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Vadasz B, Zak T, Aldinger J, Sukhanova M, Gao J, Wolniak KL, Chen YH, Chen QC, Ma S, Tariq H. "Accelerated" chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL): unraveling the biological gray zone of CLL/SLL in the era of novel therapies. Virchows Arch 2024:10.1007/s00428-024-03920-7. [PMID: 39243299 DOI: 10.1007/s00428-024-03920-7] [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: 06/28/2024] [Revised: 08/24/2024] [Accepted: 08/30/2024] [Indexed: 09/09/2024]
Abstract
Accelerated chronic lymphocytic leukemia/small lymphocytic lymphoma (A-CLL/SLL) is a histologically aggressive subtype of CLL/SLL that lies in between conventional CLL/SLL (C-CLL/SLL) and Richter transformation (RT) on the biological spectrum. Although the histologic criteria for A-CLL/SLL were defined 14 years ago, the clinical and genetic characteristics and survival outcomes of these patients have yet to be studied in the era of novel therapies. We retrospectively analyzed the clinicopathologic, genetic, and survival characteristics of 34 patients with confirmed tissue diagnosis of A-CLL/SLL and compared them with 120 patients with C-CLL/SLL. Patients with A-CLL/SLL had significantly higher frequencies of B-symptoms, anemia and thrombocytopenia, splenomegaly, higher LDH, and more advanced Rai stages. A-CLL/SLL showed a significantly higher frequency of TP53 mutations (55.0% vs. 11.5%;p < 0.0001) and deletions (38.2% vs. 8.3%;p < 0.0001), lower isolated del(13q) (5.8% vs. 27.5%;p < 0.0001), and increased incidence of RT (11.76% vs. 0.83%;p = 0.0025). The overall survival of patients with A-CLL/SLL was significantly lower than C-CLL/SLL (median survival: 6.17 years vs. not reached; 2 and 5-year survival rates: 75.5% vs. 94.7% and 53.3% vs. 93.7%, respectively; p < 0.0001); however, novel agents have improved the outcomes dramatically compared to the previously published data in the pre-BTKi era. Our results support the categorization of A-CLL/SLL as a distinct biologically aggressive subtype of CLL/SLL and highlight the need to revise the diagnostic criteria utilizing a multifaceted approach that integrates the overall pathobiological profile of the disease, in addition to the histology.
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Affiliation(s)
- Brian Vadasz
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Taylor Zak
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Jonathan Aldinger
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Madina Sukhanova
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Juehua Gao
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Kristy Lucile Wolniak
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Yi-Hua Chen
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Qing Ching Chen
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA
| | - Shuo Ma
- Robert H. Lurie Comprehensive Cancer Center, Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 675 N St Clair, Chicago, IL, 60611, USA
| | - Hamza Tariq
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 251 E. Huron St. 7-213F, Chicago, IL, 60611, USA.
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Feng B, Huang L, Liu Y, Chen Y, Zhou H, Yu T, Xue H, Chen Q, Zhou T, Kuang Q, Yang Z, Chen X, Chen X, Peng Z, Long W. A Transfer Learning Radiomics Nomogram for Preoperative Prediction of Borrmann Type IV Gastric Cancer From Primary Gastric Lymphoma. Front Oncol 2022; 11:802205. [PMID: 35087761 PMCID: PMC8789309 DOI: 10.3389/fonc.2021.802205] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Objective This study aims to differentiate preoperative Borrmann type IV gastric cancer (GC) from primary gastric lymphoma (PGL) by transfer learning radiomics nomogram (TLRN) with whole slide images of GC as source domain data. Materials and Methods This study retrospectively enrolled 438 patients with histopathologic diagnoses of Borrmann type IV GC and PGL. They received CT examinations from three hospitals. Quantitative transfer learning features were extracted by the proposed transfer learning radiopathomic network and used to construct transfer learning radiomics signatures (TLRS). A TLRN, which integrates TLRS, clinical factors, and CT subjective findings, was developed by multivariate logistic regression. The diagnostic TLRN performance was assessed by clinical usefulness in the independent validation set. Results The TLRN was built by TLRS and a high enhanced serosa sign, which showed good agreement by the calibration curve. The TLRN performance was superior to the clinical model and TLRS. Its areas under the curve (AUC) were 0.958 (95% confidence interval [CI], 0.883–0.991), 0.867 (95% CI, 0.794–0.922), and 0.921 (95% CI, 0.860–0.960) in the internal and two external validation cohorts, respectively. Decision curve analysis (DCA) showed that the TLRN was better than any other model. TLRN has potential generalization ability, as shown in the stratification analysis. Conclusions The proposed TLRN based on gastric WSIs may help preoperatively differentiate PGL from Borrmann type IV GC. Borrmann type IV gastric cancer, primary gastric lymphoma, transfer learning, whole slide image, deep learning.
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Affiliation(s)
- Bao Feng
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China.,School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, China
| | - Liebin Huang
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Yu Liu
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, China
| | - Yehang Chen
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, China
| | - Haoyang Zhou
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, China
| | - Tianyou Yu
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China
| | - Huimin Xue
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Qinxian Chen
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Tao Zhou
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Qionglian Kuang
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
| | - Zhiqi Yang
- Department of Radiology, Meizhou People's Hospital, Meizhou, China
| | - Xiangguang Chen
- Department of Radiology, Meizhou People's Hospital, Meizhou, China
| | - Xiaofeng Chen
- Department of Radiology, Meizhou People's Hospital, Meizhou, China
| | - Zhenpeng Peng
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wansheng Long
- Department of Radiology, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, China
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Yang Y, Zhao M, Liu X, Ge P, Zheng F, Chen T, Sun X. Two-way detection of image features and immunolabeling of lymphoma cells with one-step microarray analysis. BIOMICROFLUIDICS 2018; 12:064106. [PMID: 30867867 PMCID: PMC6404911 DOI: 10.1063/1.5063369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/10/2018] [Indexed: 05/04/2023]
Abstract
Detecting the number of pathological lymphoma cells and lymphocyte subtypes in blood is helpful for clinical diagnosis and typing of lymphoma. In the current study, cell type is identified by cell morphological features and immunolabeled lymphocyte subtypes. Red blood cells and leukocytes were separated using a microfluidic cell chip based on physical blood cell parameters, and leukocytes were identified using five characteristic parameters: energy variance, entropy variance, moment of inertia variance, color mean, and cell area individually. The number of red blood cells that could come into contact with the leukocyte membrane was ≤2 based on the microfluidic injection flow rate of microfluidic chips. Anti-CD3 and anti-CD19 antibodies were used for immunofluorescence staining of T-lymphocyte and B-lymphocyte surface antigens, respectively. The results suggested that the microfluidic assay could detect lymphocyte surface antigen markers and intact leukocytes. Therefore, we report a one-step microfluidic chip for classifying hematological lymphoma cells based on the physical parameters of cells, which can simultaneously measure the overall morphology of blood cells and immunolabeling of lymphocyte surface antigens in one step, solving the current problem of detecting subtypes of hematological lymphoma cells based on multiple methods and multi-step detection.
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Affiliation(s)
- Yu Yang
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, People’s Republic of China
| | - Meng Zhao
- School of Computer Science and Engineering, Tianjin University of Technology, Tianjin 300384, People’s Republic of China
| | - Xiaodan Liu
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, People’s Republic of China
| | - Peng Ge
- Department of Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People’s Republic of China
| | - Fang Zheng
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, People’s Republic of China
| | - Tao Chen
- Institute of Laser Engineering, Beijing University of Technology, Beijing 100124, People’s Republic of China
| | - Xuguo Sun
- School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, People’s Republic of China
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