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Wang M, Guo Y, Dong L, Bi K. Coexistence of nodal marginal zone B-cell lymphoma and multiple myeloma: A case report and literature review. Medicine (Baltimore) 2022; 101:e29219. [PMID: 35512080 PMCID: PMC9276404 DOI: 10.1097/md.0000000000029219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/15/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Nodal marginal zone B-cell lymphoma (NMZL) is a relatively rare indolent lymphoma that is the least common subtype of marginal zone B-cell lymphoma. Furthermore, coexistence of lymphoma and multiple myeloma (MM) is rare. Here, we report a case of the coexistence of NMZL and MM. PATIENT CONCERNS The patient was a 66-year-old man with pain in the left rib and lower left back. Enlarged lymph nodes were palpable in the cervical and inguinal regions, the biggest of which was 4.0 × 2.0 cm in size in the left groin. DIAGNOSIS Pathological and immunohistochemical findings of the left inguinal lymph node revealed NMZL. The patient met the diagnostic criteria for symptomatic MM. Therefore, the patient was diagnosed with NMZL and lambda-type MM. INTERVENTION We adopted a bortezomib, liposomal adriamycin, and dexamethasone (PAD) chemotherapy regimen mainly for MM. OUTCOMES After 3 cycles of treatment, the patient achieved complete remission of myeloma. A 50% decrease in enlarged lymph node size was observed. LESSON To our knowledge, this is the first case report of the simultaneous occurrence of NMZL and MM. Further studies are required to explain the association between these 2 tumors and improve treatment selection.
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Hsu A, Kurt H, Zayac AS, Olszewski AJ. CD5 expression in marginal zone lymphoma predicts differential response to rituximab or bendamustine/rituximab. Leuk Lymphoma 2021; 63:31-42. [PMID: 34467833 DOI: 10.1080/10428194.2021.1973670] [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] [Indexed: 01/28/2023]
Abstract
We examined outcomes of 244 patients with marginal zone lymphoma (MZL) diagnosed in 2010-2020, of which 25 (10%) expressed CD5. CD5 expression was present in 22% of splenic, 8% of nodal, and 5% of extranodal MZL, and showed frequent blood/bone marrow involvement, elevated lactate dehydrogenase, and TP53 deletions. CD5 expression was not associated with progression-free or overall survival, but it conferred a significantly higher risk of histologic transformation (22% versus 4% at 5 years, p = 0.002). Among patients receiving first-line rituximab monotherapy, CD5 expression was associated with lower response rate (30% versus 77%, p = 0.006), PFS (25% versus 45% at 3 years, p = 0.003) and OS (44% versus 77%, p = 0.010), whereas CD5 status did not significantly affect outcomes of patients receiving bendamustine with rituximab (P for interaction = 0.012 for progression-free survival). CD5-positive MZL may have a propensity to leukemic dissemination, histologic transformation, and may derive benefit from first-line bendamustine/rituximab rather than rituximab alone.
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Affiliation(s)
- Andrew Hsu
- Division of Hematology/Oncology, Lifespan Cancer Institute, Providence, RI, USA.,Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Habibe Kurt
- Department of Pathology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Adam S Zayac
- Division of Hematology/Oncology, Lifespan Cancer Institute, Providence, RI, USA
| | - Adam J Olszewski
- Division of Hematology/Oncology, Lifespan Cancer Institute, Providence, RI, USA.,Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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3
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Rodrigues CD, Peixeiro RP, Viegas D, Chorão P, Couto ME, Gaspar CL, Fernandes JP, Alves D, Ribeiro LA, de Vasconcelos M P, Tomé AL, Badior M, Coelho H, Príncipe F, Chacim S, da Silva MG, Coutinho R. Clinical Characteristics, Treatment and Evolution of Splenic and Nodal Marginal Zone Lymphomas-Retrospective and Multicentric Analysis of Portuguese Centers. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:e839-e844. [PMID: 34326035 DOI: 10.1016/j.clml.2021.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/13/2021] [Accepted: 06/19/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Treatment of Splenic (SMZL) and Nodal (NMZL) Marginal Zone Lymphoma is not consensual. Histologic transformation (HT) to aggressive lymphoma is a poorly understood event, with an unfavorable outcome. OBJECTIVES Describe the clinical characteristics, treatment, outcomes and incidence of HT. METHODS Characteristics of patients with SMZL and NMZL consecutively diagnosed in 8 Portuguese centers were retrospectively reviewed. Endpoints were overall survival (OS), time to first systemic treatment (TTFST), frequency of HT and time to transformation (TTT). RESULTS This study included 122 SMZL and 68 NMZL, most of them received systemic treatment: 55.4% and 76.5%, respectively. Splenectomy was performed in 58.7% of patients with SMZL. Different treatment protocols were used. OS or TTFST did not differ significantly according to treatments. Given the small sample size, no conclusion can be made concerning the role of Rituximab in the treatment of NMZL and SMZL based in these results. HT was documented in 18 patients, mainly in SMZL, with a cumulative incidence at 5 years of 4.2%. We confirmed that age is a prognostic factor. CONCLUSION Randomized prospective trials are needed to standardize treatment in MZL. Patients with HT did appear to have shorter OS in comparison with those who did not experience HT (OS 5 years of 68.4% vs. 80.4%), but the number of HT was too small to reach statistical significance.
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Affiliation(s)
- Catarina Dantas Rodrigues
- Centro Hospitalar de Tondela-Viseu, Viseu, Portugal; Centro Hospitalar e Universitário do Porto, Hospital Geral de Santo António, Porto, Portugal.
| | - Rita Pinho Peixeiro
- Centro Hospitalar e Universitário do Porto, Hospital Geral de Santo António, Porto, Portugal
| | - Diana Viegas
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | | | - M Eduarda Couto
- Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | | | | | | | | | | | | | | | | | - Sérgio Chacim
- Instituto Português de Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Rita Coutinho
- Centro Hospitalar e Universitário do Porto, Hospital Geral de Santo António, Porto, Portugal
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4
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Lopetegui‐Lia N, Delasos L, Asad SD, Kumar M, Harrison JS. Primary central nervous system marginal zone B-cell lymphoma arising from the dural meninges: A case report and review of literature. Clin Case Rep 2020; 8:491-497. [PMID: 32185043 PMCID: PMC7069868 DOI: 10.1002/ccr3.2680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/26/2019] [Accepted: 12/16/2019] [Indexed: 12/26/2022] Open
Abstract
Primary central nervous system (CNS) marginal zone B-cell lymphoma (MZBCL) arising from the dural meninges is a rare but indolent disease. This malignancy can present in various ways, hence making it difficult to diagnose. Biopsy results dictate an appropriate treatment plan, which commonly consists of a combination of surgical resection, whole brain radiotherapy and systemic therapy.
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Affiliation(s)
| | - Lukas Delasos
- Department of MedicineUniversity of Connecticut SystemFarmingtonCTUSA
| | - Syed Daniyal Asad
- Department of MedicineUniversity of Connecticut SystemFarmingtonCTUSA
| | - Manish Kumar
- Department of MedicineUniversity of Connecticut SystemFarmingtonCTUSA
| | - Jonathan S. Harrison
- Department of Hematology/Oncology, Carole and Ray Neag Comprehensive Cancer CenterUniversity of Connecticut SystemFarmingtonCTUSA
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5
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Valle A, Papagermanos V, Wotman M, Shani D. A case of Moyamoya disease complicated by aHUS in a patient with a history of marginal zone B-cell lymphoma: lightning strikes thrice? BMJ Case Rep 2019; 12:e229194. [PMID: 31811102 PMCID: PMC6904183 DOI: 10.1136/bcr-2019-229194] [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] [Accepted: 11/02/2019] [Indexed: 11/04/2022] Open
Abstract
Atypical haemolytic uraemic syndrome (aHUS) is a rare, acquired thrombotic microangiopathy, mediated by complement activation, in very sick patients. Moyamoya is similarly a rare disease in which stenosis or occlusion of segment(s) of the anterior cerebral circulation leads to the formation of many thin collaterals. Other reports have described an association between HUS and Moyamoya disease in the paediatric population. However, this case study presents the exceptionally rare presentation of an adult with aHUS and Moyamoya disease in a patient who was treated with rituximab for marginal zone B-cell lymphoma.
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Affiliation(s)
- Ana Valle
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Vassiliki Papagermanos
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Michael Wotman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Dana Shani
- Department of Hematology/Oncology, Lenox Hill Hospital, Northwell Health, New York City, New York, USA
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6
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Granai M, Amato T, Di Napoli A, Santi R, Vergoni F, Di Stefano G, Mancini V, Kovalchuk S, Cencini E, Carta AG, Aversa S, Ziepert M, Cevenini G, Lazzi S, Leoncini L, Bellan C. IGHV mutational status of nodal marginal zone lymphoma by NGS reveals distinct pathogenic pathways with different prognostic implications. Virchows Arch 2019; 477:143-150. [PMID: 31802229 PMCID: PMC7320062 DOI: 10.1007/s00428-019-02712-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/18/2019] [Accepted: 10/29/2019] [Indexed: 12/30/2022]
Abstract
The precise B cell of origin and molecular pathogenesis of nodal marginal zone lymphoma (NMZL) remain poorly defined. To date, due to the rarity of NMZL, the vast majority of already-published studies have been conducted on a limited number of samples and the technical approach to analyze the immunoglobulin genes was of amplifying rearranged variable region genes with the classical direct sequencing of the PCR products followed by cloning. Here, we studied the B cell Ig heavy-chain repertoires by next-generation sequencing (NGS) in 30 NMZL cases. Most of the cases were mutated (20/28; 71.5%) with homologies to the respective germ line genes ranging from 85 to 97, 83%, whereas 8/28 (28.5%) were unmutated. In addition, our results show that NMZL cases have a biased usage of specific immunoglobulin heavy-chain variable (IGHV) region genes. Moreover, we documented intraclonal diversity in all (100%) of the mutated cases and ongoing somatic hypermutations (SHM) have been confirmed by hundreds of reads. We analyzed the mutational pattern to detect and quantify antigen selection pressure and we found a positive selection in 4 cases, whereas in the remaining cases there was an unspecific stimulation. Finally, the disease-specific survival and the progression-free survival were significantly different between cases with mutated and unmutated IGHV genes, pointing out mutational status as a possible new biomarker in NMZL.
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Affiliation(s)
- Massimo Granai
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Teresa Amato
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Pathology Unit, University of Rome "La Sapienza", Rome, Italy
| | - Raffaella Santi
- Florence Pathology Unit, Careggi University Hospital, Florence, Italy
| | - Federica Vergoni
- Florence Pathology Unit, Careggi University Hospital, Florence, Italy
| | - Gioia Di Stefano
- Florence Pathology Unit, Careggi University Hospital, Florence, Italy
| | - Virginia Mancini
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Sofya Kovalchuk
- Florence Hematology Unit, University of Florence, Florence, Italy
| | | | - Alberto Giulio Carta
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Sara Aversa
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Marita Ziepert
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Gabriele Cevenini
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Stefano Lazzi
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
| | - Lorenzo Leoncini
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy.
| | - Cristiana Bellan
- Department of Medical Biotechnologies, Anatomic Pathology Division, University of Siena, Via delle Scotte, 6, 53100, Siena, Italy
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7
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8
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Becnel MR, Nastoupil LJ, Samaniego F, Davis RE, You MJ, Green M, Hagemeister FB, Fanale MA, Fayad LE, Westin JR, Wang M, Oki Y, Forbes SG, Feng L, Neelapu SS, Fowler NH. Lenalidomide plus rituximab (R 2 ) in previously untreated marginal zone lymphoma: subgroup analysis and long-term follow-up of an open-label phase 2 trial. Br J Haematol 2019; 185:874-882. [PMID: 30919940 PMCID: PMC6619290 DOI: 10.1111/bjh.15843] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/18/2019] [Indexed: 02/06/2023]
Abstract
Lack of consensus for first‐line marginal zone lymphoma (MZL) treatment and toxicities associated with currently available systemic therapies have inspired evaluation of immunotherapeutic agents yielding robust outcomes with improved tolerability. We previously reported durable efficacy with first‐line lenalidomide and rituximab (R2) in follicular lymphoma, MZL and small lymphocytic lymphoma with a subsequent long‐term follow‐up shown here in MZL patients. This phase 2 investigator‐initiated study included previously untreated, stage III/IV MZL patients treated with lenalidomide 20 mg/day on days 1–21 and rituximab 375 mg/m2 on day 1 of each 28‐day cycle, continuing in responders for ≥6–12 cycles. The primary endpoint was overall response rate (ORR); secondary endpoints were complete and partial response (CR, PR), safety, and progression‐free survival (PFS). The ORR was 93% with 70% attaining CR/CR unconfirmed. At median follow‐up of 75·1 months, median PFS was 59·8 months and 5‐year OS was 96%. Most non‐haematological adverse events (AE) were grade 1/2. Grade 3 haematological AEs were neutropenia (33%) and leucopenia (7%), and grade 4 were leucopenia (3%) and thrombocytopenia (3%). Two patients died of secondary malignancies; no treatment‐related fatalities occurred. With extended follow‐up, outcomes for MZL patients receiving R2 were robust with no unexpected late or delayed toxicities.
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Affiliation(s)
- Melody R Becnel
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Loretta J Nastoupil
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Felipe Samaniego
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richard E Davis
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M J You
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Green
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Fredrick B Hagemeister
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle A Fanale
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Seattle Genetics Inc., Bothell, WA, USA
| | - Luis E Fayad
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason R Westin
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Wang
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yasuhiro Oki
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sheryl G Forbes
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lei Feng
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sattva S Neelapu
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nathan H Fowler
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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9
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Cheung CY, Lau WH, Cheuk W. Epstein-Barr Virus-Associated Nodal Marginal Zone Lymphoma: Part of the Spectrum of Posttransplant Lymphoproliferative Disorder? Int J Surg Pathol 2018; 27:94-97. [PMID: 29944019 DOI: 10.1177/1066896918784184] [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: 11/16/2022]
Abstract
A 56-year-old man, who received deceased kidney transplant 20 years ago, presented with an enlarged submandibular lymph node. Histologic examination revealed nodal marginal zone lymphoma in which the neoplastic lymphoid cells showed diffuse positivity for Epstein-Barr virus early RNA by in situ hybridization. Systemic lymphoma workup showed stage I disease. The tumor was managed as a posttransplant lymphoproliferative disorder and the immunosuppression was modified. There was no evidence of lymphoma at follow-up 6 years after excision alone. This case supports the inclusion of Epstein-Barr virus-positive nodal marginal zone lymphoma as a form of monomorphic B-cell lymphoproliferative disorder, in line with the status of its extranodal mucosa-associated lymphoid tissue lymphoma counterpart.
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Affiliation(s)
| | | | - Wah Cheuk
- 1 Queen Elizabeth Hospital, Hong Kong, China SAR
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10
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Pillonel V, Juskevicius D, Ng CKY, Bodmer A, Zettl A, Jucker D, Dirnhofer S, Tzankov A. High-throughput sequencing of nodal marginal zone lymphomas identifies recurrent BRAF mutations. Leukemia 2018; 32:2412-2426. [PMID: 29556019 PMCID: PMC6224405 DOI: 10.1038/s41375-018-0082-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/15/2018] [Accepted: 02/05/2018] [Indexed: 12/23/2022]
Abstract
Nodal marginal zone lymphoma (NMZL) is a rare small B-cell lymphoma lacking disease-defining phenotype and precise diagnostic markers. To better understand the mutational landscape of NMZL, particularly in comparison to other nodal small B-cell lymphomas, we performed whole-exome sequencing, targeted high-throughput sequencing, and array-comparative genomic hybridization on a retrospective series. Our study identified for the first time recurrent, diagnostically useful, and potentially therapeutically relevant BRAF mutations in NMZL. Sets of somatic mutations that could help to discriminate NMZL from other closely related small B-cell lymphomas were uncovered and tested on unclassifiable small B-cell lymphoma cases, in which clinical, morphological, and phenotypical features were equivocal. Application of targeted gene panel sequencing gave at many occasions valuable clues for more specific classification.
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Affiliation(s)
- V Pillonel
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - D Juskevicius
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - C K Y Ng
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland.,Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - A Bodmer
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Zettl
- Pathology, Viollier AG, Allschwil, Switzerland
| | - D Jucker
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - S Dirnhofer
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, Basel, Switzerland.
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11
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Cozzi M, Marconato L, Martini V, Aresu L, Riondato F, Rossi F, Stefanello D, Comazzi S. Canine nodal marginal zone lymphoma: Descriptive insight into the biological behaviour. Vet Comp Oncol 2017; 16:246-252. [PMID: 29205839 DOI: 10.1111/vco.12374] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 10/30/2017] [Accepted: 11/01/2017] [Indexed: 12/19/2022]
Abstract
Canine nodal marginal zone lymphoma (nMZL) is classified as an indolent lymphoma. Such lymphomas are typified by low mitotic rate and slow clinical progression. While the clinical behaviour of canine splenic MZL has been described, characterized by an indolent course and a good prognosis following splenectomy, there are no studies specifically describing nMZL. The aim of this study was to describe the clinical features of and outcome for canine nMZL. Dogs with histologically confirmed nMZL undergoing a complete staging work-up (including blood analysis, flow cytometry [FC] on lymph node [LN], peripheral blood and bone marrow, imaging, histology and immunohistochemistry on a surgically removed peripheral LN) were retrospectively enrolled. Treatment consisted of chemotherapy or chemo-immunotherapy. Endpoints were response rate (RR), time to progression (TTP) and lymphoma-specific survival (LSS). A total of 35 cases were enrolled. At diagnosis, all dogs showed generalized lymphadenopathy. One-third was systemically unwell. All dogs had stage V disease; one-third also had extranodal involvement. The LN population was mainly composed of medium-sized CD21+ cells with scant resident normal lymphocytes. Histology revealed diffuse LN involvement, referring to "late-stage" MZL. Median TTP and LSS were 149 and 259 days, respectively. Increased LDH activity and substage b were significantly associated with a shorter LSS. Dogs with nMZL may show generalized lymphadenopathy and an advanced disease stage. Overall, the outcome is poor, despite the "indolent" designation. The best treatment option still needs to be defined.
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Affiliation(s)
- M Cozzi
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - L Marconato
- Centro Oncologico Veterinario, Bologna, Italy
| | - V Martini
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - L Aresu
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - F Riondato
- Department of Veterinary Sciences, University of Turin, Turin, Italy
| | - F Rossi
- Centro Oncologico Veterinario, Bologna, Italy
| | - D Stefanello
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - S Comazzi
- Department of Veterinary Medicine, University of Milan, Milan, Italy
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