1
|
Blomme S, De Paepe P, Devos H, Emmerechts J, Snauwaert S, Cauwelier B. Alternative genetic alterations of MYC, BCL2, and/or BCL6 in high-grade B-cell lymphoma (HGBL) and diffuse large B-cell lymphoma (DLBCL): Can we identify different prognostic subgroups? Genes Chromosomes Cancer 2024; 63:e23211. [PMID: 37897298 DOI: 10.1002/gcc.23211] [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: 07/05/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023] Open
Abstract
High-grade B-cell lymphoma (HGBL)/diffuse large B-cell lymphoma (DLBCL) with rearrangements (R) in MYC and BCL2 and/or BCL6 are correlated with poor prognosis. Little is known about the impact of other genetic alterations (gain (G) or amplification (A)) of these genes. The aim of the study was to investigate whether we can identify new prognostic subgroups. Fluorescence in situ hybridization (FISH) results from 169 HGBL/DLBCL were retrospectively categorized into: (1) concurrent MYC-R and BCL2-R and/or BCL6-R-samples with MYC-R and BCL2-R (+/- BCL6-R); n = 21, and HGBL/DLBCL with MYC-R and BCL6-R; n = 11; (2) concurrent R and G/A in MYC and BCL2 and/or BCL6 called "alternative HGBL/DLBCL"-samples with (n = 16) or without (n = 6) BCL2 involvement; (3) BCL2 and/or BCL6 alterations without MYC involvement (n = 35); (4) concurrent G/A in MYC and BCL2 and/or BCL6 without R (n = 25); and (5) "No alterations" (n = 55). Patients with HGBL/DLBCL-MYC/BCL2 and "alternative" HGBL/DLBCL (with BCL2 involvement) had significantly worse survival rates compared to the "no alterations" group. G/A of these genes in the absence of rearrangements did not show any prognostic significance. HGBL/DLBCL with MYC-R and BCL6-R without BCL2 involvement showed a better survival rate compared to HGBL/DLBCL-MYC/BCL2. According to immunohistochemistry, "double/triple" expression (DEL/TEL) did not show a significantly worse outcome compared to absent DEL/TEL. This study highlights the continued value of FISH assessment of MYC, BCL2, and BCL6 in the initial evaluation of HGBL/DLBCL with different survival rates between several genetic subgroups.
Collapse
Affiliation(s)
- Siska Blomme
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Pascale De Paepe
- Department of Pathology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Helena Devos
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Jan Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Sylvia Snauwaert
- Department of Clinical Hematology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - Barbara Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| |
Collapse
|
2
|
Abdelhamid TM, Gaber AA, Abdelfattah RM, Algamal DA, Hamdy O, Mohamed G. The significance of concurrent MYC and BCL2 expression in Egyptian patients with diffuse large B-cell NHL. Pathol Res Pract 2024; 253:154973. [PMID: 38101156 DOI: 10.1016/j.prp.2023.154973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
This study aimed to investigate the frequency of MYC/BCL2 co-expression using immunohistochemistry (IHC) in Egyptian patients with diffuse large B-cell lymphoma (DLBCL) and its impact on treatment outcomes, overall survival (OS), and disease-free survival (DFS). A total of 100 adult patients with newly diagnosed DLBCL were included in the study and treated with the R-CHOP regimen. The cases were classified into germinal center B-cell (GCB) and non-germinal center B-cell (non-GCB) subtypes based on IHC. Our results showed that a subset of the studied cases didn't achieve complete remission (CR) after chemotherapy (22%). Co-expression of MYC and BCL2 was observed in 20% of the cases, with most of them belonging to the non-GCB subtype. The CR rate was significantly lower in the double-expressor (DE) group (45%), while no significant difference was observed in CR between the GCB and non-GCB cases. The DE group was associated with advanced stage, extra-nodal involvement, and high-risk R-International Prognostic Index (R-IPI). Both the non-DE and GCB groups demonstrated better DFS, while the non-DE group only showed better OS. Both non-DE status and GCB subtype were identified as independent factors affecting DFS. In conclusion, the concurrent expression of MYC and BCL2 in DLBCL indicates an inferior outcome and lower chemotherapy response. The current chemotherapeutic strategy has not effectively improved the outcomes of this aggressive lymphoma subtype. Therefore, the identification of these patients is crucial for selecting appropriate treatment options.
Collapse
Affiliation(s)
- Thoraya M Abdelhamid
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ayman A Gaber
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Raafat M Abdelfattah
- Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Dina A Algamal
- Medical Oncology Department, Tanta Cancer Center, Tanta, Egypt
| | - Omar Hamdy
- Faculty of Engineering, Cairo University, Giza, Egypt
| | - Ghada Mohamed
- Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt.
| |
Collapse
|
3
|
Dominguez EC, Roleder C, Ball B, Danilov AV. Cyclin-dependent kinase-9 in B-cell malignancies: pathogenic role and therapeutic implications. Leuk Lymphoma 2023; 64:1893-1904. [PMID: 37552126 DOI: 10.1080/10428194.2023.2244102] [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: 06/02/2023] [Accepted: 07/29/2023] [Indexed: 08/09/2023]
Abstract
Cyclin-dependent kinases (CDK) regulate cell cycle and transcriptional activity. Pan-CDK inhibitors demonstrated early efficacy in lymphoid malignancies, but also have been associated with narrow therapeutic index. Among transcriptional CDKs, CDK7 and CDK9 emerged as promising targets. CDK9 serves as a component of P-TEFb elongation complex and thus is indispensable in mRNA transcription. Selective CDK9 inhibitors demonstrated pre-clinical efficacy in in vitro and in vivo models of B-cell non-Hodgkin lymphoma. CDK9 inhibition results in transcriptional pausing with rapid downmodulation of short-lived oncogenic proteins, e.g. Myc and Mcl-1, followed by cell apoptosis. Early phase clinical trials established safety of CDK9 inhibitors, with manageable neutropenia, infections and gastrointestinal toxicities. In this review, we summarize the rationale of targeting CDK9 in lymphoid malignancies, as well as pre-clinical and early clinical data with pan-CDK and selective CDK9 inhibitors.
Collapse
Affiliation(s)
| | - Carly Roleder
- City of Hope National Medical Center, Duarte, CA, USA
| | - Brian Ball
- City of Hope National Medical Center, Duarte, CA, USA
| | | |
Collapse
|
4
|
El-Sharkawi D, Sud A, Prodger C, Khwaja J, Shotton R, Hanley B, Peacock V, Peng YY, Arasaretnam A, Sharma S, Aldridge F, Sharma B, Wotherspoon A, Cheung B, De Lord C, Johnston R, Kassam S, Pettengel R, Linton K, Greaves P, Cook L, Naresh KN, Cwynarski K, Eyre TA, Chau I, Cunningham D, Iyengar S. A retrospective study of MYC rearranged diffuse large B-cell lymphoma in the context of the new WHO and ICC classifications. Blood Cancer J 2023; 13:54. [PMID: 37072385 PMCID: PMC10113386 DOI: 10.1038/s41408-023-00827-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/20/2023] Open
Affiliation(s)
- Dima El-Sharkawi
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - Amit Sud
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Catherine Prodger
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Rohan Shotton
- The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Brian Hanley
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Ying Ying Peng
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Sarkhara Sharma
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - Frances Aldridge
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - Bhupinder Sharma
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - Andrew Wotherspoon
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | | | - Corinne De Lord
- Epsom and St Helier University Hospitals NHS Trust, London, UK
| | | | - Shireen Kassam
- King's College Hospital NHS Foundation Trust, London, UK
| | - Ruth Pettengel
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kim Linton
- The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Paul Greaves
- Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, UK
| | - Lucy Cook
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Kate Cwynarski
- University College Hospitals NHS Foundation Trust, London, UK
| | - Toby A Eyre
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ian Chau
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - David Cunningham
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK
| | - Sunil Iyengar
- The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, UK.
| |
Collapse
|
5
|
Martínez-Martín S, Beaulieu ME, Soucek L. Targeting MYC-driven lymphoma: lessons learned and future directions. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2023; 6:205-222. [PMID: 37457123 PMCID: PMC10344726 DOI: 10.20517/cdr.2022.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/24/2023] [Accepted: 03/22/2023] [Indexed: 07/18/2023]
Abstract
MYC plays a central role in tumorigenesis by orchestrating cell proliferation, growth and survival, among other transformation mechanisms. In particular, MYC has often been associated with lymphomagenesis. In fact, MYC overexpressing lymphomas such as high-grade B-cell lymphoma (HGBL) and double expressor diffuse large B-cell lymphomas (DLBCL), are considered addicted to MYC. In such a context, MYC targeting therapies are of special interest, as MYC withdrawal is expected to result in tumor regression. However, whether high MYC levels are always predictive of increased sensitivity to these approaches is not clear yet. Even though no MYC inhibitor has received regulatory approval to date, substantial efforts have been made to investigate avenues to render MYC a druggable target. Here, we summarize the different classes of molecules currently under development, which mostly target MYC indirectly in aggressive B-cell lymphomas, paying special attention to subtypes with MYC/BCL2 or BCL6 translocations or overexpression.
Collapse
Affiliation(s)
| | - Marie-Eve Beaulieu
- Peptomyc S.L., Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
| | - Laura Soucek
- Peptomyc S.L., Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Preclinical & Translational Research Program, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
| |
Collapse
|
6
|
Czarny J, Andrzejewska M, Zając-Spychała O, Latos-Grażyńska E, Pastorczak A, Wypyszczak K, Szczawińska-Popłonyk A, Niewiadomska-Wojnałowicz I, Wziątek A, Marciniak-Stępak P, Dopierała M, Małdyk J, Jończyk-Potoczna K, Derwich K. Successful Treatment of Large B-Cell Lymphoma in a Child with Compound Heterozygous Mutation in the ATM Gene. Int J Mol Sci 2023; 24:ijms24021099. [PMID: 36674612 PMCID: PMC9866559 DOI: 10.3390/ijms24021099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Ataxia-telangiectasia (AT) is a multisystemic neurodegenerative inborn error of immunity (IEI) characterized by DNA repair defect, chromosomal instability, and hypersensitivity to ionizing radiation. Impaired DNA double-strand break repair determines a high risk of developing hematological malignancies, especially lymphoproliferative diseases. Poor response to treatment, excessive chemotherapy toxicities, and the need for avoiding exposure to ionizing radiation make the successful clinical management of patients with AT challenging for oncologists. We describe the favorable outcome of the LBCL with IRF4 rearrangement at stage III in a 7-year-old female patient diagnosed with AT. The patient was treated according to the B-HR arm of the INTER-B-NHL-COP 2010 protocol, including the administration of rituximab, cyclophosphamide, methotrexate, prednisone, etc. She presented excessive treatment toxicities despite individually reduced doses of methotrexate and cyclophosphamide. However, in the MRI there was no significant reduction in pathologic lymph nodes after three immunochemotherapy courses. Therefore, a lymph node biopsy was taken. Its subsequent histopathological examination revealed tuberculosis-like changes, though tuberculosis suspicion was excluded. After two following immunochemotherapy courses, PET-CT confirmed complete remission. From March 2022 onwards, the patient has remained in remission under the care of the outpatient children's oncology clinic.
Collapse
Affiliation(s)
- Jakub Czarny
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Marta Andrzejewska
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Elżbieta Latos-Grażyńska
- Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wrocław Medical University, 50-556 Wrocław, Poland
| | - Agata Pastorczak
- Department of Pediatrics, Oncology and Hematology, Medical University of Łódź, 91-738 Łódź, Poland
| | - Kamila Wypyszczak
- Department of Pediatrics, Oncology and Hematology, Medical University of Łódź, 91-738 Łódź, Poland
| | - Aleksandra Szczawińska-Popłonyk
- Department of Pediatric Pneumonology, Allergy and Clinical Immunology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Izabela Niewiadomska-Wojnałowicz
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Agnieszka Wziątek
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Patrycja Marciniak-Stępak
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Michał Dopierała
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
- Department of Pathology and Clinical Immunology, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Jadwiga Małdyk
- Department of Pathology, Medical University of Warsaw, 02-106 Warsaw, Poland
| | - Katarzyna Jończyk-Potoczna
- Department of Pediatric Radiology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
| | - Katarzyna Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznań University of Medical Sciences, 60-355 Poznań, Poland
- Correspondence:
| |
Collapse
|
7
|
Cortese MJ, Wei W, Cerdeña S, Watkins MP, Olson M, Jodon G, Kaiser J, Haverkos B, Hughes ME, Namoglu E, Grover NS, Snow A, Orellana-Noia V, Rainey M, Sohail M, Rudoni J, Portell C, Voorhees T, Landsburg DJ, Kamdar M, Kahl BS, Hill BT. A multi-center analysis of the impact of DA-EPOCH-R dose-adjustment on clinical outcomes of patients with double/triple-hit lymphoma. Leuk Lymphoma 2023; 64:107-118. [PMID: 36323309 DOI: 10.1080/10428194.2022.2140281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Patients with double- and triple-hit lymphomas (DHL/THL) have inferior outcomes with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), and higher-intensity regimens such as dose-adjusted (DA)-EPOCH-R are standard. Dose-intensification of DA-EPOCH-R is guided by hematologic toxicity, without conclusive benefit for DHL/THL patients. To determine if cumulative doses of DA-EPOCH-R or compliance with dose adjustment impacts survival, we retrospectively evaluated detailed clinical data from 109 adult (age ≥18 years) patients with DHL/THL treated with ≥4 cycles of induction DA-EPOCH-R from 2014 to 2019 at six centers. A comprehensive multivariate analysis was performed. Survival outcomes for the entire cohort were comparable to historical estimates for DHL/THL treated with this regimen (median follow-up 27.9 months). Overall survival (OS) and progression-free survival (PFS) were not significantly associated with cumulative chemotherapy dose, dose escalation, or compliance with dose adjustment. Heterogeneous dosing practices were observed. Prospective investigation is warranted to evaluate the practice of dose adjustment of R-EPOCH for patients with DHL/THL.
Collapse
Affiliation(s)
- Matthew J Cortese
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland, OH, USA
| | - Wei Wei
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Lerner Research Institute, Cleveland, OH, USA
| | - Sebastian Cerdeña
- Barnes-Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Marcus P Watkins
- Barnes-Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Marissa Olson
- Barnes-Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Gray Jodon
- University of Colorado Cancer Center, Aurora, CO, USA
| | - Jeff Kaiser
- University of Colorado Cancer Center, Aurora, CO, USA
| | | | - Mitchell E Hughes
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Esin Namoglu
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Natalie S Grover
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Anson Snow
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Victor Orellana-Noia
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA, USA
| | - Magdalena Rainey
- Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Mohammad Sohail
- Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Joslyn Rudoni
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Craig Portell
- Division of Hematology/Oncology, University of Virginia, Charlottesville, VA, USA
| | - Timothy Voorhees
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Daniel J Landsburg
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Manali Kamdar
- University of Colorado Cancer Center, Aurora, CO, USA
| | - Brad S Kahl
- Barnes-Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA
| | - Brian T Hill
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland, OH, USA
| |
Collapse
|
8
|
New Therapeutics for Extracellular Vesicles: Delivering CRISPR for Cancer Treatment. Int J Mol Sci 2022; 23:ijms232415758. [PMID: 36555398 PMCID: PMC9779094 DOI: 10.3390/ijms232415758] [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] [Received: 10/30/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Cancers are defined by genetic defects, which underlines the prospect of using gene therapy in patient care. During the past decade, CRISPR technology has rapidly evolved into a powerful gene editing tool with high fidelity and precision. However, one of the impediments slowing down the clinical translation of CRISPR-based gene therapy concerns the lack of ideal delivery vectors. Extracellular vesicles (EVs) are nano-sized membrane sacs naturally released from nearly all types of cells. Although EVs are secreted for bio-information conveyance among cells or tissues, they have been recognized as superior vectors for drug or gene delivery. Recently, emerging evidence has spotlighted EVs in CRISPR delivery towards cancer treatment. In this review, we briefly introduce the biology and function of the CRISPR system and follow this with a summary of current delivery methods for CRISPR applications. We emphasize the recent progress in EV-mediated CRISPR editing for various cancer types and target genes. The reported strategies for constructing EV-CRISPR vectors, as well as their limitations, are discussed in detail. The review aims to throw light on the clinical potential of engineered EVs and encourage the expansion of our available toolkit to defeat cancer.
Collapse
|
9
|
Ji L, Hua F, Wu Y, Qiao T, Gu J, Zhang X, Liu P, Li F, Cheng Y. Clinical practice of precision medicine in lymphoma. CLINICAL AND TRANSLATIONAL DISCOVERY 2022. [DOI: 10.1002/ctd2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Lili Ji
- Department of Hematology Zhongshan Hospital Fudan University Shanghai China
| | - Fanli Hua
- Department of Hematology Zhongshan Hospital Qingpu Branch, Fudan University Shanghai China
| | - Yu Wu
- Department of Hematology, West China hospital Sichuan University Chengdu China
| | - Tiankui Qiao
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital Fudan University Shanghai China
| | - Jianying Gu
- Department of Plastic Surgery Zhongshan Hospital Fudan University Shanghai China
| | - Xiaohui Zhang
- Institute of Hematology Peking University People's Hospital, Peking University Beijing China
| | - Peng Liu
- Department of Hematology Zhongshan Hospital Fudan University Shanghai China
| | - Feng Li
- Department of Hematology Zhongshan Hospital Fudan University Shanghai China
- Department of Hematology Zhongshan Hospital Qingpu Branch, Fudan University Shanghai China
| | - Yunfeng Cheng
- Department of Hematology Zhongshan Hospital Fudan University Shanghai China
- Department of Hematology Zhongshan Hospital Qingpu Branch, Fudan University Shanghai China
- Center for Tumor Diagnosis and Therapy, Jinshan Hospital Fudan University Shanghai China
- Institute of Clinical Science Zhongshan Hospital Fudan University Shanghai China
| |
Collapse
|
10
|
Gini G, Di Rocco A, Nassi L, Arcari A, Tisi MC, Loseto G, Olivieri A, Gentile M, Annibali O, Cabras MG, Chiappella A, Rusconi C, Ferreri AJM, Balzarotti M. CNS Prophylaxis: How Far Is Routine Practice From the Guidelines? Focus on a Nationwide Survey by the Fondazione Italiana Linfomi (FIL). Front Oncol 2021; 11:730194. [PMID: 34804924 PMCID: PMC8602788 DOI: 10.3389/fonc.2021.730194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/27/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Guido Gini
- Clinic of Hematology, Ospedali Riuniti, Ancona, Italy
| | - Alice Di Rocco
- Department of Traslational and Precision Medicine, Sapienza University, Roma, Italy
| | - Luca Nassi
- Hematology, Department of Translational Medicine, University of Eastern Piedmont and AOU Maggiore della Carità, Novara, Italy
| | - Annalisa Arcari
- Division of Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Maria Chiara Tisi
- Department of Hematology and Cell Therapy, San Bortolo Hospital, Vicenza, Italy
| | - Giacomo Loseto
- Division of Hematology, IRCCS Ospedale Oncologico, Bari, Italy
| | | | - Massimo Gentile
- Department of Onco-Hematology, Hematology Unit, A.O of Cosenza, Cosenza, Italy
| | - Ombretta Annibali
- Unit of Hematology and Stem Cell Transplantation, University "Campus Bio-Medico", Rome, Italy
| | | | - Annalisa Chiappella
- Department of Hematology, Azienda Ospedaliero Universitaria Citta`della Salute e della Scienza di Torino, Torino, Italy
| | - Chiara Rusconi
- Division of Hematology, Ospedale Niguarda Ca' Granda, Milan, Italy
| | | | | |
Collapse
|
11
|
Rodríguez-López JL, Patel AK, Balasubramani GK, Glaser SM, Beriwal S, Vargo JA. Treatment selection and survival outcomes in Early-Stage peripheral T-Cell lymphomas: does anaplastic lymphoma kinase mutation impact the benefit of consolidative radiotherapy? Leuk Lymphoma 2020; 62:538-548. [PMID: 33251899 DOI: 10.1080/10428194.2020.1842398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The role of consolidative radiotherapy (RT) is less substantiated in uncommon peripheral T-cell lymphomas (PTCLs). Anaplastic lymphoma kinase (ALK) mutation sub-categorizes PTCLs, with ALK (+) having a distinctly favorable prognosis. We aimed to use the National Cancer Database to examine the potential role of RT in PTCLs and if ALK mutation can be used to predict the benefit of consolidative RT after multi-agent chemotherapy (combined modality therapy). We identified 3670 stage I-II PTCL patients treated with multi-agent chemotherapy alone or combined modality therapy (CMT) between 1998-2012. After adjusting for immortal-time and indication bias, CMT was associated with better OS than multi-agent chemotherapy alone for ALK (-) patients (HR 0.69, 95% CI 0.52-0.92, p = .01); no significant difference was noted for ALK (+) (HR 1.03, 95% CI 0.75-1.41, p = .85). CMT is associated with improved OS for ALK (-) PTCLs; while no such benefit was seen for the ALK (+) subgroup.
Collapse
Affiliation(s)
- Joshua L Rodríguez-López
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ankur K Patel
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Goundappa K Balasubramani
- Department of Epidemiology, Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Scott M Glaser
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - Sushil Beriwal
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - John A Vargo
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
12
|
Mehta A, Verma A, Gupta G, Tripathi R, Sharma A. Double Hit and Double Expresser Diffuse Large B Cell Lymphoma Subtypes: Discrete Subtypes and Major Predictors of Overall Survival. Indian J Hematol Blood Transfus 2020; 36:627-634. [PMID: 33100703 PMCID: PMC7572989 DOI: 10.1007/s12288-019-01248-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/28/2019] [Indexed: 01/18/2023] Open
Abstract
Double hit lymphomas (DHL) and double expresser lymphomas (DEL) are subsets of diffuse large B cell lymphomas (DLBCL) which are being increasingly recognised as cause of treatment failure. This emphasizes the need for their separation from other DLBCL cases in order to prognosticate and administer more aggressive treatment to this set of patients. The present study was conducted with the aim to identify the DHL/DEL patients and study their distinctive clinicopathological profile and overall survival. This retrospective analysis involved 172 cases of DLBCL sub-classified on the basis of cell of origin. Immunohistochemical (IHC) analysis for MYC, BCL2, BCL6, MUM1 and CD10 was performed. Rearrangement studies were performed using break apart Fluorescent in situ hybridization. Overall survival (OS) was also evaluated. Distinctive clinical and pathological features of DHL and DEL were identified. Rearrangement study by FISH revealed seven cases of DHL (MYC + BCL2 &/or BCL6 rearrangement). Also, 20 patients (11.6%) showed a concurrent expression of BCL2 and MYC oncoproteins (DEL) on IHC. Most (6/7) DHL patients were double expressors also. The DHL patients demonstrated a significant association with female gender, high serum LDH levels (> 750 U/L) and GCB phenotype. DEL patients contrarily predominated amongst males, had intermediate LDH levels (251-500 U/L) and non GCB phenotype. The OS of the patients was 63.8% at 4 years. The OS of the DLBCL, DEL and DHL patients was 71.9%, 46.9%, and 0%, respectively at 4 years (p value 0.010). In case of DEL subtype, factors such as age < 60 years (66.7%), male sex (60.8%), nodal localization (52.5%), early disease stage (84.6%), low IPI score (60%), absence of B symptoms (50%), LDH < 250 U/L (80%) and GCB phenotype (53.3%) were associated with better OS. Further, the OS of DHL cases was 0% at 4 years. Double hit and double expresser lymphomas have poor prognostic outcomes and should be separated from DLBCL. All DELs should be tested for DHLs and especially those with immunoblastic morphology. DHL and DEL subtypes delineate the subtypes with inferior OS and reinstate the need for aggressive interventions.
Collapse
Affiliation(s)
- Anurag Mehta
- Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi India
- Molecular Diagnostic Services, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, Delhi 110085 India
| | - Ajita Verma
- Department of Laboratory and Transfusion Services, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi India
| | - Garima Gupta
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi India
| | - Rupal Tripathi
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi India
| | - Anurag Sharma
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi India
| |
Collapse
|
13
|
Prognostic implications of 5-hydroxymethylcytosines from circulating cell-free DNA in diffuse large B-cell lymphoma. Blood Adv 2020; 3:2790-2799. [PMID: 31570490 DOI: 10.1182/bloodadvances.2019000175] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/18/2019] [Indexed: 12/17/2022] Open
Abstract
An elevated level of circulating cell-free DNA (cfDNA) has been associated with tumor bulk and poor prognosis in diffuse large B-cell lymphoma (DLBCL), but the tumor-specific molecular alterations in cfDNA with prognostic significance remain unclear. We investigated the association between 5-hydroxymethylcytosines (5hmC), a mark of active demethylation and gene activation, in cfDNA from blood plasma and prognosis in newly diagnosed DLBCL patients. We used 5hmC-Seal, a highly sensitive chemical labeling technique, to profile genome-wide 5hmC in plasma cfDNA from 48 DLBCL patients at the University of Chicago Medical Center between 2010 and 2013. Patients were followed through 31 December 2017. We found a distinct genomic distribution of 5hmC in cfDNA marking tissue-specific enhancers, consistent with their putative roles in gene regulation. The 5hmC profiles in cfDNA differed by cell of origin and were associated with clinical prognostic factors, including stage and the International Prognostic Index. We developed a 29 gene-based weighted prognostic score (wp-score) for predicting event-free survival (EFS) and overall survival (OS) by applying the elastic net regularization on the Cox proportional-hazards model. The wp-scores outperformed (eg, prognostic accuracy, sensitivity, specificity) established prognostic factors in predicting EFS and OS. In multivariate Cox models, patients with high wp-scores had worse EFS (hazard ratio, 9.17; 95% confidence interval, 2.01-41.89; P = .004) compared with those in the low-risk group. Our findings suggest that the 5hmC signatures in cfDNA at the time of diagnosis are associated with clinical outcomes and may provide a novel minimally invasive prognostic approach for DLBCL.
Collapse
|
14
|
COO and MYC/BCL2 status do not predict outcome among patients with stage I/II DLBCL: a retrospective multicenter study. Blood Adv 2020; 3:2013-2021. [PMID: 31285189 DOI: 10.1182/bloodadvances.2019000251] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/09/2019] [Indexed: 02/02/2023] Open
Abstract
In advanced-stage diffuse large B-cell lymphoma (DLBCL), the presence of an activated B-cell phenotype or a non-germinal center (GCB) phenotype, coexpression of MYC and BCL2 by immunohistochemistry, and the cooccurrence of MYC and BCL2 or BCL6 rearrangements are associated with inferior outcomes. It is unclear whether these variables remain prognostic in stage I/II patients. In this retrospective study, we evaluated the prognostic impact of cell of origin (COO), as well as dual-expressor (DE) status and molecular double-hit (DH) status, in stage I/II DLBCL by positron emission tomography with computed tomography (PET-CT). A total of 211 patients treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-like regimens, with or without radiotherapy, was included. The median follow-up in the entire cohort was 4 years (range, 0.4-9.4), with estimated 4-year progression-free survival (PFS) and overall survival (OS) rates of 85% (95% confidence interval [CI], 79-89) and 88% (95% CI, 83-92), respectively. By univariable analysis, DE (PFS: hazard ratio [HR], 1.27; 95% CI, 0.58-2.81, P = .55 and OS: HR, 1.40; 95% CI, 0.60-3.30; P = .44), DH (PFS: HR, 1.21; 95% CI, 0.27-5.31; P = .80 and OS: HR, 0.61; 95% CI, 0.08-4.73; P = .64), and non-GCB status (PFS: HR, 1.59; 95% CI, 0.83-3.03; P = .16 and OS: HR, 1.80; 95% CI, 0.89-3.67; P = .10) were associated with poorer outcomes. In patients with PET-CT-defined stage I/II DLBCL treated with R-CHOP-like therapy, with or without radiation, COO and DE and DH status were not significantly associated with inferior PFS or OS.
Collapse
|
15
|
Anti-Cancer Effects of CKD-581, a Potent Histone Deacetylase Inhibitor against Diffuse Large B-Cell Lymphoma. Int J Mol Sci 2020; 21:ijms21124377. [PMID: 32575557 PMCID: PMC7352247 DOI: 10.3390/ijms21124377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 12/11/2022] Open
Abstract
Double-hit lymphoma (DHL) and double-expressor lymphoma (DEL) are aggressive forms of lymphoma that require better treatments to improve patient outcomes. CKD-581 is a new histone deacetylase (HDAC) inhibitor that exhibited a better safety profile in clinical trials compared to other HDAC inhibitors. Here, we demonstrate that CKD-581 inhibited the class I-II HDAC family via histone H3 and tubulin acetylation. CKD-581 treatment also up-regulated the phosphorylation of histone H2AX (γH2AX, DNA double-strand break marker), and reduced levels of MYC and anti-apoptotic proteins such as BCL-2, BCL-6, BCL-XL, and MCL-1 in DH/DE-diffuse large B cell lymphoma (DLBCL) cell lines. Ultimately, CKD-581 also induced apoptosis via poly(ADP ribose) polymerase 1 (PARP1) cleavage. In a DLBCL SCID mouse xenograft model, CKD-581 exhibited anti-cancer effects comparable with those of rituximab (CD20 mAb). Our findings suggest that CKD-581 could be a good candidate for the treatment of DLBCL.
Collapse
|
16
|
Deb B, Pandey MR, Torka P, Sundaram S. Diffuse large B-Cell lymphoma associated with paraneoplastic Guillain-Barré syndrome: A diagnostic and therapeutic challenge. Hematol Oncol Stem Cell Ther 2020:S1658-3876(20)30106-0. [PMID: 32470333 DOI: 10.1016/j.hemonc.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
Paraneoplastic neurological syndromes are a rare manifestation of non-Hodgkin lymphoma and can make treatment of these patients more challenging. We report the case of a 67-year-old man with high grade diffuse large B-cell lymphoma who presented with severe paraneoplastic Guillain-Barré syndrome. He was treated with intravenous immunoglobulin therapy and definitive chemoimmunotherapy, and achieved a full neurological recovery. In this report, we discuss various mechanisms of neurological dysfunction seen in lymphomas. Prompt oncologic treatment and immunotherapy for Guillain-Barré syndrome if instituted concurrently and early in the course of the disease can be associated with the best outcomes.
Collapse
Affiliation(s)
- Brototo Deb
- Roswell Park Comprehensive Cancer Centre, Buffalo, NY, USA
| | - Manu R Pandey
- Roswell Park Comprehensive Cancer Centre, Buffalo, NY, USA
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Centre, Buffalo, NY, USA
| | | |
Collapse
|
17
|
Calimeri T, Ferreri AJM. Prevention of CNS relapse in diffuse large B-cell lymphoma: common sense prevails where science fails. Br J Haematol 2020; 190:645-647. [PMID: 32394433 DOI: 10.1111/bjh.16719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Teresa Calimeri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Andrés J M Ferreri
- Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| |
Collapse
|
18
|
Zayac AS, Olszewski AJ. Burkitt lymphoma: bridging the gap between advances in molecular biology and therapy. Leuk Lymphoma 2020; 61:1784-1796. [PMID: 32255708 DOI: 10.1080/10428194.2020.1747068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Genomic studies have revealed molecular mechanisms involved in the pathogenesis of Burkitt's lymphoma, including the ID3/TCF3-dependent centroblast gene expression program, tonic PI3K-AKT-mTOR signaling, and deregulation of cell cycle and apoptosis through mutations in cyclin D3, CDKN2A, or TP53. Unfortunately, these advances have not been translated into treatment, which relies on dose-intense cytotoxic chemotherapy. While most patients achieve long-term survival, options for relapsed/refractory disease are lacking, as Burkitt lymphoma is often excluded from clinical trials of novel approaches. The lower-intensity, dose-adjusted EPOCH plus rituximab (DA-EPOCH-R) regimen constitutes a major advance allowing for treatment of older and HIV-positive patients but needs augmentation to better address the central nervous system involvement. Furthermore, DA-EPOCH-R provides a platform for the study of targeted or immunotherapeutic approaches while de-escalating cytotoxic agents and their associated adverse effects. In this review we discuss the epidemiology and molecular genetics of BL, first-line treatment considerations, and potential novel treatment strategies.
Collapse
Affiliation(s)
- Adam S Zayac
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Division of Hematology-Oncology, Rhode Island Hospital, Providence, RI, USA
| | - Adam J Olszewski
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Division of Hematology-Oncology, Rhode Island Hospital, Providence, RI, USA
| |
Collapse
|
19
|
Virdis P, Migheli R, Galleri G, Fancello S, Cadoni MPL, Pintore G, Petretto GL, Marchesi I, Fiorentino FP, di Francesco A, Sanges F, Bagella L, Muroni MR, Fozza C, De Miglio MR, Podda L. Antiproliferative and proapoptotic effects of Inula viscosa extract on Burkitt lymphoma cell line. Tumour Biol 2020; 42:1010428319901061. [PMID: 32013807 DOI: 10.1177/1010428319901061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Burkitt lymphoma is a very aggressive B-cell non-Hodgkin lymphoma. Although remarkable progress has been made in the therapeutic scenario for patients with Burkitt lymphoma, search and development of new effective anticancer agents to improve patient outcome and minimize toxicity has become an urgent issue. In this study, the antitumoral activity of Inula viscosa, a traditional herb obtained from plants collected on the Asinara Island, Italy, was evaluated in order to explore potential antineoplastic effects of its metabolites on Burkitt lymphoma. Raji human cell line was treated with increasing Inula viscosa extract concentration for cytotoxicity screening and subsequent establishment of cell cycle arrest and apoptosis. Moreover, gene expression profiles were performed to identify molecular mechanisms involved in the anticancer activities of this medical plant. The Inula viscosa extract exhibited powerful antiproliferative and cytotoxic activities on Raji cell line, showing a dose- and time-dependent decrease in cell viability, obtained by cell cycle arrest in the G2/M phase and an increase in cell apoptosis. The treatment with Inula viscosa caused downregulation of genes involved in cell cycle and proliferation (c-MYC, CCND1) and inhibition of cell apoptosis (BCL2, BCL2L1, BCL11A). The Inula viscosa extract causes strong anticancer effects on Burkitt lymphoma cell line. The molecular mechanisms underlying such antineoplastic activity are based on targeting and downregulation of genes involved in cell cycle and apoptosis. Our data suggest that Inula viscosa natural metabolites should be further exploited as potential antineoplastic agents against Burkitt lymphoma.
Collapse
Affiliation(s)
- Patrizia Virdis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Rossana Migheli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Grazia Galleri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Silvia Fancello
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Piera L Cadoni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giorgio Pintore
- Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
| | | | - Irene Marchesi
- Kitos Biotech Srls, Porto Conte Ricerche, Sassari, Italy
| | - Francesco Paolo Fiorentino
- Kitos Biotech Srls, Porto Conte Ricerche, Sassari, Italy.,Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra di Francesco
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Francesca Sanges
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luigi Bagella
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.,Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Claudio Fozza
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Luigi Podda
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| |
Collapse
|
20
|
Chung C. Driving toward precision medicine for B cell lymphomas: Targeting the molecular pathogenesis at the gene level. J Oncol Pharm Pract 2020; 26:943-966. [DOI: 10.1177/1078155219895079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Lymphomas are a diverse group of hematologic malignancies that arise from either T cell, B cell or the natural killer cell lineage. B cell lymphomas arise from gene mutations with critical functions during normal B cell development. Recent advances in the understanding of molecular pathogenesis demonstrate that many different recurrent genomic and molecular abnormalities and dysregulated oncogenic regulatory pathways exist for many subtypes of B cell lymphomas, both across and within histological subtypes. Pathogenetic processes such as (1) chromosomal aberrations, for example, t(14;18) in follicular lymphoma, t(11;14) in mantle cell lymphoma, t(8;14) in Burkitt lymphoma; dysregulations in signaling pathways of (2) nuclear factor- κB (NF-κB); (3) B cell receptor (BCR); (4) Janus kinase/signal transducers and transcription activators (JAK-STAT); (5) impaired apoptosis/cell cycle regulation due to mutated, rearranged or amplified MYC, BCL-2, BCL-6 proto-oncogenes; (6) epigenetic aberrations may contribute to pathogenesis. More studies are under way to elucidate the molecular heterogeneity underlying many types of lymphomas that account for variable responses to treatment, generation of subclones and treatment resistance. Although significant research is still needed, targeted therapy promises to provide new options for the treatment of patients with lymphomas. This article provides a non-exhaustive overview on the current understanding on the genetics of pathogenesis of B cell lymphomas and their therapeutic implications.
Collapse
Affiliation(s)
- Clement Chung
- Houston Methodist Baytown Hospital, Baytown, TX, USA
| |
Collapse
|
21
|
Targeting ubiquitin-activating enzyme induces ER stress-mediated apoptosis in B-cell lymphoma cells. Blood Adv 2020; 3:51-62. [PMID: 30617217 DOI: 10.1182/bloodadvances.2018026880] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/29/2018] [Indexed: 12/26/2022] Open
Abstract
Alterations in the ubiquitin proteasome system (UPS) leave malignant cells in heightened cellular stress, making them susceptible to proteasome inhibition. However, given the limited efficacy of proteasome inhibitors in non-Hodgkin lymphoma (NHL), novel approaches to target the UPS are needed. Here, we show that TAK-243, the first small-molecule inhibitor of the ubiquitin activating enzyme (UAE) to enter clinical development, disrupts all ubiquitin signaling and global protein ubiquitination in diffuse large B-cell lymphoma (DLBCL) cells, thereby inducing endoplasmic reticulum (ER) stress and the unfolded protein response (UPR). Activation of the ER stress response protein kinase R (PKR)-like ER kinase and phosphorylation of eukaryotic translation initiator factor 2α led to upregulation of the proapoptotic molecule C/EBP homologous protein and cell death across a panel of DLBCL cell lines independent of cell of origin. Concurrently, targeting UAE led to accumulation of Cdt1, a replication licensing factor, leading to DNA rereplication, checkpoint activation, and cell cycle arrest. MYC oncoprotein sensitized DLBCL cells to UAE inhibition; engineered expression of MYC enhanced while genetic MYC knockdown protected from TAK-243-induced apoptosis. UAE inhibition demonstrated enhanced ER stress and UPR and increased potency compared with bortezomib in DLBCL cell lines. In vivo treatment with TAK-243 restricted the growth of xenografted DLBCL tumors, accompanied by reduced cell proliferation and apoptosis. Finally, primary patient-derived DLBCL cells, including those expressing aberrant MYC, demonstrated susceptibility to UAE inhibition. In sum, targeting UAE may hold promise as a novel therapeutic approach in NHL.
Collapse
|
22
|
Kim A, Stevenson P, Cassaday RD, Soma L, Fromm JR, Gopal AK, Smith SD, Till B, Lynch RC, Ujjani C, Shadman M, Warren EH, Menon M, Russell K, Tseng YD. Impact of Double- or Triple-Hit Pathology on Rates and Durability of Radiation Therapy Response Among Patients With Relapsed or Refractory Large B-Cell Lymphoma. Pract Radiat Oncol 2020; 10:44-52. [DOI: 10.1016/j.prro.2019.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/12/2019] [Accepted: 09/24/2019] [Indexed: 11/28/2022]
|
23
|
Challenges and Opportunities for High-grade B-Cell Lymphoma With MYC and BCL2 and/or BCL6 Rearrangement (Double-hit Lymphoma). Am J Clin Oncol 2019; 42:304-316. [PMID: 29419530 DOI: 10.1097/coc.0000000000000427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The most common subtype of non-Hodgkin lymphoma, diffuse large B-cell lymphoma, is cured in approximately two thirds of patients after initial therapy. The remaining one-third of patients who suffer relapse or become refractory have very poor survival outcomes despite salvage chemotherapy with or without stem cell transplantation. A considerable proportion of relapsed or refractory large B cells belong to the WHO subtype known as high-grade B-cell lymphoma with rearrangement of MYC and BCL2 and/or BCL6, also known as double-hit lymphoma (DHL). Most DHL patients present with Ann Arbor's stage III/IV, a comparatively higher rate of extranodal involvement including bone marrow and central nervous system infiltration, high levels of lactate dehydrogenase, and an elevated Ki67 expression in the tumor cells. Newer therapeutic approaches, including targeted therapy against BCL2, MYC, or other associated pathways, are needed. In addition, recent therapies that harness the immune system, such as checkpoint inhibitors and chimeric antigen receptor T-cell therapy, are changing the paradigm of treatment for non-Hodgkin lymphoma and could impact the outcome of DHL.
Collapse
|
24
|
Salas MQ, Climent F, Tapia G, DomingoDomènech E, Mercadal S, Oliveira AC, Aguilera C, Olga G, Moreno Velázquez M, Andrade-Campos M, Encuentra M, Fernández de Sevilla A, Sureda A, Sancho JM, González-Barca E. Clinicopathologic features and prognostic significance of CD30 expression in de novo diffuse large B-cell lymphoma (DLBCL): results in a homogeneous series from a single institution. Biomarkers 2019; 25:69-75. [DOI: 10.1080/1354750x.2019.1691656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- María Queralt Salas
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Fina Climent
- Department of Pathology, University Hospital of Bellvitge, Barcelona, Spain
| | - Gustavo Tapia
- Department of Pathology of Hospital Germans Trías i Pujol, Universitat Autònoma de Barcelona
| | - Eva DomingoDomènech
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Santiago Mercadal
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Ana Carla Oliveira
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Carmen Aguilera
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - García Olga
- Department of Clinical Haematology of Institut Català Oncologia (ICO)-Hospital Germans Trias i Pujol, IJC, Badalona, Spain
| | - Miriam Moreno Velázquez
- Department of Clinical Haematology of Institut Català Oncologia (ICO)-Hospital Germans Trias i Pujol, IJC, Badalona, Spain
| | - Marcio Andrade-Campos
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Maite Encuentra
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | | | - Anna Sureda
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| | - Juan Manuel Sancho
- Department of Clinical Haematology of Institut Català Oncologia (ICO)-Hospital Germans Trias i Pujol, IJC, Badalona, Spain
| | - Eva González-Barca
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, IDIBELL, Barcelona, Spain
| |
Collapse
|
25
|
Salas MQ, Mercadal S, Domingo Domenech E, Oliveira AC, Encuentra M, Climent F, Andrade Campos M, Aguilera C, Fernández de Sevilla A, Sureda A, González-Barca E. Validation of the NCCN-IPI and the GELTAMO-IPI for diffuse large B-Cell lymphoma treated with R-CHOP in a large cohort of patients from a single institution. Leuk Lymphoma 2019; 61:575-581. [PMID: 31684781 DOI: 10.1080/10428194.2019.1683733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The discriminative power of International Prognostic Index (IPI) in diffuse large B-cell lymphoma (DLBCL) decreased with the addition of rituximab to chemotherapy. The National Comprehensive Cancer Network (NCCN)-IPI and the Grupo Español de Linfomas y Trasplante Autólogo de Médula Ósea (GELTAMO)-IPI were developed to improve the risk prediction for DLBCL patients. We aim to validate the NCCN-IPI and GELTAMO-IPI in a large and homogeneous cohort of 337 DLBCL patients treated with curative intent with R-CHOP/R-CHOP-like immunochemotherapy. The IPI stratifies patients in two independent risk groups and the estimated 5-year overall survival (OS) of the high-risk (HR) group was 43%. NCCN-IPI discriminated four risk groups and GELTAMO-IPI three risk groups of patients. The predicted 5-year OS of the HR group was 38% and 29%, respectively. NCCN-IPI and GELTAMO-IPI are more accurate prognostic indices than IPI in DBLCL patients treated with immunochemotherapy. GELTAMO-IPI demonstrated enhanced discrimination than NCCN-IPI for the higher-risk population.
Collapse
Affiliation(s)
- María Queralt Salas
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Santiago Mercadal
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Eva Domingo Domenech
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Ana Carla Oliveira
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Maite Encuentra
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Fina Climent
- Department of Pathology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Marcio Andrade Campos
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Carmen Aguilera
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | | | - Anna Sureda
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| | - Eva González-Barca
- Department of Clinical Haematology, Institut Català Oncologia (ICO)-Hospitalet, Barcelona, Spain
| |
Collapse
|
26
|
Implication of Rituximab Infusion Reactions on Clinical Outcomes in Patients With Diffuse Large B-cell Lymphoma: A Single Institution Experience. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:806-811. [PMID: 31648954 DOI: 10.1016/j.clml.2019.09.604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/09/2019] [Accepted: 09/21/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND The addition of the anti-CD20 monoclonal antibody rituximab to chemotherapy for diffuse large B-cell lymphoma (DLBCL) has led to improvements in progression-free survival and overall survival, although the exact mechanism of rituximab is not known. Rituximab administration often results in transient, non-life-threatening infusion reactions (IRs). We report a retrospective cohort of patients with DLBCL who received rituximab to determine the significance of IRs on clinical outcomes. PATIENTS AND METHODS We identified and analyzed a retrospective cohort of 229 patients with DLBCL. They were stratified into 2 cohorts; those who did and did not have an IR. Univariate and multivariate analyses were performed to evaluate the prognostic significance of rituximab-related IRs relative to DLBCL subtype, International Prognostic Index score, c-Myc translocations or amplifications, chemotherapy regimen, and Ki-67 proliferative index. RESULTS Baseline characteristics did not differ significantly between the 2 groups. Rituximab was included as initial treatment in all patients. Patients with an IR had a significantly higher overall survival (hazard ratio, 0.26; 95% confidence interval, 0.07-0.95) at 5 years. In addition, subgroup analysis showed a significantly higher progression-free survival in patients with the germinal center subtype of disease and c-Myc alterations who had a rituximab-related IR (log-rank P < .0001). CONCLUSIONS The presence of a rituximab-related IR is associated with a better overall survival in patients with DLBCL. Although limited by the small sample size and retrospective nature, these results provide rationale for further investigation into the mechanism of action of rituximab in order to optimize the efficacy of CD20 monoclonal antibodies.
Collapse
|
27
|
Reagan M. CAUSES OF CANCER. Cancer 2019. [DOI: 10.1002/9781119645214.ch3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
28
|
Villodre ES, Felipe KB, Oyama MZ, Oliveira FHD, Lopez PLDC, Solari C, Sevlever G, Guberman A, Lenz G. Silencing of the transcription factors Oct4, Sox2, Klf4, c-Myc or Nanog has different effect on teratoma growth. Biochem Biophys Res Commun 2019; 517:324-329. [DOI: 10.1016/j.bbrc.2019.07.064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 10/26/2022]
|
29
|
Wawire J, Sayed S, Moloo Z, Sohani AR. Diffuse Large B-Cell Lymphoma in Kenya: MYC, BCL2, and the Cell of Origin. J Glob Oncol 2019; 5:1-8. [PMID: 31045473 PMCID: PMC6657604 DOI: 10.1200/jgo.18.00203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin lymphoma in adults in Kenya. Cell of origin (COO) and double expression of MYC and BCL2 are two important prognostic factors for DLBCL. A small subset (5% to 10%) of DLBCL cases show positivity for CD5 and are associated with poor prognosis, whereas CD30 antigen, seen in up to 10% of cases, may be a useful target for therapy. We sought to determine the prevalence of MYC/BCL2 double expression, COO, and proportion of Epstein-Barr virus positivity among patients with DLBCL diagnosed at a tertiary referral laboratory in Kenya. PATIENTS AND METHODS All cases of DLBCL diagnosed from 2012 through 2015 in our pathology department were analyzed. Tumor tissue microarray sections were stained with CD20, CD3, CD5, CD30, BCL2, BCL6, CD10, MUM1, MYC, and Ki67, classified for COO on the basis of the Hans algorithm, and subjected to Epstein-Barr virus-encoded small RNAs in situ hybridization. RESULTS Among 165 DLBCL cases, the median age was 50 years, and there was no sex predilection. Only 18 (10.9%) cases showed double expression for MYC and BCL2. Germinal center B (GCB)-cell type DLBCL accounted for 67 cases (40.6%) and 97 cases (59.4%) were classified as non-GCB. The mean Ki67 proliferation index was significantly higher in the double-expressing (45%) and non-GCB groups (36%) compared with the non-double-expressing group (29%) and GCB group (26%). Sixteen cases (9.7%) were Epstein-Barr virus-encoded small RNAs positive, 12 (75%) of which were non-GCB. CONCLUSION DLBCL in Kenya is seen in much younger patients with the poor prognostic non-GCB-type accounting for 59.4% of cases. MYC and BCL2 double expression was seen in fewer tumors than reported in the literature and in significantly older patients.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Disease Susceptibility
- Female
- Gene Expression Regulation, Neoplastic
- Genes, myc
- Humans
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Population Surveillance
- Proto-Oncogene Proteins c-bcl-2/genetics
- Young Adult
Collapse
Affiliation(s)
| | | | | | - Aliyah R. Sohani
- Massachusetts General Hospital, Boston,
MA
- Harvard Medical School, Boston, MA
| |
Collapse
|
30
|
Huang X, She L, Luo X, Huang S, Wu J. MiR-222 promotes the progression of polycystic ovary syndrome by targeting p27 Kip1. Pathol Res Pract 2019; 215:918-923. [PMID: 30718101 DOI: 10.1016/j.prp.2019.01.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/04/2019] [Accepted: 01/25/2019] [Indexed: 02/07/2023]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most complex and common reproductive and endocrinologic disorders in the child-bearing age of women. Recently, miR-222 were reported to be associated with the etiology of PCOS. However, the function of miR-222 during the pathogenesis of PCOS remains unclear. In the present study, we aimed to investigate the role of miR-222 in PCOS. Firstly, miR-222 expression was examined by quantitative real-time PCR (qRT-PCR) in PCOS. The effects of miR-222 on proliferation, apoptosis and cell cycle in KGN cells were analyzed by CCK-8 assay and flow cytometry analysis, respectively. In addition, bioinformatics analysis was used to predict the target genes of miR-222, and dual-luciferase reporter assay was applied to verified the interaction between miR-222 and p27 Kip1 in KGN cells. Moreover, the expressions of p27 Kip1 in KGN cells treated with miR-222 mimics or miR-222 inhibitor were evaluated by qRT-PCR and western blot assays. The results showed that the expression of miR-222 was remarkably upregulated in PCOS tissues compared with corresponding normal tissues. In the gain-of-function and loss-of-function assays, we revealed that miR-222 mimics significantly promoted cell proliferation, while miR-222 inhibitor induced cell apoptosis and cell cycle arrested. Furthermore, p27 Kip1 was identified as a target gene of miR-222, and could be negatively regulated by miR-222 mimics in KGN cells. In conclusion, our findings suggested that miR-222 may promote the progression of PCOS by targeting p27 Kip1.
Collapse
Affiliation(s)
- Xiaolan Huang
- Department of Reproductive Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, 362000, PR China.
| | - Liping She
- Department of Reproductive Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, 362000, PR China
| | - Xiangmin Luo
- Department of Reproductive Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, 362000, PR China
| | - Shuzhen Huang
- Department of Reproductive Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, 362000, PR China
| | - Jinxiang Wu
- Department of Reproductive Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, 362000, PR China
| |
Collapse
|
31
|
Hupp M, Williams S, Dunnette B, Tessier KM, Courville EL. Comparison of evaluation techniques, including digital image analysis, for MYC protein expression by immunohistochemical stain in aggressive B-cell lymphomas. Hum Pathol 2018; 83:124-132. [PMID: 30172916 DOI: 10.1016/j.humpath.2018.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/09/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
Incorporation of an MYC immunohistochemical stain in the workup of large B-cell lymphomas has become common in hematopathology practice. Evaluation of this stain can be difficult because of staining heterogeneity and can have interobserver variability, particularly when performed on the entire tumor sections. We identified 87 cases of aggressive B-cell lymphoma (34 core needle and 53 excisional biopsies) and compared the following methods of MYC immunohistochemical staining evaluation: the original pathologist's interpretation, a systematic retrospective method of evaluation by manual analysis, and a retrospective method of evaluation by digital image analysis (using scanned slides analyzed via the Aperio Nuclear algorithm). Overall, concordance among these methods was around 80% with κ statistics showing good agreement. However, nearly one-third of our cases had a percent MYC positivity in the 30% to 50% range, and for these cases, concordance among the various methods was marginal/poor. This suggests limited utility as a prognostic or predictive marker using 40% as a cutoff value. In our series, core biopsy specimens were poor predictors of MYC gene rearrangement, and there was no association between MYC immunohistochemical stain and MYC gene gain/amplification. Our retrospective digital image analysis showed strong correlation in MYC percent positivity with our retrospective manual review (correlation coefficient of 0.90) and similar concordance to pathologist interpretation as among pathologists, suggesting that digital image analysis is a viable alternative to manual determination of MYC percent positivity. Digital image analysis provides further opportunities for more sophisticated and standardized scoring systems, which may be helpful in future prognostic/predictive studies.
Collapse
Affiliation(s)
- Meghan Hupp
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Sarah Williams
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Brian Dunnette
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Katelyn M Tessier
- Masonic Cancer Center Biostatistics Core, University of Minnesota, Minneapolis, MN 55455, USA
| | - Elizabeth L Courville
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
| |
Collapse
|
32
|
Novel synthetic 4-chlorobenzoyl berbamine inhibits c-Myc expression and induces apoptosis of diffuse large B cell lymphoma cells. Ann Hematol 2018; 97:2353-2362. [DOI: 10.1007/s00277-018-3439-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/09/2018] [Indexed: 12/18/2022]
|
33
|
Double hit lymphoma: How do we define it and how do we treat it? Best Pract Res Clin Haematol 2018; 31:233-240. [PMID: 30213392 DOI: 10.1016/j.beha.2018.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/20/2018] [Indexed: 12/14/2022]
Abstract
Double/triple hit lymphoma is recognised as a distinct entity within the heterogeneous group of high grade B-cell lymphomas, accounting for between 5 and 10% of cases of diffuse large B-cell lymphoma. Under the WHO 2016 it is now known as high-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6. When treated with standard chemotherapy it has a poor outcome. There is currently no standard of care for the management of this condition. Diagnosing double hit lymphoma requires identification of translocations of MYC and BCL2 and/or BCL6. This review will discuss the role of stratification to screen cases based on immunohistochemical profiling as a viable option. Treatment options in the frontline and relapsed setting will be reviewed based on the current literature. Recognition of the risk of CNS involvement and how best to manage this will be discussed. Future considerations and current research will be described.
Collapse
|
34
|
Cherng HJJ, Sargent RL, Nasta SD, Svoboda J, Schuster SJ, Mato AR, Schrank-Hacker A, Morrissette JJD, Landsburg DJ. Interim PET/CT Result Is Not Predictive of Survival in Patients With MYC-rearranged Non-Burkitt Aggressive B-cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:673-678. [PMID: 30033208 DOI: 10.1016/j.clml.2018.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/03/2018] [Accepted: 06/11/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patients with a diagnosis of MYC-rearranged non-Burkitt aggressive B-cell lymphoma (MYC-R), including those with double hit lymphoma, are at high risk of developing relapsed/refractory disease, even if treated with intensive front-line immunochemotherapy. It is common in clinical practice and clinical trials to perform an interim positron emission tomography (PET)/computed tomography (CT) scan (iPET) during front-line therapy for diffuse large B-cell lymphoma. However, the utility of the iPET result for MYC-R patients for predicting outcomes is unclear. PATIENTS AND METHODS We performed a single-center retrospective study with centralized pathologic review and PET/CT image acquisition and interpretation for 28 MYC-R patients. The patients received front-line therapy with R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin [doxorubicin], Oncovin [vincristine], prednisone) or intensive immunochemotherapy. RESULTS Eight patients had iPET-positive (iPET+) and 20 patients had iPET-negative (iPET-) results using the Deauville visual assessment criteria. At a median follow-up length of 30.4 months, progression-free survival was 65% and overall survival was 76%, neither of which differed significantly between the iPET- and iPET+ patients. The positive predictive value of iPET for progression at 30 months was 25%, and the negative predictive value was 65%. CONCLUSION Although patients with MYC-R lymphoma have been reported to be at high risk of primary treatment failure, this was not predicted by iPET+ results. Thus, the iPET result should not be used to guide changes in front-line or consolidative therapy for these patients.
Collapse
Affiliation(s)
- Hua-Jay J Cherng
- Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
| | - Rachel Lynn Sargent
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sunita Dwivedy Nasta
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Jakub Svoboda
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Stephen J Schuster
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Anthony R Mato
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - April Schrank-Hacker
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Daniel J Landsburg
- Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
35
|
Hancock C, Knouse P, Almanaseer I, Bitran J. A Retrospective Study of Double-hit Lymphomas in Elderly Patients (Aged > 70 Years): Overall Outcomes. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:280-285. [DOI: 10.1016/j.clml.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/19/2018] [Accepted: 02/10/2018] [Indexed: 11/25/2022]
|
36
|
Savage KJ. Secondary CNS relapse in diffuse large B-cell lymphoma: defining high-risk patients and optimization of prophylaxis strategies. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2017; 2017:578-586. [PMID: 29222307 PMCID: PMC6142549 DOI: 10.1182/asheducation-2017.1.578] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite improvement in survival in diffuse large B-cell lymphoma (DLBCL) with the introduction of rituximab, central nervous system (CNS) relapse continues to represent a clinical challenge. A number of studies have evaluated clinical risk factors in an attempt to identify high-risk patients to direct CNS staging investigations and consider prophylaxis strategies. The CNS International Prognostic Index is a robust and reproducible risk model that can identity patients at high risk of CNS relapse, but its specificity remains limited. Studies are emerging of biomarkers that predict CNS relapse that can be integrated with clinical risk models to better identify high-risk patients for CNS-directed prophylaxis strategies. Because CNS parenchymal disease is the predominant compartment, prophylaxis should include deeply penetrant drugs such as high-dose methotrexate. However, this has been associated with toxicity and has limited use in older patients. Novel therapies are being tested in primary CNS lymphoma with encouraging results and may represent rational strategies to be further explored in the prophylaxis setting.
Collapse
MESH Headings
- Central Nervous System Neoplasms/metabolism
- Central Nervous System Neoplasms/pathology
- Central Nervous System Neoplasms/prevention & control
- Humans
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/prevention & control
- Methotrexate/therapeutic use
- Models, Neurological
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/prevention & control
- Rituximab/therapeutic use
- Secondary Prevention/methods
Collapse
Affiliation(s)
- Kerry J Savage
- Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| |
Collapse
|
37
|
Liu L, Xu F, Chang CK, He Q, Wu LY, Zhang Z, Li X. MYCN contributes to the malignant characteristics of erythroleukemia through EZH2-mediated epigenetic repression of p21. Cell Death Dis 2017; 8:e3126. [PMID: 29022893 PMCID: PMC5682688 DOI: 10.1038/cddis.2017.526] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 01/18/2023]
Abstract
MYC proto-oncogene family including c-myc and n-myc (MYCN) are critical for normal cell development and tumorigenesis. Overexpression of c-myc causes acute erythroleukemia in vivo. However, the role of MYCN in acute erythroleukemia remains poorly understood. In this study, we found that the patients with erythroleukemia showed higher expression of MYCN than normal controls. In vitro experiments, knockdown of MYCN resulted in decreased cell proliferation, elevated autonomously cell apoptosis and increased P21-mediated cell senescence. On the contrary, overexpression of MYCN obviously promoted cell proliferation, and induced erythroid differentiation block and apoptosis resistance to cytotoxic agent. Further gene microarray and functional analysis revealed that EZH2 is a target of MYCN. Knockdown of MYCN inhibited the expression of EZH2, and then activated p21 expression through removal of H3K27me3 at the p21 promoter. Overexpression of ezh2 could antagonize the p21 activation caused by MYCN knockdown. In addition, Aurora inhibitor MLN8237 inhibited the proliferation of erythroleukemia cells through repression of MYCN/EZH2 axis, whereas it minimally affected the normal hematopoietic cells. In conclusion, MYCN contributes to the malignant characteristics of erythroleukemia through EZH2-meidated epigenetic repression of p21. MYCN may serve as a therapy target for the patients with acute erythroleukemia.
Collapse
Affiliation(s)
- Li Liu
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Feng Xu
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Chun-Kang Chang
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Qi He
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Ling-Yun Wu
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Zheng Zhang
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| | - Xiao Li
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233, China
| |
Collapse
|
38
|
Adolescent and young adult lymphoma: collaborative efforts toward optimizing care and improving outcomes. Blood Adv 2017; 1:1945-1958. [PMID: 29296842 DOI: 10.1182/bloodadvances.2017008748] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/12/2017] [Indexed: 01/10/2023] Open
Abstract
Lymphomas are responsible for approximately 20% to 25% of annual cancer diagnoses in the adolescent and young adult (AYA) population. In 2006, the National Cancer Institute and the Lance Armstrong Foundation developed a joint Adolescent and Young Adult Oncology Progress Review Group (AYAO-PRG) to formally address the unique cancer burden of patients age 15 to 39 years. As part of their recommendations, the AYAO-PRG identified 5 imperatives for improving outcomes of AYAs with cancer. Broadly, the recommended areas of focus included research, awareness and education, investigational infrastructure, care delivery, and advocacy. In response to the challenges highlighted by the AYAO-PRG, the Lymphoma Research Foundation held the first AYA Lymphoma Research Foundation Symposium on 2 October 2015. At this symposium, clinicians and basic scientists from both pediatric and adult disciplines gave presentations describing the state of the science and proposed a collaborative research agenda built on the imperatives proposed by the AYAO-PRG. The following review presents an in-depth discussion of lymphoma management across pediatric and adult oncologic disciplines, focusing on Hodgkin lymphoma, mature B-cell lymphomas, and anaplastic large cell lymphoma.
Collapse
|
39
|
Further Exploration of the Complexities of Large B-Cell Lymphomas With MYC Abnormalities and the Importance of a Blastoid Morphology. Am J Surg Pathol 2017; 41:1155-1166. [DOI: 10.1097/pas.0000000000000818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
40
|
Nabhan C, Mato AR. Emerging Strategies in Treating Double Hit Lymphomas. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:563-568. [DOI: 10.1016/j.clml.2017.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/09/2017] [Accepted: 06/15/2017] [Indexed: 11/28/2022]
|
41
|
Abstract
CONTEXT - The diagnosis of gastrointestinal lymphoproliferative disorders can be challenging because of the small size of biopsies and the wide spectrum of lymphoproliferative disorders that may be encountered. OBJECTIVE - To review the spectrum of lymphoproliferative disorders involving the gastrointestinal tract, highlighting potential pitfalls. DATA SOURCES - Peer-reviewed articles and clinical experience. CONCLUSIONS - Interpretation of lymphoid infiltrates in gastrointestinal biopsies requires synthesis of morphologic, immunophenotypic, molecular genetic, and clinical information. Knowledge of indolent lymphoproliferative disorders that may mimic aggressive lymphomas will help in preventing misdiagnoses.
Collapse
Affiliation(s)
- Brian F Skinnider
- From the Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| |
Collapse
|
42
|
Aoki T, Shimada K, Sakamoto A, Sugimoto K, Morishita T, Kojima Y, Shimada S, Kato S, Iriyama C, Kuno S, Harada Y, Tomita A, Hayakawa F, Kiyoi H. Emetine elicits apoptosis of intractable B-cell lymphoma cells with MYC rearrangement through inhibition of glycolytic metabolism. Oncotarget 2017; 8:13085-13098. [PMID: 28055963 PMCID: PMC5355079 DOI: 10.18632/oncotarget.14393] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/13/2016] [Indexed: 12/15/2022] Open
Abstract
Despite improved clinical outcomes of diffuse large B-cell lymphoma, a certain proportion of patients still develop a primary refractory disease. To overcome these lymphomas that are intractable to existing treatment strategies, the tumor microenvironment has been identified as a potential therapeutic target. Here we describe our search for effective drugs for primary refractory lymphoma cells with MYC rearrangement. Through the drug screening of 3,440 known compounds, we identified a unique compound, emetine. This compound was effective against lymphoma cells with MYC rearrangement from two different patients that were co-cultured with cancer associated fibroblasts. Emetine induced the death of these cells with a half maximal inhibitory concentration of 312 nM and 506 nM, respectively. Subsequent analyses of the mechanism of action of emetine showed that the drug induced apoptosis of tumor cells via alteration of glucose metabolism through inhibition of hypoxia inducible factor-1α. Moreover, emetine inhibited the potential of cancer associated fibroblasts to support tumor cell viability in vitro and demonstrated significant inhibition of tumor growth in in vivo analyses. Emetine also induced cell death in other primary refractory lymphoma cells with MYC rearrangement. Our combined data indicate that emetine is a potential promising drug for the treatment of intractable lymphomas, which targets both the tumor and its microenvironment.
Collapse
Affiliation(s)
- Tomohiro Aoki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyuki Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Institute for Advanced Research, Nagoya University, Nagoya, Japan
| | - Akihiko Sakamoto
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Mechanism of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Keiki Sugimoto
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Fujii Memorial Research Institute, Otsuka Pharmaceutical Co., Ltd., Otsu, Japan
| | - Takanobu Morishita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Yuki Kojima
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoko Shimada
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Seiichi Kato
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Chisako Iriyama
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shunsuke Kuno
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiko Harada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiro Tomita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Fumihiko Hayakawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
43
|
Yu Y, Xia B, Wang CY, Xu W, Tian C, Zhang YZ. [Triple-hit lymphomas treated with improved regimen followed by autologous hematopoietic stem cell transplantation: one case report and literatures review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2017; 38:722-724. [PMID: 28954355 PMCID: PMC7348238 DOI: 10.3760/cma.j.issn.0253-2727.2017.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | | | - Y Z Zhang
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer 300060, China
| |
Collapse
|
44
|
Soliman DS, Al-Sabbagh A, Ibrahim F, Fareed S, Talaat M, Yassin MA. De Novo Precursor B-Lymphoblastic Leukemia/Lymphoma With Double-Hit Gene Rearrangements ( MYC/BCL-2) Presented With Spinal Cord Compression and Acquired Factor XIII Deficiency. J Hematol 2017; 6:62-67. [PMID: 32300395 PMCID: PMC7155824 DOI: 10.14740/jh329w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 06/29/2017] [Indexed: 11/29/2022] Open
Abstract
Double-hit lymphomas (DHLs) are aggressive mature B-cell neoplasms associated with rearrangements involving MYC and B-cell lymphoma-2 (BCL-2). Such DH events are extremely rare in B-cell precursor acute lymphoblastic leukemia (B-ALL), especially in young adults. A 29-year-old male patient initially presented to emergency department with right mandibular mass of 2 months duration associated with intermittent fever. Laboratory workup revealed very high lactate dehydrogenase at 2,026.0 U/L. Peripheral blood revealed pancytopenia with many circulating blasts (about 77%). Bone marrow (BM) aspirate revealed infiltration with many small sized blasts of very high nucleocytoplasmic ratio, finely dispersed nuclear chromatin and prominent nucleoli. The BM biopsy reflected marked hypercellularity with diffuse replacement by sheets of blasts, positive for TdT, PAX-5, CD10, cMYC, BCL-2 and CD20 with Ki-67 > 90%. Flow cytometry on BM revealed a precursor B-immunophenotype (CD45 (dim), CD19, CD10, Tdt and CD20). The blasts are negative for cytoplasmic and surface IgM. Cytogenetics revealed complex karyotype: 46,XY,del(6)(q21q23),t(8;22)(q24.1;q11.2),t(14;18)(q32;q21)(20). A diagnosis of B-lymphoblastic leukemia/lymphoma with t(8;22)(q24.1;q11.2) and t(14;18)(q32;q21) was made. Fluorescent in situ hybridization (FISH) analysis revealed an abnormal hybridization signal pattern for CDKN2A probe, indicating biallelic (homozygous) deletion of the short arm of chromosome 9 (9p) in 94% of the cells analyzed. The patient had severe life-threatening bleeding despite of normal prothrombin time (PT) and activated partial thromboplastin time (APTT) due to acquired factor XIII deficiency, an overlooked rare coagulopathy disorder. In addition, the patient developed acute sudden onset paraplegia, and magnetic resonance imaging (MRI) of spine showed acute cord compression which necessitated emergency radiotherapy after which chemotherapy was started on hyper-CVAD (hyperfractionated cyclophosphamide, vincristine, adriamycin, and dexamethasone) protocol. MRI showed dramatic resolution of the mass. Very few cases of B-ALL with DH rearrangement with true precursor B-cell phenotype (positivity for TdT with negativity for surface light chain) have been reported. Many of these had frequent central nervous system (CNS) involvement, with complex karyotypes, highly aggressive course, with short survival of less than 1 year. This case however showed very good response to treatment. In contrary to DHL, de novo B-ALL with double-hit rearrangements is more prevalent in pediatrics and young adults. Although most of reported cases represent transformation of follicular lymphoma, our patient’s young age, acute onset and absent lymphadenopathies all support de novo ALL.
Collapse
Affiliation(s)
- Dina Sameh Soliman
- Department of Laboratory Medicine and Pathology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.,Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ahmad Al-Sabbagh
- Department of Laboratory Medicine and Pathology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Feryal Ibrahim
- Department of Laboratory Medicine and Pathology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Shehab Fareed
- Department of Hematology and Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Talaat
- Department of Radiology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Hematology and Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
45
|
Hsi ED. 2016 WHO Classification update-What's new in lymphoid neoplasms. Int J Lab Hematol 2017; 39 Suppl 1:14-22. [DOI: 10.1111/ijlh.12650] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/25/2017] [Indexed: 12/18/2022]
Affiliation(s)
- E. D. Hsi
- Department of Laboratory Medicine; Cleveland Clinic; Cleveland OH USA
| |
Collapse
|
46
|
Sakumura M, Tajiri K, Miwa S, Nagata K, Kawai K, Miyazono T, Arita K, Wada A, Murakami J, Sugiyama T. Hepatic Sinusoidal Obstruction Syndrome Induced by Non-transplant Chemotherapy for Non-Hodgkin Lymphoma. Intern Med 2017; 56:395-400. [PMID: 28202860 PMCID: PMC5364191 DOI: 10.2169/internalmedicine.56.7669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Hepatic sinusoidal obstruction syndrome (SOS), a serious complication that mainly occurs after hematopoietic-stem cell transplantation (HSCT), is caused by damage to the sinusoidal endothelial cells after the obstruction of the sinusoid. Recently, hepatic SOS was reported to occur after non-HSCT chemotherapies. This report describes a patient who experienced hepatic SOS after non-HSCT chemotherapy for non-Hodgkin lymphoma. A liver biopsy showed the slight dilatation of the hepatic sinusoid, which may be indicative of hepatic SOS. Hepatic SOS should be included in the differential diagnosis of patients with severe liver injury following the administration of chemotherapy regimens that are toxic to the vascular endothelial cells.
Collapse
Affiliation(s)
- Miho Sakumura
- The Third Department of Internal Medicine, Toyama University Hospital, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Prognostic impact of concurrent MYC and BCL6 rearrangements and expression in de novo diffuse large B-cell lymphoma. Oncotarget 2016; 7:2401-16. [PMID: 26573234 PMCID: PMC4823044 DOI: 10.18632/oncotarget.6262] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 09/09/2015] [Indexed: 12/24/2022] Open
Abstract
Double-hit B-cell lymphoma is a common designation for a group of tumors characterized by concurrent translocations of MYC and BCL2, BCL6, or other genes. The prognosis of concurrent MYC and BCL6 translocations is not well known. In this study, we assessed rearrangements and expression of MYC, BCL2 and BCL6 in 898 patients with de novo diffuse large B-cell lymphoma treated with standard chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab). Neither BCL6 translocation alone (more frequent in activated B-cell like diffuse large B-cell lymphoma) nor in combination with MYC translocation (observed in 2.0% of diffuse large B-cell lymphoma) predicted poorer survival in diffuse large B-cell lymphoma patients. Diffuse large B-cell lymphoma patients with MYC/BCL6 co-expression did have significantly poorer survival, however, MYC/BCL6 co-expression had no effect on prognosis in the absence of MYC/BCL2 co-expression, and had no additive impact in MYC+/BCL2+ cases. The isolated MYC+/BCL6+/BCL2− subset, more frequent in germinal center B-cell like diffuse large B-cell lymphoma, had significantly better survival compared with the isolated MYC+/BCL2+/BCL6− subset (more frequent in activated B-cell like diffuse large B-cell lymphoma). In summary, diffuse large B-cell lymphoma patients with either MYC/BCL6 rearrangements or MYC/BCL6 co-expression did not always have poorer prognosis; MYC expression levels should be evaluated simultaneously; and double-hit B-cell lymphoma needs to be refined based on the specific genetic abnormalities present in these tumors.
Collapse
|
48
|
Jafari N, Zargar SJ, Yassa N, Delnavazi MR. Induction of Apoptosis and Cell Cycle Arrest by Dorema Glabrum Root Extracts in a Gastric Adenocarcinoma (AGS) Cell Line. Asian Pac J Cancer Prev 2016; 17:5189-5193. [PMID: 28124886 PMCID: PMC5454657 DOI: 10.22034/apjcp.2016.17.12.5189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: Dorema glabrum Fisch. & C.A. Mey is a perennial plant that has several curative properties. Anti-proliferative activity of seeds of this plant has been demonstrated in a mouse fibrosarcoma cell line. The aim of the present study was to evaluate cytotoxicity of D. glabrum root extracts in a human gastric adenocarcinoma (AGS) cell line and explore mechanisms of apoptosis induction, cell cycle arrest and altered gene expression in cancer cells. Materials and Methods: The MTT assay was used to evaluate IC50 values, EB/AO staining to analyze the mode of cell death, and flow cytometry to assess the cell cycle. Quantitative real-time polymerase chain reaction (qRT-PCR) amplification was performed with apoptosis and cell cycle-related gene primers, for cyclin D1, c-myc, survivin, VEGF, Bcl-2, Bax, and caspase-3 to determine alteration of gene expression. Results: Our results showed that n-hexane and chloroform extracts had greatest toxic effects on gastric cancer cells with IC50 values of 6.4 µg/ml and 4.6 µg/ml, respectively, after 72 h. Cell cycle analysis revealed that the population of treated cells in the G1 phase was increased in comparison to controls. Cellular morphological changes indicated induction of apoptosis. In addition, mRNA expression levels of Bax and caspase-3 were increased, and of bcl-2 survivin, VEGF, c-myc and cyclin D1 were decreased. Conclusion: Our study results suggest that D. glabrum has cytotoxic effects on AGS cells, characterized by enhanced apoptosis, reduced cell viability and arrest of cell cycling.
Collapse
|
49
|
Hiemcke-Jiwa LS, Leguit RJ, van der Veken LT, Buijs A, Leeuwis JW, de Boer M, Jiwa NM, Bloem AC, Petersen EJ, de Weger RA, Huibers MMH. Lymphoblastic lymphoma with a triple-hit profile: a rare but distinct and relevant entity. Hum Pathol 2016; 63:171-176. [PMID: 27867103 DOI: 10.1016/j.humpath.2016.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/31/2016] [Accepted: 11/03/2016] [Indexed: 11/24/2022]
Abstract
Follicular lymphoma with progression to a high-grade lymphoma bears a poor prognosis. We describe a case of a 60-year-old man who presented in 2012 with an epidural mass, diagnosed as a diffuse large B-cell lymphoma (DLBCL) with concurrent low-grade follicular lymphoma. Three years later, the patient presented with a cervical mass, diagnosed as a lymphoblastic lymphoma (LBL). Both the DLBCL and LBL contained a "triple hit" with BCL2, BCL6, and cMYC translocations demonstrated by fluorescence in situ hybridization analysis and a complex karyotype by single-nucleotide polymorphism array analysis. Furthermore, the 2 lymphomas were shown to be clonally related by clonality analysis and single-nucleotide polymorphism array analysis. This case report presents a highly unusual case of an LBL with a triple hit, originating from a DLBCL, which has rarely been described in the literature and deserves further exploration.
Collapse
Affiliation(s)
- Laura S Hiemcke-Jiwa
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands.
| | - Roos J Leguit
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Lars T van der Veken
- Department of Genetics, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Arjan Buijs
- Department of Genetics, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Jan Willem Leeuwis
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Mirthe de Boer
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - N Mehdi Jiwa
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Andries C Bloem
- Department of Immunology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Eefke J Petersen
- Department of Hematology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Roel A de Weger
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| | - Manon M H Huibers
- Department of Pathology, University Medical Center Utrecht, 3584, CX, Utrecht, the Netherlands
| |
Collapse
|
50
|
Silencing c-Myc translation as a therapeutic strategy through targeting PI3Kδ and CK1ε in hematological malignancies. Blood 2016; 129:88-99. [PMID: 27784673 DOI: 10.1182/blood-2016-08-731240] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 10/12/2016] [Indexed: 12/20/2022] Open
Abstract
Phosphoinositide 3-kinase (PI3K) and the proteasome pathway are both involved in activating the mechanistic target of rapamycin (mTOR). Because mTOR signaling is required for initiation of messenger RNA translation, we hypothesized that cotargeting the PI3K and proteasome pathways might synergistically inhibit translation of c-Myc. We found that a novel PI3K δ isoform inhibitor TGR-1202, but not the approved PI3Kδ inhibitor idelalisib, was highly synergistic with the proteasome inhibitor carfilzomib in lymphoma, leukemia, and myeloma cell lines and primary lymphoma and leukemia cells. TGR-1202 and carfilzomib (TC) synergistically inhibited phosphorylation of the eukaryotic translation initiation factor 4E (eIF4E)-binding protein 1 (4E-BP1), leading to suppression of c-Myc translation and silencing of c-Myc-dependent transcription. The synergistic cytotoxicity of TC was rescued by overexpression of eIF4E or c-Myc. TGR-1202, but not other PI3Kδ inhibitors, inhibited casein kinase-1 ε (CK1ε). Targeting CK1ε using a selective chemical inhibitor or short hairpin RNA complements the effects of idelalisib, as a single agent or in combination with carfilzomib, in repressing phosphorylation of 4E-BP1 and the protein level of c-Myc. These results suggest that TGR-1202 is a dual PI3Kδ/CK1ε inhibitor, which may in part explain the clinical activity of TGR-1202 in aggressive lymphoma not found with idelalisib. Targeting CK1ε should become an integral part of therapeutic strategies targeting translation of oncogenes such as c-Myc.
Collapse
|