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Imuta N, Miyai K, Tsuchiya M, Saito M, Sone T, Kobayashi S, Ogata S, Kimura F, Matsukuma S. Concurrent intestinal plasmablastic lymphoma and diffuse large B-cell lymphoma with a clonal relationship: a case report and literature review. J Pathol Transl Med 2024; 58:191-197. [PMID: 38910357 DOI: 10.4132/jptm.2024.05.14] [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: 03/08/2024] [Accepted: 05/07/2024] [Indexed: 06/25/2024] Open
Abstract
Herein, we report a case of plasmablastic lymphoma (PBL) and diffuse large B-cell lymphoma (DLBCL) that occurred concurrently in the large intestine. An 84-year-old female presented with a palpable rectal tumor and ileocecal tumor observed on imaging analyses. Endoscopic biopsy of both lesions revealed lymphomatous round cells. Hartmann's operation and ileocecal resection were performed for regional control. The ileocecal lesion consisted of a proliferation of CD20/CD79a-positive lymphoid cells, indicative of DLBCL. In contrast, the rectal tumor showed proliferation of atypical cells with pleomorphic nuclei and abundant amphophilic cytoplasm, with immunohistochemical findings of CD38/CD79a/MUM1/MYC (+) and CD20/CD3/CD138/PAX5 (-). Tumor cells were positive for Epstein-Barr virus- encoded RNA based on in situ hybridization and MYC rearrangement in fluorescence in situ hybridization analysis. These findings indicated the rectal tumor was most likely a PBL. Sequencing analysis for immunoglobulin heavy variable genes indicated a common B-cell origin of the two sets of lymphoma cells. This case report and literature review provide new insights into PBL tumorigenesis.
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Affiliation(s)
- Nao Imuta
- Medical Student, National Defense Medical College, Tokorozawa, Japan
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kosuke Miyai
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Motohiro Tsuchiya
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Mariko Saito
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Takehiro Sone
- Department of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Shinichi Kobayashi
- Department of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Sho Ogata
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Fumihiko Kimura
- Department of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Susumu Matsukuma
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Laboratory Medicine, National Defense Medical College Hospital, Tokorozawa, Japan
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Bibas M. Plasmablastic Lymphoma. A State-of-the-Art Review: Part 2-Focus on Therapy. Mediterr J Hematol Infect Dis 2024; 16:e2024015. [PMID: 38468838 PMCID: PMC10927196 DOI: 10.4084/mjhid.2024.015] [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: 01/25/2024] [Accepted: 02/14/2024] [Indexed: 03/13/2024] Open
Abstract
The objective of this two-part review is to present a current and comprehensive understanding of the diagnosis and management of plasmablastic lymphoma. The first part, which was published previously, focused on the study of epidemiology, etiology, clinicopathological characteristics, differential diagnosis, prognostic variables, and the impact of plasmablastic lymphoma on specific populations. This second part addresses the difficult topic of the treatment of plasmablastic lymphoma, specifically examining both the conventional, consolidated approach and the novel therapeutic strategy.
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Affiliation(s)
- Michele Bibas
- Department of Clinical Research, Hematology. National Institute for Infectious Diseases "Lazzaro Spallanzani" I.R.C.S.S. Via Portuense 292 00148 Rome Italy
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3
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Li JW, Peng HL, Zhou XY, Wang JJ. Plasmablastic lymphoma: current knowledge and future directions. Front Immunol 2024; 15:1354604. [PMID: 38415257 PMCID: PMC10896986 DOI: 10.3389/fimmu.2024.1354604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/29/2024] Open
Abstract
Plasmablastic lymphoma (PBL) is an aggressive non-Hodgkin lymphoma associated with HIV infection and immunodeficiency. However, PBL can also be seen immunocompetent individuals in recent studies. PBL was characterized by distinct clinical and pathological features, such as plasmablastic morphology and universal expression of plasma cell markers. The clinicopathologic features were different between HIV-negative and HIV-positive patients. Gene expression analysis identified the unique molecular feature in PBL, including frequent c-MYC rearrangement and downregulation of BCR signaling pathway. Despite the recent advances in the treatment of PBL, the prognosis of PBL patients remains dismal. The objectives of this review are to summarize the current knowledge on the epidemiology, molecular profiles, clinical and pathological features, differential diagnosis, treatment strategies, prognostic factors, and potential novel therapeutic approaches in PBL patients.
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Affiliation(s)
- Ji-Wei Li
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hong-Ling Peng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Yan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Pathology, Fudan University, Shanghai, China
| | - Jing-Jing Wang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
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4
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Plasmablastic lymphoma masked by hidradentitis suppurativa. JAAD Case Rep 2022; 27:13-15. [PMID: 35990238 PMCID: PMC9389130 DOI: 10.1016/j.jdcr.2022.06.016] [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: 11/24/2022] Open
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5
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Jessa R, Chien N, Villa D, Freeman CL, Slack GW, Savage KJ, Scott DW, Sehn LH, Song KW, Gerrie AS. Clinicopathological characteristics and long-term outcomes of plasmablastic lymphoma in British Columbia. Br J Haematol 2022; 199:230-238. [PMID: 35961783 DOI: 10.1111/bjh.18399] [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] [Received: 05/02/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
Plasmablastic lymphoma (PBL) is an aggressive and rare subtype of non-Hodgkin lymphoma with no standard-of-care therapy. We reviewed all patients diagnosed with histologically confirmed PBL in British Columbia, Canada between 1997 and 2019. Overall, 42 patients were identified, including 15 (36%) positive for HIV and nine (21%) on chronic immunosuppression. Curative-intent treatment consisting primarily of cyclophosphamide, doxorubicin, vincristine and prednisone was administered to 31 patients, of which 74% achieved response, however 61% relapsed after a median of 7.5 months. At a median follow-up of eight years for the whole cohort, five-year progression-free survival (PFS) and overall survival (OS) were 18% [95% confidence interval (CI): 6%, 30%] and 22% (95% CI: 8%, 36%) with median eight and 15 months respectively. There were no differences in relapse rate (p = 0.962), PFS (p = 0.228) or OS (p = 0.340) according to immune status. For those treated with curative intent, five-year PFS and OS were 24% (95% CI: 8%, 40%) and 31% (95% CI: 13%, 49%) with median 18 and 27 months respectively. In this population-based cohort of PBL patients spanning 20 years, survival outcomes were poor. Ultimately, further research is needed to develop more effective treatment strategies and to improve survival for patients.
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Affiliation(s)
- Rehan Jessa
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Chien
- Leukemia/Bone Marrow Transplant Program of BC and Division of Hematology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Diego Villa
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ciara L Freeman
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Graham W Slack
- Department of Pathology and Laboratory Medicine, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kerry J Savage
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - David W Scott
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laurie H Sehn
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin W Song
- Leukemia/Bone Marrow Transplant Program of BC and Division of Hematology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alina S Gerrie
- Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, British Columbia, Canada
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6
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Bortezomib, Lenalidomide and Dexamethasone Combination Induced Complete Remission in Relapsed/Refractory Plasmablastic Lymphoma: Case Report of a Potential Novel Treatment Approach. Curr Oncol 2022; 29:5042-5053. [PMID: 35877259 PMCID: PMC9323819 DOI: 10.3390/curroncol29070399] [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: 06/06/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Plasmablastic lymphoma is a rare subtype of large B-cell lymphoma characterised by an aggressive clinical course with frequent relapses and refractoriness to chemotherapy. It is usually associated with HIV, however, it can also be seen in immunocompetent patients. It has distinct pathological characteristics, such as plasmablastic morphology and lack of CD20 expression. These characteristics pose a clinical and pathological challenge. There is no standard of care established in this entity. In this case report, we described a novel bortezomib-based plasma cell targeted regimen in a HIV-negative patient refractory to chemotherapy.
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7
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Nwanwene K, Khan NAJ, Alsharedi M. Testicular Plasmablastic Lymphoma in an HIV-Negative Patient: A Rare Case Presentation. J Investig Med High Impact Case Rep 2021; 9:23247096211017423. [PMID: 34032157 PMCID: PMC8155771 DOI: 10.1177/23247096211017423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is a very rare disease and it is usually considered a human
immunodeficiency virus (HIV)–related B-cell lymphoma that carries a poor prognosis. It
mostly involves the oral cavity, lungs, nasal cavity, gastrointestinal tract, lymph node,
and skin. Therapeutic regimens like dose-adjusted etoposide, vincristine, doxorubicin,
cyclophosphamide, and prednisone (DA-EPOCH) have shown better results in these aggressive
lymphomas. We report a rare case of PBL in an HIV-negative patient who presented to the
clinic with a complaint of left testicular swelling for 3 months. Ultrasound showed an
enlarged left testicle. He underwent a left orchiectomy and the pathology showed PBL with
involvement of the spermatic cord margin. Positron emission tomography scan showed
hypermetabolic mediastinal and hilar lymph nodes. He was started on DA-EPOCH but showed no
response. Accordingly, salvage therapy with bortezomib in addition to ifosfamide
carboplatin and etoposide (B-ICE) chemotherapy was initiated with remarkable response.
Several other regimens can be used in the refractory setting; however, the evidence is
mostly based on retrospective analysis.
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8
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Ramis-Zaldivar JE, Gonzalez-Farre B, Nicolae A, Pack S, Clot G, Nadeu F, Mottok A, Horn H, Song JY, Fu K, Wright G, Gascoyne RD, Chan WC, Scott DW, Feldman AL, Valera A, Enjuanes A, Braziel RM, Smeland EB, Staudt LM, Rosenwald A, Rimsza LM, Ott G, Jaffe ES, Salaverria I, Campo E. MAP-kinase and JAK-STAT pathways dysregulation in plasmablastic lymphoma. Haematologica 2021; 106:2682-2693. [PMID: 33951889 PMCID: PMC8485662 DOI: 10.3324/haematol.2020.271957] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 11/09/2022] Open
Abstract
Plasmablastic lymphoma (PBL) is an aggressive B-cell lymphoma with an immunoblastic/large cell morphology and plasmacytic differentiation. The differential diagnosis with Burkitt lymphoma (BL), plasma cell myeloma (PCM) and some variants of diffuse large B-cell lymphoma (DLBCL) may be challenging due to the overlapping morphological, genetic and immunophenotypic features. Furthermore, the genomic landscape in PBL is not well known. To characterize the genetic and molecular heterogeneity of these tumors, we investigated thirty-four PBL using an integrated approach, including fluorescence in situ hybridization, targeted sequencing of 94 B-cell lymphoma related genes, and copy-number arrays. PBL were characterized by high genetic complexity including MYC translocations (87%), gains of 1q21.1-q44, trisomy 7, 8q23.2-q24.21, 11p13-p11.2, 11q14.2-q25, 12p and 19p13.3-p13.13, losses of 1p33, 1p31.1-p22.3, 13q and 17p13.3-p11.2, and recurrent mutations of STAT3 (37%), NRAS and TP53 (33%), MYC and EP300 (19%) and CARD11, SOCS1 and TET2 (11%). Pathway enrichment analysis suggested a cooperative action between MYC alterations and MAPK (49%) and JAK-STAT (40%) signaling pathways. Of note, EBVnegative PBL cases had higher mutational and copy-number load and more frequent TP53, CARD11 and MYC mutations, whereas EBV-positive PBL tended to have more mutations affecting the JAK-STAT pathway. In conclusion, these findings further unravel the distinctive molecular heterogeneity of PBL identifying novel molecular targets and the different genetic profile of these tumors related to EBV infection.
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Affiliation(s)
- Joan Enric Ramis-Zaldivar
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Blanca Gonzalez-Farre
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Alina Nicolae
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Svetlana Pack
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Guillem Clot
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Ferran Nadeu
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Anja Mottok
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - Heike Horn
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen
| | - Joo Y Song
- Department of Pathology, City of Hope National Medical Center, Duarte
| | - Kai Fu
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
| | - George Wright
- Biometric Research Branch, Division of Cancer Diagnosis and Treatment, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Randy D Gascoyne
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte
| | - David W Scott
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver
| | - Andrew L Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Alexandra Valera
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona
| | - Anna Enjuanes
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Rita M Braziel
- Department of Clinical Pathology, Oregon Health and Science University, Oregon
| | - Erlend B Smeland
- Department of Immunology and Centre for Cancer Biomedicine, University of Oslo and Oslo University Hospital, Oslo
| | - Louis M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Institutes of Health, Bethesda
| | | | - Lisa M Rimsza
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, and University of Tübingen
| | - Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, Bethesda
| | - Itziar Salaverria
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid
| | - Elias Campo
- Hematopathology Unit, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid.
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Makady NF, Ramzy D, Ghaly R, Abdel-Malek RR, Shohdy KS. The Emerging Treatment Options of Plasmablastic Lymphoma: Analysis of 173 Individual Patient Outcomes. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 21:e255-e263. [PMID: 33419717 DOI: 10.1016/j.clml.2020.11.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/18/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022]
Abstract
Plasmablastic lymphoma (PBL) is a newly recognized aggressive subtype of non-Hodgkin lymphoma. Its rarity hinders testing effective treatment options in clinical trials. We conducted a systematic review of PubMed and our internal records to retrieve patients with a PBL diagnosis with evaluable treatment outcomes. Aggressive chemotherapy was defined as more intense regimens than CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). We compiled a meta-dataset of 173 patients. The median age at diagnosis was 48.5 years, 75% of patients were male, and stages III/IV accounted for 47% of the cohort. Of 138 patients with known response status after first-line chemotherapy, 63 (45%) achieved a complete response with a 2-year relapse-free survival of 71.6%. Sixty-nine (50%) patients received first-line CHOP. There was no significant difference in the objective response rate among the 2 most commonly used regimens, CHOP and DA-EPOCH (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) (69% vs. 79%; P = .4). The median follow-up was 9 months, and the 2-year overall survival (OS) was 47.4%. A univariate analysis identified factors associated with worse OS, including stage III/IV (hazard ratio [HR], 2.82; P < .001), human herpes virus-8-positive (HR, 3.30; P = .01), bone marrow (HR, 1.07; P = .035), and cardiorespiratory involvement (HR, 2.26; P = .015). Meanwhile, Epstein-Varr virus-encoded small RNA-positivity (HR, 0.31; P < .001) and involvement of head and neck (HR, 0.44; P = .009) were associated with better OS. Multivariate analysis showed that aggressive chemotherapy was significantly associated with better OS (HR, 0.22; P = .016). Patients with PBL with high-risk features, such as advanced stage, human herpes virus-8-positivity, bone marrow, and cardiorespiratory involvement, require more aggressive chemotherapy. Bortezomib and lenalidomide are promising add-on agents.
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Affiliation(s)
- Nafie F Makady
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt; Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
| | - David Ramzy
- Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Ramy Ghaly
- Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Raafat R Abdel-Malek
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Kyrillus S Shohdy
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt; Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY
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Clonally Related Plasmablastic Lymphoma Simultaneously Occurring with Diffuse Large B-Cell Lymphoma. Case Rep Hematol 2020; 2020:8876567. [PMID: 33335784 PMCID: PMC7723488 DOI: 10.1155/2020/8876567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma. Although it was first described in HIV- (human immunodeficiency virus-) infected patients, PBL has been diagnosed in patients with other immunodeficiencies as well as in immunocompetent patients. PBL immunohistochemically expresses plasmacytic markers and lacks pan B-cell markers. The cells of origin of PBL are considered to be plasmablasts. MYC gene rearrangement and MYC overexpression are frequently found in PBL, but the pathogenesis of PBL is yet to be elucidated. Here, we report a case of composite lymphoma of PBL and diffuse large B-cell lymphoma (DLBCL); that is, PBL in the urinary bladder and DLBCL in the nasal cavity occurred simultaneously. We extracted DNA from the two lymphomas for polymerase chain reaction and sequenced the amplified immunoglobulin heavy variable genes and the complementarity-determining region- (CDR-) 3. The sequence of the CDR3 region of both tumors matched. MYC rearrangement was found in the bladder tumor but not in the nasal tumor. The patient was treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone), and durable remission had been obtained. The results of the DNA analysis indicated that both PBL and DLBCL emerged from common postgerminal B cells. This case may help to elucidate the pathogenesis of PBL.
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11
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Fu WJ, He MX, Huang AJ, Gao L, Lu GH, Chen J, Chen L, Ni X, Zhang WP, Wang JM, Yang JM. [Clinical characteristics and survival analysis of 15 cases of HIV-negative plasmablastic lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:456-461. [PMID: 32654457 PMCID: PMC7378287 DOI: 10.3760/cma.j.issn.0253-2727.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
目的 分析HIV阴性的浆母细胞淋巴瘤(PBL)患者的临床病理特征及转归。 方法 回顾性分析海军军医大学附属长海医院2013年1月至2019年8月诊断及治疗的15例HIV阴性PBL患者的临床病理资料及随访结果。 结果 15例HIV阴性PBL患者中男8例,女7例,中位年龄59(17~69)岁,均无明确的免疫抑制状态。所有患者均出现结外受累,Ann Arbor-Cotswolds分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为1例(6.7%)、2例(13.3%)、3例(20.0%)、9例(60.0%)。病理形态表现为类似免疫母细胞的大肿瘤细胞弥漫性增生,免疫组化示肿瘤细胞主要表达浆细胞标志CD38、CD138、Mum-1,B细胞标志CD20、CD10、PAX-5、BCL-6少见,Ki-67中位数为80%(70%~90%)。3例患者行EBER原位杂交检测,1例阳性。15例患者均接受化疗,80%(12/15)联合硼替佐米作为一线治疗。最佳疗效6例完全缓解(其中2例分别于治疗后4.9和26.1个月疾病进展),2例部分缓解(分别于治疗后3.0和6.8个月疾病进展),4例疾病进展,3例无法评估。中位随访时间30.3(4.8~61.1)个月,11例患者中位无进展生存(PFS)期6.8(95%CI 2.5~11.1)个月,预计3年PFS率为21.2%(95%CI 1.4%~56.8%)。所有患者中位总生存(OS)期为17.9(95%CI 5.6~30.2)个月,预计3年OS率为38.5%(95%CI 12.0%~65.0%)。 结论 HIV阴性PBL侵袭性强,结外受累常见,多数患者诊断时分期较晚。通过以硼替佐米为基础的强化疗方案序贯自体造血干细胞移植可望获得长期生存。
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Affiliation(s)
- W J Fu
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - M X He
- Department of Pathology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - A J Huang
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - L Gao
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - G H Lu
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - J Chen
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - L Chen
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - X Ni
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - W P Zhang
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - J M Wang
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
| | - J M Yang
- Department of Hematology, Institute of Hematology, Changhai Hospital Affiliated to Navy Military Medical University, Shanghai 200433, China
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12
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Farrugia ME, Goodfellow JA. A Practical Approach to Managing Patients With Myasthenia Gravis-Opinions and a Review of the Literature. Front Neurol 2020; 11:604. [PMID: 32733360 PMCID: PMC7358547 DOI: 10.3389/fneur.2020.00604] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/25/2020] [Indexed: 12/14/2022] Open
Abstract
When the diagnosis of myasthenia gravis (MG) has been secured, the aim of management should be prompt symptom control and the induction of remission or minimal manifestations. Symptom control, with acetylcholinesterase inhibitors such as pyridostigmine, is commonly employed. This may be sufficient in mild disease. There is no single universally accepted treatment regimen. Corticosteroids are the mainstay of immunosuppressive treatment in patients with more than mild MG to induce remission. Immunosuppressive therapies, such as azathioprine are prescribed in addition to but sometimes instead of corticosteroids when background comorbidities preclude or restrict the use of steroids. Rituximab has a role in refractory MG, while plasmapheresis and immunoglobulin therapy are commonly prescribed to treat MG crisis and in some cases of refractory MG. Data from the MGTX trial showed clear evidence that thymectomy is beneficial in patients with acetylcholine receptor (AChR) antibody positive generalized MG, up to the age of 65 years. Minimally invasive thymectomy surgery including robotic-assisted thymectomy surgery has further revolutionized thymectomy and the management of MG. Ocular MG is not life-threatening but can be significantly disabling when diplopia is persistent. There is evidence to support early treatment with corticosteroids when ocular motility is abnormal and fails to respond to symptomatic treatment. Treatment needs to be individualized in the older age-group depending on specific comorbidities. In the younger age-groups, particularly in women, consideration must be given to the potential teratogenicity of certain therapies. Novel therapies are being developed and trialed, including ones that inhibit complement-induced immunological pathways or interfere with antibody-recycling pathways. Fatigue is common in MG and should be duly identified from fatigable weakness and managed with a combination of physical therapy with or without psychological support. MG patients may also develop dysfunctional breathing and the necessary respiratory physiotherapy techniques need to be implemented to alleviate the patient's symptoms of dyspnoea. In this review, we discuss various facets of myasthenia management in adults with ocular and generalized disease, including some practical approaches and our personal opinions based on our experience.
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Affiliation(s)
- Maria Elena Farrugia
- Neurology Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - John A Goodfellow
- Neurology Department, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom.,Neuroimmunology Laboratory, Laboratory Medicine and Facilities Building, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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13
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Chen Y, Li R, Zhu Y, Zhong S, Qian J, Yang D, Jurczyszyn A, Beksac M, Gu C, Yang Y. Dihydroartemisinin Induces Growth Arrest and Overcomes Dexamethasone Resistance in Multiple Myeloma. Front Oncol 2020; 10:767. [PMID: 32500030 PMCID: PMC7242728 DOI: 10.3389/fonc.2020.00767] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 04/21/2020] [Indexed: 12/13/2022] Open
Abstract
The discovery of artemisinin (ART) for malaria treatment won the 2015 Nobel Prize in Medicine, which inspired the rediscovery and development of ART for the treatment of other diseases including cancer. In this study, we investigated the potential therapeutic effect of ART and dihydroartemisinin (DHA) on multiple myeloma (MM) cells including primary MM cells and in 5TMM3VT mouse model. Both in vitro and in vivo experiments showed that DHA might be a more promising anti-MM agent with significantly improved efficacy compared to ART. Mechanistic analyses suggested that DHA activated the mitochondrial apoptotic pathway by interacting with ferrous (Fe2+) ions and oxygen to produce reactive oxygen species (ROS). Intriguingly, DHA could reverse the upregulated expression of B-cell lymphoma 2 (Bcl-2) protein, a typical mitochondrial apoptotic marker, induced by dexamethasone (Dexa) in MM. We further demonstrated that DHA treatment could overcome Dexa resistance and enhance Dexa efficacy in MM. Additionally, DHA combined with Dexa resulted in increased ROS production and cytochrome C translocation from the mitochondria to the cytoplasm, resulting in alterations to the mitochondrial membrane potential and caspase-mediated apoptosis. In summary, our study demonstrated that DHA was superior to ART in MM treatment and overcame Dexa resistance both in vitro and in vivo, providing a promising therapeutic strategy for MM therapy.
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Affiliation(s)
- Ying Chen
- The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Rui Li
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuqi Zhu
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Department of Internal Medicine, University of Iowa, Iowa City, IA, United States
| | - Sixia Zhong
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jinjun Qian
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Dongqing Yang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Artur Jurczyszyn
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - Meral Beksac
- Department of Hematology, School of Medicine, Ankara University, Ankara, Turkey
| | - Chunyan Gu
- The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ye Yang
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Key Laboratory for Combination of Acupuncture and Chinese Materia Medica of Chinese Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China
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14
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Chee ARY, Ng TF, Lam SJP, Wright M, Leahy MF. An unusual case of plasmablastic lymphoma presenting as dermatomyositis. Clin Case Rep 2020; 8:843-847. [PMID: 32477530 PMCID: PMC7250978 DOI: 10.1002/ccr3.2787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 11/11/2022] Open
Abstract
We report a rare case of aggressive plasmablastic lymphoma with an initial presentation of dermatomyositis. The challenges associated with the diagnosis and treatment approach are also highlighted in this case report.
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Affiliation(s)
| | - Teng Fong Ng
- Department of HaematologyRoyal Perth HospitalPerthWAAustralia
| | - Stephanie Jin Ping Lam
- Department of HaematologyRoyal Perth HospitalPerthWAAustralia
- Present address:
Department of HaematologySir Charles Gairdner HospitalNedlandsWAAustralia
| | - Matthew Wright
- Department of HaematologyFiona Stanley HospitalMurdochWAAustralia
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15
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Abstract
Bortezomib is a dipeptidyl boronic acid that selectively inhibits the ubiquitin proteasome pathway, which plays a role in the degradation of many intracellular proteins. It is the first-in-class selective and reversible inhibitor of the 26S proteasome, with antiproliferative and antitumor activity. It exerts its anti-neoplastic action mainly via the inhibition of the nuclear factor-κB pathway components associated with cell proliferation, apoptosis, and angiogenesis. The drug has revolutionized the treatment of multiple myeloma and, more recently, mantle cell lymphoma. In 2003, bortezomib received accelerated approval from the US Food and Drug Administration for the treatment of relapsed/refractory multiple myeloma and in 2008 for patients with previously untreated multiple myeloma. In 2006, bortezomib was approved for the treatment of refractory/relapsed mantle cell lymphoma and, in 2014, for previously untreated mantle cell lymphoma. Bortezomib has also demonstrated clinical efficacy both as a single drug and in combination with other agents in light chain amyloidosis, lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia, and peripheral T-cell lymphomas. Furthermore, continued clinical studies are required to confirm its value for patients with indolent and aggressive B-cell non-Hodgkin lymphomas and acute leukemias.
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16
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Wang L, Wei CY, Xu YY, Deng XY, Wang Q, Ying JH, Zhang SM, Yuan X, Xuan TF, Pan YY, Gu JY. Prognostic genes of melanoma identified by weighted gene co-expression network analysis and drug repositioning using a network-based method. Oncol Lett 2019; 18:6066-6078. [PMID: 31788081 PMCID: PMC6864934 DOI: 10.3892/ol.2019.10961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 08/21/2019] [Indexed: 12/19/2022] Open
Abstract
Melanoma is one of the most malignant types of skin cancer. However, the efficacy and utility of available drug therapies for melanoma are limited. The objective of the present study was to identify potential genes associated with melanoma progression and to explore approved therapeutic drugs that target these genes. Weighted gene co-expression network analysis was used to construct a gene co-expression network, explore the associations between genes and clinical characteristics and identify potential biomarkers. Gene expression profiles of the GSE65904 dataset were obtained from the Gene Expression Omnibus database. RNA-sequencing data and clinical information associated with melanoma obtained from The Cancer Genome Atlas were used for biomarker validation. A total of 15 modules were identified through average linkage hierarchical clustering. In the two significant modules, three network hub genes associated with melanoma prognosis were identified: C-X-C motif chemokine receptor 4 (CXCR4), interleukin 7 receptor (IL7R) and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit γ (PIK3CG). The receiver operating characteristic curve indicated that the mRNA levels of these genes exhibited excellent prognostic efficiency for primary and metastatic tumor tissues. In addition, the proximity between candidate genes associated with melanoma progression and drug targets obtained from DrugBank was calculated in the protein interaction network, and the top 15 drugs that may be suitable for treating melanoma were identified. In summary, co-expression network analysis led to the selection of CXCR4, IL7R and PIK3CG for further basic and clinical research on melanoma. Utilizing a network-based method, 15 drugs that exhibited potential for the treatment of melanoma were identified.
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Affiliation(s)
- Lu Wang
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Chuan-Yuan Wei
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Yuan-Yuan Xu
- Department of Surgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Xin-Yi Deng
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Qiang Wang
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Jiang-Hui Ying
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Si-Min Zhang
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Xin Yuan
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Tian-Fan Xuan
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Yu-Yan Pan
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
| | - Jian-Ying Gu
- Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
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17
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Arora N, Eule C, Gupta A, Li HC, Sadeghi N. Clinicopathologic features, management, and outcomes of plasmablastic lymphoma: A 10-year experience. Am J Hematol 2019; 94:E127-E129. [PMID: 30734351 DOI: 10.1002/ajh.25432] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/05/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Nivedita Arora
- Department of Internal MedicineUniversity of Texas Southwestern Medical Center Dallas Texas
| | - Corbin Eule
- Department of Internal MedicineUniversity of Texas Southwestern Medical Center Dallas Texas
| | - Arjun Gupta
- Department of Internal MedicineUniversity of Texas Southwestern Medical Center Dallas Texas
| | - Hsiao C. Li
- Division of Hematology and OncologyUniversity of Texas Southwestern Medical Center Dallas Texas
- Division of Hematology and OncologyParkland Health and Hospital System
| | - Navid Sadeghi
- Division of Hematology and OncologyUniversity of Texas Southwestern Medical Center Dallas Texas
- Division of Hematology and OncologyParkland Health and Hospital System
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18
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Cabeçadas J, Martinez D, Andreasen S, Mikkelsen LH, Molina-Urra R, Hall D, Strojan P, Hellquist H, Bandello F, Rinaldo A, Cardesa A, Ferlito A. Lymphomas of the head and neck region: an update. Virchows Arch 2019; 474:649-665. [PMID: 30778677 DOI: 10.1007/s00428-019-02543-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/06/2019] [Accepted: 02/08/2019] [Indexed: 12/13/2022]
Abstract
The field of haematopathology is rapidly evolving and for the non-specialized pathologist receiving a specimen with the possibility of a lymphoid malignancy may be a daunting experience. The coincidence of the publication, in 2017, of the WHO monographies on head and neck and haematopoietic and lymphoid tumours prompted us to write this review. Although not substantially different from lymphomas elsewhere, lymphomas presenting in this region pose some specific problems and these are central to the review. In addition, differences in subtype frequency and morphological variations within the same entity are discussed. The difficulty in diagnosis related to some specimens led us to briefly mention common subtypes of systemic lymphomas presenting in the head and neck region.
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Affiliation(s)
- José Cabeçadas
- Departamento de Diagnóstico Laboratorial, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Rua Prof. Lima Basto, Lisbon, Portugal.
| | - Daniel Martinez
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Simon Andreasen
- Department of Otorhinolaryngology Head & Neck Surgery and Audiology, Department of Pathology, Rigshospitalet, 2100, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, 2100, Copenhagen, Denmark
| | - Ricardo Molina-Urra
- Pathology and Cytopathology Department, Hospital Base Puerto Montt, Puerto Montt, Chile
| | - Diane Hall
- Department and Pathology, Henry Ford Allegiance Health, Jackson, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences, CBMR, Algarve Biomedical Centre, University of Algarve, Faro, Portugal
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute-IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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19
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A Rare Presentation of HIV-Negative Plasmablastic Lymphoma: A Diagnostic Dilemma. Case Rep Hematol 2019; 2019:2907317. [PMID: 30906602 PMCID: PMC6393929 DOI: 10.1155/2019/2907317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/17/2018] [Accepted: 01/01/2019] [Indexed: 11/17/2022] Open
Abstract
Plasmablastic lymphoma (PBL) and plasmablastic plasma cell myeloma (PCM) have many overlapping characteristics. Clinical correlation can help make the distinction between the two entities. Human immunodeficiency virus- (HIV-) negative PBL is a rare disease, making the diagnosis more challenging. While there is no standard of care for PBL, current recommendations include dose-adjusted EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone), with or without bortezomib. We report an aggressive case of HIV-negative plasmablastic lymphoma and discuss the challenge in establishing a diagnosis. We review the literature regarding this disease and current recommendations for treatment.
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20
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Lopez A, Abrisqueta P. Plasmablastic lymphoma: current perspectives. BLOOD AND LYMPHATIC CANCER-TARGETS AND THERAPY 2018; 8:63-70. [PMID: 31360094 PMCID: PMC6467349 DOI: 10.2147/blctt.s142814] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Plasmablastic lymphoma (PbL) is a rare and aggressive B-cell malignancy with large neoplastic cells, most of them resembling plasmablasts that have a CD20-negative phenotype. Although initially described as being associated with HIV, over the years it has also been identified in patients with solid organ transplant and immunocompetent patients. Little is known about molecular basis that drives PbL, and still its diagnosis remains challenging given its rarity. However, proper recognition of its clinical characteristics, localization, and morphological features can establish a correct diagnosis of PbL within the spectrum of CD20-negative large B-cell lymphomas (LBCLs). PbL is characterized by CD20 and PAX5 negativity together with the expression of CD38, CD138, MUM1/IRF4, Blimp1, and XBP1 plasmacytic differentiation markers. It is usually associated with Epstein–Barr virus infections, and MYC gene rearrangements. PbL should be carefully differentiated from other CD20-negative B-cell neoplasms, ie, primary effusion lymphoma, anaplastic lymphoma kinase-positive (ALK) large B-cell lymphoma, and LBCL in human herpesvirus 8-associated multicentric Castleman disease. Despite our improved understanding of this disease, its prognosis remains dismal with short overall survival. There is no standard of care for this entity. Several chemotherapy combinations have been used with hardly any differences on its outcome. Thus, new approaches with the addition of novel molecules are needed to overcome its poor prognosis. Our current understanding and knowledge of PbL relies primarily on case reports and small case series. In this review, we revise through an extensive literature search, the clinical and biological characteristics of this entity, and the potential therapeutic options.
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Affiliation(s)
- Andres Lopez
- Lymphoma Unit, Department of Hematology, Vall d'Hebron University Hospital, Barcelona, Spain,
| | - Pau Abrisqueta
- Department of Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
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21
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Zuze T, Painschab MS, Seguin R, Kudowa E, Kaimila B, Kasonkanji E, Tomoka T, Dhungel BM, Mulenga M, Chikasema M, Tewete B, Ntangwanika A, Chiyoyola S, Chimzimu F, Kampani C, Krysiak R, Montgomery ND, Fedoriw Y, Gopal S. Plasmablastic lymphoma in Malawi. Infect Agent Cancer 2018; 13:22. [PMID: 29988350 PMCID: PMC6022505 DOI: 10.1186/s13027-018-0195-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/22/2018] [Indexed: 02/03/2023] Open
Abstract
Plasmablastic lymphoma (PBL) clinical descriptions are scarce from sub-Saharan Africa (SSA) where both HIV and EBV are highly endemic. We identified 12 patients with pathologically confirmed PBL from a prospective cohort in Lilongwe, Malawi. Median age was 46 (range 26-71), seven (58%) were male, and six (50%) were HIV-positive. Eight patients were treated with CHOP and four with a modified EPOCH regimen. One-year overall survival was 56% (95% CI 24-79%), without clear differences based on HIV status. PBL occurs in Malawi in HIV-positive and HIV-negative individuals and can be treated successfully with curative intent, even in a low-resource setting in SSA.
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Affiliation(s)
- Takondwa Zuze
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi
| | - Matthew S Painschab
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,2University of North Carolina, Chapel Hill, USA
| | - Ryan Seguin
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,2University of North Carolina, Chapel Hill, USA
| | | | | | | | - Tamiwe Tomoka
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,3University of Malawi College of Medicine, Blantyre, Malawi
| | - Bal Mukunda Dhungel
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,2University of North Carolina, Chapel Hill, USA
| | | | | | | | | | | | - Fred Chimzimu
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi
| | | | - Robert Krysiak
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,2University of North Carolina, Chapel Hill, USA
| | | | | | - Satish Gopal
- UNC Project-Malawi, Private Bag, A-104 Lilongwe, Malawi.,2University of North Carolina, Chapel Hill, USA.,3University of Malawi College of Medicine, Blantyre, Malawi
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22
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Shi J, Bodo J, Zhao X, Durkin L, Goyal T, Meyerson H, Hsi ED. SLAMF7 (CD319/CS1) is expressed in plasmablastic lymphoma and is a potential diagnostic marker and therapeutic target. Br J Haematol 2018; 185:145-147. [PMID: 29785767 DOI: 10.1111/bjh.15393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- John Shi
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Juraj Bodo
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaoxian Zhao
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Durkin
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Tanu Goyal
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Pathology, University Hospitals, Cleveland, OH, USA
| | - Howard Meyerson
- Department of Pathology, University Hospitals, Cleveland, OH, USA
| | - Eric D Hsi
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
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23
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Gong J, Zhou Y, Liu D, Huo J. F-box proteins involved in cancer-associated drug resistance. Oncol Lett 2018; 15:8891-8900. [PMID: 29805625 DOI: 10.3892/ol.2018.8500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/24/2018] [Indexed: 12/11/2022] Open
Abstract
The ubiquitin proteasome system (UPS) regulated human biological processes through the appropriate and efficient proteolysis of cellular proteins. F-box proteins are the vital components of SKP1-CUL1-FBP (SCF)-type E3 ubiquitin ligases that determine substrate specificity. As F-box proteins have the ability to control the degradation of several crucial protein targets associated with drug resistance, the dysregulation of these proteins may lead to induction of chemoresistance in cancer cells. Chemotherapy is one of the most conventional therapeutic approaches of treatment of patients with cancer. However, its exclusive application in clinical settings is restricted due to the development of chemoresistance, which typically results treatment failure. Therefore, overcoming drug resistance is considered as one of the most critical issues that researchers and clinician associated with oncology face. The present review serves to provide a comprehensive overview of F-box proteins and their possible targets as well as their correlation with the chemoresistance and chemosensitization of cancer cells. The article also presents an integrated representation of the complex regulatory mechanisms responsible for chemoresistance, which may lay the foundation to explore sensible candidate drugs for therapeutic intervention.
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Affiliation(s)
- Jian Gong
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Yuqian Zhou
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Deliang Liu
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Jirong Huo
- Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
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24
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Menter T, Tzankov A. Mechanisms of Immune Evasion and Immune Modulation by Lymphoma Cells. Front Oncol 2018; 8:54. [PMID: 29564225 PMCID: PMC5845888 DOI: 10.3389/fonc.2018.00054] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/20/2018] [Indexed: 02/06/2023] Open
Abstract
Purpose Targeting cancer cells by modulating the immune system has become an important new therapeutic option in many different malignancies. Inhibition of CTLA4/B7 and PD1/PDL1 signaling is now also being investigated and already successfully applied to various hematologic malignancies. Methods A literature review of PubMed and results of our own studies were compiled in order to give a comprehensive overview on this topic. Results We elucidate the pathophysiological role of immunosuppressive networks in lymphomas, ranging from changes in the cellular microenvironment composition to distinct signaling pathways such as PD1/PDL1 or CTLA4/B7/CD28. The prototypical example of a lymphoma manipulating and thereby silencing the immune system is Hodgkin lymphoma. Also other lymphomas, e.g., primary mediastinal B-cell lymphoma and some Epstein–Barr virus (EBV)-driven malignancies, use analogous survival strategies, while diffuse large B-cell lymphoma of the activated B-cell type, follicular lymphoma and angioimmunoblastic T-cell lymphoma to name a few, exert further immune escape strategies each. These insights have already led to new treatment opportunities and results of the most important clinical trials based on this concept are briefly summarized. Immune checkpoint inhibition might also have severe side effects; the mechanisms of the rather un(der)recognized hematological side effects of this treatment approach are discussed. Conclusion Silencing the host’s immune system is an important feature of various lymphomas. Achieving a better understanding of distinct pathways of interactions between lymphomas and different immunological microenvironment compounds yields substantial potential for new treatment concepts.
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Affiliation(s)
- Thomas Menter
- Institute of Pathology and Medical Genetics, University Hospital of Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Pathology and Medical Genetics, University Hospital of Basel, Basel, Switzerland
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25
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Rezahosseini O, Hanaei S, Hamadani M, Keshavarz-Fathi M, Rezaei N. The promising role of monoclonal antibodies for immunotherapy of the HIV-associated cancer, non-Hodgkin lymphoma. Int Rev Immunol 2017; 37:165-173. [PMID: 29257907 DOI: 10.1080/08830185.2017.1405396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Association between HIV/AIDS and some of the cancers such as lymphomais is well known. Relative risk for developing non-Hodgkin lymphoma (NHL) increases 60-200 folds in HIV-infected individuals. Diffuse large B cell lymphoma (DLBCL), primary effusion lymphoma (PEL), Burkitt's lymphoma (BL) and Plasmablastic Lymphoma (PBL) are among the most frequent subtypes. During the last century, scientists found that the immune system could potentially detect and destroy cancer cells. Therefore, they started a new field of study, which is named immunotherapy. There are different immunotherapeutic methods, among which therapeutic antibodies, such as Brentuximabvedotin (Adcetris), Ibritumomabtiuxetan (Zevalin) and rituximab (Rituxan), used for treatment of NHLs showed promising results. In this article, we will review the immunotherapeutic option, monoclonal antibodies, for treatment of HIV-associated NHLs as well as their recent clinical status. We will also discuss the selective monoclonal antibody for each subtype of NHLs.
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Affiliation(s)
- Omid Rezahosseini
- a Cancer Immunology Project (CIP) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran.,b Department of Infectious and Tropical diseases , Imam Khomeini Hospital Complex, Tehran University of Medical Sciences , Tehran , Iran
| | - Sara Hanaei
- a Cancer Immunology Project (CIP) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran.,c Research Center for Immunodeficiencies , Children's Medical Center, Tehran University of Medical Sciences , Tehran , Iran.,d School of Medicine , Tehran University of Medical Sciences , Tehran , Iran
| | - Mehdi Hamadani
- e Division of Hematology & Oncology , Medical College of Wisconsin , Milwaukee , WI , USA.,f Cancer Immunology Project (CIP) , Universal Scientific Education and Research Network (USERN) , Milwaukee , WI , USA
| | - Mahsa Keshavarz-Fathi
- a Cancer Immunology Project (CIP) , Universal Scientific Education and Research Network (USERN) , Tehran , Iran.,c Research Center for Immunodeficiencies , Children's Medical Center, Tehran University of Medical Sciences , Tehran , Iran.,d School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,g Students' Scientific Research Center , Tehran University of Medical Sciences , Tehran , Iran
| | - Nima Rezaei
- c Research Center for Immunodeficiencies , Children's Medical Center, Tehran University of Medical Sciences , Tehran , Iran.,h Department of Immunology, School of Medicine , Tehran University of Medical Sciences , Tehran , Iran.,i Cancer Immunology Project (CIP) , Universal Scientific Education and Research Network (USERN) , Sheffield , UK
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