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Venturutti L, Rivas MA, Pelzer BW, Flümann R, Hansen J, Karagiannidis I, Xia M, McNally DR, Isshiki Y, Lytle A, Teater M, Chin CR, Meydan C, Knittel G, Ricker E, Mason CE, Ye X, Pan-Hammarström Q, Steidl C, Scott DW, Reinhardt HC, Pernis AB, Béguelin W, Melnick AM. An Aged/Autoimmune B-cell Program Defines the Early Transformation of Extranodal Lymphomas. Cancer Discov 2023; 13:216-243. [PMID: 36264161 PMCID: PMC9839622 DOI: 10.1158/2159-8290.cd-22-0561] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/26/2022] [Accepted: 10/17/2022] [Indexed: 01/17/2023]
Abstract
A third of patients with diffuse large B-cell lymphoma (DLBCL) present with extranodal dissemination, which is associated with inferior clinical outcomes. MYD88L265P is a hallmark extranodal DLBCL mutation that supports lymphoma proliferation. Yet extranodal lymphomagenesis and the role of MYD88L265P in transformation remain mostly unknown. Here, we show that B cells expressing Myd88L252P (MYD88L265P murine equivalent) activate, proliferate, and differentiate with minimal T-cell costimulation. Additionally, Myd88L252P skewed B cells toward memory fate. Unexpectedly, the transcriptional and phenotypic profiles of B cells expressing Myd88L252P, or other extranodal lymphoma founder mutations, resembled those of CD11c+T-BET+ aged/autoimmune memory B cells (AiBC). AiBC-like cells progressively accumulated in animals prone to develop lymphomas, and ablation of T-BET, the AiBC master regulator, stripped mouse and human mutant B cells of their competitive fitness. By identifying a phenotypically defined prospective lymphoma precursor population and its dependencies, our findings pave the way for the early detection of premalignant states and targeted prophylactic interventions in high-risk patients. SIGNIFICANCE Extranodal lymphomas feature a very poor prognosis. The identification of phenotypically distinguishable prospective precursor cells represents a milestone in the pursuit of earlier diagnosis, patient stratification, and prophylactic interventions. Conceptually, we found that extranodal lymphomas and autoimmune disorders harness overlapping pathogenic trajectories, suggesting these B-cell disorders develop and evolve within a spectrum. See related commentary by Leveille et al. (Blood Cancer Discov 2023;4:8-11). This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
- Leandro Venturutti
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z1L3, Canada., Terry Fox Laboratory, BC Cancer, Vancouver, BC V5Z1L3, Canada., Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T1Z7, Canada.,Corresponding authors: Leandro Venturutti, PhD. Centre for Lymphoid Cancer and Terry Fox Laboratory, BC Cancer Research Institute, 675 W 10th Ave, Vancouver, BC, V5Z 1L3, Canada. Phone: 604-675-8000; Fax: 604-877-0712; , Ari M. Melnick, MD. Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, 413 E 69th St, New York, NY, 10021, USA. Phone: 646-962-6725; Fax: 646-962-0576;
| | - Martin A. Rivas
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Benedikt W. Pelzer
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA., Mildred Scheel School of Oncology Aachen Bonn Cologne Düsseldorf (MSSO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne D-50937, Germany
| | - Ruth Flümann
- Department I of Internal Medicine, University Hospital Cologne, Cologne 50931, Germany., Max-Planck-Institute for Biology of Aging, Cologne 50931, Germany
| | - Julia Hansen
- Department I of Internal Medicine, University Hospital Cologne, Cologne 50931, Germany., Max-Planck-Institute for Biology of Aging, Cologne 50931, Germany
| | - Ioannis Karagiannidis
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Min Xia
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Dylan R. McNally
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Yusuke Isshiki
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Andrew Lytle
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z1L3, Canada
| | - Matt Teater
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Christopher R. Chin
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA., Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA., The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine and the WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Cem Meydan
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA., The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine and the WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Gero Knittel
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital of Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Edd Ricker
- Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY 10021, USA
| | - Christopher E. Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA., The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine and the WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY 10021, USA
| | - Xiaofei Ye
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Huddinge, Stockholm, Sweden
| | - Qiang Pan-Hammarström
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Huddinge, Stockholm, Sweden
| | - Christian Steidl
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z1L3, Canada., Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T1Z7, Canada
| | - David W. Scott
- Centre for Lymphoid Cancer, BC Cancer, Vancouver, BC V5Z1L3, Canada., Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T1Z7, Canada., Department of Medicine, University of British Columbia, Vancouver, BC V6T1Z7, Canada
| | - Hans Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University Hospital of Essen, University of Duisburg-Essen, Essen 45147, Germany
| | - Alessandra B. Pernis
- Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY 10021, USA
| | - Wendy Béguelin
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Ari M. Melnick
- Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA.,Corresponding authors: Leandro Venturutti, PhD. Centre for Lymphoid Cancer and Terry Fox Laboratory, BC Cancer Research Institute, 675 W 10th Ave, Vancouver, BC, V5Z 1L3, Canada. Phone: 604-675-8000; Fax: 604-877-0712; , Ari M. Melnick, MD. Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, 413 E 69th St, New York, NY, 10021, USA. Phone: 646-962-6725; Fax: 646-962-0576;
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2
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Bouclet F, Krzisch D, Leblond V, Tomowiak C, Laribi K, Ysebaert L, Tournilhac O, Dartigeas C, Leprêtre S, Jondreville L. [Waldenström disease: News and perspectives in 2022]. Bull Cancer 2023; 110:88-100. [PMID: 36229266 DOI: 10.1016/j.bulcan.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
Waldenström's disease is a B-cell neoplasm characterized by the accumulation of lymphoplasmacytic cells (LPCs) in the bone marrow, and more rarely in the lymph nodes and the spleen, which produce a monoclonal immunoglobulin M (IgM) protein. The diagnosis requires the identification of LPCs in the bone marrow, using specific markers in flow cytometry. The MYD88L265P mutation is found in 95% of cases and the CXCR4 mutation in 30-40% of cases. These markers must be sought because they have a diagnostic and prognostic role, and they might become predictive in the future. The clinical presentation is very variable, and includes anomalies related to the bone marrow infiltration of the LPCs (such as anemia), but also anomalies of the physico-chemical and/or immunological activity of the overproduced IgM (hyperviscosity, AL amyloidosis, cryoglobulinemia, anti-MAG neuropathies, etc.). Prognostic scores (IPSSWM) now make it possible to understand the prognosis of symptomatic WM requiring appropriate treatment. The therapeutic management depends on many parameters, such as the specific clinical presentation, the speed of evolution and of course the age and comorbidities. Immuno-chemotherapy is often the 1st line treatment (rituximab-cyclophosphamide-dexamethasone (RCD) or bendamustine-rituximab (BR)) but the role of targeted therapies is becoming preponderant. Bruton tyrosine kinase inhibitors (BTKi) are used today in first relapse. Other therapeutic perspectives will certainly allow us tomorrow to better understand this incurable chronic disease, such as new generations of BTKi, BCL2 inhibitors, anti-CXCR4, bi-specific antibodies, and CAR-T cells.
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Affiliation(s)
- Florian Bouclet
- Centre Henri Becquerel, department of clinical haematology, 76038 Rouen, France
| | - Daphné Krzisch
- AP-HP, Sorbonne université, hôpital Pitié-Salpêtrière, Paris, France
| | - Véronique Leblond
- AP-HP, Sorbonne université, hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Loïc Ysebaert
- Institut universitaire du cancer de toulouse (IUCT) - Oncopole, Toulouse, France
| | | | | | - Stéphane Leprêtre
- Centre Henri Becquerel, department of clinical haematology, 76038 Rouen, France; Centre Henri Becquerel and Normandie university UNIROUEN, Inserm U1245 and department of hematology, Rouen, France.
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3
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Visentin A, Pravato S, Castellani F, Campagnolo M, Angotzi F, Cavarretta CA, Cellini A, Ruocco V, Salvalaggio A, Tedeschi A, Trentin L, Briani C. From Biology to Treatment of Monoclonal Gammopathies of Neurological Significance. Cancers (Basel) 2022; 14:1562. [PMID: 35326711 PMCID: PMC8946535 DOI: 10.3390/cancers14061562] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/06/2022] [Accepted: 03/15/2022] [Indexed: 12/23/2022] Open
Abstract
Monoclonal gammopathy and peripheral neuropathy are common diseases of elderly patients, and almost 10% of patients with neuropathy of unknown cause have paraprotein. However, growing evidence suggests that several hematological malignancies synthesize and release monoclonal proteins that damage the peripheral nervous system through different mechanisms. The spectrum of the disease varies from mild to rapidly progressive symptoms, sometimes affecting not only sensory nerve fibers, but also motor and autonomic fibers. Therefore, a multidisciplinary approach, mainly between hematologists and neurologists, is recommended in order to establish the correct diagnosis of monoclonal gammopathy of neurological significance and to tailor therapy based on specific genetic mutations. In this review, we summarize the spectrum of monoclonal gammopathies of neurological significance, their distinctive clinical and neurophysiological phenotypes, the most relevant pathophysiological events and new therapeutic approaches.
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Affiliation(s)
- Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Stefano Pravato
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Francesca Castellani
- Neurology Unit, Department of Neurosciences, University of Padova, 35128 Padova, Italy; (F.C.); (M.C.); (A.S.); (C.B.)
| | - Marta Campagnolo
- Neurology Unit, Department of Neurosciences, University of Padova, 35128 Padova, Italy; (F.C.); (M.C.); (A.S.); (C.B.)
| | - Francesco Angotzi
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Chiara Adele Cavarretta
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Alessandro Cellini
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Valeria Ruocco
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Alessandro Salvalaggio
- Neurology Unit, Department of Neurosciences, University of Padova, 35128 Padova, Italy; (F.C.); (M.C.); (A.S.); (C.B.)
| | - Alessandra Tedeschi
- ASST Grande Ospedale Metropolitano Niguarda, Niguarda Cancer Center, 20162 Milano, Italy;
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, 35128 Padova, Italy; (S.P.); (F.A.); (C.A.C.); (A.C.); (V.R.); (L.T.)
| | - Chiara Briani
- Neurology Unit, Department of Neurosciences, University of Padova, 35128 Padova, Italy; (F.C.); (M.C.); (A.S.); (C.B.)
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4
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Kroft SH, Sever CE, Bagg A, Billman B, Diefenbach C, Dorfman DM, Finn WG, Gratzinger DA, Gregg PA, Leonard JP, Smith S, Souter L, Weiss RL, Ventura CB, Cheung MC. Laboratory Workup of Lymphoma in Adults: Guideline From the American Society for Clinical Pathology and the College of American Pathologists. Arch Pathol Lab Med 2021; 145:269-290. [PMID: 33175094 DOI: 10.5858/arpa.2020-0261-sa] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The diagnostic workup of lymphoma continues to evolve rapidly as experience and discovery led to the addition of new clinicopathologic entities and techniques to differentiate them. The optimal clinically effective, efficient, and cost-effective approach to diagnosis that is safe for patients can be elusive, in both community-based and academic practice. Studies suggest that there is variation in practice in both settings. OBJECTIVE.— To develop an evidence-based guideline for the preanalytic phase of testing, focusing on specimen requirements for the diagnostic evaluation of lymphoma. DESIGN.— The American Society for Clinical Pathology, the College of American Pathologists, and the American Society of Hematology convened a panel of experts in the laboratory workup of lymphoma to develop evidence-based recommendations. The panel conducted a systematic review of literature to address key questions. Using the Grading of Recommendations Assessment, Development, and Evaluation approach, recommendations were derived based on the available evidence, strength of that evidence, and key judgements as defined in the Grading of Recommendations Assessment, Development, and Evaluation Evidence to Decision framework. RESULTS.— Thirteen guideline statements were established to optimize specimen selection, ancillary diagnostic testing, and appropriate follow-up for safe and accurate diagnosis of indolent and aggressive lymphoma. CONCLUSIONS.— Primary diagnosis and classification of lymphoma can be achieved with a variety of specimens. Application of the recommendations can guide decisions on specimen suitability, diagnostic capabilities, and correct use of ancillary testing. Disease prevalence in patient populations, availability of ancillary testing, and diagnostic goals should be incorporated into algorithms tailored to each practice environment.
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Affiliation(s)
- Steven H Kroft
- From the Department of Pathology, Froedtert Hospital and the Medical Colleges of Wisconsin, Milwaukee (Kroft)
| | - Cordelia E Sever
- Pathology Associates of Albuquerque, Albuquerque, New Mexico (Sever)
| | - Adam Bagg
- The Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Bagg)
| | - Brooke Billman
- Governance Services (Billman), College of American Pathologists, Northfield, Illinois
| | - Catherine Diefenbach
- The Department of Medicine, New York University School of Medicine, New York, New York (Diefenbach)
| | - David M Dorfman
- The Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Dorfman)
| | - William G Finn
- The Department of Pathology and Laboratory Medicine, Warde Medical Laboratory, Ann Arbor, Michigan (Finn)
| | - Dita A Gratzinger
- The Department of Pathology, Stanford Health Care, Stanford, California (Gratzinger)
| | - Patricia A Gregg
- The Department of Pathology, Lehigh Regional Medical Center, Lehigh Acres, Florida (Gregg)
| | - John P Leonard
- The Department of Hematology and Oncology, Weill Cornell Medical College, New York, New York (Leonard)
| | - Sonali Smith
- The Department of Medicine, University of Chicago Medicine, Chicago, Illinois (Smith)
| | - Lesley Souter
- Souter is in private practice in Wellandport, Ontario, Canada
| | - Ronald L Weiss
- The Department of Pathology, ARUP Laboratories Inc, Salt Lake City, Utah (Weiss)
| | - Christina B Ventura
- The Pathology and Laboratory Quality Center (Ventura), College of American Pathologists, Northfield, Illinois
| | - Matthew C Cheung
- The Department of Medicine, Odette Cancer Centre/Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Cheung)
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5
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Branagan AR, Lei M, Treon SP, Castillo JJ. Clinical application of genomics in Waldenström macroglobulinemia. Leuk Lymphoma 2021; 62:1805-1815. [PMID: 33569985 DOI: 10.1080/10428194.2021.1881514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Waldenström Macroglobulinemia (WM) is an incurable hematologic malignancy characterized by lymphoplasmacytic infiltration of the bone marrow and the presence of monoclonal immunoglobulin (IgM). Although a portion of WM patients may experience a relatively indolent course, patients may experience IgM-related morbidity and/or disease-related mortality. This underscores the need for novel approaches to improve response and survival rates. Significant progress had been made in our understanding of the genomics and biology of WM. The discovery of the highly recurrent somatic mutations in the MYD88 gene detected in 90-95% and the CXCR4 gene detected in 30-40% of WM patients has provided an opportunity to develop novel targeted approaches. Mutational status has important implications in predicting response to therapies such as BTK inhibitors. Treatment of WM should be guided by many factors including performance status, comorbidities, goals of therapy, and toxicities. In this review, we describe how current genomics may be utilized to optimize WM treatment selection. As the therapeutic landscape of WM continues to expand with more targeted approaches, the genomics in WM will likely play a greater role in individualizing treatment.
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Affiliation(s)
- Andrew R Branagan
- Department of Hematologic Oncology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Mathew Lei
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
| | - Steven P Treon
- Harvard Medical School, Boston, MA, USA.,Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jorge J Castillo
- Harvard Medical School, Boston, MA, USA.,Bing Center for Waldenström Macroglobulinemia, Dana-Farber Cancer Institute, Boston, MA, USA
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6
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Kroft SH, Sever CE, Bagg A, Billman B, Diefenbach C, Dorfman DM, Finn WG, Gratzinger DA, Gregg PA, Leonard JP, Smith S, Souter L, Weiss RL, Ventura CB, Cheung MC. Laboratory Workup of Lymphoma in Adults. Am J Clin Pathol 2021; 155:12-37. [PMID: 33219376 DOI: 10.1093/ajcp/aqaa191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The diagnostic workup of lymphoma continues to evolve rapidly as experience and discovery lead to the addition of new clinicopathologic entities and techniques to differentiate them. The optimal clinically effective, efficient, and cost-effective approach to diagnosis that is safe for patients can be elusive, in both community-based and academic practice. Studies suggest that there is variation in practice in both settings. THE AIM OF THIS REVIEW IS TO develop an evidence-based guideline for the preanalytic phase of testing, focusing on specimen requirements for the diagnostic evaluation of lymphoma. METHODS The American Society for Clinical Pathology, the College of American Pathologists, and the American Society of Hematology convened a panel of experts in the laboratory workup of lymphoma to develop evidence-based recommendations. The panel conducted a systematic review of the literature to address key questions. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, recommendations were derived based on the available evidence, the strength of that evidence, and key judgments as defined in the GRADE Evidence to Decision framework. RESULTS Thirteen guideline statements were established to optimize specimen selection, ancillary diagnostic testing, and appropriate follow-up for safe and accurate diagnosis of indolent and aggressive lymphoma. CONCLUSIONS Primary diagnosis and classification of lymphoma can be achieved with a variety of specimens. Application of the recommendations can guide decisions about specimen suitability, diagnostic capabilities, and correct utilization of ancillary testing. Disease prevalence in patient populations, availability of ancillary testing, and diagnostic goals should be incorporated into algorithms tailored to each practice environment.
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Affiliation(s)
- Steven H Kroft
- Department of Pathology, Froedtert Hospital and the Medical Colleges of Wisconsin, Milwaukee
| | | | - Adam Bagg
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
| | - Brooke Billman
- Governance Services, College of American Pathologists, Northfield, IL
| | | | - David M Dorfman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - William G Finn
- Department of Pathology and Laboratory Medicine, Warde Medical Laboratory, Ann Arbor, MI
| | | | - Patricia A Gregg
- Dept of Pathology, Lehigh Regional Medical Center, Lehigh Acres, FL
| | - John P Leonard
- Department of Hematology and Oncology, Weill Cornell Medical College, New York, NY
| | - Sonali Smith
- Department of Medicine, The University of Chicago Medicine, Chicago, IL
| | | | - Ronald L Weiss
- Department of Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Christina B Ventura
- Pathology and Laboratory Quality Center, College of American Pathologists, Northfield, IL
| | - Matthew C Cheung
- Department of Medicine, Odette Cancer Centre/Sunnybrook Health Sciences Centre, Toronto, Canada
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7
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Lymphoplasmacytic lymphoma associated with diffuse large B-cell lymphoma: Progression or divergent evolution? PLoS One 2020; 15:e0241634. [PMID: 33180881 PMCID: PMC7661053 DOI: 10.1371/journal.pone.0241634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/16/2020] [Indexed: 01/03/2023] Open
Abstract
Aim Lymphoplasmacytic lymphoma (LPL) is an indolent mature B-cell-neoplasm with involvement of the bone marrow. At least 90% of LPLs carry MYD88-L265P mutation and some of them (~10%) transform into diffuse large B-cell-lymphoma (DLBCL). Material and methods Over the past 15 years we have collected 7 cases where the both LPL and DLBCL were diagnosed in the same patient. Clinical records, analytical data and histopathological specimens were reviewed. FISH studies on paraffin-embedded tissue for MYC, BCL2 and BCL6 genes were performed, as well as MYD88-L265P mutation and IGH rearrangement analysis by PCR. A mutational study was done by massive next generation sequencing (NGS). Results There were 4 women and 3 men between 36–91 years of age. Diagnoses were made simultaneously in 4 patients. In two cases the LPL appeared before the DLBCL and in the remaining case the high-grade component was discovered 5 years before the LPL. In 6 cases both samples shared the MYD88-L265P mutation. IGH rearrangement analysis showed overlapping features in two of 6 cases tested. Mutational study was evaluable in three cases for both samples showing shared and divergent mutations. Conclusions These data suggest different mechanisms of DLBCL development in LPL patients.
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8
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Briani C, Visentin A, Cerri F, Quattrini A. From pathogenesis to personalized treatments of neuropathies in hematological malignancies. J Peripher Nerv Syst 2020; 25:212-221. [PMID: 32686258 DOI: 10.1111/jns.12405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/21/2022]
Abstract
The peripheral nervous system may be involved at any stage in the course of several hematological diseases, the most common being monoclonal gammopathies (of undetermined significance or malignant) or lymphomas. The underlying pathogenic mechanisms are different and therapies aim at targeting the dangerous either B-cell or plasma cell clones. Recently, high-throughput technologies, and next-generation sequencing have increased our knowledge of hematological diseases pathogenesis by the identification of somatic mutation affecting pivotal signaling pathways. Accordingly, new target therapies are used that may also be borrowed for treatment of neuropathies in hematological diseases.
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Affiliation(s)
- Chiara Briani
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Federica Cerri
- Experimental Neuropathology Unit, Institute of Experimental Neurology (INSPE), Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Institute of Experimental Neurology (INSPE), Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
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9
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Jalali S, Shi J, Buko A, Ahsan N, Paludo J, Serres M, Wellik LE, Abeykoon J, Kim H, Tang X, Yang ZZ, Novak AJ, Witzig TE, Ansell SM. Increased glutathione utilization augments tumor cell proliferation in Waldenstrom Macroglobulinemia. Redox Biol 2020; 36:101657. [PMID: 32763516 PMCID: PMC7404570 DOI: 10.1016/j.redox.2020.101657] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 02/03/2023] Open
Abstract
Metabolic reprogramming is a hallmark of cancer cells. In Waldenstrom Macroglobulinemia (WM), the infiltration of IgM-secreting lymphoplamacytic cells into the bone marrow (BM) could shift the homeostasis of proteins and metabolites towards a permissive niche for tumor growth. Here, we investigated whether alerted metabolic pathways contribute to the pathobiology of WM and whether the cytokine composition of the BM promotes such changes. Metabolomics analysis on WM patients and normal donors' serum samples revealed a total of 75 metabolites that were significantly altered between two groups. While these metabolites belonged to amino acids, glucose, glutathione and lipid metabolism pathways, the highest number of the differentially expressed metabolites belonged to glutathione metabolism. Proteomics analysis and immunohistochemical staining both confirmed the increased protein levels mediating glutathione metabolism, including GCLC, MT1X, QPCT and GPX3. Moreover, treatment with IL-6 and IL-21, cytokines that induce WM cell proliferation and IgM secretion, increased gene expression of the amino acid transporters mediating glutathione metabolism, including ASCT2, SLC7A11 and 4F2HC, indicating that cytokines in the WM BM could modulate glutathione metabolism. Glutathione synthesis inhibition using Buthionine sulphoximine (BSO) significantly reduced WM cells proliferation in vitro, accompanied with decreased NFκB-p65 and MAPK-p38 phosphorylation. Moreover, BSO treatment significantly reduced the tumor growth rate in a WM xenograft model, further highlighting the role of glutathione metabolism in promoting tumor growth and proliferation. In summary, our data highlight a central role for glutathione metabolism in WM pathobiology and indicate that intervening with the metabolic processes could be a potential therapy for WM patients.
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Affiliation(s)
- Shahrzad Jalali
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jie Shi
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Hematology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Alex Buko
- Human Metabolome Technologies (HMT) America, Boston, MA, USA
| | - Nagib Ahsan
- COBRE Center for Cancer Research Development, Proteomics Core Facility, Rhode Island Hospital, Providence, RI, 02903, USA; Division of Biology and Medicine, Brown University, Providence, RI, 02903, USA
| | - Jonas Paludo
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Makayla Serres
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Linda E Wellik
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jithma Abeykoon
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - HyoJin Kim
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Xinyi Tang
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Zhi-Zhang Yang
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anne J Novak
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas E Witzig
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stephen M Ansell
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN, USA.
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10
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Ntanasis-Stathopoulos I, Gavriatopoulou M, Terpos E, Fotiou D, Kastritis E, Dimopoulos MA. Monitoring Plasma Cell Dyscrasias With Cell-free DNA Analysis. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:e905-e909. [PMID: 32723621 DOI: 10.1016/j.clml.2020.06.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022]
Abstract
The analysis of cell-free tumor DNA (cfDNA) has emerged as a promising method to determine the evolving genomic landscape of the whole tumor compartment, mainly in solid malignancies. Plasma cell dyscrasias are characterized by complex and constantly changing genomic aberrations that are important in terms of prognosis, evaluation of the minimal residual disease, and response monitoring. In multiple myeloma, the detection of clonal immunoglobulin rearrangements and driver gene mutations in the cfDNA has shown high concordance rates with their identification in bone marrow-derived tumor DNA. In Waldenström macroglobulinemia, cfDNA can be a reliable alternative to bone marrow aspiration for determining the mutational status of the MYD88 and CXCR4 genes. Importantly, cfDNA can be representative of the whole bone marrow compartment and of extramedullary sites in contrast to the sampling of a single bone marrow site. However, standardization and validation of the techniques are necessary before integrating cfDNA in the clinical practice. Therefore, we encourage the conduction of clinical trials with novel cfDNA-based designs and the adoption of cfDNA-guided endpoints in order to precisely determine the role of cfDNA in the current management of plasma cell dyscrasias.
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Affiliation(s)
- Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece.
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Despoina Fotiou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital, Athens, Greece
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11
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Scientific Advances and the Evolution of Diagnosis, Subclassification and Treatment of Lymphoma. Arch Med Res 2020; 51:749-764. [PMID: 32553461 DOI: 10.1016/j.arcmed.2020.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022]
Abstract
The diagnosis of lymphoma has evolved tremendously over time. Initially, diagnosis of lymphoma was largely based on morphology alone. Over time, immunophenotyping using flow cytometry and immunohistochemistry, and then in situ hybridization, have contributed dramatically to the pathologist's ability to recognize, diagnose and subclassify lymphomas more precisely. In recent years, cytogenetic and molecular genetic techniques have developed that allow evaluation of abnormalities in lymphomas, leading to an understanding of their pathogenesis and opening the door to targeted therapies that will lead to better outcomes for lymphoma patients.
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12
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Ntanasis‐Stathopoulos I, Bagratuni T, Gavriatopoulou M, Patseas D, Liacos C, Kanellias N, Fotiou D, Tsiligkeridou E, Andreatou A, Mavrianou‐Koutsoukou N, Migkou M, Eleutherakis‐Papaiakovou E, Roussou M, Terpos E, Kastritis E, Dimopoulos MA. Cell-free DNA analysis for the detection of MYD88 and CXCR4 mutations in IgM monoclonal gammopathies; an update with clinicopathological correlations. Am J Hematol 2020; 95:E148-E150. [PMID: 32242972 DOI: 10.1002/ajh.25802] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Ioannis Ntanasis‐Stathopoulos
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Tina Bagratuni
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Maria Gavriatopoulou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Dimitrios Patseas
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Christine Liacos
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Nikolaos Kanellias
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Despina Fotiou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Eleni Tsiligkeridou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Amalia Andreatou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Nefeli Mavrianou‐Koutsoukou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Magdalini Migkou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Evangelos Eleutherakis‐Papaiakovou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Maria Roussou
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Evangelos Terpos
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Efstathios Kastritis
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
| | - Meletios A. Dimopoulos
- Department of Clinical TherapeuticsNational and Kapodistrian University of Athens, School of Medicine, Alexandra General Hospital Athens Greece
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13
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Piazza F, Manni S, Arjomand A, Visentin A, Trentin L, Semenzato G. New responsibilities for aged kinases in B-lymphomas. Hematol Oncol 2019; 38:3-11. [PMID: 31782972 DOI: 10.1002/hon.2694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022]
Abstract
The knowledge accumulated over the last decade on B-cell-derived non-Hodgkin lymphoma (B-NHL) pathogenesis has led to the identification of several molecular abnormalities, opening new perspectives in the design of novel therapies. Indeed, drugs targeting specific biochemical pathways critical for B-NHL cell survival, proliferation, and fitness within the malignant microenvironment are now available to the clinician: the B-cell receptor signaling inhibitors of BTK, PI3Kδ, ζ, γ, and SYK or the pro-apoptotic BH3-mimetics are clear examples of it. Moreover, it is emerging that malignant B-cell growth is sustained not only by mutations in oncogenes/tumor suppressors but also by the "addiction" to nononcogene (ie, nonstructurally altered) molecules. In this regard, a consistent body of data has established that the Ser/Thr kinases CK1, CK2, and GSK3 are involved in malignant lymphocyte biology and act as pro-survival and signaling-boosting molecules, both in precursor and mature B-cell tumors. Currently, an experimental and clinical groundwork is available, upon which to design CK1-, CK2-, and GSK3-directed antilymphoma/leukemia therapies. In this review, we have examined the main features of CK1, CK2, and GSK3 kinases, summarized the data in B-NHL supporting them as suitable therapeutic targets, and proposed a perspective on potential future research development.
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Affiliation(s)
- Francesco Piazza
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
| | - Sabrina Manni
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
| | - Arash Arjomand
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
| | - Andrea Visentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
| | - Gianpietro Semenzato
- Department of Medicine, Hematology and Clinical Immunology Branch, University of Padova, Padova, Italy.,Unit of Hematological Malignancies - Laboratory of Myeloma and Lymphoma Pathobiology, Foundation for Advanced Biomedical Research - Veneto Institute of Molecular Medicine (FABR-VIMM), Padova, Italy
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14
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Koehler M, Moita F, Cabeçadas J, Gomes da Silva M. Mixed Lytic and Blastic Bone Lesions as a Presenting Feature of Waldenström Macroglobulinemia: Case Report and Review of the Literature. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 20:e87-e91. [PMID: 31899159 DOI: 10.1016/j.clml.2019.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Mariana Koehler
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Lisbon, Portugal.
| | - Filipa Moita
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Lisbon, Portugal
| | - José Cabeçadas
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Lisbon, Portugal
| | - Maria Gomes da Silva
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, EPE, Lisbon, Portugal
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15
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Briani C, Visentin A, Campagnolo M, Salvalaggio A, Ferrari S, Cavallaro T, Manara R, Gasparotti R, Piazza F. Peripheral nervous system involvement in lymphomas. J Peripher Nerv Syst 2019; 24:5-18. [PMID: 30556258 DOI: 10.1111/jns.12295] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/01/2018] [Accepted: 12/08/2018] [Indexed: 12/11/2022]
Abstract
The peripheral nervous system may be involved at any stage in the course of lymphoproliferative diseases. The different underlying mechanisms include neurotoxicity secondary to chemotherapy, direct nerve infiltration (neurolymphomatosis), infections, immune-mediated, paraneoplastic or metabolic processes and nutritional deficiencies. Accordingly, the clinical features are heterogeneous and depend on the localization of the damage (ganglia, roots, plexi, and peripheral nerves) and on the involved structures (myelin, axon, and cell body). Some clinical findings, such a focal or diffuse involvement, symmetric or asymmetric pattern, presence of pain may point to the correct diagnosis. Besides a thorough medical history and neurological examination, neurophysiological studies, cerebrospinal fluid analysis, nerve biopsy (in selected patients with suspected lymphomatous infiltration) and neuroimaging techniques (magnetic resonance neurography and nerve ultrasound) may be crucial for a proper diagnostic workup.
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Affiliation(s)
- Chiara Briani
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
| | | | | | - Sergio Ferrari
- Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
| | - Tiziana Cavallaro
- Department of Neurology, Azienda Ospedaliera Universitaria Integrata, University Hospital G.B. Rossi, Verona, Italy
| | - Renzo Manara
- Neuroradiology, Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Roberto Gasparotti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Piazza
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy
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