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Carbone A, Chadburn A, Gloghini A, Vaccher E, Bower M. Immune deficiency/dysregulation -associated lymphoproliferative disorders. Revised classification and management. Blood Rev 2024; 64:101167. [PMID: 38195294 DOI: 10.1016/j.blre.2023.101167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024]
Abstract
Significant advances in the field of lymphoma have resulted in two recent classification proposals, the International Consensus Classification (ICC) and the 5th edition WHO. A few entities are categorized differently in the ICC compared to the WHO. Nowhere is this more apparent than the immunodeficiency lymphoproliferative disorders. The three previous versions of the WHO classification (3rd, 4th and revised 4th editions) and the ICC focused on four clinical settings in which these lesions arise for primary categorization. In contrast the 2023 WHO 5th edition includes pathologic characteristics including morphology and viral status, in addition to clinical setting, as important information for lesion classification. In addition, the 2023 WHO recognizes a broader number of clinical scenarios in which these lesions arise, including not only traditional types of immune deficiency but also immune dysregulation. With this classification it is hoped that new treatment strategies will be developed leading to better patient outcomes.
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Affiliation(s)
- Antonino Carbone
- Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute, Aviano, Italy.
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, United States of America.
| | - Annunziata Gloghini
- Department of Advanced Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Emanuela Vaccher
- Infectious Diseases and Tumors Unit, Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy.
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London SW109NH, UK.
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Wang W, Mai B, Ali H, Savariya BU, Chen L. Primary bone marrow Epstein-Barr virus-associated polymorphic B-cell lymphoproliferative disorder. Int J Lab Hematol 2022; 44:e224-e226. [PMID: 35732589 DOI: 10.1111/ijlh.13884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas, USA
| | - Brenda Mai
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas, USA
| | - Haval Ali
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas, USA
| | - Badal U Savariya
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas, USA
| | - Lei Chen
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas, USA.,Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Kimura S, Oshiro Y, Iwasaki H, Kadowaki M, Mihashi Y, Sakata T, Kawauchi S, Wang Z, Takamatsu Y, Takeshita M. Programmed cell death-ligand 1 (PD-L1) + tumour cells and low-reacting programmed cell death 1 (PD1) + tumour-infiltrating lymphocytes predict poor prognosis in Epstein-Barr virus + diffuse large B-cell lymphoma. Clin Exp Med 2021; 22:411-419. [PMID: 34515880 DOI: 10.1007/s10238-021-00754-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
Epstein-Barr virus (EBV)+ diffuse large B-cell lymphoma (DLBCL) has specific tumour cell characteristics, and these patients have worse outcomes than EBV-negative DLBCL patients. We compared 38 EBV+ DLBCL patients with 43 methotrexate-associated EBV+ B-cell lymphoproliferative disorders (MTX+/EBV+ BLPDs) and 30 non-germinal centre (GC) subtype DLBCL. Lymphoma cells of the EBV+ DLBCL group were positive for BCL2 in 17 patients (44.7%), CMYC in 23 patients (60.5%), and p53 in 33 patients (86.8%), which was significantly higher than in the MTX+/EBV+ BLPD group (P < 0.05), and were positive for CD30 in 29 patients (76.3%), compared with two in non-GC subtype DLBCL (6.7%) (P < 0.0001). Significantly more EBV+ DLBCL patients (n = 16, 42.1%) had programmed cell death-ligand 1 (PD-L1)+ tumour cells than patients with non-GC subtype DLBCL (n = 5, 16.7%; P = 0.024), and PD-L1+ tumour cells were more common in advanced stages than in early stages (P = 0.048). Twenty-five EBV+ DLBCL patients (69.4%) had few reactive PD1+ tumour-infiltrating lymphocytes (TILs), compared with 12 patients with MTX+/EBV+ BLPDs (37.5%) (P = 0.008). In the EBV+ DLBCL group, CD30, BCL2, CMYC, and p53 expression was not related to patient prognosis. Poor outcomes were associated with PD-L1+ tumour cells (P = 0.001) and low-reacting PD1+ TILs (P = 0.02), while their combination conferred a worse outcome (P < 0.0001). Immune evasion by PD-L1+ tumour cells and exhaustion of PD1+ TILs may occur in EBV+ DLBCL patients, and PD-L1/PD1 interactions may influence tumour progression and poor prognosis.
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Affiliation(s)
- Shoichi Kimura
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Yumi Oshiro
- Department of Pathology, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, 7910000, Japan
| | - Hiromi Iwasaki
- Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Masanori Kadowaki
- Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Yasuhito Mihashi
- Department of Otolaryngology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Toshifumi Sakata
- Department of Otolaryngology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Shigeto Kawauchi
- Department of Pathology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Ziyao Wang
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Haematology and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Morishige Takeshita
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan. .,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.
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