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Dammacco R, Lisch W, Kivelä TT, Terpos E, Kastritis E, Sisto D, Mavilio A, Ria R, Alessio G, Vacca A, Dammacco F. The Spectrum of Ocular Manifestations in Patients with Waldenström's Macroglobulinemia. Ocul Immunol Inflamm 2022; 30:1659-1668. [PMID: 34270382 DOI: 10.1080/09273948.2021.1933068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the ocular manifestations in 91 Waldenström's macroglobulinemia (WM) patients. METHODS Retrospective, cross-sectional, observational analysis. RESULTS Ocular impairments, detected in 19 patients, included flame-shaped hemorrhages, venous sausaging, papilledema, macular detachments, or central retinal vein occlusion in 16 patients; paraproteinemic keratopathy in 2; and a CANOMAD syndrome in 1. Best-corrected visual acuity was ≥0.5 logMAR units in 11 of 38 eyes. Intraocular pressure was increased in seven eyes. Genetic analysis in seven patients showed a mutation in the MYD88 gene in six patients and a nonsense mutation in the CXCR4 gene in five patients. Plasmapheresis followed by chemotherapy with or without the addition of rituximab resulted in improvement or normalization of the ophthalmological findings in 15 patients. CONCLUSION The ocular manifestations of WM are protean and potentially sight threatening. Recent advances in genomic profiling and chemotherapy have remarkably improved the hematological and ophthalmological outcomes of these patients.
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Affiliation(s)
- Rosanna Dammacco
- Department of Ophthalmology and Neuroscience, University of Bari "Aldo Moro", Medical School, Bari, Italy
| | - Walter Lisch
- Department of Ophthalmology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Tero T Kivelä
- Department of Ophthalmology, University of Helsinki, Helsinki, Finland
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian School of Medicine, University of Athens, Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian School of Medicine, University of Athens, Athens, Greece
| | - Dario Sisto
- Department of Ophthalmology and Neuroscience, University of Bari "Aldo Moro", Medical School, Bari, Italy
| | - Alberto Mavilio
- Social Health District, Glaucoma Center, Azienda Sanitaria Locale, Brindisi, Italy
| | - Roberto Ria
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Medical School, Bari, Italy
| | - Giovanni Alessio
- Department of Ophthalmology and Neuroscience, University of Bari "Aldo Moro", Medical School, Bari, Italy
| | - Angelo Vacca
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Medical School, Bari, Italy
| | - Franco Dammacco
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Medical School, Bari, Italy
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Miyata R, Miyabe C, Fukuya Y, Tanaka N, Tanaka J, Ishiguro N. Skin lesions as the initial sign of systemic relapse in a case of Waldenström's macroglobulinemia. Int J Dermatol 2021; 61:e278-e280. [PMID: 34708872 DOI: 10.1111/ijd.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ryujin Miyata
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Chie Miyabe
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuko Fukuya
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Norina Tanaka
- Department of Hematology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Naoko Ishiguro
- Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
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Xue C, Wang X, Zhang L, Qu Q, Zhang Q, Jiang Y. Ibrutinib in B-cell lymphoma: single fighter might be enough? Cancer Cell Int 2020; 20:467. [PMID: 33005100 PMCID: PMC7523373 DOI: 10.1186/s12935-020-01518-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022] Open
Abstract
Background In recent years, the B cell receptor (BCR) signaling pathway has become a "hot point" because it plays a critical role in B-cell proliferation and function. Bruton's tyrosine kinase (BTK) is overexpressed in many subtypes of B-cell lymphoma as a downstream kinase in the BCR signaling pathway. Ibrutinib, the first generation of BTK inhibitor, has shown excellent antitumor activity in both indolent and aggressive B-cell lymphoma. Main body Ibrutinib monotherapy has been confirmed to be effective with a high response rate (RR) and well-tolerated in many B-cell lymphoma subgroups. To achieve much deeper and faster remission, combination strategies contained ibrutinib were conducted to evaluate their synergistic anti-tumor effect. Conclusions For patients with indolent B-cell lymphoma, most of them respond well with ibrutinib monotherapy. Combination strategies contained ibrutinib might be a better choice to achieve deeper and faster remission in the treatment of aggressive subtypes of B-cell lymphoma. Further investigations on the long-term efficacy and safety of the ibrutinib will provide novel strategies for individualized treatment of B-cell lymphoma.
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Affiliation(s)
- Chao Xue
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 China.,School of Medicine, Shandong University, Jinan, 250012 Shandong China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, 250021 Jinan, Shandong China
| | - Lingyan Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, 250021 Jinan, Shandong China
| | - Qingyuan Qu
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 China
| | - Qian Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, 250021 Jinan, Shandong China
| | - Yujie Jiang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324, Jingwu Road, 250021 Jinan, Shandong China
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Abstract
Lymphoma-related amyloidosis is a rare entity. Systemic AL amyloidosis is generally caused by an underlying plasma cell clone in the bone marrow with an intact monoclonal immunoglobulin G (IgG) or IgA protein. The rarity of the lymphoma-related amyloidosis makes the generation of data in randomized trials and the determination of the optimal treatment almost impossible. Therefore, treatment recommendations discussed here are based on either retrospective or small prospective trials of single centers.
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Varettoni M, Boveri E, Zibellini S, Tedeschi A, Candido C, Ferretti VV, Rizzo E, Doni E, Merli M, Farina L, Goldaniga M, Gallì A, Rattotti S, Frustaci AM, Deodato M, Bandiera L, Isimbaldi G, Uccella S, Cabras AD, Gianelli U, Baldini L, Paulli M, Arcaini L. Clinical and molecular characteristics of lymphoplasmacytic lymphoma not associated with an IgM monoclonal protein: A multicentric study of the Rete Ematologica Lombarda (REL) network. Am J Hematol 2019; 94:1193-1199. [PMID: 31378966 DOI: 10.1002/ajh.25600] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/16/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022]
Abstract
Lymphoplasmacytic lymphoma (LPL) is usually associated with a serum IgM paraprotein, corresponding to Waldenström's Macroglobulinemia (WM). Cases presenting with IgG or IgA, or without a monoclonal protein are extremely rare. We analyzed clinical characteristics, frontline treatment, and the outcome of 45 patients with non-IgM LPL, and compared them with a control group of WM patients. The median age was similar, with significantly higher prevalence of females in non-IgM LPL, than in WM patients (60% vs 39%, P = .016). Patients with non-IgM LPL more frequently presented with lymphadenopathies (53% vs 15%, P < .001), splenomegaly (22% vs 8%, P = .015) or extranodal involvement (20% vs 8%, P = .05). In non-IgM LPL a serum monoclonal protein and bone marrow infiltration were less common than in WM patients (69% and 84% of cases respectively, P < .001 for both comparisons). The MYD88 (L265P) mutation was found in 8/19 patients using allele-specific polymerase chain reaction. A CXCR4 mutation was found in 4/17 cases using Sanger. In 16 patients we performed targeted next-generation sequencing of genes MYD88, CXCR4, ARID1-A, KMT2D, NOTCH2, TP53, PRDM1, CD79B, TRAF3, MYBBP1A, TNFAIP3. Seven patients (44%) had a MYD88 mutation (S219C in one), four (25%) a CXCR4 mutation, three (19%) a KMT2D mutation, one (6%) a TP53 mutation and one (6%) a TRAF3 mutation. With a median follow-up of 55.7 months, 36 non-IgM LPL patients (80%) were treated. Non-IgM LPL patients received more frequently anthracycline-containing regimens, as compared with WM patients, who mainly received alkylating-based therapies. Five-year overall survival (OS) was 84%, similar to that of WM patients.
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Affiliation(s)
- Marzia Varettoni
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Emanuela Boveri
- Anatomic Pathology SectionFondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Silvia Zibellini
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
| | | | - Chiara Candido
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
| | | | | | - Elisa Doni
- Division of HematologyOspedale San Gerardo ‐ Università Degli Studi Milano Bicocca Monza Italy
| | - Michele Merli
- Division of HematologyOspedale di Circolo & Fondazione Macchi Varese Italy
| | - Lucia Farina
- Division of HematologyFondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Maria Goldaniga
- Division of HematologyIRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena Milan Italy
| | - Anna Gallì
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
| | - Sara Rattotti
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
| | | | - Marina Deodato
- Department of HematologyNiguarda Cancer Center, Niguarda Hospital Italy
| | - Laura Bandiera
- Department of Laboratory MedicineNiguarda Ca' Granda Hospital Milan Italy
| | - Giuseppe Isimbaldi
- Department of PathologyUniversity Milan Bicocca, San Gerardo Hospital Monza Italy
| | - Silvia Uccella
- Unit of Pathology, Department of Medicine and SurgeryUniversity of Insubria Varese Italy
| | - Antonello Domenico Cabras
- Department of Pathology and Laboratory MedicineFondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Umberto Gianelli
- Division of PathologyUniversity of Milan, IRCCS Ca' Granda‐Maggiore Policlinico Hospital Foundation Milan Italy
| | - Luca Baldini
- Division of HematologyIRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena Milan Italy
| | - Marco Paulli
- Anatomic Pathology SectionFondazione IRCCS Policlinico San Matteo Pavia Italy
- Department of Molecular MedicineUniversity of Pavia Pavia Italy
| | - Luca Arcaini
- Division of HematologyFondazione IRCCS Policlinico San Matteo Pavia Italy
- Department of Molecular MedicineUniversity of Pavia Pavia Italy
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Platts-Mills TAE. Dr. Kimishige Ishizaka: 1926-2018: The discovery of IgE and the revolution in the study of allergic disease. Ann Allergy Asthma Immunol 2018; 122:2-7. [PMID: 30287256 DOI: 10.1016/j.anai.2018.09.464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 01/22/2023]
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The Pathologic Basis for the Classification of Non-Hodgkin and Hodgkin Lymphomas. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00073-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Mazzucchelli M, Frustaci AM, Deodato M, Cairoli R, Tedeschi A. Waldenstrom's Macroglobulinemia: An Update. Mediterr J Hematol Infect Dis 2018; 10:e2018004. [PMID: 29326801 PMCID: PMC5760071 DOI: 10.4084/mjhid.2018.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/13/2017] [Indexed: 12/19/2022] Open
Abstract
Waldenstrom Macroglobulinemia is a rare lymphoproliferative disorder with distinctive clinical features. Diagnostic and prognostic characterisation in WM significantly changed with the discovery of two molecular markers: MYD88 and CXCR4. Mutational status of these latter influences both clinical presentation and prognosis and demonstrated therapeutic implications. Treatment choice in Waldenstrom disease is strictly guided by patients age and characteristics, specific goals of therapy, the necessity for rapid disease control, the risk of treatment-related neuropathy, disease features, the risk of immunosuppression or secondary malignancies and potential for future autologous stem cell transplantation. The therapeutic landscape has expanded during the last years and the approval of ibrutinib, the first drug approved for Waldenstrom Macroglobulinemia, represents a significant step forward for a better management of the disease.
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Affiliation(s)
- Maddalena Mazzucchelli
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Anna Maria Frustaci
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Marina Deodato
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Roberto Cairoli
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Alessandra Tedeschi
- Department of Haematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano
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Abstract
Waldenstrom Macroglobulinemia is a rare lymphoproliferative disorder with distinctive clinical features. Diagnostic and prognostic characterisation in WM significantly changed with the discovery of two molecular markers: MYD88 and CXCR4. Mutational status of these latter influences both clinical presentation and prognosis and demonstrated therapeutic implications. Treatment choice in Waldenstrom disease is strictly guided by patients age and characteristics, specific goals of therapy, the necessity for rapid disease control, the risk of treatment-related neuropathy, disease features, the risk of immunosuppression or secondary malignancies and potential for future autologous stem cell transplantation. The therapeutic landscape has expanded during the last years and the approval of ibrutinib, the first drug approved for Waldenstrom Macroglobulinemia, represents a significant step forward for a better management of the disease.
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10
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Lymphoma of the eyelid. Surv Ophthalmol 2017; 62:312-331. [DOI: 10.1016/j.survophthal.2016.11.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 12/20/2022]
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11
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Singh G. Serum Free Light Chain Assay and κ/λ Ratio: Performance in Patients With Monoclonal Gammopathy-High False Negative Rate for κ/λ Ratio. J Clin Med Res 2016; 9:46-57. [PMID: 27924175 PMCID: PMC5127215 DOI: 10.14740/jocmr2802w] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2016] [Indexed: 12/24/2022] Open
Abstract
Background Serum free light chain assay (SFLCA) and κ/λ ratio, and protein electrophoretic methods are used in the diagnosis and monitoring of monoclonal gammopathies. Methods Results for serum free light chains, serum and urine protein electrophoreses and immunofixation electrophoreses in 468 patients with a diagnosis of monoclonal gammopathy were compared. The results of the two methods were graded as concordant, non-concordant or discordant with the established diagnoses to assess the relative performance of the methods. Results of κ/λ ratio in samples with monoclonal protein detectable by electrophoretic methods were also analyzed. Results Protein electrophoreses results were concordant with the established diagnoses significantly more often than κ/λ ratio. The false negative rate for κ/λ ratio was higher than that for electrophoretic methods. κ/λ ratio was falsely negative in about 27% of the 1,860 samples with detectable monoclonal immunoglobulin. The false negative rate was higher in lesions with lambda chains (32%) than those with kappa chains (24%). The false negative rate for κ/λ ratio was over 55% in samples with monoclonal gammopathy of undetermined significance. Even at first encounter, the false negative rates for κ/λ ratios for monoclonal gammopathy of undetermined significance, smoldering myeloma and multiple myeloma were 66.98%, 23.08%, and 30.15%, respectively, with false negative rate for lambda chain lesions being higher. Conclusions Electrophoretic studies of serum and urine are superior to SFLCA and κ/λ ratio. Abnormal κ/λ ratio, per se, is not diagnostic of monoclonal gammopathy. A normal κ/λ ratio does not exclude monoclonal gammopathy. False negative rates for lesions with lambda chain are higher than those for lesions with kappa chains. Electrophoretic studies of urine are underutilized. Clinical usefulness and medical necessity of SFLCA and κ/λ ratio is of questionable value in routine clinical testing.
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Affiliation(s)
- Gurmukh Singh
- Department of Pathology, Division of Clinical Pathology, Medical College of Georgia at Augusta University, 1120 15th Street, BI 2008A, Augusta, GA 30912, USA.
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Clinical Validation of a CXCR4 Mutation Screening Assay for Waldenstrom Macroglobulinemia. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2016; 16:395-403.e1. [DOI: 10.1016/j.clml.2016.04.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/05/2016] [Accepted: 04/26/2016] [Indexed: 11/21/2022]
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13
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King RL, Gonsalves WI, Ansell SM, Greipp PT, Frederick LA, Viswanatha DS, He R, Kyle RA, Gertz MA, Kapoor P, Morice WG, Howard MT. Lymphoplasmacytic Lymphoma With a Non-IgM Paraprotein Shows Clinical and Pathologic Heterogeneity and May Harbor MYD88 L265P Mutations. Am J Clin Pathol 2016; 145:843-51. [PMID: 27329639 DOI: 10.1093/ajcp/aqw072] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Lymphoplasmacytic lymphoma (LPL) with non-immunoglobulin M (IgM) paraproteinemia remains poorly understood. The goal of this study was to investigate the clinicopathologic features of LPL in the bone marrow in patients with immunoglobulin G (IgG) or immunoglobulin A (IgA) paraproteins and evaluate MYD88 L265P mutation status to determine the relationship of these cases to Waldenström macroglobulinemia (WM). METHODS Bone marrows from LPL cases with IgG or IgA paraproteins diagnosed between January 1, 2007, and June 30, 2014, were retrieved from the clinical archive. Clinicopathologic features were retrospectively reviewed. MYD88 L265P mutation status was assessed by allele-specific polymerase chain reaction prospectively on all cases. RESULTS Of 27 cases, four were reclassified as multiple myeloma, all MYD88 mutation negative. MYD88 L265P mutations were present in 10 (43%) of 23 remaining cases. No association between MYD88 status and bone marrow morphologic or phenotypic features, including the presence of Dutcher bodies, mast cells, expression of CD19 by plasma cells, or hemosiderin, was identified, although these features were present in a subset of cases, similar to WM. Clinical features of WM such as hyperviscosity were uncommon in this group and did not correlate with MYD88 status. CONCLUSIONS Non-IgM LPLs are a clinically and pathologically heterogeneous group and often harbor MYD88 L265P mutation, albeit at a lower rate than classic WM. MYD88 status does not correlate with any specific pathologic or clinical manifestations.
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Affiliation(s)
| | | | | | | | | | | | - Rong He
- From the Division of Hematopathology
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Abstract
PURPOSE To determine whether Myd88 L265P mutations occur in diffuse large B-cell vitreoretinal lymphomas. METHODS The formalin-fixed paraffin-embedded cells from three patients with classic clinical findings of vitreoretinal lymphoma that also had histologic confirmation were evaluated using a validated amplification-refractory mutation system polymerase chain reaction to determine the presence of the mutation. RESULTS The 74 ± 2 base pair product seen from the mutated Myd-88 protein was noted in 2 of the 3 cases. CONCLUSION Myd-88 L265P constitutive activating mutations are present in at least some cases of the diffuse large B-cell lymphoma form of vitreoretinal lymphoma. Further studies on the incidence of this mutation in retinal lymphomas are warranted.
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Phase I/II trial of everolimus in combination with bortezomib and rituximab (RVR) in relapsed/refractory Waldenstrom macroglobulinemia. Leukemia 2015; 29:2338-46. [DOI: 10.1038/leu.2015.164] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/07/2015] [Accepted: 05/15/2015] [Indexed: 12/17/2022]
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Leblebjian H, Noonan K, Paba-Prada C, Treon SP, Castillo JJ, Ghobrial IM. Cyclophosphamide, bortezomib, and dexamethasone combination in waldenstrom macroglobulinemia. Am J Hematol 2015; 90:E122-3. [PMID: 25703132 DOI: 10.1002/ajh.23985] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 02/17/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Houry Leblebjian
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Kimberly Noonan
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Claudia Paba-Prada
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Steven P. Treon
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Jorge J. Castillo
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Irene M. Ghobrial
- Harvard Medical School; Dana-Farber Cancer Institute; Boston Massachusetts
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