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Onkarappa Mangala Y, Onukogu ID, Breen CM, Colvin GA. Primary Cutaneous Gamma-Delta T-cell Lymphoma: A Case Report and Review of Literature. Cureus 2023; 15:e35442. [PMID: 36994286 PMCID: PMC10042491 DOI: 10.7759/cureus.35442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 02/27/2023] Open
Abstract
Primary cutaneous gamma-delta T-cell lymphoma (PCGD-TCL) is a rare type of lymphoma, representing less than 1% of all cutaneous T-cell lymphomas. It is typically aggressive and chemotherapy-refractory. Hence, most institutions tend to employ intensive chemotherapy followed by stem cell transplantation although there is no standard of care established. We report a case of PCGD-TCL and discuss the challenges associated with the diagnosis and management of PCGD-TCL.
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2
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Kreher MA, Ahn J, Werbel T, Motaparthi K. Subcutaneous panniculitis-like T-cell lymphoma after COVID-19 vaccination. JAAD Case Rep 2022; 28:18-20. [PMID: 35966352 PMCID: PMC9364717 DOI: 10.1016/j.jdcr.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - John Ahn
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
| | - Tyler Werbel
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
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3
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A Clinical Case of a Homozygous Deletion in the APOA5 Gene with Severe Hypertriglyceridemia. Genes (Basel) 2022; 13:genes13061062. [PMID: 35741823 PMCID: PMC9222921 DOI: 10.3390/genes13061062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/28/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Hypertriglyceridemia (HTG) is one of the most common forms of lipid metabolism disorders. The leading clinical manifestations are pancreatitis, atherosclerotic vascular lesions, and the formation of eruptive xanthomas. The most severe type of HTG is primary (or hereditary) hypertriglyceridemia, linked to pathogenic genetic variants in LPL, APOC2, LMF1, and APOA5 genes. Case: We present a clinical case of severe primary hypertriglyceridemia (TG level > 55 mmol/L in a 4-year-old boy) in a consanguineous family. The disease developed due to a previously undescribed homozygous deletion in the APOA5 gene (NM_052968: c.579_592delATACGCCGAGAGCC p.Tyr194Gly*68). We also evaluate the clinical significance of a genetic variant in the LPL gene (NM_000237.2: c.106G>A (rs1801177) p.Asp36Asn), which was previously described as a polymorphism. In one family, we also present a different clinical significance even in heterozygous carriers: from hypertriglyceridemia to normotriglyceridemia. We provide evidence that this heterogeneity has developed due to polymorphism in the LPL gene, which plays the role of an additional trigger. Conclusions: The homozygous deletion of the APOA5 gene is responsible for the severe hypertriglyceridemia, and another SNP in the LPL gene worsens the course of the disease.
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4
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Muhsen IN, El Fakih R, Hamadani M, Lazarus HM, Kharfan-Dabaja MA, Aljurf M. Clinical, Diagnostic and Prognostic Characteristics of Primary Cutaneous Gamma Delta T-cell Lymphomas. Clin Hematol Int 2022; 4:1-10. [PMID: 35950208 PMCID: PMC9358781 DOI: 10.1007/s44228-022-00011-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/26/2021] [Indexed: 12/04/2022] Open
Abstract
Primary cutaneous γδ T-cell lymphoma (PCGDTL) is a rare subtype of non-Hodgkin lymphoma (NHL) that arises from T-cells with γδ T-cell receptors. The exact incidence of PCGDTL is unknown, as it is usually lumped with other cutaneous lymphomas, which are also uncommon. It is one of the peripheral T-cell lymphoma (PTCL) subtypes which is known to have a dismal prognosis due to poor response and the paucity of available therapies. Despite the rarity and uncertainties of PCGDTL, a number of studies over the past decade were published about the pathologic, diagnostic, cytogenetic and clinical features of this disease. These diagnostic advances will open the doors to explore new therapeutics for this rare entity, specifically targeted and immune therapies. In this review, we highlight these advances, summarize the contemporary treatment approaches, and shed the light on future potential therapeutic targets.
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Affiliation(s)
| | - Riad El Fakih
- Oncology Center, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh, 11211 Saudi Arabia
| | - Mehdi Hamadani
- BMT and Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI USA
| | - Hillard M. Lazarus
- Division of Hematology and Oncology, Case Western Reserve University, Cleveland, OH USA
| | - Mohamed A. Kharfan-Dabaja
- Division of Hematology-Oncology and Blood and Marrow Transplantation and Cellular Therapies Program, Mayo Clinic, Jacksonville, FL USA
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital and Research Center, PO Box 3354, Riyadh, 11211 Saudi Arabia
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5
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[PD-1 monoclonal antibody combined with chemotherapy in the treatment of subcutaneous panniculitis-like T-cell lymphoma: a case report and literature review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2021; 42:959-961. [PMID: 35045660 PMCID: PMC8763599 DOI: 10.3760/cma.j.issn.0253-2727.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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6
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Jothishankar B, Espinosa ML, Zain J, Parekh V, Di Raimondo C, Abdulla F. Complete response to romidepsin as monotherapy in treatment-resistant subcutaneous panniculitis-like T-cell lymphoma. JAAD Case Rep 2020; 6:1245-1247. [PMID: 33294555 PMCID: PMC7701033 DOI: 10.1016/j.jdcr.2020.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Maria L. Espinosa
- University of Chicago Pritzker School of Medicine, Chicago, Illinois
- Correspondence to: Maria L. Espinosa, BS, 924 E 57th St Suite 104, Chicago, IL 60637.
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7
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Abstract
Hypertriglyceridemia is one of the most common lipid abnormalities encountered in clinical practice. Many monogenic disorders causing severe hypertriglyceridemia have been identified, but in most patients triglyceride elevations result from a combination of multiple genetic variations with small effects and environmental factors. Common secondary causes include obesity, uncontrolled diabetes, alcohol misuse, and various commonly used drugs. Correcting these factors and optimizing lifestyle choices, including dietary modification, is important before starting drug treatment. The goal of drug treatment is to reduce the risk of pancreatitis in patients with severe hypertriglyceridemia and cardiovascular disease in those with moderate hypertriglyceridemia. This review discusses the various genetic and acquired causes of hypertriglyceridemia, as well as current management strategies. Evidence supporting the different drug and non-drug approaches to treating hypertriglyceridemia is examined, and an easy to adopt step-by-step management strategy is presented.
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Affiliation(s)
- Vinaya Simha
- Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
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8
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Sallam MA, Prakash S, Krishnan V, Todorova K, Mandinova A, Mitragotri S. Hyaluronic Acid Conjugates of Vorinostat and Bexarotene for Treatment of Cutaneous Malignancies. ADVANCED THERAPEUTICS 2020. [DOI: 10.1002/adtp.202000116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Marwa A. Sallam
- John A. Paulson School of Engineering and Applied Sciences, and Wyss Institute of Biologically Inspired Engineering Harvard University Cambridge MA 02138 USA
- Faculty of pharmacy Alexandria University Egypt
| | - Supriya Prakash
- John A. Paulson School of Engineering and Applied Sciences, and Wyss Institute of Biologically Inspired Engineering Harvard University Cambridge MA 02138 USA
| | - Vinu Krishnan
- John A. Paulson School of Engineering and Applied Sciences, and Wyss Institute of Biologically Inspired Engineering Harvard University Cambridge MA 02138 USA
| | - Kristina Todorova
- Cutaneous Biology Research Center Massachusetts General Hospital and Harvard Medical School Building 149 13th Street Charlestown MA 02129 USA
| | - Anna Mandinova
- Cutaneous Biology Research Center Massachusetts General Hospital and Harvard Medical School Building 149 13th Street Charlestown MA 02129 USA
- Broad Institute of Harvard and MIT 7 Cambridge Center Cambridge MA 02142 USA
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied Sciences, and Wyss Institute of Biologically Inspired Engineering Harvard University Cambridge MA 02138 USA
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9
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Stranzenbach R. How do we treat cutaneous T-cell lymphoma? Ital J Dermatol Venerol 2020; 156:534-544. [PMID: 32938164 DOI: 10.23736/s2784-8671.20.06606-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cutaneous T-cell lymphomas are a heterogeneous group of non-Hodgkin lymphomas which are based on the malignant proliferation of skin-related T lymphocytes. The clinical appearance, as well as the course and the associated therapeutic approach, are sometimes very different between the different subtypes. Since allogeneic stem cell transplantation is currently the only curative option, and the morbidity and mortality are not insignificant, a therapy concept should be developed that considers its often rather indolent but chronic course. This concept should enable a good disease control with as few side effects as possible and preserve or improve the quality of life. In the early stages of the disease, skin-oriented therapies are generally used first before systemic and increasingly aggressive therapeutic agents are used as the disease progresses. Considering the current guidelines, literature and subjective experience, we summarize in this review how we treat cutaneous T-cell lymphomas.
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Affiliation(s)
- René Stranzenbach
- Department of Dermatology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany -
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10
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Mamun AA, Uddin MS, Bin Bashar MF, Zaman S, Begum Y, Bulbul IJ, Islam MS, Sarwar MS, Mathew B, Amran MS, Md Ashraf G, Bin-Jumah MN, Mousa SA, Abdel-Daim MM. Molecular Insight into the Therapeutic Promise of Targeting APOE4 for Alzheimer's Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:5086250. [PMID: 32509144 PMCID: PMC7245681 DOI: 10.1155/2020/5086250] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease that causes chronic cognitive dysfunction. Most of the AD cases are late onset, and the apolipoprotein E (APOE) isoform is a key genetic risk factor. The APOE gene has 3 key alleles in humans including APOE2, APOE3, and APOE4. Among them, APOE4 is the most potent genetic risk factor for late-onset AD (LOAD), while APOE2 has a defensive effect. Research data suggest that APOE4 leads to the pathogenesis of AD through various processes such as accelerated beta-amyloid aggregations that raised neurofibrillary tangle formation, cerebrovascular diseases, aggravated neuroinflammation, and synaptic loss. However, the precise mode of actions regarding in what way APOE4 leads to AD pathology remains unclear. Since APOE contributes to several pathological pathways of AD, targeting APOE4 might serve as a promising strategy for the development of novel drugs to combat AD. In this review, we focus on the recent studies about APOE4-targeted therapeutic strategies that have been advanced in animal models and are being prepared for use in humans for the management of AD.
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Affiliation(s)
- Abdullah Al Mamun
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
- Pharmakon Neuroscience Research Network, Dhaka, Bangladesh
| | - Md. Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
- Pharmakon Neuroscience Research Network, Dhaka, Bangladesh
| | - Md. Fahim Bin Bashar
- Department of Pharmacy, University of Development Alternative, Dhaka, Bangladesh
| | - Sonia Zaman
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | - Yesmin Begum
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | | | | | - Md. Shahid Sarwar
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Bijo Mathew
- Division of Drug Design and Medicinal Chemistry Research Lab, Department of Pharmaceutical Chemistry, Ahalia School of Pharmacy, Palakkad, India
| | - Md. Shah Amran
- Department of Pharmaceutical Chemistry, University of Dhaka, Dhaka, Bangladesh
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - May N. Bin-Jumah
- Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh 11474, Saudi Arabia
| | - Shaker A. Mousa
- Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, New York, NY 12144, USA
| | - Mohamed M. Abdel-Daim
- Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
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11
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Pralatrexate for refractory or recurrent subcutaneous panniculitis-like T-cell lymphoma with hemophagocytic syndrome. J Am Acad Dermatol 2019; 82:489-491. [PMID: 31319088 DOI: 10.1016/j.jaad.2019.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/07/2019] [Accepted: 07/09/2019] [Indexed: 11/22/2022]
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12
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Xu L, Che Y, Ding X, Song J, Zhang X, Sun X. Successful treatment of a rare subcutaneous panniculitis-like T-cell lymphoma: An unusual case report and literature review. Dermatol Ther 2019; 32:e12878. [PMID: 30884048 DOI: 10.1111/dth.12878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 03/02/2019] [Accepted: 03/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Liye Xu
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
| | - Yuxuan Che
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
| | - Xiaolei Ding
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
| | - Jincheng Song
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
| | - Xian Zhang
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
| | - Xiuhua Sun
- Medical Oncology, The Second Affiliated Hospital of Dalian Medical University, Liaoning Sheng, China
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13
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14
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Siaghani PJ, Wong JT, Chan J, Weisenburger DD, Song JY. Epidemiology and Pathology of T- and NK-Cell Lymphomas. Cancer Treat Res 2019; 176:1-29. [PMID: 30596211 DOI: 10.1007/978-3-319-99716-2_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE This review will describe and update readers on the recent changes in the 2017 WHO classification regarding peripheral T-cell lymphomas. RECENT FINDINGS Signficant advances in molecular studies have resulted in revisions to the classification as well as introduction to provisional entities such as breast implant-associated ALCL and nodal PTCL with T-follicular helper phenotype. SUMMARY Major advances in molecular and gene expression profiling has expanded our knowledge of these rare and aggressive diseases.
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Affiliation(s)
- Parwiz J Siaghani
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Jerry T Wong
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - John Chan
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.
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15
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Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29:iv30-iv40. [PMID: 29878045 DOI: 10.1093/annonc/mdy133] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
MESH Headings
- Administration, Cutaneous
- Aftercare/methods
- Aftercare/standards
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/standards
- Biomarkers, Tumor/genetics
- CD79 Antigens/genetics
- Chemoradiotherapy/methods
- Dermatologic Surgical Procedures/methods
- Dermatologic Surgical Procedures/standards
- Europe
- Humans
- Incidence
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Medical Oncology/methods
- Medical Oncology/standards
- Myeloid Differentiation Factor 88/genetics
- Neoplasm Staging
- Ointments
- Precision Medicine/methods
- Precision Medicine/standards
- Skin/drug effects
- Skin/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Societies, Medical/standards
- Survivorship
- Treatment Outcome
- Ultraviolet Therapy/methods
- Ultraviolet Therapy/standards
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Affiliation(s)
- R Willemze
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E Hodak
- Department of Dermatology, Rabin Medical Centre, Beilinson Hospital, Petach Tikva, Israel
| | - P L Zinzani
- Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy
| | - L Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - M Ladetto
- Divisione di Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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16
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Heyman B, Beaven A. Mycophenolate Mofetil for the Treatment of Subcutaneous Panniculitis-Like T-Cell Lymphoma: Case Report and Review of the Literature. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:e437-e440. [DOI: 10.1016/j.clml.2018.07.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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17
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Shoucri BM, Hung VT, Chamorro-García R, Shioda T, Blumberg B. Retinoid X Receptor Activation During Adipogenesis of Female Mesenchymal Stem Cells Programs a Dysfunctional Adipocyte. Endocrinology 2018; 159:2863-2883. [PMID: 29860300 PMCID: PMC6669823 DOI: 10.1210/en.2018-00056] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/24/2018] [Indexed: 02/08/2023]
Abstract
Early life exposure to endocrine-disrupting chemicals (EDCs) is an emerging risk factor for the development of obesity and diabetes later in life. We previously showed that prenatal exposure to the EDC tributyltin (TBT) results in increased adiposity in the offspring. These effects linger into adulthood and are propagated through successive generations. TBT activates two nuclear receptors, the peroxisome proliferator-activated receptor (PPAR) γ and its heterodimeric partner retinoid X receptor (RXR), that promote adipogenesis in vivo and in vitro. We recently employed a mesenchymal stem cell (MSC) model to show that TBT promotes adipose lineage commitment by activating RXR, not PPARγ. This led us to consider the functional consequences of PPARγ vs RXR activation in developing adipocytes. We used a transcriptomal approach to characterize genome-wide differences in MSCs differentiated with the PPARγ agonist rosiglitazone (ROSI) or TBT. Pathway analysis suggested functional deficits in TBT-treated cells. We then compared adipocytes differentiated with ROSI, TBT, or a pure RXR agonist IRX4204 (4204). Our data show that RXR activators ("rexinoids," 4204 and TBT) attenuate glucose uptake, blunt expression of the antidiabetic hormone adiponectin, and fail to downregulate proinflammatory and profibrotic transcripts, as does ROSI. Finally, 4204 and TBT treatment results in an inability to induce markers of adipocyte browning, in part due to sustained interferon signaling. Taken together, these data implicate rexinoids in the development of dysfunctional white adipose tissue that could potentially exacerbate obesity and/or diabetes risk in vivo. These data warrant further screening and characterization of EDCs that activate RXR.
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Affiliation(s)
- Bassem M Shoucri
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, California
- Medical Scientist Training Program, University of California, Irvine, Irvine, California
| | - Victor T Hung
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, California
| | - Raquel Chamorro-García
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, California
| | - Toshi Shioda
- Center for Cancer Research, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Bruce Blumberg
- Department of Developmental and Cell Biology, University of California, Irvine, Irvine, California
- Department of Pharmaceutical Sciences, University of California, Irvine, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California
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18
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Fujii K. New Therapies and Immunological Findings in Cutaneous T-Cell Lymphoma. Front Oncol 2018; 8:198. [PMID: 29915722 PMCID: PMC5994426 DOI: 10.3389/fonc.2018.00198] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/17/2018] [Indexed: 01/08/2023] Open
Abstract
Primary cutaneous lymphomas comprise a group of lymphatic malignancies that occur primarily in the skin. They represent the second most common form of extranodal non-Hodgkin’s lymphoma and are characterized by heterogeneous clinical, histological, immunological, and molecular features. The most common type is mycosis fungoides and its leukemic variant, Sézary syndrome. Both diseases are considered T-helper cell type 2 (Th2) diseases. Not only the tumor cells but also the tumor microenvironment can promote Th2 differentiation, which is beneficial for the tumor cells because a Th1 environment enhances antitumor immune responses. This Th2-dominant milieu also underlies the infectious susceptibility of the patients. Many components, such as tumor-associated macrophages, cancer-associated fibroblasts, and dendritic cells, as well as humoral factors, such as chemokines and cytokines, establish the tumor microenvironment and can modify tumor cell migration and proliferation. Multiagent chemotherapy often induces immunosuppression, resulting in an increased risk of serious infection and poor tolerance. Therefore, overtreatment should be avoided for these types of lymphomas. Interferons have been shown to increase the time to next treatment to a greater degree than has chemotherapy. The pathogenesis and prognosis of cutaneous T-cell lymphoma (CTCL) differ markedly among the subtypes. In some aggressive subtypes of CTCLs, such as primary cutaneous gamma/delta T-cell lymphoma and primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, hematopoietic stem cell transplantation should be considered, whereas overtreatment should be avoided with other, favorable subtypes. Therefore, a solid understanding of the pathogenesis and immunological background of cutaneous lymphoma is required to better treat patients who are inflicted with this disease. This review summarizes the current knowledge in the field to attempt to achieve this objective.
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Affiliation(s)
- Kazuyasu Fujii
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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19
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Kheterpal M, Mehta-Shah N, Virmani P, Myskowski PL, Moskowitz A, Horwitz SM. Managing Patients with Cutaneous B-Cell and T-Cell Lymphomas Other Than Mycosis Fungoides. Curr Hematol Malig Rep 2017; 11:224-33. [PMID: 27101016 DOI: 10.1007/s11899-016-0322-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cutaneous lymphomas (CL) are a heterogeneous group of neoplasms characterized with clinical and histopathological variation, as well as overlap with benign dermatoses. Diagnosis and treatment of CLs is challenging and often requires a multidisciplinary approach. However, prognostic knowledge of these conditions and awareness of treatment options can help optimize appropriate use of available regimens, thereby improving care for patients. Here, we review the most recent literature and outline treatment themes for managing patients with cutaneous B-cell and T-cell lymphomas other than mycosis fungoides.
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Affiliation(s)
- Meenal Kheterpal
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, 500 Westchester Ave, West Harrison, NY, 10604, USA
| | - Neha Mehta-Shah
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, 1233 York Avenue, New York, NY, 10065, USA
| | - Pooja Virmani
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 16 E60th Street, New York, NY, 10022, USA
| | - Patricia L Myskowski
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 16 E60th Street, New York, NY, 10022, USA
| | - Alison Moskowitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 1275 York Avenue, New York, NY, 10065, USA
| | - Steven M Horwitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Memorial Sloan Kettering Cancer Center, 1233 York Avenue, New York, NY, 10065, USA.
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Dhawale TM, Shustov AR. Autologous and Allogeneic Hematopoietic Cell Transplantation in Peripheral T/NK-cell Lymphomas: A Histology-Specific Review. Hematol Oncol Clin North Am 2017; 31:335-357. [PMID: 28340882 DOI: 10.1016/j.hoc.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Peripheral T-cell lymphoma and natural killer/T-cell lymphomas (PT/NKCL) make up a diverse subgroup of non-Hodgkin's lymphomas characterized by an aggressive clinical course. The use of hematopoietic stem cell transplantation (HSCT) in the treatment of PT/NKCL remains controversial because of the absence of randomized controlled trials. The best available data suggest that certain subtypes of PT/NKCL may benefit more from the application of HSCT than other subtypes and that this benefit results from their unique clinical characteristics and underlying biology. Ultimately, however, prospective randomized controlled trials are needed to clarify the optimal type and timing of HSCT in patients with PT/NKCL.
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Affiliation(s)
- Tejaswini M Dhawale
- Department of Medicine, University of Washington School of Medicine, SCCA, 825 Eastlake Avenue East, M-Box G3-200, Seattle, WA 98109, USA
| | - Andrei R Shustov
- Department of Medicine, University of Washington School of Medicine, SCCA, 825 Eastlake Avenue East, M-Box G3-200, Seattle, WA 98109, USA.
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Abstract
Peripheral T-cell lymphomas represent 10% to 15% of non-Hodgkin lymphomas and comprise more than 20 different entities. Treatment of very rare T-cell lymphomas can be challenging because there are no large or randomized studies to guide clinical decision making, and treatment paradigms are often based on small series or imperfect data. Although a strict algorithm cannot be written with certainty, through the literature that exists and clinical experience, themes and principles of approaches do emerge that when coupled with clinical judgment allow reasonable and logical decisions.
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Nanoformulation of dual bexarotene-tailed phospholipid conjugate with high drug loading. Eur J Pharm Sci 2017; 100:197-204. [DOI: 10.1016/j.ejps.2017.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/03/2017] [Accepted: 01/11/2017] [Indexed: 11/22/2022]
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Lee JB, Zgair A, Kim TH, Kim MG, Yoo SD, Fischer PM, Gershkovich P. Simple and sensitive HPLC-UV method for determination of bexarotene in rat plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1040:73-80. [DOI: 10.1016/j.jchromb.2016.11.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/11/2016] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
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Ceppi F, Pope E, Ngan B, Abla O. Primary Cutaneous Lymphomas in Children and Adolescents. Pediatr Blood Cancer 2016; 63:1886-94. [PMID: 27229270 DOI: 10.1002/pbc.26076] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 12/22/2022]
Abstract
Primary cutaneous lymphomas are rare in children and mostly represented by mycosis fungoides and CD30(+) lymphoproliferative disorders. Most pediatric cutaneous lymphomas have similar clinical/pathological features as their adult counterparts, particularly the T-cell subtypes. With regard to outcome, adult cutaneous mature T-cell lymphomas have a tendency to progression, while this appears to be relatively infrequent in children. The outcome of cutaneous B-cell lymphomas depends on subtype, with the B-lymphoblastic entity being associated with similar outcomes to precursor B acute lymphoblastic leukemia, while there are insufficient data on other entities. The diagnosis and treatment of these patients require a close collaboration between experienced pediatric pathologists, dermatologists, and oncologists. Prospective collection of longitudinal clinical and biological data from children with these rare lymphomas is needed to better understand their biological and clinical behavior and to ultimately discover the best therapeutic strategies.
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Affiliation(s)
- Francesco Ceppi
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Ontario, Toronto, Canada
| | - Elena Pope
- Division of Dermatology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bo Ngan
- Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Ontario, Toronto, Canada.
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Rubio-Gonzalez B, Zain J, Rosen ST, Querfeld C. Clinical manifestations and pathogenesis of cutaneous lymphomas: current status and future directions. Br J Haematol 2016; 176:16-36. [PMID: 27782301 DOI: 10.1111/bjh.14402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The primary cutaneous lymphomas are a heterogeneous group of T-, Natural Killer- and B- cell neoplasms with a wide range of clinical and pathological presentations, and with very different prognoses compared to systemic lymphomas. Recent studies have shown that the skin microenvironment, which is composed of various immune cell subsets as well as their spatial distribution and T-cell interactions through different chemokines and cytokines, has an important role in the development and pathogenesis of cutaneous lymphomas and has assisted in the development of novel and more effective immunotherapies. The following review will focus on the major subtypes of primary cutaneous lymphomas, including the clinical and histological patterns, molecular hallmarks, and current and future treatment strategies.
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Affiliation(s)
| | - Jasmine Zain
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | - Steven T Rosen
- Department of Hematology/Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA
| | - Christiane Querfeld
- Department of Pathology, City of Hope, Duarte, CA, USA.,Department of Hematology/Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, USA.,Division of Dermatology, City of Hope, Duarte, CA, USA
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Wang Y, Rong J, Zhang J, Liu Y, Meng X, Guo H, Liu H, Chen L. Morphology, in vivo distribution and antitumor activity of bexarotene nanocrystals in lung cancer. Drug Dev Ind Pharm 2016; 43:132-141. [PMID: 27588517 DOI: 10.1080/03639045.2016.1225752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study was to develop and evaluate the morphology, biodistribution and antitumor activity of bexarotene nanocrystals delivery system. The morphology was investigated using scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscope and bexarotene nanocrystals exhibited the advantages of making the efficacy more steady and durable compared with control group in lung with less cardiac accumulation as shown by biodistribution studies in vivo. In addition, MTT assay, flow cytometry analysis, observation of morphological changes and apoptotic body demonstrated that bexarotene nanocrystals could significantly enhance the in vitro cytotoxicity and induced G1 cycle arrest and apoptosis against A549 cells. Also, bexarotene nanocrystals had significant antitumor activity in mice bearing A549 cell line. This finding was correlated with both in vitro and in vivo. Thereby, the overall results suggest that the bexarotene nanocrystals represent a potential source of medicine, which made bexarotene nanocrystals a promising candidate for the treatment of lung cancer.
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Affiliation(s)
- Yongjie Wang
- b Department of Pharmaceutics , School of Pharmaceutical Sciences, Shandong University , Jinan , 250012 , P.R. China
| | - Jinghong Rong
- a Department of Pharmaceutics , School of Pharmaceutical Sciences, Liaoning University , Shenyang , 110036 , P.R. China
| | - Jiaozhen Zhang
- c Department of Natural Products Chemistry, Key Lab of Chemical Biology (MOE) , School of Pharmaceutical Sciences, Shandong University , Jinan , 250012 , P.R. China
| | - Yu Liu
- a Department of Pharmaceutics , School of Pharmaceutical Sciences, Liaoning University , Shenyang , 110036 , P.R. China
| | - Xuelian Meng
- a Department of Pharmaceutics , School of Pharmaceutical Sciences, Liaoning University , Shenyang , 110036 , P.R. China
| | - Hejian Guo
- b Department of Pharmaceutics , School of Pharmaceutical Sciences, Shandong University , Jinan , 250012 , P.R. China
| | - Hongsheng Liu
- d Research Center for Computer Simulating and Information Processing of Bio-macromolecules of Liaoning Province , Shenyang , 110036 , P.R. China
| | - Lijiang Chen
- a Department of Pharmaceutics , School of Pharmaceutical Sciences, Liaoning University , Shenyang , 110036 , P.R. China.,d Research Center for Computer Simulating and Information Processing of Bio-macromolecules of Liaoning Province , Shenyang , 110036 , P.R. China
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Yamazaki Y, Painter MM, Bu G, Kanekiyo T. Apolipoprotein E as a Therapeutic Target in Alzheimer's Disease: A Review of Basic Research and Clinical Evidence. CNS Drugs 2016; 30:773-89. [PMID: 27328687 PMCID: PMC5526196 DOI: 10.1007/s40263-016-0361-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is a devastating neurodegenerative disorder that causes progressive cognitive decline. The majority of AD cases are sporadic and late-onset (>65 years old) making it the leading cause of dementia in the elderly. While both genetic and environmental factors contribute to the development of late-onset AD (LOAD), APOE polymorphism is a major genetic risk determinant for LOAD. In humans, the APOE gene has three major allelic variants: ε2, ε3, and ε4, of which APOE ε4 is the strongest genetic risk factor for LOAD, whereas APOE ε2 is protective. Mounting evidence suggests that APOE ε4 contributes to AD pathogenesis through multiple pathways including facilitated amyloid-β deposition, increased tangle formation, synaptic dysfunction, exacerbated neuroinflammation, and cerebrovascular defects. Since APOE modulates multiple biological processes through its corresponding protein apolipoprotein E (apoE), APOE gene and apoE properties have been a promising target for therapy and drug development against AD. In this review, we summarize the current evidence regarding how the APOE ε4 allele contributes to the pathogenesis of AD and how relevant therapeutic approaches can be developed to target apoE-mediated pathways in AD.
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Affiliation(s)
- Yu Yamazaki
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Meghan M Painter
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Takahisa Kanekiyo
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Kikuchi–Fujimoto Disease Associated With Subcutaneous Panniculitis-Like T-Cell Lymphoma. Am J Dermatopathol 2016; 38:e77-80. [DOI: 10.1097/dad.0000000000000486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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O'Suoji C, Welch JJG, Perkins SL, Smith LM, Weitzman S, Simko SJ, Galardy PJ, Bollard CM, Gross TG, Termuhlen AM. Rare Pediatric Non-Hodgkin Lymphomas: A Report From Children's Oncology Group Study ANHL 04B1. Pediatr Blood Cancer 2016; 63:794-800. [PMID: 26728447 DOI: 10.1002/pbc.25881] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/02/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) is a relatively common malignancy in pediatric patients; however, a small subgroup have unusual lymphoma subtypes for the pediatric population. PROCEDURE The Children's Oncology Group Rare and Cutaneous NHL registry's (protocol ANHL 04B1) main objectives were to determine the pathologic, biologic, and clinical features of rare and cutaneous pediatric NHL and establish a bank of centrally reviewed tissue specimens. We report the clinical data, treatment data, and outcome for rare pediatric NHL. RESULTS In 101 lymphomas, there is a 97.8% concordance between the reviewing study pathologists and an 87.6% concordance between the central and institutional pathology review. Samples in the specimen bank include primary tumor tissue that is snap frozen, in paraffin blocks, or H&E-stained and unstained paraffin slides as well as blood, serum, and bone marrow. This descriptive analysis shows that children with pediatric follicular lymphoma, mucosa-associated lymphoid tissue, nodal marginal zone lymphoma, primary cutaneous, primary central nervous system lymphoma, and subcutaneous panniculitis-like T-cell lymphomas have 100% survival at a median of 2 years from enrollment. There are early deaths, mostly from progressive disease, in subjects with peripheral T-cell (not otherwise specified), NKT, and hepatosplenic T-cell lymphomas. CONCLUSIONS This registry provides high-quality biologic specimens with clinical data to investigators working on the biology of these unusual pediatric diseases.
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Affiliation(s)
- Chibuzo O'Suoji
- Division of Pediatric Hematology/Oncology, West Virginia University, Charleston, West Virginia
| | - Jennifer J G Welch
- Division of Pediatric Hematology/Oncology, Hasbro Children's Hospital, Alpert Medical School Brown University, Providence, Rhode Island
| | - Sherrie L Perkins
- Department of Pathology, University of Utah Health Sciences, Salt Lake City, Utah
| | - Lynette M Smith
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Sheila Weitzman
- Division of Pediatric Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen J Simko
- Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Paul J Galardy
- Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, Minnesota
| | - Catherine M Bollard
- Children's National Health System, The George Washington University, Washington, District of Columbia
| | | | - Amanda M Termuhlen
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
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Gupta V, Arava S, Bakhshi S, Vashisht KR, Reddy R, Gupta S. Subcutaneous Panniculitis-Like T-Cell Lymphoma with Hemophagocytic Syndrome in a Child. Pediatr Dermatol 2016; 33:e72-6. [PMID: 26764131 DOI: 10.1111/pde.12776] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) characterized by subcutaneous infiltration of pleomorphic T-cells of the α/β phenotype rarely affects children. Development of hemophagocytic syndrome (HPS) leads to a poor prognosis with this otherwise indolent lymphoma. We report a case of SPTCL in a 5-year-old child complicated by HPS treated successfully with combination chemotherapy. We discuss the potential pitfalls in reaching an early diagnosis and challenges in its management. Previously reported cases of SPTCL with HPS in children are briefly reviewed.
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Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sudheer Arava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Kanya Rani Vashisht
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Reddy
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Wagner G, Rose C, Meyer V, Klemke CD, Back W, Sachse MM. [Subcutaneous panniculitis-like T-cell lymphoma : Two case reports]. DER HAUTARZT 2015; 67:397-402. [PMID: 26676418 DOI: 10.1007/s00105-015-3739-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Histopathology, immunohistochemical, and molecular genetic findings revealed the diagnosis of subcutaneous panniculitis-like T-cell-lymphoma in two patients, aged 44 and 70 years. The clinical morphology of the lymphoma manifestations showed varied significantly. One patient presented with a singular erythematous nodule in the chin region. The other patient suffered from extended plate-like resistances and atrophy of the face, upper arms and left breast. Hemophagocytic syndrome was not present in either patient. Prognosis of subcutaneous panniculitis-like T-cell lymphoma without associated hemophagocytic syndrome is reported to be favorable. Radiotherapy of the singular lesion on the chin and systemic corticosteroids of the extended plaques induced complete remission in both patients.
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Affiliation(s)
- G Wagner
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland.
| | - Ch Rose
- Dermatohistologisches Labor, Lübeck, Deutschland
| | - V Meyer
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland
| | - C-D Klemke
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland
- Hautklinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland
| | - W Back
- Pathologisches Institut Bremerhaven, Bremerhaven, Deutschland
| | - M M Sachse
- Klinik für Dermatologie, Allergologie und Phlebologie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland
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Tachibana M, Shinohara M, Yamazaki Y, Liu CC, Rogers J, Bu G, Kanekiyo T. Rescuing effects of RXR agonist bexarotene on aging-related synapse loss depend on neuronal LRP1. Exp Neurol 2015; 277:1-9. [PMID: 26688581 DOI: 10.1016/j.expneurol.2015.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/18/2015] [Accepted: 12/10/2015] [Indexed: 12/13/2022]
Abstract
Apolipoprotein E (apoE) plays a critical role in maintaining synaptic integrity by transporting cholesterol to neurons through the low-density lipoprotein receptor related protein-1 (LRP1). Bexarotene, a retinoid X receptor (RXR) agonist, has been reported to have potential beneficial effects on cognition by increasing brain apoE levels and lipidation. To investigate the effects of bexarotene on aging-related synapse loss and the contribution of neuronal LRP1 to the pathway, forebrain neuron-specific LRP1 knockout (nLrp1(-/-)) and littermate control mice were administered with bexarotene-formulated diet (100mg/kg/day) or control diet at the age of 20-24 months for 8 weeks. Upon bexarotene treatment, levels of brain apoE and ATP-binding cassette sub-family A member 1 (ABCA1) were significantly increased in both mice. While levels of PSD95, glutamate receptor 1 (GluR1), and N-methyl-d-aspartate receptor NR1 subunit (NR1), which are key postsynaptic proteins that regulate synaptic plasticity, were decreased with aging, they were restored by bexarotene treatment in the brains of control but not nLrp1(-/-) mice. These results indicate that the beneficial effects of bexarotene on synaptic integrity depend on the presence of neuronal LRP1. However, we also found that bexarotene treatment led to the activation of glial cells, weight loss and hepatomegaly, which are likely due to hepatic failure. Taken together, our results demonstrate that apoE-targeted treatment through the RXR pathway has a potential beneficial effect on synapses during aging; however, the therapeutic application of bexarotene requires extreme caution due to its toxic side effects.
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Affiliation(s)
- Masaya Tachibana
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Mitsuru Shinohara
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Yu Yamazaki
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Chia-Chen Liu
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Justin Rogers
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
| | - Takahisa Kanekiyo
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
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Abstract
Abstract
Although all the peripheral T-cell lymphomas are uncommon, there are some entities that are truly rare. Subtypes, such as enteropathy-associated T-cell lymphoma, hepatosplenic T-cell lymphoma, extranodal NK/T-cell lymphoma, and subcutaneous panniculitis-like T-cell lymphoma, have an approximate annual incidence in United States of <500 each. In these very rare subtypes, there is limited data to guide clinical decision-making. As such, our treatment decisions are often based on extrapolation, case series, personal experience, and biases. We summarize the existing data regarding initial management of these entities and compare how that management follows paradigms established for the more common T-cell lymphomas.
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Hu ZL, Sang H, Deng L, Li Z. Subcutaneous Panniculitis-Like T-Cell Lymphoma in Children: A Review of the Literature. Pediatr Dermatol 2015; 32:526-32. [PMID: 25727090 DOI: 10.1111/pde.12452] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a type of skin lymphoma. Pleomorphic T-cells infiltrate the subcutaneous tissue and mimic lobular panniculitis. We report a case occurring in a 12-year-old Chinese boy who presented with multiple indolent erythematous subcutaneous nodules on both extremities without systemic symptoms. He had a protracted course of multiple erythematous subcutaneous nodules for 1 year and underwent biopsy of lesional skin for histology and T-cell receptor (TCR) gene analysis. Histopathology showed infiltration of medium to large atypical pleomorphic cells involving the subcutis with characteristic rimming of fat spaces. TCR gene rearrangement shows monoclonal rearrangements of the TCR β and γ chains. Immunophenotypic studies showed that CD3, CD4, and CD8 were strongly and diffusely positive in lesional cells and that CD56 was focally positive. In contrast, these cells were negative for CD20, CD30, and CD68. The combined morphology, characteristic histologic features, and positive T-CR gene rearrangement supported a diagnosis of SPTCL. He is being treated with combination chemotherapy of cyclophosphamide, doxorubicin, vincristine, and prednisolone.
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Affiliation(s)
- Zhi Li Hu
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hong Sang
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lin Deng
- Department of Dermatology, Jinling Hospital, Southern Medical University, Nanjing, China
| | - ZongHui Li
- Department of Dermatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Sandlund JT, Perkins SL. Uncommon non-Hodgkin lymphomas of childhood: pathological diagnosis, clinical features and treatment approaches. Br J Haematol 2015; 169:631-46. [PMID: 25851546 DOI: 10.1111/bjh.13359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We provide a review of the pathological and clinical features for uncommon B-cell and T-cell lymphomas of childhood with a specific focus on advances in treatment approaches and outcomes. There is clearly a need for prospective investigation of both the clinical and biological features of the uncommon non-Hodgkin lymphoma subtypes in childhood. These results should lead to more uniform and more effective treatment approaches.
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Affiliation(s)
- John T Sandlund
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Sherrie L Perkins
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
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Corradini P, Marchetti M, Barosi G, Billio A, Gallamini A, Pileri S, Pimpinelli N, Rossi G, Zinzani P, Tura S. SIE-SIES-GITMO Guidelines for the management of adult peripheral T- and NK-cell lymphomas, excluding mature T-cell leukaemias. Ann Oncol 2014; 25:2339-2350. [DOI: 10.1093/annonc/mdu152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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38
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Maliniemi P, Hahtola S, Ovaska K, Jeskanen L, Väkevä L, Jäntti K, Stadler R, Michonneau D, Fraitag S, Hautaniemi S, Ranki A. Molecular characterization of subcutaneous panniculitis-like T-cell lymphoma reveals upregulation of immunosuppression- and autoimmunity-associated genes. Orphanet J Rare Dis 2014; 9:160. [PMID: 25928531 PMCID: PMC4320460 DOI: 10.1186/s13023-014-0160-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/09/2014] [Indexed: 12/21/2022] Open
Abstract
Background Subcutaneous panniculitis-like T cell lymphomas represent a rare and difficult to diagnose entity of cutaneous T cell lymphomas. SPTL affects predominantly young adults and presents with multifocal subcutaneous nodules and frequently associated autoimmune features. The pathogenesis of SPTL is not completely understood. Methods The aim of this study was to unravel molecular pathways critical to the SPTL pathogenesis. Therefore, we analyzed 23 skin samples from 20 newly diagnosed SPTL patients and relevant control samples of adipose and non-malignant panniculitis tissue by using gene expression microarray, quantitative PCR, and two-colour immunohistochemistry. Results Interestingly, indoleamine 2,3-dioxygenase (IDO-1), an immunotolerance-inducing enzyme, was among the most highly overexpressed genes in all comparisons. The expression of Th1-specific cytokines, known to be associated with autoimmune inflammation (i.e. IFNG, CXCR3, CXCL9, CXCL10, CXCL11, and CCL5), were also significantly increased. Confirmed using immunohistochemistry, the morphologically malignant lymphocytes expressed CXCR3 and CXCL9. IDO-1 expression was found both in some morphologically malignant lymphocytes rimming the adipocytes and in surrounding CD11c− CD68− cells but not in CD11c+ dendritic cells in the microenvironment. The proportion of FoxP3+ cells in SPTL exceeded that in the benign panniculitis samples. Conclusions Our results indicate that the up regulation of the tolerogenic IDO-1 together with the up regulation of IFNG, CXCR3 ligands, and CCL5 are features of SPTL lesions. We anticipate that the IFNG-inducible IDO-1 expression contributes to the formation of an immunosuppressive microenvironment, favorable for the malignant T cells. This study provides a relevant molecular basis for further studies exploring novel therapeutic means for subcutaneous T cell lymphoma. Electronic supplementary material The online version of this article (doi:10.1186/s13023-014-0160-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pilvi Maliniemi
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Sonja Hahtola
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Kristian Ovaska
- Systems Biology Laboratory, Institute of Biomedicine and Genome-Scale Biology Program, University of Helsinki, Helsinki, Finland.
| | - Leila Jeskanen
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Liisa Väkevä
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Kirsi Jäntti
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Rudolf Stadler
- Johannes-Wesling-Klinikum Minden, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Hannover, Minden, Germany.
| | - David Michonneau
- Institut Pasteur, Département d'immunologie, Equipe Dynamique des réponses immunes, 25 rue du Docteur Roux, 75015, Paris, France.
| | - Sylvie Fraitag
- Service d'anatomie et de cytologie pathologiques, Hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743, Paris Cedex 15, France.
| | - Sampsa Hautaniemi
- Systems Biology Laboratory, Institute of Biomedicine and Genome-Scale Biology Program, University of Helsinki, Helsinki, Finland.
| | - Annamari Ranki
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
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Qi L, Guo Y, Luan J, Zhang D, Zhao Z, Luan Y. Folate-modified bexarotene-loaded bovine serum albumin nanoparticles as a promising tumor-targeting delivery system. J Mater Chem B 2014; 2:8361-8371. [DOI: 10.1039/c4tb01102c] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Abstract
Gamma-delta T-cell lymphomas are aggressive and rare diseases originating from gamma-delta lymphocytes. These cells, which naturally play a role in the innate, non-specific immune response, develop from thymic precursor in the bone marrow, lack the major histocompatibility complex restrictions and can be divided into two subpopulations: Vdelta1, mostly represented in the intestine, and Vdelta2, prevalently located in the skin, tonsils and lymph nodes. Chronic immunosuppression such as in solid organ transplanted subjects and prolonged antigenic exposure are probably the strongest risk factors for the triggering of lymphomagenesis. Two entities are recognised by the 2008 WHO Classification: hepatosplenic gamma-delta T-cell lymphoma (HSGDTL) and primary cutaneous gamma-delta T-cell lymphoma (PCGDTL). The former is more common among young males, presenting with B symptoms, splenomegaly and thrombocytopenia, usually with the absence of nodal involvement. Natural behaviour of HSGDTL is characterised by low response rates, poor treatment tolerability, common early progression of disease and disappointing survival figures. PCGDTL accounts for <1% of all primary cutaneous lymphomas, occurring in adults with relevant comorbidities. Cutaneous lesions may vary, but its clinical behaviour is usually aggressive and long-term survival is anecdotal. Available literature on gamma-delta T-cell lymphomas is fractioned, mostly consisting of case reports or small cumulative series. Therefore, clinical suspicion and diagnosis are usually delayed, and therapeutic management remains to be established. This review critically analyses available evidence on diagnosis, staging and behaviour of gamma-delta T-cell lymphomas, provides recommendations for therapeutic management in routine practice and discusses relevant unmet clinical needs for future studies.
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Affiliation(s)
- Marco Foppoli
- Unit of Lymphoid Malignancies, Division of Onco-Hematological Medicine, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy
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Li D, Huang L, Guo B, Wen Q, Wang W, Luo J, Fan S. Primary cutaneous γδ-T-cell lymphoma (CGD-TCL) with unilateral lower extremity swelling as first-onset symptom: a rare case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:5337-5342. [PMID: 25197420 PMCID: PMC4152110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/01/2014] [Indexed: 06/03/2023]
Abstract
Primary cutaneous γδ-T-cell lymphoma (CGD-TCL) is a distinct disease entity which is an extremely rare neoplasm with poor prognosis, characterized by the γ/δ T-cell receptor expression on atypical lymphocytes. We report the case of a 42-year-old man who first presented with a swelling in the extremities and subsequent appeared subcutaneous nodule over the body. In order to clarify the diagnosis, a biopsy of subcutaneous nodule for pathology had been done. CGD-TCL was diagnosed by histopathology, immunophenotype, in situ hybridization and analysis of TCRγ genes rearrangement. The patient was treated with chemotherapeutic regimens-CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone). After one period of chemotherapy, subcutaneous nodules became small, even disappeared, swelling and ulcer in the left pedal gone away gradually. One month later after first chemotherapy, tumor relapsed with lesions growing back rapidly, also showed disease in double lungs. The patient was just 10-month survival time from the onset. To our knowledge, this case is the first report of CGD-TCL with unilateral lower extremity swelling as the first-onset symptom. If patient is presented the first symptoms such as swelling of extremities, especially when ulceration appears, it is of great significance to be considerate about the possibility of CGD-TCL.
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Affiliation(s)
- Duo Li
- Department of Pathology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
| | - Lijun Huang
- Department of Hematology and Oncology, the Affiliated Tumor Hospital, Central South UniversityChangsha, Hunan, China
| | - Bin Guo
- Department of Anesthesiology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
| | - Qiuyuan Wen
- Department of Pathology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
| | - Weiyuan Wang
- Department of Pathology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
| | - Jiadi Luo
- Department of Pathology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
| | - Songqing Fan
- Department of Pathology, the Second Xiangya Hospital, Central South UniversityChangsha, Hunan, China
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Abstract
Bexarotene is a retinoid that specifically binds retinoid X receptors and has numerous effects on cellular growth and differentiation. It is approved for the treatment of cutaneous T cell lymphoma both topically and systemically. Adverse effects include hyperlipidemia, central hypothyroidism, and neutropenia with bexarotene capsules, and an irritant dermatitis with bexarotene gel. With aggressive management of these potential side effects, bexarotene is an additional option in the armamentarium for management of cutaneous T cell lymphoma.
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Affiliation(s)
- Courtney R Schadt
- Medicine (Dermatology), University of Louisville, Louisville, Kentucky
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Li L, Liu Y, Wang J, Chen L, Zhang W, Yan X. Preparation, in vitro and in vivo evaluation of bexarotene nanocrystals with surface modification by folate-chitosan conjugates. Drug Deliv 2014; 23:79-87. [DOI: 10.3109/10717544.2014.904455] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Li Li
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
| | - Yu Liu
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
| | - Jinjing Wang
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
| | - Lijiang Chen
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
| | - Wenjun Zhang
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
| | - Xichen Yan
- School of Pharmaceutical Sciences, Liaoning University, Shengyang, Liaoning Province, China
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Khan M, Scarisbrick JJ. Pediatric cutaneous lymphomas: rare diseases requiring expert diagnosis and management. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.2013.838041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Chen L, Wang Y, Zhang J, Hao L, Guo H, Lou H, Zhang D. Bexarotene nanocrystal-Oral and parenteral formulation development, characterization and pharmacokinetic evaluation. Eur J Pharm Biopharm 2013; 87:160-9. [PMID: 24333772 DOI: 10.1016/j.ejpb.2013.12.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 11/28/2013] [Accepted: 12/08/2013] [Indexed: 12/26/2022]
Abstract
Bexarotene (Targretin®) is a synthetic retinoid that selectively activates the retinoid X receptor subfamily of retinoid receptors and exhibits potent anti-tumor activity. However, the poor solubility and bioavailability limit its application. The main aim of this study is to investigate the potential of oral and parenteral nanocrystals in enhancing the bioavailability of bexarotene. In this work, the orthogonal design was used to screen the optimum stabilizers and precipitation-combined microfluidization method was employed to obtain the optimal nanocrystals. According to DSC, X-ray diffraction analysis and Raman examination, the nanocrystals were still in crystalline state after the preparation procedure. By reducing the particle size, the in vitro dissolution rate of bexarotene was increased significantly. The in vivo test was carried out in rats and pharmacokinetic parameters of the bexarotene solution and bexarotene nanocrystals were compared after gavage and intravenous administration. The higher AUC and lower Cmax indicated that oral bexarotene nanocrystals significantly increased the bioavailability of bexarotene and decreased its side effects. Compared to the oral nanocrystals, the intravenous nanocrystals cut losses and increased bioavailability because of the absence of first pass effect and enterohepatic circulation.
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Affiliation(s)
- Lijiang Chen
- Department of Natural Products Chemistry, Key Lab of Chemical Biology (MOE), School of Pharmaceutical Sciences, Shandong University, Jinan, PR China; Department of Pharmaceutics, School of Pharmaceutical Sciences, Liaoning University, Shenyang, PR China
| | - Yongjie Wang
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Liaoning University, Shenyang, PR China
| | - Jiaozhen Zhang
- Department of Natural Products Chemistry, Key Lab of Chemical Biology (MOE), School of Pharmaceutical Sciences, Shandong University, Jinan, PR China
| | - Leilei Hao
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Shandong University, Jinan, PR China
| | - Hejian Guo
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Shandong University, Jinan, PR China
| | - Hongxiang Lou
- Department of Natural Products Chemistry, Key Lab of Chemical Biology (MOE), School of Pharmaceutical Sciences, Shandong University, Jinan, PR China.
| | - Dianrui Zhang
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Shandong University, Jinan, PR China.
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Willemze R, Hodak E, Zinzani P, Specht L, Ladetto M. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi149-54. [DOI: 10.1093/annonc/mdt242] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pileri A, Delfino C, Grandi V, Pimpinelli N. Role of bexarotene in the treatment of cutaneous T-cell lymphoma: the clinical and immunological sides. Immunotherapy 2013; 5:427-33. [PMID: 23557425 DOI: 10.2217/imt.13.15] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group of lymphoid neoplasms. The incidence of CTCLs has risen over the last three decades. The most common CTCLs are mycosis fungoides and Sèzary syndrome. Therapies for CTCLs are various and range from skin-directed therapy to chemotherapy. Retinoids have been used in CTCL treatment since the 1980s with good results. Bexarotene is the first retinoid approved by the US FDA for CTCL therapy. Since then, numerous experiences of both its efficacy and mechanism of action have been reported. The aim of this paper is to review bexarotene action on CTCLs, as well as to highlight its immunological targets.
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Affiliation(s)
- Alessandro Pileri
- Dermatology, Department of Specialised, Experimental & Diagnostic Medicine, University of Bologna, Italy.
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Huppmann AR, Xi L, Raffeld M, Pittaluga S, Jaffe ES. Subcutaneous panniculitis-like T-cell lymphoma in the pediatric age group: a lymphoma of low malignant potential. Pediatr Blood Cancer 2013; 60:1165-70. [PMID: 23382035 PMCID: PMC6324177 DOI: 10.1002/pbc.24462] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 12/10/2012] [Indexed: 11/08/2022]
Abstract
BACKGROUND Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare neoplasm of mature αβ cytotoxic T-cells. Most commonly occurring in young adults, few reports are described in children. A separate analysis of a significant cohort of pediatric patients has not previously been performed. PROCEDURE We analyzed the pathology including molecular results as well as available clinical data from 16 pediatric patients (age 5 months to 21 years) who had a total of 19 biopsies submitted to the National Cancer Institute from 1999 to 2011. This included 6 males and 10 females. RESULTS Most patients (10/16, 62.5%) had multiple skin lesions at the time of biopsy. Histologic features included rimming of adipocytes by atypical lymphocytes, fat necrosis, and karyorrhectic debris. Four biopsies showed only partial involvement by lymphoma; and plasma cells were identified in 14/19 (74%) cases, including three in which they were focally prominent. The neoplastic cells in general were positive for CD3, CD8, TIA-1, and βF1 and were negative for CD4 and CD56. CD5 expression was weak to negative in 5/8 cases (63%). A clonal T-cell receptor gene rearrangement was demonstrated in 11/17 (65%). Patients were treated with a variety of agents. While 5/9 (56%) patients had evidence of recurrent skin lesions, no deaths were attributed to disease for the seven patients with follow-up information. CONCLUSIONS Pediatric SPTCL shares many clinical and pathologic features with adult SPTCL. The presence of partial involvement or admixed plasma cells makes the differential diagnosis with reactive conditions challenging in some cases.
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Affiliation(s)
| | | | | | | | - Elaine S. Jaffe
- Correspondence to: Dr. Elaine S. Jaffe, MD, National Institutes of Health, National Cancer Institute, 10 Center Drive Bldg 10, Room 2B42, Bethesda, MD 20892.
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Jaffe ES, Nicolae A, Pittaluga S. Peripheral T-cell and NK-cell lymphomas in the WHO classification: pearls and pitfalls. Mod Pathol 2013; 26 Suppl 1:S71-87. [PMID: 23281437 PMCID: PMC6324567 DOI: 10.1038/modpathol.2012.181] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Peripheral T-cell and NK-cell lymphomas are functionally, pathologically, and clinically complex. Most nodal T-cell lymphomas belong to the adaptive immune system, whereas many extranodal T-cell and NK-cell lymphomas are derived from innate immune cells. The pathological manifestations often reflect the functional attributes of the neoplastic cells. Several forms of peripheral T-cell lymphoma are derived from T-follicular helper cells (T(FH)), and include angioimmunoblastic T-cell lymphoma, the follicular variant of peripheral T-cell lymphoma, not otherwise specified, and primary cutaneous small/medium CD4-positive T-cell lymphoma. T(FH)-derived neoplasms are often associated with atypical and clonal B-cell proliferations, which take a number of forms, sometimes mimicking classical Hodgkin's lymphoma, and sometimes showing marked plasmacytic differentiation. Most extranodal T-cell lymphomas are cytotoxic and often arise in mucosal-associated sites. They can be derived from either αβ or γδ cytotoxic T cells, and include subcutaneous panniculitis-like T-cell lymphoma, and enteropathy-associated T-cell lymphomas, both Type I and Type II. Type I enteropathy-associated lymphomas occur in association with celiac disease, whereas Type II lymphomas are more often sporadic. For some T-cell lymphomas, such as hepatosplenic T-cell lymphoma, immunophenotypic heterogeneity is seen within a single disease entity. New data are emerging on the molecular pathogenesis of T-cell and NK-cell lymphoma, but most tumor types remain poorly characterized.
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Affiliation(s)
- Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, 10 Center Drive, Bethesda, MD 20892, USA.
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