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Wang Y, Yuan X, Wang T, Wei W, Wu S, Hou H. Comprehensive evaluation of immune dysregulation in secondary hemophagocytic lymphohistiocytosis. Virulence 2024; 15:2342276. [PMID: 38629410 PMCID: PMC11028026 DOI: 10.1080/21505594.2024.2342276] [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: 11/20/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
Host immune dysfunction plays a crucial role in the onset, progression, and outcome of hemophagocytic lymphohistiocytosis (HLH). This study aimed to comprehensively evaluate the peripheral immune profiles in patients with newly diagnosed secondary hemophagocytic lymphohistiocytosis (sHLH), and explore their predictive value for patient prognosis. A total of 77 patients with sHLH were enrolled in this study, with 31 of them experiencing mortality. Flow cytometry was used to assess the percentages, absolute numbers, and phenotypes of lymphocyte subsets. Simultaneously, cytokine levels and routine laboratory indicators were also collected. In sHLH patients, lymphocyte subset absolute numbers were significantly impaired, accompanied by T cell hyperactivation, B cell hyperactivation, and increased plasmablast proliferation. Prognostic analysis revealed that lower CD8+ T cell percentages, elevated APTT, IL-6, IL-10 levels, and increased CD4+CD28null T cell proportions were associated with poor patient outcomes. The study demonstrates dysregulation in the counts and phenotypes of lymphocyte subsets in sHLH patients. Several key factors, including IL-6, IL-10, APTT, and various T cell percentages, have potential as prognostic markers and therapeutic targets in sHLH.
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Affiliation(s)
- Yun Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Yuan
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wei
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shiji Wu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongyan Hou
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Xu Z, Shier L, Huebsch L. A relapsed aggressive NK-cell leukemia with CNS involvement diagnosed by cerebrospinal fluid examination. Diagn Cytopathol 2016; 44:314-6. [PMID: 26890009 DOI: 10.1002/dc.23454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/16/2016] [Accepted: 01/26/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Zhaodong Xu
- Division of Haematopathology and Transfusion Medicine, Department of Pathology and Laboratory Medicine, the Ottawa Hospital and Eastern Ontario Regional Laboratory Association, Ottawa, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, K1H 8L6, Canada
| | - Luke Shier
- Division of Haematopathology and Transfusion Medicine, Department of Pathology and Laboratory Medicine, the Ottawa Hospital and Eastern Ontario Regional Laboratory Association, Ottawa, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, K1H 8L6, Canada
| | - Lothar Huebsch
- Division of Haematology, Department of Medicine, the Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada
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Dalal BI, Vakil AP, Khare NS, Wang SY, Richards MJ, Chen LYC. Abnormalities of the lymphocyte subsets and their immunophenotype, and their prognostic significance in adult patients with hemophagocytic lymphohistiocytosis. Ann Hematol 2015; 94:1111-7. [DOI: 10.1007/s00277-015-2350-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
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Ruskova A, Thula R, Chan G. Aggressive Natural Killer-Cell Leukemia: report of five cases and review of the literature. Leuk Lymphoma 2005; 45:2427-38. [PMID: 15621755 DOI: 10.1080/10428190400004513] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report 5 cases of Aggressive Natural Killer-Cell Leukemia (ANKL) diagnosed and treated in our institution within a period of 5 years. Presented are the clinical, hematological, immunophenotypic, immunogenotypic and cytogenetic data. ANKL is a very rare disorder. On review of the English-language literature only 68 published cases were identified. Analysis was performed on a total number of 73 cases (68 from the literature and the series of 5 presented hereby). Presented and discussed are the epidemiology, clinical picture, morphology, cell marker, immunogenotype, cytogenetics, and survival data of the analysis, as well as the associations with the Epstein-Barr virus (EBV). To our knowledge this is the largest series of cases of ANKL analyzed and therefore it is hoped to contribute towards a better characterization of the disorder.
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Affiliation(s)
- Anna Ruskova
- Haematology Laboratory Auckland City Hospital Auckland New Zealand.
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Mao X, Onadim Z, Price EA, Child F, Lillington DM, Russell-Jones R, Young BD, Whittaker S. Genomic alterations in blastic natural killer/extranodal natural killer-like T cell lymphoma with cutaneous involvement. J Invest Dermatol 2003; 121:618-27. [PMID: 12925224 DOI: 10.1046/j.1523-1747.2003.12406.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Natural killer and natural killer-like T cell lymphomas represent a rare type of non-Hodgkin's lymphoma originally described to involve the upper aerodigestive tract. This malignancy has been increasingly observed in other extranodal sites, particularly in the skin. Patients with cutaneous natural killer cell lymphoma generally have a poor prognosis; however, the etiology and the underlying molecular pathogenesis remain unclear. This study aimed to investigate comprehensively genomic changes in blastic natural killer and extranodal natural killer-like T cell lymphoma with cutaneous involvement. Comparative genomic hybridization showed chromosome imbalances in six of eight cases studied (75%). The mean number of chromosome imbalances per sample was 2.18+/-1.63 with similar number of gains (1.18+/-1.17) and losses (1.00+/-1.34). The most frequent DNA copy number changes observed were losses of 9/9p (83%), followed by loss of 13q and gain of 7 (67%). Similar patterns of chromosome imbalances were observed in both blastic natural killer and cutaneous natural killer-like T cell lymphomas. Loss of the RB1 gene at 13q14.2 was detected in one blastic natural killer cell lymphoma with 13q loss using a gene dosage assay, and in one cutaneous natural killer-like T cell lymphoma without 13q loss using fluorescent in situ hybridization. Genomic microarray analysis identified oncogene copy number gains of PAK1 and JUNB in three of four cases studied, and gains of RAF1, CTSB, FGFR1, and BCR in two cases. Real-time polymerase chain reaction detected amplification of CTSB and RAF1 in four of five cases analyzed, JUNB and MYCN in three cases, and REL and YES1 in two cases, respectively. In conjunction with this study, an extensive literature search for the published G-banded karyotypes of four subsets of natural killer cell lymphomas was conducted, which showed a nonrandom pattern of multiple chromosome aberrations. These results reveal consistent genetic alterations in cutaneous natural killer cell lymphomas, and provide a basis for further investigation of molecular pathogenesis in this malignancy.
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Affiliation(s)
- Xin Mao
- Skin Tumour Unit, St John's Institute of Dermatology, 4th Floor, South Wing Block 7, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK.
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Savaşan S, Lorenzana A, Williams JA, Mohamed AN, Ravindranath Y, Zielenska M, Hamre M, Haas JE, Rector F, Sawaf H, Abella E. Constitutional balanced translocations in alveolar rhabdomyosarcoma. CANCER GENETICS AND CYTOGENETICS 1998; 105:50-4. [PMID: 9689930 DOI: 10.1016/s0165-4608(98)00014-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Chromosomal analysis of tumor tissue from two children with alveolar rhabdomyosarcoma revealed t(1;5)(q32;q31) and t(1;22)(q21;q11.2) in all metaphases examined, respectively. Peripheral blood lymphocytes carried the same cytogenetic abnormality as that of the tumor cells in both patients. Parental lymphocytes were karyotypically normal in the patient with t(1;22), indicating a de novo constitutional translocation, but t(1;5) was paternally inherited in the other patient. The presence of constitutional translocations in these two children might have contributed to the development of alveolar rhabdomyosarcoma.
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Affiliation(s)
- S Savaşan
- Department of Pathology and Laboratory Medicine, Barbara Ann Karmanos Cancer Institute and Children's Hospital of Michigan, Detroit, USA
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Nonnasal Lymphoma Expressing the Natural Killer Cell Marker CD56: A Clinicopathologic Study of 49 Cases of an Uncommon Aggressive Neoplasm. Blood 1997. [DOI: 10.1182/blood.v89.12.4501] [Citation(s) in RCA: 560] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Expression of the natural killer (NK) cell antigen CD56 is uncommon among lymphomas, and those that do are almost exclusively of non–B-cell lineage and show a predilection for the nasal and nasopharyngeal region. This study analyzes 49 cases of nonnasal CD56+ lymphomas, the largest series to date, to characterize the clinicopathologic spectrum of these rare neoplasms. All patients were Chinese. Four categories could be delineated. (1) Nasal-type NK/T cell lymphoma (n = 34) patients were adults 21 to 76 years of age (median, 50 years), including 25 men and 9 women. They presented with extranodal disease, usually in multiple sites. The commonest sites of involvement were skin, upper aerodigestive tract, testis, soft tissue, gastrointestinal tract, and spleen. Only 7 cases (21%) apparently had stage I disease. The neoplastic cells were often pleomorphic, with irregular nuclei and granular chromatin, and angiocentric growth was common. The characteristic immunophenotype was CD2+ CD3/Leu4− CD3ε+ CD56+, and 32 cases (94%) harbored Epstein-Barr virus (EBV). Follow-up information was available in 29 cases: 24 died at a median of 3.5 months; 3 were alive with relapse at 5 months to 2.5 years; and 2 were alive and well at 3 and 5 years, respectively. (2) Aggressive NK cell leukemia/lymphoma (n = 5) patients presented with hepatomegaly and blood/marrow involvement, sometimes accompanied by splenomegaly or lymphadenopathy. The neoplastic cells often had round nuclei and azurophilic granules in the pale cytoplasm. All cases exhibited an immunophenotype of CD2+ CD3/Leu4− CD56+ CD16− CD57− and all were EBV+. All of these patients died within 6 weeks. (3) In blastoid NK cell lymphoma (n = 2), the lymphoma cells resembled those of lymphoblastic or myeloid leukemia. One case studied for CD2 was negative and both cases were EBV−. One patient was alive with disease at 10 months and one was a recent case. (4) Other specific lymphoma types with CD56 expression (n = 8) included one case each of hepatosplenic γδ T-cell lymphoma and S100 protein+ T-cell lymphoproliferative disease and two cases each of T-chronic lymphocytic/prolymphocytic leukemia, lymphoblastic lymphoma, and true histiocytic lymphoma. All of these cases were EBV−. Six patients died at a median of 6.5 months. Nonnasal CD56+ lymphomas are heterogeneous, but all pursue a highly aggressive clinical course. The nasal-type NK/T-cell lymphoma and aggressive NK cell leukemia/lymphoma show distinctive clinicopathologic features and a very strong association with EBV. Blastoid NK cell lymphoma appears to be a different entity and shows no association with EBV.
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Donner LR. Cytogenetics of lymphomas: a brief review of its theoretical and practical significance. CANCER GENETICS AND CYTOGENETICS 1997; 94:20-6. [PMID: 9078287 DOI: 10.1016/s0165-4608(96)00213-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- L R Donner
- Department of Pathology, Scott & White Clinic, Temple, TX 76508, USA
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