Borrello IM, Huff CA, Jain T, Ambinder A, DeZern AE, Gocke CB, Gladstone DE, Swinnen LJ, Wagner-Johnston ND, Fuchs EJ. Mismatched donor transplantation with post-transplantation cyclophosphamide for advanced cutaneous T-cell lymphoma: a single-center retrospective study. Leuk Lymphoma 2022; 63:2987-2991. [PMID: 35915978 DOI: 10.1080/10428194.2022.2105330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Michael S Hughes
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cole H Sterling
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ravi Varadhan
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard F Ambinder
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard J Jones
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ronald J Sweren
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sima Rozati
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Javier Bolaños-Meade
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leo Luznik
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Philip H Imus
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Syed Abbas Ali
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ivan M Borrello
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carol Ann Huff
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tania Jain
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Ambinder
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amy E DeZern
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian B Gocke
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Douglas E Gladstone
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lode J Swinnen
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nina D Wagner-Johnston
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ephraim J Fuchs
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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29
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Geng X, Wang C, Gao X, Chowdhury P, Weiss J, Villegas JA, Saed B, Perera T, Hu Y, Reneau J, Sverdlov M, Wolfe A, Brown N, Harms P, Bailey NG, Inamdar K, Hristov AC, Tejasvi T, Montes J, Barrionuevo C, Taxa L, Casavilca S, de Pádua Covas Lage JLA, Culler HF, Pereira J, Runge JS, Qin T, Tsoi LC, Hong HS, Zhang L, Lyssiotis CA, Ohe R, Toubai T, Zevallos-Morales A, Murga-Zamalloa C, Wilcox RA. GATA-3 is a proto-oncogene in T-cell lymphoproliferative neoplasms. Blood Cancer J 2022; 12:149. [PMID: 36329027 PMCID: PMC9633835 DOI: 10.1038/s41408-022-00745-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Neoplasms originating from thymic T-cell progenitors and post-thymic mature T-cell subsets account for a minority of lymphoproliferative neoplasms. These T-cell derived neoplasms, while molecularly and genetically heterogeneous, exploit transcription factors and signaling pathways that are critically important in normal T-cell biology, including those implicated in antigen-, costimulatory-, and cytokine-receptor signaling. The transcription factor GATA-3 regulates the growth and proliferation of both immature and mature T cells and has recently been implicated in T-cell neoplasms, including the most common mature T-cell lymphoma observed in much of the Western world. Here we show that GATA-3 is a proto-oncogene across the spectrum of T-cell neoplasms, including those derived from T-cell progenitors and their mature progeny, and further define the transcriptional programs that are GATA-3 dependent, which include therapeutically targetable gene products. The discovery that p300-dependent acetylation regulates GATA-3 mediated transcription by attenuating DNA binding has novel therapeutic implications. As most patients afflicted with GATA-3 driven T-cell neoplasms will succumb to their disease within a few years of diagnosis, these findings suggest opportunities to improve outcomes for these patients.
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Affiliation(s)
- Xiangrong Geng
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Chenguang Wang
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Xin Gao
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Pinki Chowdhury
- Department of Pediatrics, Dayton Children's Hospital, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Jonathan Weiss
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - José A Villegas
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Badeia Saed
- Department of Chemistry, College of Liberal Arts and Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Thilini Perera
- Department of Chemistry, College of Liberal Arts and Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Ying Hu
- Department of Chemistry, College of Liberal Arts and Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - John Reneau
- Department of Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Maria Sverdlov
- Department of Pathology, University of Illinois Chicago, Chicago, IL, USA
| | - Ashley Wolfe
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Noah Brown
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Paul Harms
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Nathanael G Bailey
- Division of Hematopathology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kedar Inamdar
- Department of Pathology, Henry Ford Hospital, Detroit, MI, USA
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Jaime Montes
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru
| | - Carlos Barrionuevo
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru
| | - Luis Taxa
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru
| | - J Luís Alberto de Pádua Covas Lage
- Department of Hematology, Hemotherapy and Cell Therapy, Faculty of Medicine, Sao Paulo University, Laboratory of Medical Investigation 31 in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology, Sao Paulo, Brazil
| | - Hebert Fabrício Culler
- Department of Hematology, Hemotherapy and Cell Therapy, Faculty of Medicine, Sao Paulo University, Laboratory of Medical Investigation 31 in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology, Sao Paulo, Brazil
| | - Juliana Pereira
- Department of Hematology, Hemotherapy and Cell Therapy, Faculty of Medicine, Sao Paulo University, Non-Hodgkin's Lymphomas and Histiocytic Disorders, Sao Paulo, Brazil
| | - John S Runge
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Tingting Qin
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Lam C Tsoi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Hanna S Hong
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Li Zhang
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Costas A Lyssiotis
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Rintaro Ohe
- Department of Pathology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tomomi Toubai
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University of Medicine, Yamagata, Japan
| | | | | | - Ryan A Wilcox
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA.
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30
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Fki A, Kotti N, Dhouib F, Kammoun N, Frikha M, Jmal Hammami K, Masmoudi M, Turki H, Hajjaji M. Les facteurs professionnels associés au mycosis fongoïde. ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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31
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Immunotherapy approaches for hematological cancers. iScience 2022; 25:105326. [PMID: 36325064 PMCID: PMC9619355 DOI: 10.1016/j.isci.2022.105326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Hematological cancers such as leukemia, lymphoma, and multiple myeloma have traditionally been treated with chemo and radiotherapy approaches. Introduction of immunotherapies for treatment of these diseases has led to patient remissions that would not have been possible with traditional approaches. In this critical review we identify main disease characteristics, symptoms, and current treatment options. Five common immunotherapies, namely checkpoint inhibitors, vaccines, cell-based therapies, antibodies, and oncolytic viruses, are described, and their applications in hematological cancers are critically discussed.
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32
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Molecular pathogenesis of Cutaneous T cell Lymphoma: Role of chemokines, cytokines, and dysregulated signaling pathways. Semin Cancer Biol 2022; 86:382-399. [PMID: 34906723 DOI: 10.1016/j.semcancer.2021.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 01/27/2023]
Abstract
Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphoproliferative neoplasms that exhibit a wide spectrum of immune-phenotypical, clinical, and histopathological features. The biology of CTCL is complex and remains elusive. In recent years, the application of next-generation sequencing (NGS) has evolved our understanding of the pathogenetic mechanisms, including genetic aberrations and epigenetic abnormalities that shape the mutational landscape of CTCL and represent one of the important pro-tumorigenic principles in CTCL initiation and progression. Still, identification of the major pathophysiological pathways including genetic and epigenetic components that mediate malignant clonal T cell expansion has not been achieved. This is of prime importance given the role of malignant T cell clones in fostering T helper 2 (Th2)-bias tumor microenvironment and fueling progressive immune dysregulation and tumor cell growth in CTCL patients, manifested by the secretion of Th2-associated cytokines and chemokines. Alterations in malignant cytokine and chemokine expression patterns orchestrate the inflammatory milieu and influence the migration dynamics of malignant clonal T cells. Here, we highlight recent insights about the molecular mechanisms of CTCL pathogenesis, emphasizing the role of cytokines, chemokines, and associated downstream signaling networks in driving immune defects, malignant transformation, and disease progression. In-depth characterization of the CTCL immunophenotype and tumoral microenvironment offers a facile opportunity to expand the therapeutic armamentarium of CTCL, an intractable malignant skin disease with poor prognosis and in dire need of curative treatment approaches.
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Rodrigues-Fernandes CI, Vargas PA, de Aquino IG, Lopes MA, Santos-Silva AR. Sézary syndrome: Report of a rare case with perioral manifestation and review of the literature. Oral Oncol 2022; 134:106134. [PMID: 36183500 DOI: 10.1016/j.oraloncology.2022.106134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/09/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022]
Abstract
This report aimed to describe a rare case of Sézary syndrome (SS) diagnosed in an Oral Medicine service. A 54-year-old female presented a generalized pruritus and erythema of the skin of 2 years in duration, which had been treated with antihistamines, corticosteroids, and hydrating creams, without resolution. Extra-oral examination showed a painful lymphadenopathy on the right supraclavicular region. Ultrasound-guided fine-needle aspirationbiopsy did not detect any abnormalities. The patient's skin was remarkably dry and thickened, with erythroderma, fissures, and ulcerations. The perioral region exhibited extreme peeling and angular cheilitis. Immunophenotyping of peripheral blood revealed proliferation of undifferentiated T-cells and a massive proportion of TCD4+ cells relative to TCD8+ cells. PET/CT examination demonstrated multiple lymphadenopathies, and bone marrow biopsy was negative for neoplastic cell infiltration. A diagnosis of SS was established, and the patient is currently being treated with UVB phototherapy, methotrexate, doxepin, and folic acid, with mostly complete regression of signs and symptoms.
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Affiliation(s)
- Carla Isabelly Rodrigues-Fernandes
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Iara Gonçalves de Aquino
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Unraveling the Structural Variations of Early-Stage Mycosis Fungoides—CD3 Based Purification and Third Generation Sequencing as Novel Tools for the Genomic Landscape in CTCL. Cancers (Basel) 2022; 14:cancers14184466. [PMID: 36139626 PMCID: PMC9497107 DOI: 10.3390/cancers14184466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma (CTCL). At present, knowledge of genetic changes in early-stage MF is insufficient. Additionally, low tumor cell fraction renders calling of copy-number variations as the predominant mutations in MF challenging, thereby impeding further investigations. We show that enrichment of T cells from a biopsy of a stage I MF patient greatly increases tumor fraction. This improvement enables accurate calling of recurrent MF copy-number variants such as ARID1A and CDKN2A deletion and STAT5 amplification, undetected in the unprocessed biopsy. Furthermore, we demonstrate that application of long-read nanopore sequencing is especially useful for the structural variant rich CTCL. We detect the structural variants underlying recurrent MF copy-number variants and show phasing of multiple breakpoints into complex structural variant haplotypes. Additionally, we record multiple occurrences of templated insertion structural variants in this sample. Taken together, this study suggests a workflow to make the early stages of MF accessible for genetic analysis, and indicates long-read sequencing as a major tool for genetic analysis for MF.
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Wang HQ, Ji C, Bao CB, Gong T, Elston DM. Facial milia-like eruption in a patient with alopecia. JAAD Case Rep 2022; 25:111-113. [PMID: 35898669 PMCID: PMC9310345 DOI: 10.1016/j.jdcr.2022.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hai-Qing Wang
- Department of Dermatology, Institute of Dermatology and Venereology, Fujian Dermatology and Venereology Reserch Institute, Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chao Ji
- Department of Dermatology, Institute of Dermatology and Venereology, Fujian Dermatology and Venereology Reserch Institute, Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Cheng-Bei Bao
- Department of Dermatology, Institute of Dermatology and Venereology, Fujian Dermatology and Venereology Reserch Institute, Key Laboratory of Skin Cancer of Fujian Higher Education Institutions, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ting Gong
- Central Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dirk M Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, USA
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36
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Parsons MW, Wada DA, Halwani AS, Tao R, Gaffney DK. Improved overall survival over time in advanced stage mycosis fungoides: a cross-sectional study. Leuk Lymphoma 2022; 63:2428-2435. [DOI: 10.1080/10428194.2022.2081322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Matthew W. Parsons
- Department of Radiation Oncology, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - David A. Wada
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - Ahmad S. Halwani
- Division of Hematology, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Randa Tao
- Department of Radiation Oncology, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - David K. Gaffney
- Department of Radiation Oncology, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
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37
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Photodynamic therapy in the treatment of patients with mycosis fungoides. BIOMEDICAL PHOTONICS 2022. [DOI: 10.24931/2413-9432-2022-11-1-27-36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The review highlights the current understanding of the epidemiology, etiology, pathogenesis, existing classifications of mycosis fungoides. Methods for diagnosis and treatment of the pathology are described, among which photodynamic therapy (PDT) plays an important role. The main advantages of PDT for mycosis fungoides include the absence of systemic toxicity, non-invasiveness, selectivity, absence of carcinogenic potential, the possibility of repeated courses of treatment, and good cosmetic results. This review collects and analyzes the results of clinical trials of PDT in patients with mycosis fungoides. The analysis showed high efficiency of PDT in patients with mycosis fungoides with isolated or limited spots and plaques. PDT can be considered as the therapy of choice in patients with facial lesions when a good cosmetic result is one of the main requirements, and radiation therapy, nitrogen mustard or carmustine can leave permanent and visible scars. Plaques located in the axillary or inguinal skin folds that are inaccessible to phototherapy can also be treated with PDT.
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38
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Photodynamic therapy in the treatment of patients with mycosis fungoides. BIOMEDICAL PHOTONICS 2022. [DOI: 10.24931/2413-9432-2022-11-1-27-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The review highlights the current understanding of the epidemiology, etiology, pathogenesis, existing classifications of mycosis fungoides. Methods for diagnosis and treatment of the pathology are described, among which photodynamic therapy (PDT) plays an important role. The main advantages of PDT for mycosis fungoides include the absence of systemic toxicity, non-invasiveness, selectivity, absence of carcinogenic potential, the possibility of repeated courses of treatment, and good cosmetic results. This review collects and analyzes the results of clinical trials of PDT in patients with mycosis fungoides. The analysis showed high efficiency of PDT in patients with mycosis fungoides with isolated or limited spots and plaques. PDT can be considered as the therapy of choice in patients with facial lesions when a good cosmetic result is one of the main requirements, and radiation therapy, nitrogen mustard or carmustine can leave permanent and visible scars. Plaques located in the axillary or inguinal skin folds that are inaccessible to phototherapy can also be treated with PDT.
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39
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Chen C, Liu Z, Liu J, Zhang W, Zhou D, Zhang Y. Case Report: Outcome and Adverse Events of Anti-PD-1 Antibody Plus Chidamide for Relapsed/Refractory Sézary Syndrome: Case Series and A Literature Review. Front Oncol 2022; 12:842123. [PMID: 35387123 PMCID: PMC8977601 DOI: 10.3389/fonc.2022.842123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Sézary syndrome (SS) is an aggressive leukemic variant of cutaneous T-cell lymphoma with a poor prognosis and survival rate. Existing therapies for relapsed/refractory (R/R) SS have a low response rate with a short duration time. Herein, we presented three cases of R/R SS treated with the anti-PD-1 antibody and chidamide. Case 1 and case 2 showed the potential efficacy of this combination therapy with a long duration time. Case 2 and case 3 both showed that the patients developed acute and transient worsening of erythroderma and pruritus after anti-PD-1 antibody infusion, and this flare reaction was associated with transient decreased leukocytes and lymphocytes in peripheral blood. To the best of our knowledge, this is the first report of the anti-PD-1 antibody combined with chidamide for treatment of R/R SS. This report suggests that the combination therapy may be a new and effective treatment and that further clinical trials are needed to prove it and elucidate the mechanism of this combination therapy and its flare reaction.
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Affiliation(s)
- Chao Chen
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
| | - Zhaorui Liu
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, China
| | - Jie Liu
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, China
| | - Wei Zhang
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
| | - Yan Zhang
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
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Matsuda Y, Ikeda S, Abe F, Takahashi Y, Kitadate A, Takahashi N, Wakui H, Tagawa H. Downregulation of miR-26 promotes invasion and metastasis via targeting interleukin-22 in cutaneous T-cell lymphoma. Cancer Sci 2022; 113:1208-1219. [PMID: 35133054 PMCID: PMC8990290 DOI: 10.1111/cas.15296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022] Open
Abstract
It has been reported that certain microRNAs (miRNA) are associated with the pathogenesis of lymphoma. We have previously demonstrated that histone deacetylase inhibitors restore tumor-suppressive miRNAs, such as miR-16, miR-29, miR-150, and miR-26, in advanced cutaneous T-cell lymphoma (CTCL). Among these, the function of miR-26 remains unclear. In this study, we aimed to reveal the function of miR-26 in CTCL oncogenesis. First, we confirmed that the miR-26 family was markedly dysregulated in CTCL cell lines and primary samples. In vivo analysis using miR-26a-transduced CTCL cells injected into immunodeficient NOG mice demonstrated the significant prolonged survival of the mice, suggesting that the miRNA had a tumor-suppressive function. We performed gene expression assays and identified 12 candidate miR-26 targets, namely RGS13, FAM71F1, OAF, SNX21, CDH2, PTPLB, IL22, DNAJB5, CASZ1, CACNA1C, MYH10, and CNR1. Among these, IL22 was the most likely candidate target because the IL-22-STAT3-CCL20-CCR6 cascade is associated with tumor invasion and metastasis of advanced CTCL. In vitro analysis of IL22 and IL22RA knockdown and miR-26 transduction demonstrated inhibited CTCL cell migration. In particular, IL22 knockdown induced cell apoptosis. Finally, we conducted in vivo inoculation analysis of mice injected with shIL22-transfected CTCL cells, and found no tumor invasion or metastasis in the inoculated mice, although the control mice showed multiple tumor invasions and metastases. These results, along with our previous data, demonstrated that miR-26 is a tumor suppressor that is associated with tumor invasion and the metastasis of advanced CTCL by regulating the IL-22-STAT3-CCL20 cascade. Therefore, a IL-22-targeting therapy could be a novel therapeutic strategy for advanced CTCL.
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Affiliation(s)
- Yuka Matsuda
- Department of Life ScienceGraduate School of Engineering ScienceAkita UniversityAkitaJapan
| | - Sho Ikeda
- Department of Hematology, Nephrology, and RheumatologyAkita University Graduate School of MedicineAkitaJapan
| | - Fumito Abe
- Department of Hematology, Nephrology, and RheumatologyAkita University Graduate School of MedicineAkitaJapan
| | - Yuto Takahashi
- Department of Life ScienceGraduate School of Engineering ScienceAkita UniversityAkitaJapan
| | - Akihiro Kitadate
- Department of Hematology, Nephrology, and RheumatologyAkita University Graduate School of MedicineAkitaJapan
| | - Naoto Takahashi
- Department of Hematology, Nephrology, and RheumatologyAkita University Graduate School of MedicineAkitaJapan
| | - Hideki Wakui
- Department of Life ScienceGraduate School of Engineering ScienceAkita UniversityAkitaJapan
| | - Hiroyuki Tagawa
- Department of Hematology, Nephrology, and RheumatologyAkita University Graduate School of MedicineAkitaJapan
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Telomeric Repeat-Containing RNA (TERRA): A Review of the Literature and First Assessment in Cutaneous T-Cell Lymphomas. Genes (Basel) 2022; 13:genes13030539. [PMID: 35328092 PMCID: PMC8953746 DOI: 10.3390/genes13030539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/11/2023] Open
Abstract
Telomeric Repeat-containing RNA (TERRA) are long non-coding RNAs transcribed from telomeric DNA sequences from multiple chromosome ends. Major research efforts have been made to understand TERRA roles and functions in several physiological and pathological processes. We summarize herein available data regarding TERRA’s roles in human cells and we report the first investigation in cutaneous T-cells lymphomas (CTCL) using real-time PCR. Among the TERRA analysed, our data suggest a particular role for TERRA 16p downregulation and TERRA 11q upregulation in CTCL lymphomagenesis.
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42
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Kita K, Nakatani-Kusakabe M, Nagai M, Yamanishi K, Natsuaki M, Imai Y, Kanazawa N. Single-cell RNA sequencing of mycosis fungoides reveals a cluster of actively proliferating lymphocytes. Australas J Dermatol 2022; 63:e150-e154. [PMID: 35254671 DOI: 10.1111/ajd.13794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/09/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022]
Abstract
A 70-year-old man's chronic erythematous skin lesion in the extremity had developed into a tumour one year before his first visit at our hospital. A biopsy showed atypical lymphocyte-like cells, and immunostaining identified atypical cells as CD3+, CD4+, CD5+ and FOXP3+. Single-cell RNA sequencing (scRNA-seq) analysis using BD Rhapsody revealed the higher expression of CD3, CD4, CD5 and FOXP3 genes in a group of cells that highly expressed genes, such as PCNA, in the S/M phase, which is in agreement with immunofluorescence staining results. The use of scRNA-seq analysis data is expected to promote personalised medicine for cutaneous lymphoma.
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Affiliation(s)
- Kanako Kita
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | | | - Makoto Nagai
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kiyofumi Yamanishi
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masaru Natsuaki
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yasutomo Imai
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Nobuo Kanazawa
- Department of Dermatology, Hyogo College of Medicine, Nishinomiya, Japan
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43
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Gökşin Ş, İmren IG, Cenk H, Kaçar N, Duygulu Ş. The Use of Interferon‐α2a as Monotherapy in Stage
IB
Patients with Mycosis Fungoides: A Retrospective Chart Review of Patient Outcomes. Dermatol Ther 2022; 35:e15344. [DOI: 10.1111/dth.15344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/28/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Şule Gökşin
- Pamukkale University Medical Faculty, Dermatology Department Denizli
| | - Işıl Göğem İmren
- Pamukkale University Medical Faculty, Dermatology Department Denizli
| | - Hülya Cenk
- Pamukkale University Medical Faculty, Dermatology Department Denizli
| | - Nida Kaçar
- Pamukkale University Medical Faculty, Dermatology Department Denizli
| | - Şeniz Duygulu
- Pamukkale University Medical Faculty, Dermatology Department Denizli
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44
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Filipovic N, Likic R, Bulat V, Gašparov S, Azdajic MD. Brentuximab induced splinter nail haemorrhages in a patient with Sézary syndrome: a case report. Br J Clin Pharmacol 2022; 88:3883-3886. [PMID: 35088431 DOI: 10.1111/bcp.15247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022] Open
Abstract
Sézary syndrome is a systemic variant of cutaneous T-cell lymphoma (CTCL) characterized by erythroderma, lymphadenopathy, and circulating atypical lymphocytes (Sézary cells). It may present with nonspecific lesions on multiple digits. We describe an atypical case of brentuximab-induced splinter nail haemorrhages in a patient with Sézary syndrome, associated with a poor prognosis during follow-up. Concomitantly with the appearance of nail lesions, significant lymphocytosis was detected as well as infiltration of bone marrow and nail matrices. The lesions followed a precise sequence which can be traced back to the monthly application of brentuximab and its direct cytotoxic effect on CD30+ T lymphocytes in the nail matrix. Brentuximab-induced nail lesions might be associated with decreased efficacy of brentuximab in this patient with advanced CTCL.
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Affiliation(s)
- Nika Filipovic
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Robert Likic
- University of Zagreb School of Medicine, Zagreb, Croatia.,Division for Clinical Pharmacology and Therapeutics, Department of Internal Medicine University Hospital Centre Zagreb, Zagreb, Croatia
| | - Vedrana Bulat
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Slavko Gašparov
- Department of Pathology, School of Medicine, University of Zagreb, Merkur University Hospital, Zagreb, Croatia
| | - Marija Delas Azdajic
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
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Feline and Canine Cutaneous Lymphocytosis: Reactive Process or Indolent Neoplastic Disease? Vet Sci 2022; 9:vetsci9010026. [PMID: 35051110 PMCID: PMC8778986 DOI: 10.3390/vetsci9010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 02/01/2023] Open
Abstract
Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.
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46
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Wen P, Xie Y, Wang L. The Role of microRNA in Pathogenesis, Diagnosis, Different Variants, Treatment and Prognosis of Mycosis Fungoides. Front Oncol 2021; 11:752817. [PMID: 34966672 PMCID: PMC8710607 DOI: 10.3389/fonc.2021.752817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023] Open
Abstract
Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), accounting for approximately 50% of all CTCLs. Although various molecular changes in MF have been described in existing studies, no obvious disease-specific changes have been found thus far. microRNAs (miRs) are short, noncoding RNA molecules that play roles in the post-transcriptional regulation of oncogenes and tumor suppressor genes in various diseases. Recently, there has been rapidly expanding experimental evidence for the role of miRs in the progression, early diagnosis, prognosis prediction for MF. Efforts to improve early diagnosis and develop personalized therapy options have become more important in recent years. Here, we provide an overview and update of recent advances regarding miRs associated with MF. Furthermore, we provide insights into future opportunities for miR-based therapies.
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Affiliation(s)
- Pengfei Wen
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Xie
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Wang
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, China
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47
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Gan L, Shi H, Zhang Y, Sun J, Chen H. Proteomic Screening and Verification of Biomarkers in Different Stages of Mycosis Fungoides: A pilot Study. Front Cell Dev Biol 2021; 9:747017. [PMID: 34966737 PMCID: PMC8711087 DOI: 10.3389/fcell.2021.747017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/04/2021] [Indexed: 11/18/2022] Open
Abstract
Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma; in advanced stages, it can involve multiple organs and has a poor prognosis. Early detection of the disease is still urgent, but there is no optimal therapy for advanced MF. In the present study, quantitative proteomic analyses (label-free quantitation, LFQ) were applied to tissue samples of different stages of MF and tissue samples from controls (eczema patients and healthy donors) to conduct preliminary molecular analysis to clarify the pathogenesis of the disease. Differential protein expression analysis demonstrated that 113 and 305 proteins were associated with the early and advanced stages of MF, respectively. Gene ontology (GO) enrichment analysis was conducted to determine the potential functions of the proteins, which could be classified into three categories: biological process, cellular component, and molecular function. The results revealed that a series of biological processes, including “initiation of DNA replication” and “nucleosome assembly,” were involved in the disease. Moreover, cellular components, including the “desmosome” and “integrin complex,” may affect the invasion and metastasis of MF via molecular functions, including “integrin binding” and “cadherin binding”. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis demonstrated that “focal adhesion DNA replication,” “Toll-like receptor signalling pathway” and other pathways were also involved. A parallel reaction monitoring (PRM) assay was applied to validate the identified differentially expressed proteins. In conclusion, the above proteomic findings may have great diagnostic and prognostic value in diverse malignancies, especially MF. Nevertheless, further studies are still needed to explore the precise mechanisms of MF.
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Affiliation(s)
- Lu Gan
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Haoze Shi
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ying Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Jianfang Sun
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Hao Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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Jonak C, Tittes J, Brunner PM, Guenova E. Mycosis fungoides und Sézary-Syndrom. J Dtsch Dermatol Ges 2021; 19:1307-1335. [PMID: 34541808 DOI: 10.1111/ddg.14610_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Constanze Jonak
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Julia Tittes
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | | | - Emmanuella Guenova
- Universitätsklinik für Dermatologie, Fakultät für Biologie und Medizin, Universität Lausanne, Lausanne, Schweiz
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Jonak C, Tittes J, Brunner PM, Guenova E. Mycosis fungoides and Sézary syndrome. J Dtsch Dermatol Ges 2021; 19:1307-1334. [PMID: 34541796 PMCID: PMC9293091 DOI: 10.1111/ddg.14610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are primary cutaneous T-cell lymphomas (CTCL) with not yet fully understood etiology and pathogenesis. Conceptually, MF and SS are classified as distinct entities arising from different T helper cell subsets. MF is the most common CTCL entity, while SS is very rare. MF presents clinically with patch, plaque and/or tumor stages, but can also evolve as erythroderma, which in turn is pathognomonic for SS. SS is characterized by a detectable tumor-cell burden (Sézary cells) in the peripheral blood consistent with advanced-stage disease and a poor prognosis. In early-stage disease of MF, which is the predominant form, the prognosis is generally favorable. However, in up to 30 % of patients, there is progression of skin lesions, which can ultimately lead to visceral involvement. The histological manifestation of MF can be subtle in early-stage disease and therefore a careful clinicopathological correlation is paramount. The treatment of MF/SS is dependent on the disease stage. Therapeutic options include both skin-directed and systemic regimens. Apart from allogeneic stem cell transplantation (alloSCT), there is as yet no curative therapy for MF/SS. Accordingly, the treatment approach is symptom oriented and aims to reduce the tumor burden and improve health-related quality of life. However, the therapeutic landscape for CTCL is constantly being expanded by the discovery of novel therapeutic targets.
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Affiliation(s)
- Constanze Jonak
- Department of Dermatology, Medical University of Vienna, Austria
| | - Julia Tittes
- Department of Dermatology, Medical University of Vienna, Austria
| | | | - Emmanuella Guenova
- Department of Dermatology, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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50
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Patel RP, Thomas JR, Curt KM, Fitzsimmons CM, Batista PJ, Bates SE, Gottesman MM, Robey RW. Dual Inhibition of Histone Deacetylases and the Mechanistic Target of Rapamycin Promotes Apoptosis in Cell Line Models of Uveal Melanoma. Invest Ophthalmol Vis Sci 2021; 62:16. [PMID: 34533562 PMCID: PMC8458781 DOI: 10.1167/iovs.62.12.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose Over 90% of uveal melanomas harbor pathogenic variants of the GNAQ or GNA11 genes that activate survival pathways. As previous studies found that Ras-mutated cell lines were vulnerable to a combination of survival pathway inhibitors and the histone-deacetylase inhibitor romidepsin, we investigated whether this combination would be effective in models of uveal melanoma. Methods A small-scale screen of inhibitors of bromodomain-containing protein 4 (BRD4; OTX-015), extracellular signal-related kinase (ERK; ulixertinib), mechanistic target of rapamycin (mTOR; AZD-8055), or phosphoinositide 3-kinase (PI3K; GDC-0941) combined with a clinically relevant administration of romidepsin was performed on a panel of uveal melanoma cell lines (92.1, Mel202, MP38, and MP41) and apoptosis was quantified by flow cytometry after 48 hours. RNA sequencing analysis was performed on Mel202 cells treated with romidepsin alone, AZD-8055 alone, or the combination, and protein changes were validated by immunoblot. Results AZD-8055 with romidepsin was the most effective combination in inducing apoptosis in the cell lines. Increased caspase-3 and PARP cleavage were noted in the cell lines when they were treated with romidepsin and mTOR inhibitors. RNA sequencing analysis of Mel202 cells revealed that apoptosis was the most affected pathway in the romidepsin/AZD-8055-treated cells. Increases in pro-apoptotic BCL2L11 and decreases in anti-apoptotic BIRC5 and BCL2L1 transcripts noted in the sequencing analysis were confirmed at the protein level in Mel202 cells. Conclusions Our data suggest that romidepsin in combination with mTOR inhibition could be an effective treatment strategy against uveal melanoma due in part to changes in apoptotic proteins.
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Affiliation(s)
- Ruchi P Patel
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Joanna R Thomas
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Katherine M Curt
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Christina M Fitzsimmons
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Pedro J Batista
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Susan E Bates
- Columbia University Medical Center, Division of Hematology/Oncology, New York, New York, United States
| | - Michael M Gottesman
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Robert W Robey
- Laboratory of Cell Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States
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