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Naresh KN. Understanding splenic B-cell lymphoma/leukaemia with prominent nucleoli: Diagnosis, underpinnings for disease classification and future directions. Br J Haematol 2024. [PMID: 39253895 DOI: 10.1111/bjh.19754] [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: 07/23/2024] [Accepted: 08/26/2024] [Indexed: 09/11/2024]
Abstract
The 5th edition of the WHO classification of haematolymphoid tumours (WHO-HAEM5) introduced a new category, splenic B-cell lymphoma/leukaemia with prominent nucleoli (SBLPN). The diagnostic entity B-cell prolymphocytic leukaemia (B-PLL) has been discontinued and the category of hairy cell leukaemia variant (HCLv) has been conceptually reframed. B-PLL and HCLv diagnoses were uncommon. Overlap existed between B-PLL and other indolent lymphomas like chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). HCLv lacked consistent cytomorphological, immunophenotypic and genetic features. To address these issues, the WHO-HAEM5 classification has introduced SBLPN to serve as a temporary holding ground for entities that do not neatly fit into the existing classification. Cases previously classified as CD5-negative B-PLL and HCLv fall under the SBLPN category. Some splenic marginal zone lymphoma and splenic diffuse red pulp small B-cell lymphoma cases with higher number of medium or large nucleolated B cells would also be classified as SBLPN under the WHO-HAEM5. This review explores the rationale for discontinuing B-PLL and HCLv diagnoses. It then examines the concept of SBLPN, offers practical guidance for diagnosis and discusses future directions in classifying splenic B-cell lymphomas.
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Affiliation(s)
- Kikkeri N Naresh
- Section of Pathology, Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
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Cerapio JP, Gravelle P, Quillet-Mary A, Valle C, Martins F, Franchini DM, Syrykh C, Brousset P, Traverse-Glehen A, Ysebaert L, Fournie JJ, Laurent C. Integrated spatial and multimodal single-cell transcriptomics reveal patient-dependent cell heterogeneity in splenic marginal zone lymphoma. J Pathol 2024; 263:442-453. [PMID: 38828498 DOI: 10.1002/path.6296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/22/2023] [Accepted: 04/17/2024] [Indexed: 06/05/2024]
Abstract
Biological hallmarks of splenic marginal zone lymphoma (SMZL) remain poorly described. Herein, we performed in-depth SMZL characterization through multimodal single-cell analyses of paired blood/spleen samples. The 3'-single-cell RNA-sequencing, Cellular Indexing of Transcriptomes and Epitopes by sequencing, and 5'-V(D)J single-cell RNA-sequencing datasets were integrated to characterize SMZL transcriptome profiles, including B-cell receptor and T-cell receptor repertoires. Hyperexpanded B-cell clones in the spleen were at a memory-like stage, whereas recirculating tumor B-cells in blood encompassed multiple differentiation stages, indicating an unexpected desynchronization of the B-cell maturation program in SMZL cells. Spatial transcriptomics showed the enrichment of T-effector and T-follicular helper (TFH) signatures in the nodular subtype of SMZL. This latter also exhibited gene-based cell-cell interactions suggestive of dynamic crosstalk between TFH and cancer cells in transcriptomics, further substantiated by using imaging mass cytometry. Our findings provide a comprehensive high-resolution description of SMZL biological hallmarks and characterize, for the first time in situ, inter- and intra-patient heterogeneity at both transcriptomic and protein levels. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Juan Pablo Cerapio
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
| | - Pauline Gravelle
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
- Centre Hospitalier Universitaire, Toulouse, France
| | - Anne Quillet-Mary
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
| | - Carine Valle
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
| | - Frederic Martins
- Institut Maladies Metaboliques et Cardiovasculaires, INSERM UMR1297, Toulouse, France
| | - Don-Marc Franchini
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
- Centre Hospitalier Universitaire, Toulouse, France
| | - Charlotte Syrykh
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Centre Hospitalier Universitaire, Toulouse, France
| | - Pierre Brousset
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
- Centre Hospitalier Universitaire, Toulouse, France
| | | | - Loic Ysebaert
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
- Centre Hospitalier Universitaire, Toulouse, France
| | - Jean-Jacques Fournie
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
| | - Camille Laurent
- Université de Toulouse, INSERM UMR1037, CNRS UMR5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France
- Institut Universitaire du Cancer-Oncopole de Toulouse, Toulouse, France
- Laboratoire d'Excellence 'TOUCAN-2', Toulouse, France
- Institut Carnot Lymphome - ADREP CALYM, Paris, France
- Centre Hospitalier Universitaire, Toulouse, France
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Mirandari A, Parker H, Ashton-Key M, Stevens B, Walewska R, Stamatopoulos K, Bryant D, Oscier DG, Gibson J, Strefford JC. The genomic and molecular landscape of splenic marginal zone lymphoma, biological and clinical implications. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2024; 5:877-901. [PMID: 39280243 PMCID: PMC11390296 DOI: 10.37349/etat.2024.00253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/08/2024] [Indexed: 09/18/2024] Open
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare, predominantly indolent B-cell lymphoma constituting fewer than 2% of lymphoid neoplasms. However, around 30% of patients have a shorter survival despite currently available treatments and the prognosis is especially poor for the 5-15% of cases that transform to a large cell lymphoma. Mounting evidence suggests that the molecular pathogenesis of SMZL is critically shaped by microenvironmental triggering and cell-intrinsic aberrations. Immunogenetic investigations have revealed biases in the immunoglobulin gene repertoire, indicating a role of antigen selection. Furthermore, cytogenetic studies have identified recurrent chromosomal abnormalities such as deletion of the long arm of chromosome 7, though specific disease-associated genes remain elusive. Our knowledge of SMZL's mutational landscape, based on a limited number of cases, has identified recurring mutations in KLF2, NOTCH2, and TP53, as well as genes clustering within vital B-cell differentiation pathways. These mutations can be clustered within patient subgroups with different patterns of chromosomal lesions, immunogenetic features, transcriptional signatures, immune microenvironments, and clinical outcomes. Regarding SMZL epigenetics, initial DNA methylation profiling has unveiled epigenetically distinct patient subgroups, including one characterized by elevated expression of Polycomb repressor complex 2 (PRC2) components. Furthermore, it has also demonstrated that patients with evidence of high historical cell division, inferred from methylation data, exhibit inferior treatment-free survival. This review provides an overview of our current understanding of SMZL's molecular basis and its implications for patient outcomes. Additionally, it addresses existing knowledge gaps, proposes future research directions, and discusses how a comprehensive molecular understanding of the disease will lead to improved management and treatment choices for patients.
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Affiliation(s)
- Amatta Mirandari
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
| | - Helen Parker
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
| | - Margaret Ashton-Key
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
- Department of Pathology, University Hospital Southampton NHS Foundation Trust, SO16 6YD Southampton, UK
| | - Benjamin Stevens
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
| | - Renata Walewska
- Department of Molecular Pathology, University Hospitals Dorset, SO16 6YD Bournemouth, UK
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 57001 Thessaloniki, Greece
| | - Dean Bryant
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
| | - David G Oscier
- Department of Molecular Pathology, University Hospitals Dorset, SO16 6YD Bournemouth, UK
| | - Jane Gibson
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
| | - Jonathan C Strefford
- Cancer Sciences, Faculty of Medicine, University of Southampton, SO16 6YD Southampton, UK
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Walewska R, Eyre TA, Barrington S, Brady J, Fields P, Iyengar S, Joshi A, Menne T, Parry-Jones N, Walter H, Wotherspoon A, Linton K. Guideline for the diagnosis and management of marginal zone lymphomas: A British Society of Haematology Guideline. Br J Haematol 2024; 204:86-107. [PMID: 37957111 DOI: 10.1111/bjh.19064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Renata Walewska
- Cancer Care, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Toby A Eyre
- Department of Haematology, Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sally Barrington
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's Health Partners, Kings College London, London, UK
| | - Jessica Brady
- Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul Fields
- Guy's and St Thomas' Hospital, Kings Health Partners, London, UK
| | - Sunil Iyengar
- Department of Haematology, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Anurag Joshi
- All Wales Lymphoma Panel, Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nilima Parry-Jones
- Department of Haematology, Aneurin Bevan University Health Board, Newport, Wales, UK
| | - Harriet Walter
- The Ernest and Helen Scott Haematological Research Institute, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Andrew Wotherspoon
- Department of Histopathology, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Kim Linton
- Division of Cancer Sciences, The Christie NHS Foundation Trust and The University of Manchester, Manchester, UK
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Wittner J, Schuh W. Krüppel-like factor 2: a central regulator of B cell differentiation and plasma cell homing. Front Immunol 2023; 14:1172641. [PMID: 37251374 PMCID: PMC10213221 DOI: 10.3389/fimmu.2023.1172641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/06/2023] [Indexed: 05/31/2023] Open
Abstract
The development of B cells, their activation and terminal differentiation into antibody-producing plasma cells are characterized by alternating phases of proliferation and quiescence that are controlled by complex transcriptional networks. The spatial and anatomical organization of B cells and plasma cells inside lymphoid organs as well as their migration within lymphoid structures and between organs are prerequisites for the generation and the maintenance of humoral immune responses. Transcription factors of the Krüppel-like family are critical regulators of immune cell differentiation, activation, and migration. Here, we discuss the functional relevance of Krüppel-like factor 2 (KLF2) for B cell development, B cell activation, plasma cell formation and maintenance. We elaborate on KLF2-mediated regulation of B cell and plasmablast migration in the context of immune responses. Moreover, we describe the importance of KLF2 for the onset and the progression of B cell-related diseases and malignancies.
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Wennerås C, Aranburu A, Wass L, Grankvist A, Staffas A, Soboli A, Mårtensson IL, Fogelstrand L, Lewerin C. Infection with Neoehrlichia mikurensis promotes the development of malignant B-cell lymphomas. Br J Haematol 2023; 201:480-488. [PMID: 36650117 DOI: 10.1111/bjh.18652] [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: 10/12/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
The tick-borne pathogen Neoehrlichia (N.) mikurensis is implicated in persistent infection of the vascular endothelium. B cells are crucial for the host defence to this infection. Chronic stimulation of B cells may result in B-cell transformation and lymphoma. Five patients with malignant B-cell lymphoma and concomitant N. mikurensis infection were investigated regarding clinical picture, lymphoma subtype, B-cell lymphoma immunophenotype and IGHV (variable region of the immunoglobulin heavy) gene repertoire. Three of the five patients improved markedly and ceased lymphoma treatment after doxycycline treatment to eliminate N. mikurensis. Sequencing the B-cell lymphoma IGHV genes revealed preferred usage of the IGHV1 (IGHV1-2, and -69) and IGHV3 (IGHV3-15, -21, -23) families. In conclusion, N. mikurensis infection may drive the development of malignant B-cell lymphomas. Eradication of the pathogen appears to induce remission with apparent curing of the lymphoma in some cases.
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Affiliation(s)
- Christine Wennerås
- Institute of Biomedicine, Department of Infectious Diseases, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Alaitz Aranburu
- Department of Rheumatology and Inflammation, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Linda Wass
- Institute of Biomedicine, Department of Infectious Diseases, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anna Grankvist
- Department of Clinical Microbiology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anna Staffas
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Anastasia Soboli
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Inga-Lill Mårtensson
- Department of Rheumatology and Inflammation, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Linda Fogelstrand
- Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Catharina Lewerin
- Department of Hematology and Coagulation, Sahlgrenska University Hospital, Göteborg, Sweden
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
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The landscape of immunoglobulin heavy chain gene repertoire and its clinical relevance in LPL/WM. Blood Adv 2022; 6:4049-4059. [PMID: 35537114 PMCID: PMC9278287 DOI: 10.1182/bloodadvances.2022007279] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/24/2022] [Indexed: 01/25/2023] Open
Abstract
We unveil the distinct patterns of IGHV repertoire and discuss the correlation between IGHV and other genetic abnormalities in LPL/WM. IGHV4 usage was a predictive marker of shorter progression-free survival in patients with LPL/WM.
Lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) is a heterogeneous disease in which the role of immunoglobulin heavy-chain genes (IGHs) remains unknown. To determine the clinical relevance of the IGH repertoire in patients with LPL/WM, we performed immunoglobulin gene rearrangement and complementarity determining region 3 (CDR3) analysis. The IGH variable gene (IGHV) repertoire was remarkably biased in LPL/WM. IGHV3-23, IGHV4-34, IGHV3-30, IGHV3-7, and IGHV3-74 accounted for one-half of the cohort’s repertoire. Most cases (97.1%) were found to carry mutated IGHV genes, based on a 98% IGHV germline homology cutoff. IGHV3-30 was associated with long heavy chain CDR3, indicating there was specific antigen selection in LPL/WM. Patients with IGHV3-7 were significantly more likely to harbor the 6q deletion (P < .001) and an abnormal karyotype (P = .004). The IGHV hypermutation rate in patients with the MYD88 L265P mutation was significantly higher than that of wild-type patients (P = .050). IGHV3-23 and IGHV3-74 segments were more frequently detected in patients with MYD88-mutated LPL/WM (P = .050), whereas IGHV3-7 presented more frequently in MYD88 wild-type patients (P = .042). Patients with IGHV4, especially IGHV4-34, had higher levels of lactate dehydrogenase, and IGHV4 was a predictive marker of shorter progression-free survival. These results showed for the first time that the IGHV repertoire has clinical relevance in LPL/WM.
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Donzel M, Baseggio L, Fontaine J, Pesce F, Ghesquières H, Bachy E, Verney A, Traverse-Glehen A. New Insights into the Biology and Diagnosis of Splenic Marginal Zone Lymphomas. ACTA ACUST UNITED AC 2021; 28:3430-3447. [PMID: 34590593 PMCID: PMC8482189 DOI: 10.3390/curroncol28050297] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Splenic marginal zone lymphoma (SMZL) is a small B-cell lymphoma, which has been recognized as a distinct pathological entity since the WHO 2008 classification. It classically presents an indolent evolution, but a third of patients progress rapidly and require aggressive treatments, such as immuno-chemotherapy or splenectomy, with all associated side effects. In recent years, advances in the comprehension of SMZL physiopathology have multiplied, thanks to the arrival of new devices in the panel of available molecular biology techniques, allowing the discovery of new molecular findings. In the era of targeted therapies, an update of current knowledge is needed to guide future researches, such as those on epigenetic modifications or the microenvironment of these lymphomas.
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Affiliation(s)
- Marie Donzel
- Institut de pathologie multi-sites, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France; (M.D.); (J.F.); (F.P.)
| | - Lucile Baseggio
- Laboratoire d’hématologie, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France;
- INSERM-Unité Mixte de Recherche 1052 CNRS 5286, Team “Clinical and Experimental Models of Lymphomagenesis”, UCBL, Cancer Research Center of Lyon, Université Lyon, 69001 Lyon, France; (H.G.); (E.B.); (A.V.)
| | - Juliette Fontaine
- Institut de pathologie multi-sites, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France; (M.D.); (J.F.); (F.P.)
| | - Florian Pesce
- Institut de pathologie multi-sites, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France; (M.D.); (J.F.); (F.P.)
| | - Hervé Ghesquières
- INSERM-Unité Mixte de Recherche 1052 CNRS 5286, Team “Clinical and Experimental Models of Lymphomagenesis”, UCBL, Cancer Research Center of Lyon, Université Lyon, 69001 Lyon, France; (H.G.); (E.B.); (A.V.)
- Service d’hématologie, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France
| | - Emmanuel Bachy
- INSERM-Unité Mixte de Recherche 1052 CNRS 5286, Team “Clinical and Experimental Models of Lymphomagenesis”, UCBL, Cancer Research Center of Lyon, Université Lyon, 69001 Lyon, France; (H.G.); (E.B.); (A.V.)
- Service d’hématologie, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France
| | - Aurélie Verney
- INSERM-Unité Mixte de Recherche 1052 CNRS 5286, Team “Clinical and Experimental Models of Lymphomagenesis”, UCBL, Cancer Research Center of Lyon, Université Lyon, 69001 Lyon, France; (H.G.); (E.B.); (A.V.)
| | - Alexandra Traverse-Glehen
- Institut de pathologie multi-sites, Hôpital Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France; (M.D.); (J.F.); (F.P.)
- INSERM-Unité Mixte de Recherche 1052 CNRS 5286, Team “Clinical and Experimental Models of Lymphomagenesis”, UCBL, Cancer Research Center of Lyon, Université Lyon, 69001 Lyon, France; (H.G.); (E.B.); (A.V.)
- Correspondence: ; Tel.: +33-4-7876-1186
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Sugita Y, Hashimoto G, Fukuda K, Takahashi K, Shioga T, Furuta T, Arakawa F, Ohshima K, Nakamura H, Miyata H, Watanabe M, Kakita A. Primary Nondural Central Nervous System Marginal ZoneB-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue Type Mimicking CNS Inflammatory Diseases. J Neuropathol Exp Neurol 2021; 80:789-799. [PMID: 34383910 DOI: 10.1093/jnen/nlab058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Marginal zone B-cell lymphomas (MZBCLs) are non-Hodgkin lymphomas arising from postgerminal center marginal zone B cells. MZBCLs are subclassified into extranodal, nodal, and splenic MZBCLs. Primary nondural central nervous system (CNS) MZBCLs of the mucosa-associated lymphoid tissue (MALT) type are among the extranodal examples. Their clinicopathological features are not well characterized. Therefore, the clinicopathological features of 8 primary nondural CNS MZBCLs of the MALT type were assessed to establish their pathological diagnostic criteria. Histologically, all cases of primary nondural CNS MZBCLs of the MALT type showed perivascular expansive monotonous proliferation of small atypical B lymphoid cells with plasma cell differentiation, low Ki-67 labeling index, and minimal invasion from the perivascular space. In addition, no vascular changes such as glomeruloid changes, obliterative fibrointimal proliferation, and intramural lymphocytic infiltration were seen. These key histological characteristics should be considered when diagnosing cases that are suspected to be primary nondural CNS MZBCLs of the MALT type. Additionally, regarding PCR for the detection of immunoglobulin heavy variable gene and T-cell receptor γ gene rearrangements, the former is detected, but the latter is not detected in all cases. Therefore, PCR detection including sequence analysis should be added when diagnosing difficult cases based on the key histological characteristics.
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Affiliation(s)
- Yasuo Sugita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Go Hashimoto
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Fukuda
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Takahashi
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Taro Shioga
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Takuya Furuta
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Fumiko Arakawa
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Koichi Ohshima
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hideo Nakamura
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hajime Miyata
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Masashi Watanabe
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Akiyoshi Kakita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
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Higher-order connections between stereotyped subsets: implications for improved patient classification in CLL. Blood 2021; 137:1365-1376. [PMID: 32992344 DOI: 10.1182/blood.2020007039] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is characterized by the existence of subsets of patients with (quasi)identical, stereotyped B-cell receptor (BcR) immunoglobulins. Patients in certain major stereotyped subsets often display remarkably consistent clinicobiological profiles, suggesting that the study of BcR immunoglobulin stereotypy in CLL has important implications for understanding disease pathophysiology and refining clinical decision-making. Nevertheless, several issues remain open, especially pertaining to the actual frequency of BcR immunoglobulin stereotypy and major subsets, as well as the existence of higher-order connections between individual subsets. To address these issues, we investigated clonotypic IGHV-IGHD-IGHJ gene rearrangements in a series of 29 856 patients with CLL, by far the largest series worldwide. We report that the stereotyped fraction of CLL peaks at 41% of the entire cohort and that all 19 previously identified major subsets retained their relative size and ranking, while 10 new ones emerged; overall, major stereotyped subsets had a cumulative frequency of 13.5%. Higher-level relationships were evident between subsets, particularly for major stereotyped subsets with unmutated IGHV genes (U-CLL), for which close relations with other subsets, termed "satellites," were identified. Satellite subsets accounted for 3% of the entire cohort. These results confirm our previous notion that major subsets can be robustly identified and are consistent in relative size, hence representing distinct disease variants amenable to compartmentalized research with the potential of overcoming the pronounced heterogeneity of CLL. Furthermore, the existence of satellite subsets reveals a novel aspect of repertoire restriction with implications for refined molecular classification of CLL.
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11
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Biderman BV, Likold EB, Smirnova SY, Nikitin EA, Koroleva DA, Zvonkov EE, Al-Radi LS, Julhakyan HL, Sudarikov AB. Repertoire of Rearranged Immunoglobulin Heavy Chain Genes in Russian Patients With B-Cell Lymphoproliferative Diseases. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:e938-e945. [PMID: 34384734 DOI: 10.1016/j.clml.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Immunoglobulin heavy chain variable region (IGHV) repertoire narrowing could be an evidence for the involvement of a limited set of antigens in the development of lymphomas. For chronic lymphocytic leukemia (CLL) the existence of more than 200 subgroups of tumor IGHV antigen-binding sites, so called "stereotypical" antigen receptors (SAR) has been shown. For others lymphomas the possibility of SARs is also suggested. The aim of this study is to compare the tumor IGHVs and possible SARs in various B-cell malignancies in Russia and other countries. MATERIALS AND METHODS The study included samples of 1800 CLL patients, 52 patients with mantle cell lymphoma, 48 patients with hairy cell lymphoma and 37 patients with splenic marginal cell lymphoma. The nucleotide sequences of the IGHV genes were determined according to ERIC protocol. RESULTS In CLL most common IGHV genes were IGHV1-69, IGHV1-2, IGHV3-30 and IGHV4-34. The most common SARs were CLL#1, CLL#6, CLL#2, CLL#3. In MCL the most common genes were IGHV4-34, IGHV3-21, IGHV3-23. In 5 MCL patients CDR3 sequences were identified matching definitions of a stereotyped. In the half of SMZL patients was identified gene IGHV1-2. Other IGHV genes were much less common. Two pairs of SMZL patients have motives similar to each other. In HCL IGHV repertoire was the most variable, no trends for antigen receptor stereotypy were observed. It was found that SARs are highly disease-specific both at the level of nucleotide and amino acid sequences. CONCLUSION Our results suggest that antigens crucial for the pathogenesis of B-cell malignancies could be disease-specific. Further studies on extended samples of non-CLL patients concerning the role of SARs in pathogenesis of these diseases may also contribute to the development of new diagnostic and prognostic markers.
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12
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Vlachonikola E, Sofou E, Chatzidimitriou A, Stamatopoulos K, Agathangelidis A. The Significance of B-cell Receptor Stereotypy in Chronic Lymphocytic Leukemia: Biological and Clinical Implications. Hematol Oncol Clin North Am 2021; 35:687-702. [PMID: 34174980 DOI: 10.1016/j.hoc.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The finding that (quasi)identical, stereotyped B-cell receptor (BcR) immunoglobulins IGs) are expressed in a significant fraction of chronic lymphocytic leukemia (CLL) highlighted the importance of antigen selection in disease pathogenesis. Subsets of patients sharing the same stereotyped BcR IG display consistent biological features and, at least for certain subsets, clinical presentation and outcome, including the response to particular treatment. On these grounds, BcR IG stereotypy emerges as a useful tool for dissecting the pronounced heterogeneity of CLL toward refining risk stratification and therapeutic management aligned with the principles of precision medicine.
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Affiliation(s)
- Elisavet Vlachonikola
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 6th km Charilaou - Thermis, 57001 Thermi, Thessaloniki, Greece; Department of Genetics and Molecular Biology, Faculty of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Electra Sofou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 6th km Charilaou - Thermis, 57001 Thermi, Thessaloniki, Greece; Laboratory of Biological Chemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Anastasia Chatzidimitriou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 6th km Charilaou - Thermis, 57001 Thermi, Thessaloniki, Greece; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala 75236, Sweden
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 6th km Charilaou - Thermis, 57001 Thermi, Thessaloniki, Greece; Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala 75236, Sweden.
| | - Andreas Agathangelidis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, 6th km Charilaou - Thermis, 57001 Thermi, Thessaloniki, Greece
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13
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Primary vitreoretinal lymphomas display a remarkably restricted immunoglobulin gene repertoire. Blood Adv 2021; 4:1357-1366. [PMID: 32267931 DOI: 10.1182/bloodadvances.2019000980] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/17/2020] [Indexed: 12/17/2022] Open
Abstract
Primary vitreoretinal lymphoma (PVRL) is a high-grade lymphoma affecting the vitreous and/or the retina. The vast majority of cases are histopathologically classified as diffuse large B-cell lymphoma (DLBCL) and considered a subtype of primary central nervous system lymphoma (PCNSL). To obtain more insight into the ontogenetic relationship between PVRL and PCNSL, we adopted an immunogenetic perspective and explored the respective immunoglobulin gene repertoire profiles from 55 PVRL cases and 48 PCNSL cases. In addition, considering that both entities are predominantly related to activated B-cell (ABC) DLBCL, we compared their repertoire with that of publicly available 262 immunoglobulin heavy variable domain gene rearrangement sequences from systemic ABC-type DLBCLs. PVRL displayed a strikingly biased repertoire, with the IGHV4-34 gene being used in 63.6% of cases, which was significantly higher than in PCNSL (34.7%) or in DLBCL (30.2%). Further repertoire bias was evident by (1) restricted associations of IGHV4-34 expressing heavy chains, with κ light chains utilizing the IGKV3-20/IGKJ1 gene pair, including 5 cases with quasi-identical sequences, and (2) the presence of a subset of stereotyped IGHV3-7 rearrangements. All PVRL IGHV sequences were highly mutated, with evidence of antigen selection and ongoing mutations. Finally, half of PVRL and PCNSL cases carried the MYD88 L265P mutation, which was present in all 4 PVRL cases with stereotyped IGHV3-7 rearrangements. In conclusion, the massive bias in the immunoglobulin gene repertoire of PVRL delineates it from PCNSL and points to antigen selection as a major driving force in their development.
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14
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Matutes E. Diagnostic and therapeutic challenges in hairy cell leukemia-variant: where are we in 2021? Expert Rev Hematol 2021; 14:355-363. [PMID: 33759673 DOI: 10.1080/17474086.2021.1908121] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Hairy cell leukemia-variant (HCL-V) is a rare B-cell neoplasm arising or homing primarily in the spleen. It has been considered in the WHO classification of Hemopoietic and Lymphoid Tumors as a provisional entity since 2008 and included under the umbrella of unclassifiable splenomegalic B-cell leukemia/lymphomas. The diagnosis is a challenge to hematopathologists and management of these patients by the clinicians is difficult due to the lack of diagnostic and therapeutic guidelines and prospective studies. AREAS COVERED This manuscript is a comprehensive review of the clinical features, pathology, immunophenotypic profile, genomic alterations and therapeutic options of HCL-V. Diagnostic and therapeutic dilemmas are extensively outlined considering the information derived from a literature search covering from 1980 to 2019. Integration of all the data is needed and recommended for establishing the diagnosis of this leukemia. EXPERT OPINION More extensive information of genomic aberrations underlying the pathogenesis of the disease would be a solid stone for the diagnosis. To this end, a collaborative work among scientists and pathologists from different centers is required and expected. In turn, this might have a relevant clinical translation by allowing to identify putative targets for therapy and to improve the outlook of these patients.
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15
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Piepenbrink MS, Park JG, Oladunni FS, Deshpande A, Basu M, Sarkar S, Loos A, Woo J, Lovalenti P, Sloan D, Ye C, Chiem K, Bates CW, Burch RE, Erdmann NB, Goepfert PA, Truong VL, Walter MR, Martinez-Sobrido L, Kobie JJ. Therapeutic activity of an inhaled potent SARS-CoV-2 neutralizing human monoclonal antibody in hamsters. CELL REPORTS MEDICINE 2021; 2:100218. [PMID: 33649747 PMCID: PMC7904445 DOI: 10.1016/j.xcrm.2021.100218] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/23/2020] [Accepted: 02/17/2021] [Indexed: 12/25/2022]
Abstract
SARS-CoV-2 infection results in viral burden in the respiratory tract, enabling transmission and leading to substantial lung pathology. The 1212C2 fully human monoclonal antibody was derived from an IgM memory B cell of a COVID-19 patient, has high affinity for the Spike protein receptor binding domain, neutralizes SARS-CoV-2, and exhibits in vivo prophylactic and therapeutic activity in hamsters when delivered intraperitoneally, reducing upper and lower respiratory viral burden and lung pathology. Inhalation of nebulized 1212C2 at levels as low as 0.6 mg/kg, corresponding to 0.03 mg/kg lung-deposited dose, reduced the viral burden below the detection limit and mitigated lung pathology. The therapeutic efficacy of an exceedingly low dose of inhaled 1212C2 supports the rationale for local lung delivery for dose-sparing benefits, as compared to the conventional parenteral route of administration. These results suggest that the clinical development of 1212C2 formulated and delivered via inhalation for the treatment of SARS-CoV-2 infection should be considered. The 1212C2 human monoclonal antibody potently neutralizes SARS-CoV-2 1212C2 mAb was isolated from an IgM memory B cell of a recovered COVID-19 patient Inhaled 1212C2 mAb is rapidly distributed in the lungs Inhaled 1212C2 mAb treatment reduces viral burden and lung pathology in hamsters
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Affiliation(s)
- Michael S Piepenbrink
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jun-Gyu Park
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | | | - Ashlesha Deshpande
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Madhubanti Basu
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sanghita Sarkar
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | | | - Chengjin Ye
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Kevin Chiem
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Christopher W Bates
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Reuben E Burch
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nathaniel B Erdmann
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paul A Goepfert
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Mark R Walter
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - James J Kobie
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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Gailllard B, Cornillet-Lefebvre P, Le QH, Maloum K, Pannetier M, Lecoq-Lafon C, Grange B, Jondreville L, Michaux L, Nadal N, Ittel A, Luquet I, Struski S, Lefebvre C, Gaillard JB, Lafage-Pochitaloff M, Balducci E, Penther D, Barin C, Collonge-Rame MA, Jimenez-Poquet M, Richebourg S, Lemaire P, Defasque S, Radford-Weiss I, Bidet A, Susin SA, Nguyen-Khac F, Chapiro E. Clinical and biological features of B-cell neoplasms with CDK6 translocations: an association with a subgroup of splenic marginal zone lymphomas displaying frequent CD5 expression, prolymphocytic cells, and TP53 abnormalities. Br J Haematol 2020; 193:72-82. [PMID: 33314017 DOI: 10.1111/bjh.17141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/04/2020] [Accepted: 09/09/2020] [Indexed: 01/16/2023]
Abstract
A translocation involving the cyclin-dependent kinase 6 (CDK6) gene [t(CDK6)] is a rare but recurrent abnormality in B-cell neoplasms. To further characterise this aberration, we studied 57 cases; the largest series reported to date. Fluorescence in situ hybridisation analysis confirmed the involvement of CDK6 in all cases, including t(2;7)(p11;q21) immunoglobulin kappa locus (IGK)/CDK6 (n = 51), t(7;14)(q21;q32) CDK6/immunoglobulin heavy locus (IGH) (n = 2) and the previously undescribed t(7;14)(q21;q11) CDK6/T-cell receptor alpha locus (TRA)/T-cell receptor delta locus (TRD) (n = 4). In total, 10 patients were diagnosed with chronic lymphocytic leukaemia, monoclonal B-cell lymphocytosis or small lymphocytic lymphoma, and 47 had small B-cell lymphoma (SmBL) including 36 cases of marginal zone lymphoma (MZL; 34 splenic MZLs, one nodal MZL and one bronchus-associated lymphoid tissue lymphoma). In all, 18 of the 26 cytologically reviewed cases of MZL (69%) had an atypical aspect with prolymphocytic cells. Among the 47 patients with MZL/SmBL, CD5 expression was found in 26 (55%) and the tumour protein p53 (TP53) deletion in 22 (47%). The TP53 gene was mutated in 10/30 (33%); the 7q deletion was detected in only one case, and no Notch receptor 2 (NOTCH2) mutations were found. Immunoglobulin heavy-chain variable-region (IGHV) locus sequencing revealed that none harboured an IGHV1-02*04 gene. Overall survival was 82% at 10 years and not influenced by TP53 aberration. Our present findings suggest that most t(CDK6)+ neoplasms correspond to a particular subgroup of indolent marginal zone B-cell lymphomas with distinctive features.
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Affiliation(s)
| | | | - Quoc-Hung Le
- Service d'Hématologie Clinique, Hôpital Robert Debré, Reims, France
| | - Karim Maloum
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France
| | - Mélanie Pannetier
- Laboratoire d'Hématologie, Centre Hospitalo-Universitaire, Rennes, France
| | | | - Béatrice Grange
- Service d'Hématologie Biologique, Hospices Civils de Lyon, Lyon, France
| | - Ludovic Jondreville
- Centre de Recherche des Cordeliers, INSERM UMRS_1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Paris, France
| | - Lucienne Michaux
- Center for Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Nathalie Nadal
- Service de génétique chromosomique et moléculaire, CHU Dijon, France
| | - Antoine Ittel
- Laboratoire de Cytogénétique Hématologique, CHU de Strasbourg, Strasbourg, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Stéphanie Struski
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | | | | | - Marina Lafage-Pochitaloff
- Laboratoire de Cytogénétique Onco-Hématologique, Hôpital de la Timone, AP-HM, Aix-Marseille Université, Marseille, France
| | - Estelle Balducci
- Laboratoire d'Hématologie, Hôpital Paul Brousse, APHP, Villejuif, France
| | - Dominique Penther
- Laboratoire de Génétique Oncologique, CLCC Henri Becquerel and INSERM U1245, Rouen, France
| | - Carole Barin
- Laboratoire de Cytogénétique hématologique, Service de Génétique, CHRU Bretonneau, Tours, France
| | | | | | - Steven Richebourg
- Laboratoire de Cytogénétique Onco-Hématologique, CHU de Québec - Université Laval, Québec, Canada
| | - Pierre Lemaire
- Laboratoire d'Hématologie, Hôpital Saint-Louis, APHP, Paris, France
| | - Sabine Defasque
- Secteur cytogénétique hématologique, Laboratoire CERBA, Saint-Ouen l'Aumône, France
| | | | - Audrey Bidet
- Laboratoire d'Hématologie, CHU Bordeaux-Haut Lévêque, Bordeaux, France
| | - Santos A Susin
- Centre de Recherche des Cordeliers, INSERM UMRS_1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Paris, France.,Sorbonne Université, Paris, France
| | - Florence Nguyen-Khac
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Centre de Recherche des Cordeliers, INSERM UMRS_1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Paris, France.,Sorbonne Université, Paris, France
| | - Elise Chapiro
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Centre de Recherche des Cordeliers, INSERM UMRS_1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Paris, France.,Sorbonne Université, Paris, France
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Milivojevic M, Che X, Bateman L, Cheng A, Garcia BA, Hornig M, Huber M, Klimas NG, Lee B, Lee H, Levine S, Montoya JG, Peterson DL, Komaroff AL, Lipkin WI. Plasma proteomic profiling suggests an association between antigen driven clonal B cell expansion and ME/CFS. PLoS One 2020; 15:e0236148. [PMID: 32692761 PMCID: PMC7373296 DOI: 10.1371/journal.pone.0236148] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 06/30/2020] [Indexed: 02/08/2023] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is an unexplained chronic, debilitating illness characterized by fatigue, sleep disturbances, cognitive dysfunction, orthostatic intolerance and gastrointestinal problems. Using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), we analyzed the plasma proteomes of 39 ME/CFS patients and 41 healthy controls. Logistic regression models, with both linear and quadratic terms of the protein levels as independent variables, revealed a significant association between ME/CFS and the immunoglobulin heavy variable (IGHV) region 3-23/30. Stratifying the ME/CFS group based on self-reported irritable bowel syndrome (sr-IBS) status revealed a significant quadratic effect of immunoglobulin lambda constant region 7 on its association with ME/CFS with sr-IBS whilst IGHV3-23/30 and immunoglobulin kappa variable region 3-11 were significantly associated with ME/CFS without sr-IBS. In addition, we were able to predict ME/CFS status with a high degree of accuracy (AUC = 0.774-0.838) using a panel of proteins selected by 3 different machine learning algorithms: Lasso, Random Forests, and XGBoost. These algorithms also identified proteomic profiles that predicted the status of ME/CFS patients with sr-IBS (AUC = 0.806-0.846) and ME/CFS without sr-IBS (AUC = 0.754-0.780). Our findings are consistent with a significant association of ME/CFS with immune dysregulation and highlight the potential use of the plasma proteome as a source of biomarkers for disease.
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Affiliation(s)
- Milica Milivojevic
- Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Xiaoyu Che
- Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, United States of America
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Lucinda Bateman
- Bateman Horne Center, Salt Lake City, UT, United States of America
| | - Aaron Cheng
- Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Benjamin A. Garcia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Mady Hornig
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Manuel Huber
- German Research Center for Environmental Health, Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Nancy G. Klimas
- Institute for Neuro Immune Medicine, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States of America
- Miami VA Medical Center, Miami, FL, United States of America
| | - Bohyun Lee
- Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Hyoungjoo Lee
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Susan Levine
- Levine Clinic, New York, NY, United States of America
| | - Jose G. Montoya
- Palo Alto Medical Foundation, Jack S. Remington Laboratory for Specialty Diagnostics of Toxoplasmosis, Palo Alto, CA, United States of America
| | - Daniel L. Peterson
- Sierra Internal Medicine at Incline Village, Incline Village, NV, United States of America
| | - Anthony L. Komaroff
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States of America
| | - W. Ian Lipkin
- Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, United States of America
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18
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Marinkovic D, Marinkovic T. Putative role of marginal zone B cells in pathophysiological processes. Scand J Immunol 2020; 92:e12920. [PMID: 32594535 DOI: 10.1111/sji.12920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/21/2020] [Indexed: 12/16/2022]
Abstract
The maintenance of inner integrity of an organism is founded on the proper performance of two immunity branches, innate and adaptive immune responses. Recently, it became apparent that subset of splenic B cells named marginal zone B cells (MZB cells) exhibits unique developmental and functional features that bridge these two immunity branches. Strategically positioned at the site where blood and lymph are filtered, MZB cells represent a population of sentinels that rapidly proliferate and differentiate into IgM plasmablast cells when encountered with blood-borne, thymus-independent (TI) Ags. Moreover, MZB cells have intrinsic capability to induce potent CD4+ helper T cell response and cytokine production upon stimulation with soluble antigens. Due to their ability to overcome a time gap prior the establishment of the full adaptive response towards pathogens, MZB cells connect and direct innate and adaptive immunity. An additional interesting characteristic of MZB cells is capacity to function as regulatory cells in autoimmune processes. MZB cells may also contribute to the control of autoimmunity via the induction of tolerance by apoptotic cells. Importantly, in the clear association with inflammation and autoimmunity, MZB cells may transform into MALT lymphoma, representing a concurrence point for the infection, immunity and malignancy. This paper presents an insight into the complex biology of marginal zone B cells and their role in intertwining and directing innate and adaptive immune processes at the physiological and pathological level.
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Affiliation(s)
- Dragan Marinkovic
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
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19
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Mechanisms of B Cell Receptor Activation and Responses to B Cell Receptor Inhibitors in B Cell Malignancies. Cancers (Basel) 2020; 12:cancers12061396. [PMID: 32481736 PMCID: PMC7352865 DOI: 10.3390/cancers12061396] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/27/2022] Open
Abstract
The B cell receptor (BCR) pathway has been identified as a potential therapeutic target in a number of common B cell malignancies, including chronic lymphocytic leukemia, diffuse large B cell lymphoma, Burkitt lymphoma, follicular lymphoma, mantle cell lymphoma, marginal zone B cell lymphoma, and Waldenstrom's macroglobulinemia. This finding has resulted in the development of numerous drugs that target this pathway, including various inhibitors of the kinases BTK, PI3K, and SYK. Several of these drugs have been approved in recent years for clinical use, resulting in a profound change in the way these diseases are currently being treated. However, the response rates and durability of responses vary largely across the different disease entities, suggesting a different proportion of patients with an activated BCR pathway and different mechanisms of BCR pathway activation. Indeed, several antigen-dependent and antigen-independent mechanisms have recently been described and shown to result in the activation of distinct downstream signaling pathways. The purpose of this review is to provide an overview of the mechanisms responsible for the activation of the BCR pathway in different B cell malignancies and to correlate these mechanisms with clinical responses to treatment with BCR inhibitors.
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20
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Basu M, Piepenbrink MS, Francois C, Roche F, Zheng B, Spencer DA, Hessell AJ, Fucile CF, Rosenberg AF, Bunce CA, Liesveld J, Keefer MC, Kobie JJ. Persistence of HIV-1 Env-Specific Plasmablast Lineages in Plasma Cells after Vaccination in Humans. Cell Rep Med 2020; 1:100015. [PMID: 32577626 PMCID: PMC7311075 DOI: 10.1016/j.xcrm.2020.100015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/22/2019] [Accepted: 04/23/2020] [Indexed: 01/21/2023]
Abstract
Induction of persistent HIV-1 Envelope (Env) specific antibody (Ab) is a primary goal of HIV vaccine strategies; however, it is unclear whether HIV Env immunization in humans induces bone marrow plasma cells, the presumed source of long-lived systemic Ab. To define the features of Env-specific plasma cells after vaccination, samples were obtained from HVTN 105, a phase I trial testing the same gp120 protein immunogen, AIDSVAX B/E, used in RV144, along with a DNA immunogen in various prime and boost strategies. Boosting regimens that included AIDSVAX B/E induced robust peripheral blood plasmablast responses. The Env-specific immunoglobulin repertoire of the plasmablasts is dominated by VH1 gene usage and targeting of the V3 region. Numerous plasmablast-derived immunoglobulin lineages persisted in the bone marrow >8 months after immunization, including in the CD138+ long-lived plasma cell compartment. These findings identify a cellular linkage for the development of sustained Env-specific Abs following vaccination in humans.
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Affiliation(s)
- Madhubanti Basu
- Infectious Diseases Division, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - Bo Zheng
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - David A. Spencer
- Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA
| | - Ann J. Hessell
- Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA
| | | | | | - Catherine A. Bunce
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - Jane Liesveld
- Division of Hematology/Oncology, University of Rochester, Rochester, NY, USA
| | - Michael C. Keefer
- Infectious Diseases Division, University of Rochester, Rochester, NY, USA
| | - James J. Kobie
- Infectious Diseases Division, University of Alabama at Birmingham, Birmingham, AL, USA
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21
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Colombo M, Bagnara D, Reverberi D, Matis S, Cardillo M, Massara R, Mastracci L, Ravetti JL, Agnelli L, Neri A, Mazzocco M, Squillario M, Mazzarello AN, Cutrona G, Agathangelidis A, Stamatopoulos K, Ferrarini M, Fais F. Tracing CLL-biased stereotyped immunoglobulin gene rearrangements in normal B cell subsets using a high-throughput immunogenetic approach. Mol Med 2020; 26:25. [PMID: 32156260 PMCID: PMC7063734 DOI: 10.1186/s10020-020-00151-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 02/21/2020] [Indexed: 01/10/2023] Open
Abstract
Background B cell receptor Immunoglobulin (BcR IG) repertoire of Chronic Lymphocytic Leukemia (CLL) is characterized by the expression of quasi-identical BcR IG. These are observed in approximately 30% of patients, defined as stereotyped receptors and subdivided into subsets based on specific VH CDR3 aa motifs and phylogenetically related IGHV genes. Although relevant to CLL ontogeny, the distribution of CLL-biased stereotyped immunoglobulin rearrangements (CBS-IG) in normal B cells has not been so far specifically addressed using modern sequencing technologies. Here, we have investigated the presence of CBS-IG in splenic B cell subpopulations (s-BCS) and in CD5+ and CD5− B cells from the spleen and peripheral blood (PB). Methods Fractionation of splenic B cells into 9 different B cell subsets and that of spleen and PB into CD5+ and CD5− cells were carried out by FACS sorting. cDNA sequences of BcR IG gene rearrangements were obtained by NGS. Identification of amino acidic motifs typical of CLL stereotyped subsets was carried out on IGHV1-carrying gene sequences and statistical evaluation has been subsequently performed to assess stereotypes distribution. Results CBS-IG represented the 0.26% average of IGHV1 genes expressing sequences, were detected in all of the BCS investigated. CBS-IG were more abundant in splenic and circulating CD5+ B (0.57%) cells compared to CD5− B cells (0.17%). In all instances, most CBS IG did not exhibit somatic hypermutation similar to CLL stereotyped receptors. However, compared to CLL, they exhibited a different CLL subset distribution and a broader utilization of the genes of the IGHV1 family. Conclusions CBS-IG receptors appear to represent a part of the “public” BcR repertoire in normal B cells. This repertoire is observed in all BCS excluding the hypothesis that CLL stereotyped BcR accumulate in a specific B cell subset, potentially capable of originating a leukemic clone. The different relative representation of CBS-IG in normal B cell subgroups suggests the requirement for additional selective processes before a full transformation into CLL is achieved.
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Affiliation(s)
- Monica Colombo
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Davide Bagnara
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Daniele Reverberi
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Serena Matis
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Martina Cardillo
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Rosanna Massara
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Luca Mastracci
- U.O. Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | | | - Luca Agnelli
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Antonino Neri
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Michela Mazzocco
- U.O. Laboratorio di Istocompatibilità, E.O. Ospedali Galliera, Genoa, Italy
| | - Margherita Squillario
- Department of Informatic Bioengeneering, Robotic and System Engeneering, University of Genoa, Genoa, Italy
| | | | - Giovanna Cutrona
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andreas Agathangelidis
- Institute of Applied Biosciences, Center for Research and Technology Hellas CERTH, Thessaloniki, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas CERTH, Thessaloniki, Greece
| | - Manlio Ferrarini
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Franco Fais
- U.O. Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Department of Experimental Medicine, University of Genoa, Genoa, Italy
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22
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Gemenetzi K, Agathangelidis A, Zaragoza-Infante L, Sofou E, Papaioannou M, Chatzidimitriou A, Stamatopoulos K. B Cell Receptor Immunogenetics in B Cell Lymphomas: Immunoglobulin Genes as Key to Ontogeny and Clinical Decision Making. Front Oncol 2020; 10:67. [PMID: 32083012 PMCID: PMC7006488 DOI: 10.3389/fonc.2020.00067] [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: 10/13/2019] [Accepted: 01/15/2020] [Indexed: 12/21/2022] Open
Abstract
The clonotypic B cell receptor immunoglobulin (BcR IG) plays a seminal role in B cell lymphoma development and evolution. From a clinical perspective, this view is supported by the remarkable therapeutic efficacy of BcR signaling inhibitors, even among heavily pre-treated, relapsed/refractory patients. This clinical development complements immunogenetic evidence for antigen drive in the natural history of these tumors. Indeed, BcR IG gene repertoire biases have been documented in different B cell lymphoma subtypes, alluding to selection of B cell progenitors that express particular BcR IG. Moreover, distinct entities display imprints of somatic hypermutation within the clonotypic BcR IG gene following patterns that strengthen the argument for antigen selection. Of note, at least in certain B cell lymphomas, the BcR IG genes are intraclonally diversified, likely in a context of ongoing interactions with antigen(s). Moreover, BcR IG gene repertoire profiling suggests that unique immune pathways lead to distinct B cell lymphomas through targeting cells at different stages in the B cell differentiation trajectory (e.g., germinal center B cells in follicular lymphoma, FL). Regarding the implicated antigens, although their precise nature remains to be fully elucidated, immunogenetic analysis has offered important hints by revealing similarities between the BcR IG of particular lymphomas and B cell clones with known antigenic specificity: this has paved the way to functional studies that identified relevant antigenic determinants of classes of structurally similar epitopes. Finally, in certain tumors, most notably chronic lymphocytic leukemia (CLL), immunogenetic analysis has also proven instrumental in accurate patient risk stratification since cases with differing BcR IG gene sequence features follow distinct disease courses and respond differently to particular treatment modalities. Overall, delving into the BcR IG gene sequences emerges as key to understanding B cell lymphoma pathophysiology, refining prognostication and assisting in making educated treatment choices.
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Affiliation(s)
- Katerina Gemenetzi
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Andreas Agathangelidis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Laura Zaragoza-Infante
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Electra Sofou
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Maria Papaioannou
- Hematology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
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23
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Unclassifiable Isolated Monoclonal Lymphocytosis: Comprehensive Description of a Retrospective Cohort. Cancers (Basel) 2019; 11:cancers11101495. [PMID: 31590326 PMCID: PMC6826630 DOI: 10.3390/cancers11101495] [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: 06/23/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 11/24/2022] Open
Abstract
According to the World Health Organization (WHO) classification, the nosology of B-cell neoplasms integrates clinical, morphological, phenotypic, and genetic data. In this retrospective analysis, we identified 18 patients with isolated neoplastic lymphocytosis that could not be accurately classified within the WHO classification. Most of them were asymptomatic at the time of diagnosis and the evolution was relatively indolent, as only five patients required treatment after a median follow-up of 48 months. The neoplastic B-cells expressed CD5 in most cases, but the Royal Marsden Hospital score was strictly below 3. Trisomy 12 was the most frequent cytogenetic abnormality. High-throughput sequencing highlighted mutations found in both chronic lymphocytic leukemia (CLL) and marginal zone lymphoma (MZL). Similarly, the immunoglobulin heavy chain variable region repertoire was distinct from those reported in CLL or MZL. However, as treatment choice is dependent on the correct classification of the lymphoproliferative disorder, a histological diagnosis should be performed in case patients need to be treated.
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24
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Xochelli A, Bikos V, Polychronidou E, Galigalidou C, Agathangelidis A, Charlotte F, Moschonas P, Davis Z, Colombo M, Roumelioti M, Sutton LA, Groenen P, van den Brand M, Boudjoghra M, Algara P, Traverse-Glehen A, Ferrer A, Stalika E, Karypidou M, Kanellis G, Kalpadakis C, Mollejo M, Pangalis G, Vlamos P, Amini RM, Pospisilova S, Gonzalez D, Ponzoni M, Anagnostopoulos A, Giudicelli V, Lefranc MP, Espinet B, Panagiotidis P, Piris MA, Du MQ, Rosenquist R, Papadaki T, Belessi C, Ferrarini M, Oscier D, Tzovaras D, Ghia P, Davi F, Hadzidimitriou A, Stamatopoulos K. Disease-biased and shared characteristics of the immunoglobulin gene repertoires in marginal zone B cell lymphoproliferations. J Pathol 2019; 247:416-421. [PMID: 30484876 DOI: 10.1002/path.5209] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 11/12/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
The B cell receptor immunoglobulin (Ig) gene repertoires of marginal zone (MZ) lymphoproliferations were analyzed in order to obtain insight into their ontogenetic relationships. Our cohort included cases with MZ lymphomas (n = 488), i.e. splenic (SMZL), nodal (NMZL) and extranodal (ENMZL), as well as provisional entities (n = 76), according to the WHO classification. The most striking Ig gene repertoire skewing was observed in SMZL. However, restrictions were also identified in all other MZ lymphomas studied, particularly ENMZL, with significantly different Ig gene distributions depending on the primary site of involvement. Cross-entity comparisons of the MZ Ig sequence dataset with a large dataset of Ig sequences (MZ-related or not; n = 65 837) revealed four major clusters of cases sharing homologous ('public') heavy variable complementarity-determining region 3. These clusters included rearrangements from SMZL, ENMZL (gastric, salivary gland, ocular adnexa), chronic lymphocytic leukemia, but also rheumatoid factors and non-malignant splenic MZ cells. In conclusion, different MZ lymphomas display biased immunogenetic signatures indicating distinct antigen exposure histories. The existence of rare public stereotypes raises the intriguing possibility that common, pathogen-triggered, immune-mediated mechanisms may result in diverse B lymphoproliferations due to targeting versatile progenitor B cells and/or operating in particular microenvironments. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Vasilis Bikos
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Eleftheria Polychronidou
- Information Technologies Institute, CERTH, Thessaloniki, Greece
- Department of Informatics, Ionian University, Corfu, Greece
| | | | - Andreas Agathangelidis
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frédéric Charlotte
- Department of Pathology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Monica Colombo
- Molecular Pathology, Ospedale Policlinico SanMartino, Genoa, Italy
| | - Maria Roumelioti
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Lesley-Ann Sutton
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Patricia Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Myriam Boudjoghra
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | | | - Ana Ferrer
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - Maria Karypidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | | | | | | | | | - Rose-Marie Amini
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - David Gonzalez
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | | | | | - Véronique Giudicelli
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Marie-Paule Lefranc
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Blanca Espinet
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | | | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Manlio Ferrarini
- Direzione Scientifica, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliera Universitaria (AOU) San Martino-IST, Genoa, Italy
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | | | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frederic Davi
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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25
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Nguyen PH, Niesen E, Hallek M. New roles for B cell receptor associated kinases: when the B cell is not the target. Leukemia 2019; 33:576-587. [PMID: 30700840 DOI: 10.1038/s41375-018-0366-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/02/2018] [Indexed: 12/14/2022]
Abstract
Targeting of B cell receptor associated kinases (BAKs), such as Bruton's tyrosine kinase (BTK) or phosphoinositol-3-kinase (PI3K) delta, by specific inhibitors has revolutionized the therapy of B lymphoid malignancies. BAKs are critical signaling transducers of BCR signaling and seem relevant in B cell lymphoma pathogenesis. The functional relevance of BTK for lymphoid malignancies is strongly supported by the observation that resistance to therapy in CLL patients treated with BTK inhibitors such as ibrutinib is often associated with mutations in genes coding for BTK or Phospholipase-C gamma (PLCɣ). In some contrast, next generation sequencing data show that BAKs are mutated at very low frequency in treatment-naïve B cell lymphomas. Therefore, it remains debatable whether BAKs are essential drivers for lymphoma development. In addition, results obtained by targeted deletion of BAKs such as Lyn and Btk in murine CLL models suggest that BAKs may be essential to shape the dialogue between malignant B cells and the tumor microenvironment (TME). Since BAKs are expressed in multiple cell types, BAK inhibitors may disrupt the lymphoma supportive microenvironment. This concept also explains the typical response to BAK inhibitor treatment, characterized by a long-lasting increase of peripheral blood lymphoid cells, due to a redistribution from the lymphoid homing compartments. In addition, BAK inhibitors have shown some efficacy in solid tumors, probably through mediator cells in the TME. This review summarizes and validates the evidence for BAK inhibitors being part of a class of agents that modulate the (hematopoietic) microenvironment of cancers.
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Affiliation(s)
- Phuong-Hien Nguyen
- Department I of Internal Medicine, University Hospital of Cologne; Center for Integrated Oncology Cologne-Bonn; CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases; Center for Molecular Medicine Cologne, University of Cologne, 50931, Cologne, Germany
| | - Emanuel Niesen
- Department I of Internal Medicine, University Hospital of Cologne; Center for Integrated Oncology Cologne-Bonn; CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases; Center for Molecular Medicine Cologne, University of Cologne, 50931, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine, University Hospital of Cologne; Center for Integrated Oncology Cologne-Bonn; CECAD Center of Excellence on Cellular Stress Responses in Aging-Associated Diseases; Center for Molecular Medicine Cologne, University of Cologne, 50931, Cologne, Germany.
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Agathangelidis A, Psomopoulos F, Stamatopoulos K. Stereotyped B Cell Receptor Immunoglobulins in B Cell Lymphomas. Methods Mol Biol 2019; 1956:139-155. [PMID: 30779034 DOI: 10.1007/978-1-4939-9151-8_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Comprehensive analysis of the clonotypic B cell receptor immunoglobulin (BcR IG) gene rearrangement sequences in patients with mature B cell neoplasms has led to the identification of significant repertoire restrictions, culminating in the discovery of subsets of patients expressing highly similar, stereotyped BcR IG. This finding strongly supports selection by common epitopes or classes of structurally similar epitopes in the ontogeny of these tumors. BcR IG stereotypy was initially described in chronic lymphocytic leukemia (CLL), where the stereotyped fraction of the disease accounts for a remarkable one-third of patients. However, subsequent studies showed that stereotyped BcR IG are also present in other neoplasms of mature B cells, including mantle cell lymphoma (MCL) and splenic marginal zone lymphoma (SMZL). Subsequent cross-entity comparisons led to the conclusion that stereotyped IG are mostly "disease-specific," implicating distinct immunopathogenetic processes. Interestingly, mounting evidence suggests that a molecular subclassification of lymphomas based on BcR IG stereotypy is biologically and clinically relevant. Indeed, particularly in CLL, patients assigned to the same subset due to expressing a particular stereotyped BcR IG display remarkably consistent biological background and clinical course, at least for major and well-studied subsets. Thus, the robust assignment to stereotyped subsets may assist in the identification of mechanisms underlying disease onset and progression, while also refining risk stratification. In this book chapter, we provide an overview of the recent BcR IG stereotypy studies in mature B cell malignancies and outline previous and current methodological approaches used for the identification of stereotyped IG.
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Affiliation(s)
- Andreas Agathangelidis
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Fotis Psomopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece.
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
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Verney A, Traverse-Glehen A, Callet-Bauchu E, Jallades L, Magaud JP, Salles G, Genestier L, Baseggio L. Toll-like receptor expression and function differ between splenic marginal zone B cell lymphoma and splenic diffuse red pulp B cell lymphoma. Oncotarget 2018; 9:23589-23598. [PMID: 29805758 PMCID: PMC5955093 DOI: 10.18632/oncotarget.25283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/07/2018] [Indexed: 11/25/2022] Open
Abstract
In splenic marginal zone lymphoma (SMZL), specific and functional Toll-like Receptor (TLR) patterns have been recently described, suggesting their involvement in tumoral proliferation. Splenic diffuse red pulp lymphoma with villous lymphocytes (SDRPL) is close to but distinct from SMZL, justifying here the comparison of TLR patterns and functionality in both entities. Distinct TLR profiles were observed in both lymphoma subtypes. SDRPL B cells showed higher expression of TLR7 and to a lesser degree TLR9, in comparison to SMZL B cells. In both entities, TLR7 and TLR9 pathways appeared functional, as shown by IL-6 production upon TLR7 and TLR9 agonists stimulations. Interestingly, circulating SDRPL, but not SMZL B cells, constitutively expressed CD86. In addition, stimulation with both TLR7 and TLR9 agonists significantly increased CD80 expression in circulating SDRPL but not SMZL B cells. Finally, TLR7 and TLR9 stimulations had no impact on proliferation and apoptosis of SMZL or SDRPL B cells. In conclusion, SMZL and SDRPL may derive from different splenic memory B cells with specific immunological features that can be used as diagnosis markers in the peripheral blood.
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Affiliation(s)
- Aurélie Verney
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France
| | - Alexandra Traverse-Glehen
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Service d'Anatomie-pathologique, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
| | - Evelyne Callet-Bauchu
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Laboratoire d'Hématologie Cellulaire, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
| | - Laurent Jallades
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Laboratoire d'Hématologie Cellulaire, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
| | - Jean-Pierre Magaud
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Laboratoire d'Hématologie Cellulaire, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
| | - Gilles Salles
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Service d'Hématologie, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
| | - Laurent Genestier
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France
| | - Lucile Baseggio
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon, Lyon, France.,Laboratoire d'Hématologie Cellulaire, Centre Hospitalier Lyon-Sud/Hospices Civils de Lyon, Pierre-Bénite, France
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Abstract
There are three different marginal zone lymphomas (MZLs): the extranodal MZL of mucosa-associated lymphoid tissue (MALT) type (MALT lymphoma), the splenic MZL, and the nodal MZL. The three MZLs share common lesions and deregulated pathways but also present specific alterations that can be used for their differential diagnosis. Although trisomies of chromosomes 3 and 18, deletions at 6q23, deregulation of nuclear factor kappa B, and chromatin remodeling genes are frequent events in all of them, the three MZLs differ in the presence of recurrent translocations, mutations affecting the NOTCH pathway, and the transcription factor Kruppel like factor 2 ( KLF2) or the receptor-type protein tyrosine phosphatase delta ( PTPRD). Since a better understanding of the molecular events underlying each subtype may have practical relevance, this review summarizes the most recent and main advances in our understanding of the genetics and biology of MZLs.
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Affiliation(s)
- Francesco Bertoni
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland
| | - Davide Rossi
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland
| | - Emanuele Zucca
- Università della Svizzera italiana, Institute of Oncology Research, Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland (IOSI), Ospedale San Giovanni, Bellinzona, Switzerland
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29
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Vander Meeren S, Heyrman B, Renmans W, Bakkus M, Maes B, De Raeve H, Schots R, Jochmans K. Lymphoma-like monoclonal B cell lymphocytosis in a patient population: biology, natural evolution, and differences from CLL-like clones. Ann Hematol 2018; 97:1219-1227. [PMID: 29492600 DOI: 10.1007/s00277-018-3282-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/16/2018] [Indexed: 01/23/2023]
Abstract
High-count monoclonal B cell lymphocytosis (MBL) with a chronic lymphocytic leukemia (CLL) phenotype is a well-known entity, featuring 1-4% annual risk of progression towards CLL requiring treatment. Lymphoma-like MBL (L-MBL), on the other hand, remains poorly defined and data regarding outcome are lacking. We retrospectively evaluated 33 L-MBL cases within our hospital population and compared them to 95 subjects with CLL-like MBL (C-MBL). Diagnoses of L-MBL were based on asymptomatic B cell clones with Matutes score < 3, B cells < 5.0 × 103/μl, and negative computerized tomography scans. We found that median B cell counts were considerably lower compared to C-MBL (0.6 vs 2.3 × 103/μl) and remained stable over time. Based on immunophenotyping and immunogenetic profiling, most L-MBL clones did not correspond to known lymphoma entities. A strikingly high occurrence of paraproteinemia (48%), hypogammaglobulinemia (45%), and biclonality (21%) was seen; these incidences being significantly higher than in C-MBL (17, 21, and 5%, respectively). Unrelated monoclonal gammopathy of undetermined significance was a frequent feature, as the light chain type of 5/12 paraproteins detected was different from the clonal surface immunoglobulin. After 46-month median follow-up, 2/24 patients (8%) had progressed towards indolent lymphoma requiring no treatment. In contrast, 41% of C-MBL cases evolved to CLL and 17% required treatment. We conclude that clinical L-MBL is characterized by pronounced immune dysregulation and very slow or absent progression, clearly separating it from its CLL-like counterpart.
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Affiliation(s)
- Sam Vander Meeren
- Department of Clinical Biology, Hematology Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
| | - Bert Heyrman
- Department of Internal Medicine, Hematology Division, ZNA Middelheim, Antwerpen, Belgium
| | - Wim Renmans
- Department of Clinical Biology, Hematology Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Marleen Bakkus
- Department of Clinical Biology, Hematology Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Brigitte Maes
- Department of Clinical Biology, Hematology Division, Jessa Ziekenhuis, Hasselt, Belgium
| | - Hendrik De Raeve
- Department of Pathology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Rik Schots
- Department of Internal Medicine, Hematology Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Kristin Jochmans
- Department of Clinical Biology, Hematology Division, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
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30
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Vassilakopoulos TP. Should rituximab replace splenectomy in the management of splenic marginal zone lymphoma? Best Pract Res Clin Haematol 2018; 31:65-72. [DOI: 10.1016/j.beha.2017.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/27/2017] [Accepted: 10/31/2017] [Indexed: 02/07/2023]
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31
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Thieblemont C. Improved biological insight and influence on management in indolent lymphoma. Talk 3: update on nodal and splenic marginal zone lymphoma. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2017; 2017:371-378. [PMID: 29222281 PMCID: PMC6142593 DOI: 10.1182/asheducation-2017.1.371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Splenic marginal zone lymphoma (SMZL) and nodal marginal zone lymphoma (NMZL) are rare indolent chronic B-cell lymphomas. Prognosis is typically good with median survival around 10-15 years. Management is generally based on the presence of symptoms or high tumor burden. There are no standard treatments for these 2 entities, and therapeutic strategies are rapidly evolving. Clinical developments for these 2 entities are oriented by genomic studies, with largely overlapping mutational profiles involving the NOTCH, B-cell receptor (BcR) and nuclear factor κB (NF-κB) signaling, chromatin remodeling, and the cytoskeleton. Although new therapeutic options based on targeting signaling pathways and overcoming resistance are increasingly available, few specific prospective studies are performed for these rare subtypes, limiting the conclusions that can be drawn. Novel drugs targeting B-cell signaling have shown promise, including ibrutinib and copanlisib. The second-generation oral immunomodalator (IMiD) lenalidomide showed impressive results when combined with rituximab. Other potential solutions include targeting the NF-κB, JAK/STAT, BCL2, NOTCH, and Toll-like receptor signaling pathways; however, studies in these 2 MZL entities are yet to prove a definitive benefit. Molecular profiling is now a cornerstone of diagnostic, prognostic, and therapeutic strategies to offer patient- and disease-specific solutions. The development of a wider range of effective targeted therapies and prognostic biomarkers is keenly awaited and is expected to strongly affect the natural history of SMZL and NMZL.
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Affiliation(s)
- Catherine Thieblemont
- Hemato-Oncology, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France; Diderot University, Sorbonne Paris-Cité, Paris, France; and EA7324, Descartes University, Paris, France
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32
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Agathangelidis A, Xochelli A, Stamatopoulos K. A gene is known by the company it keeps: enrichment of TNFAIP3 gene aberrations in MALT lymphomas expressing IGHV4-34 antigen receptors. J Pathol 2017; 243:403-406. [PMID: 28892161 DOI: 10.1002/path.4982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 08/29/2017] [Accepted: 09/06/2017] [Indexed: 12/17/2022]
Abstract
Associations between immunoglobulin (IG) receptors with distinctive immunogenetic features and particular gene mutations are a recurring theme in mature B-cell lymphomas. Relevant observations have been made in chronic lymphocytic leukemia (CLL), where gene mutations are distributed asymmetrically in cases bearing or not somatic hypermutations within the clonotypic immunoglobulin heavy chain variable region (IGHV) genes (e.g. TP53 mutations predominate in IG-unmutated CLL, whereas the opposite is seen for MYD88 mutations, enriched in IG-mutated CLL) and in subsets of cases with stereotyped IG (enrichment for SF3B1 mutations in CLL subset #2). Moreover, similar findings have been reported in splenic marginal-zone lymphoma, where KLF2 mutations are biased to cases expressing IGHV1-2*04 IG receptors, and in hairy cell leukemia, where IGHV4-34-expressing cases display a low frequency of BRAF mutations but a high frequency of MAP2K1 mutations. The list is now growing with the report of increased frequency of inactivating mutations in the TNFAIP3 gene in MALT lymphomas expressing IG receptors encoded by the IGHV4-34 gene, particularly of the ocular adnexa. Considering that TNFAIP3 encodes a negative regulator of NF-κB, this finding further highlights the importance of NF-κB pathway activation in the natural history of MALT lymphomas. Altogether, these findings allude to selection of genomic aberrations in lymphoma cases with distinctive immune signaling profiles linked to the expression of particular IG receptors. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Andreas Agathangelidis
- Institute of Applied Biosciences, CERTH, The Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Aliki Xochelli
- Institute of Applied Biosciences, CERTH, The Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, The Centre for Research and Technology Hellas, Thessaloniki, Greece
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33
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Rosenquist R, Beà S, Du MQ, Nadel B, Pan-Hammarström Q. Genetic landscape and deregulated pathways in B-cell lymphoid malignancies. J Intern Med 2017. [PMID: 28631441 DOI: 10.1111/joim.12633] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the introduction of next-generation sequencing, the genetic landscape of the complex group of B-cell lymphoid malignancies has rapidly been unravelled in recent years. This has provided important information about recurrent genetic events and identified key pathways deregulated in each lymphoma subtype. In parallel, there has been intense search and development of novel types of targeted therapy that 'hit' central mechanisms in lymphoma pathobiology, such as BTK, PI3K or BCL2 inhibitors. In this review, we will outline the current view of the genetic landscape of selected entities: follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, chronic lymphocytic leukaemia and marginal zone lymphoma. We will detail recurrent alterations affecting important signalling pathways, that is the B-cell receptor/NF-κB pathway, NOTCH signalling, JAK-STAT signalling, p53/DNA damage response, apoptosis and cell cycle regulation, as well as other perhaps unexpected cellular processes, such as immune regulation, cell migration, epigenetic regulation and RNA processing. Whilst many of these pathways/processes are commonly altered in different lymphoid tumors, albeit at varying frequencies, others are preferentially targeted in selected B-cell malignancies. Some of these genetic lesions are either involved in disease ontogeny or linked to the evolution of each disease and/or specific clinicobiological features, and some of them have been demonstrated to have prognostic and even predictive impact. Future work is especially needed to understand the therapy-resistant disease, particularly in patients treated with targeted therapy, and to identify novel targets and therapeutic strategies in order to realize true precision medicine in this clinically heterogeneous patient group.
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Affiliation(s)
- R Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - S Beà
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), CIBER de Cáncer, Barcelona, Spain
| | - M-Q Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - B Nadel
- CNRS, INSERM, CIML, Aix Marseille University, Marseille, France
| | - Q Pan-Hammarström
- Division of Clinical Immunology and Transfusion Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden
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34
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Ghia P, Nadel B, Sander B, Stamatopoulos K, Stevenson FK. Early stages in the ontogeny of small B-cell lymphomas: genetics and microenvironment. J Intern Med 2017; 282:395-414. [PMID: 28393412 DOI: 10.1111/joim.12608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In this review, we focus on the mechanisms underlying lymphomagenesis in chronic lymphocytic leukaemia, follicular lymphoma, mantle cell lymphoma and splenic marginal zone lymphoma. The cells of origin of these small B-cell lymphomas are distinct, as are the characteristic chromosomal lesions and clinical courses. One shared feature is retention of expression of surface immunoglobulin. Analysis of this critical receptor reveals the point of differentiation reached by the cell of origin. Additionally, the sequence patterns of the immunoglobulin-variable domains can indicate a role for stimulants of the B-cell receptor before, during and after malignant transformation. The pathways driven via the B-cell receptor are now being targeted by specific kinase inhibitors with exciting clinical effects. To consider routes to pathogenesis, potentially offering earlier intervention, or to identify causative factors, genetic tools are being used to track pretransformation events and the early phases in lymphomagenesis. These methods are revealing that chromosomal changes are only one of the many steps involved, and that the influence of surrounding cells, probably multiple and variable according to tissue location, is required, both to establish tumours and to maintain growth and survival. Similarly, the influence of the tumour microenvironment may protect malignant cells from eradication by treatment, and the resulting minimal residual disease will eventually give rise to relapse. The common and different features of the four lymphomas will be summarized to show how normal B lymphocytes can be subverted to generate tumours, how these tumours evolve and how their weaknesses can be attacked by targeted therapies.
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Affiliation(s)
- P Ghia
- Division of Experimental Oncology, Università Vita-Salute San Raffaele and IRCCS San Raffaele Scientific Institute Milan, Milan, Italy
| | - B Nadel
- Aix-Marseille Université, CNRS, INSERM, CIML, Marseille, France
| | - B Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - K Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - F K Stevenson
- Cancer Research UK Centre, Cancer Sciences Unit, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
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35
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Yi S, Yan Y, Xiong W, Lv R, Yu Z, Liu W, Liu E, Li H, Liu H, Li Z, An G, Xu Y, Ru K, Zou D, Qiu L. Distinct clinical characteristics draw a new prognostic model for splenic marginal zone lymphoma in HBV high prevalent region. Oncotarget 2017; 8:98757-98770. [PMID: 29228725 PMCID: PMC5716765 DOI: 10.18632/oncotarget.21931] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/27/2017] [Indexed: 12/14/2022] Open
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare indolent B-cell neoplasm with hepatitis virus supposed to involve in the pathogenesis. The characteristics of SMZL derived from Caucasia population and high hepatitis C virus (HCV) infection region have been widely investigated, but few was reported in the Eastern population with HBV prevalent region. We analyzed the clinical characteristics, cytogenetic aberrations and prognostic factors in 160 SMZL patients from China. 25 patients (16%) were HBsAg-positive and 54 (34%) patients with resolved HBV infection. IGH gene usage was analyzed in 39 patients. The preferential usages of IGHV genes were IGHV1-2 (26%), followed by IGHV4-34 (18%) and IGHV2-70 (10%). The patients with HBV infection presented biased IGHV-D-J rearrangements and mutational status. Using three independent factors hemoglobin level, HBsAg positivity and complex karyotype, we developed a new hierarchical prognostic model, which showed a better c-index than the previously reported IIL and HPLL scoring systems in SMZL. In conclusion, SMZL in HBV prevalent region have unique clinical and biological characteristics and new prognostic scoring model should be adopted in this population.
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Affiliation(s)
- Shuhua Yi
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Yuting Yan
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Wenjie Xiong
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Rui Lv
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Zhen Yu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Enbin Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Heng Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Huimin Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Zengjun Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Gang An
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Yan Xu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Kun Ru
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Tianjin 300020, China
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36
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Chronic Lymphocytic Leukemia Patient Clustering Based on Somatic Hypermutation (SHM) Analysis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017. [PMID: 28971394 DOI: 10.1007/978-3-319-56246-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Somatic Hypermutation (SHM) load in the immunoglobulin heavy variable (IGHV) gene of the clonotypic B cell receptor immunoglobulin (BcR IG) is one of the most important prognostic markers in CLL, segregating patients into two distinct categories, with contrariwise disease course. Over the last years, immunogenetic studies have identified that ∼30% of CLL patients carry (quasi)identical BcR IG and thus can be assigned to different subsets with distinct clinicobiological profiles. This characterization was achieved by applying rules mainly concerning the diversity of the VH complementarity determining region 3 (CDR3). Following, studies have also identified subset-specific somatic hypermutation further highlighting antigen selection in disease ontogeny and evolution. In this study, an innovative attempt to explore possible associations amongst SHMs in different CLL patients is implemented and also the potential correlations with VH CDR3 stereotypy is examined, leading to a new classification algorithm implicating both SHM and CDR3 patterns. All results are classified to a ground level analysis, focusing on the most frequent SHMs, their paired associated amino acid changes and the formation of subgroups sharing the same VH CDR3 pattern, the latter being used as a similarity metric. In addition, all results are compared to established VH CDR3 patterns of the well-known CLL subsets in order to confirm the validity of our findings.
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37
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Clinical utility of recently identified diagnostic, prognostic, and predictive molecular biomarkers in mature B-cell neoplasms. Mod Pathol 2017; 30:1338-1366. [PMID: 28664939 DOI: 10.1038/modpathol.2017.58] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 12/18/2022]
Abstract
Genomic profiling studies have provided new insights into the pathogenesis of mature B-cell neoplasms and have identified markers with prognostic impact. Recurrent mutations in tumor-suppressor genes (TP53, BIRC3, ATM), and common signaling pathways, such as the B-cell receptor (CD79A, CD79B, CARD11, TCF3, ID3), Toll-like receptor (MYD88), NOTCH (NOTCH1/2), nuclear factor-κB, and mitogen activated kinase signaling, have been identified in B-cell neoplasms. Chronic lymphocytic leukemia/small lymphocytic lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, Burkitt lymphoma, Waldenström macroglobulinemia, hairy cell leukemia, and marginal zone lymphomas of splenic, nodal, and extranodal types represent examples of B-cell neoplasms in which novel molecular biomarkers have been discovered in recent years. In addition, ongoing retrospective correlative and prospective outcome studies have resulted in an enhanced understanding of the clinical utility of novel biomarkers. This progress is reflected in the 2016 update of the World Health Organization classification of lymphoid neoplasms, which lists as many as 41 mature B-cell neoplasms (including provisional categories). Consequently, molecular genetic studies are increasingly being applied for the clinical workup of many of these neoplasms. In this review, we focus on the diagnostic, prognostic, and/or therapeutic utility of molecular biomarkers in mature B-cell neoplasms.
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38
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Moody S, Escudero-Ibarz L, Wang M, Clipson A, Ochoa Ruiz E, Dunn-Walters D, Xue X, Zeng N, Robson A, Chuang SS, Cogliatti S, Liu H, Goodlad J, Ashton-Key M, Raderer M, Bi Y, Du MQ. Significant association between TNFAIP3
inactivation and biased immunoglobulin heavy chain variable region 4-34 usage in mucosa-associated lymphoid tissue lymphoma. J Pathol 2017; 243:3-8. [DOI: 10.1002/path.4933] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/05/2017] [Accepted: 06/23/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Sarah Moody
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Leire Escudero-Ibarz
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Ming Wang
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Alexandra Clipson
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Eguzkine Ochoa Ruiz
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Deborah Dunn-Walters
- Division of Infection, Immunity and Inflammatory Disease; King's College London Faculty of Life Sciences & Medicine; London UK
| | - Xuemin Xue
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Naiyan Zeng
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
| | - Alistair Robson
- Department of Dermatopathology; St John's Institute of Dermatology; London UK
| | | | - Sergio Cogliatti
- Institute of Pathology; State Hospital St Gallen; St Gallen Switzerland
| | - Hongxiang Liu
- Molecular Malignancy Laboratory, Addenbrooke's Hospital; Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
| | - John Goodlad
- Department of Pathology, Western General Hospital; NHS Lothian University Hospitals Trust; Edinburgh UK
| | - Margaret Ashton-Key
- Department of Cellular Pathology; Southampton University Hospitals National Health Service Trust; Southampton UK
| | - Markus Raderer
- Department of Medicine I, Clinical Division of Oncology; Medical University of Vienna; Vienna Austria
| | - Yingwen Bi
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
- Department of Pathology, Eye & ENT Hospital; Fudan University; Shanghai PR China
| | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology; University of Cambridge; Cambridge UK
- Molecular Malignancy Laboratory, Addenbrooke's Hospital; Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
- Department of Histopathology, Addenbrooke's Hospital; Cambridge University Hospitals NHS Foundation Trust; Cambridge UK
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van den Brand M, Scheijen B, Hess CJ, van Krieken JHJ, Groenen PJTA. Pathways towards indolent B-cell lymphoma - Etiology and therapeutic strategies. Blood Rev 2017; 31:426-435. [PMID: 28802906 DOI: 10.1016/j.blre.2017.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 05/07/2017] [Accepted: 08/04/2017] [Indexed: 02/06/2023]
Abstract
Although patients with indolent B-cell lymphomas have a relatively good survival rate, conventional chemotherapy is not curative. Disease courses are typically characterized by multiple relapses and progressively shorter response duration with subsequent lines of therapy. There has been an explosion of innovative targeted agents in the past years. This review discusses current knowledge on the etiology of indolent B-cell lymphomas with respect to the role of micro-organisms, auto-immune diseases, and deregulated pathways caused by mutations. In particular, knowledge on the mutational landscape of indolent B-cell lymphomas has strongly increased in recent years and harbors great promise for more accurate decision making in the current wide range of therapeutic options. Despite this promise, only in chronic lymphocytic leukemia the detection of TP53 mutations and/or del17p currently have a direct effect on treatment decisions. Nevertheless, it is expected that in the near future the role of genetic testing will increase for prediction of response to targeted treatment as well as for more accurate prediction of prognosis in indolent B-cell lymphomas.
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MESH Headings
- Animals
- DNA Damage
- Epigenesis, Genetic
- Gene Expression Regulation, Neoplastic
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/etiology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/microbiology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphoma, B-Cell/etiology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/microbiology
- Lymphoma, B-Cell/therapy
- Lymphoma, B-Cell, Marginal Zone/etiology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Follicular/etiology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/microbiology
- Lymphoma, Follicular/therapy
- Molecular Targeted Therapy/methods
- Mutation
- Signal Transduction
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Affiliation(s)
- Michiel van den Brand
- Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands; Pathology-DNA, location Rijnstate, Wagnerlaan 55, 6815AD Arnhem, The Netherlands.
| | - Blanca Scheijen
- Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
| | - Corine J Hess
- Department of Hematology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
| | - J Han Jm van Krieken
- Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
| | - Patricia J T A Groenen
- Department of Pathology, Radboud university medical center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands.
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Xochelli A, Oscier D, Stamatopoulos K. Clonal B-cell lymphocytosis of marginal zone origin. Best Pract Res Clin Haematol 2017; 30:77-83. [DOI: 10.1016/j.beha.2016.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 08/10/2016] [Accepted: 08/12/2016] [Indexed: 12/25/2022]
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41
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Piris MA, Onaindía A, Mollejo M. Splenic marginal zone lymphoma. Best Pract Res Clin Haematol 2016; 30:56-64. [PMID: 28288718 DOI: 10.1016/j.beha.2016.09.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/14/2016] [Accepted: 09/14/2016] [Indexed: 01/25/2023]
Abstract
Splenic marginal zone lymphoma (SMZL) is an indolent small B-cell lymphoma involving the spleen and bone marrow characterized by a micronodular tumoral infiltration that replaces the preexisting lymphoid follicles and shows marginal zone differentiation as a distinctive finding. SMZL cases are characterized by prominent splenomegaly and bone marrow and peripheral blood infiltration. Cells in peripheral blood show a villous cytology. Bone marrow and peripheral blood characteristic features usually allow a diagnosis of SMZL to be performed. Mutational spectrum of SMZL identifies specific findings, such as 7q loss and NOTCH2 and KLF2 mutations, both genes related with marginal zone differentiation. There is a striking clinical variability in SMZL cases, dependent of the tumoral load and performance status. Specific molecular markers such as 7q loss, p53 loss/mutation, NOTCH2 and KLF2 mutations have been found to be associated with the clinical variability. Distinction from Monoclonal B-cell lymphocytosis with marginal zone phenotype is still an open issue that requires identification of precise and specific thresholds with clinical meaning.
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Affiliation(s)
- Miguel A Piris
- Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Arantza Onaindía
- Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Manuela Mollejo
- Servicio de Anatomía Patológica, Hospital Virgen de la Salud, Toledo, Spain
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42
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Spina V, Rossi D. Molecular pathogenesis of splenic and nodal marginal zone lymphoma. Best Pract Res Clin Haematol 2016; 30:5-12. [PMID: 28288716 DOI: 10.1016/j.beha.2016.09.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 12/18/2022]
Abstract
Genomic studies have improved our understanding of the biological basis of splenic (SMZL) and nodal (NMZL) marginal zone lymphoma by providing a comprehensive and unbiased view of the genes/pathways that are deregulated in these diseases. Consistent with the physiological involvement of NOTCH, NF-κB, B-cell receptor and toll-like receptor signaling in mature B-cells differentiation into the marginal zone B-cells, many oncogenic mutations of genes involved in these pathways have been identified in SMZL and NMZL. Beside genetic lesions, also epigenetic and post-transcriptional modifications contribute to the deregulation of marginal zone B-cell differentiation pathways in SMZL and NMZL. This review describes the progress in understanding the molecular mechanism underlying SMZL and NMZL, including molecular and post-transcriptional modifications, and discusses how information gained from these efforts has provided new insights on potential targets of diagnostic, prognostic and therapeutic relevance in SMZL and NMZL.
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MESH Headings
- B-Lymphocytes/metabolism
- Cell Differentiation
- Epigenesis, Genetic
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/metabolism
- Lymphoma, B-Cell, Marginal Zone/therapy
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Protein Processing, Post-Translational
- Splenic Neoplasms/diagnosis
- Splenic Neoplasms/genetics
- Splenic Neoplasms/metabolism
- Splenic Neoplasms/therapy
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Affiliation(s)
- Valeria Spina
- Hematology, Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Davide Rossi
- Hematology, Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
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43
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Antigen receptor stereotypy in chronic lymphocytic leukemia. Leukemia 2016; 31:282-291. [PMID: 27811850 DOI: 10.1038/leu.2016.322] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 02/06/2023]
Abstract
The discovery of almost identical or 'stereotyped' B-cell receptor immunoglobulins (BcR IG) among unrelated patients with chronic lymphocytic leukemia (CLL) cemented the idea of antigen selection in disease ontogeny and evolution. The systematic analysis of the stereotypy phenomenon in CLL revealed that around one-third of CLL patients may be grouped into subsets based on shared sequence motifs within the variable heavy complementarity determining region 3. Stereotyped subsets display a strikingly similar biology of the leukemic clones, referring to many different levels, from the immunogenetic and genetic and extending to the epigenetic and functional levels. Even more importantly, the homogeneity of stereotyped subsets has clinical consequences as patients assigned to the same stereotyped subset generally exhibit an overall similar disease course and outcome. In other words, stereotypy-based patient classification of CLL has already provided a more compartmentalized view of this otherwise heterogeneous disease and can assist in refining prognostication models. While this is relevant only for the one-third of cases expressing stereotyped BcR IG; in principle, however, the findings from further analysis of the stereotyped subsets may also contribute towards improved understanding of the remaining non-stereotyped fraction of CLL patients.
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44
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Vassilakopoulos TP. Treatment of splenic marginal zone lymphoma. Best Pract Res Clin Haematol 2016; 30:139-148. [PMID: 28288709 DOI: 10.1016/j.beha.2016.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/06/2023]
Abstract
Splenic marginal zone lymphoma (SMZL) is a distinct lymphoma entity characterized by an indolent clinical course and prolonged survival. Treatment is not standardized, since there are no prospective randomized trials in large series of SMZL patients. Splenectomy and rituximab represent the most effective treatment strategies used so far. The addition of chemotherapy to rituximab has not further improved the outcome, although this issue requires further investigation. Rituximab monotherapy has been associated with high response rates (∼90%), with approximately half of these responses being complete, even at the molecular level. More importantly, many of these responses are long-lasting, with a reported 7-year progression-free survival (PFS) at the rate of 69%. Maintenance rituximab treatment has been associated with further improvement of the quality of response as well as longer response duration in studies derived from one group of investigators. Based on its high efficacy and the good safety profile, rituximab represent one of the best treatment options for SMZL patients. Moreover, rituximab retains its efficacy in the relapse setting in most cases. Splenectomy is a meaningful alternative to rituximab in patients with bulky splenomegaly and cytopenias, without extensive bone marrow infiltration, who are fit for surgery. However splenectomy cannot completely eradicate the disease and it is also associated with greater morbidity or even mortality compared to rituximab. The choice of one of these two treatment approaches (rituximab or splenectomy) should mainly be based on patient's characteristics and on the disease burden. Novel agents are currently testing in low grade lymphomas including a small number of SMZL patients with promising results.
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Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, Heraklion University Hospital, 71001, University of Crete, Heraklion, Crete, Greece.
| | - Gerassimos A Pangalis
- Department of Haematology, Athens Medical Center-Psychikon Branch, 11525, Athens, Greece.
| | - Maria K Angelopoulou
- Department of Haematology, National and Kapodistrian University, Laikon General Hospital, Athens, Greece.
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45
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Vassilakopoulos TP. Current and emerging treatment approaches for splenic marginal zone lymphoma. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1198255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, Heraklion University Hospital, University of Crete, Heraklion, Crete, Greece
| | | | - Maria K. Angelopoulou
- Department of Haematology, National and Kapodistrian University, Laikon General Hospital, Athens, Greece
| | - Sotirios Sachanas
- Department of Haematology, Athens Medical Center- Psychikon Branch, Athens, Greece
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46
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Spina V, Rossi D. NF-κB deregulation in splenic marginal zone lymphoma. Semin Cancer Biol 2016; 39:61-7. [PMID: 27503810 DOI: 10.1016/j.semcancer.2016.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/03/2016] [Accepted: 08/04/2016] [Indexed: 11/29/2022]
Abstract
Splenic marginal zone lymphoma is a rare mature B-cell malignancy involving the spleen, bone marrow and blood. Over the past years, the rapid expansion of sequencing technologies allowing the genome-wide assessment of genomic, epigenetic and transcriptional changes has revolutionized our understanding of the biological basis of splenic marginal zone lymphoma by providing a comprehensive and unbiased view of the genes/pathways that are deregulated in this disease. NF-κB is a family of transcription factors that plays critical roles in development, survival, and activation of B lymphocytes. Consistent with the physiological involvement of NF-κB signalling in proliferation and commitment of mature B-cells to the marginal zone of the spleen, many oncogenic mutations involved in constitutive activation of the NF-κB pathway were recently identified in splenic marginal zone lymphoma. This review describes the progress in understanding the mechanism of NF-κB activation in splenic marginal zone lymphoma, including molecular, epigenetic and post-transcriptional modifications of NF-κB genes and of upstream pathways, and discusses how information gained from these efforts has provided new insights on potential targets of diagnostic, prognostic and therapeutic relevance for splenic marginal zone lymphoma.
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Affiliation(s)
- Valeria Spina
- Hematology, Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Davide Rossi
- Hematology, Institute of Oncology Research and Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
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47
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Hepatitis B virus-associated diffuse large B-cell lymphoma: unique clinical features, poor outcome, and hepatitis B surface antigen-driven origin. Oncotarget 2016; 6:25061-73. [PMID: 26314957 PMCID: PMC4694815 DOI: 10.18632/oncotarget.4677] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/09/2015] [Indexed: 12/20/2022] Open
Abstract
While the epidemiologic association between hepatitis B virus (HBV) infection and diffuse large B-cell lymphoma (DLBCL) is established, little is known more than this epidemiologic evidence. We studied a cohort of 587 patients with DLBCL for HBV infection status, clinicopathologic features, and the immunoglobulin variable region in HBV surface antigen (HBsAg)-positive patients. Eighty-one (81/587, 13.8%) patients were HBsAg-positive. Compared with HBsAg-negative DLBCL, HBsAg-positive DLBCL displayed a younger median onset age (45 vs. 55 years), more frequent involvement of spleen or retroperitoneal lymph node (40.7% vs. 16.0% and 61.7% vs. 31.0% respectively, both p < 0.001), more advanced disease (stage III/IV: 76.5% vs 59.5%, p = 0.003), and significantly worse outcome (2-year overall survival: 47% versus 70%, p < 0.001). In HBsAg-positive DLBCL patients, almost all (45/47, 96%) amino acid sequences of heavy and light chain complementarity determining region 3 exhibited a high homology to antibodies specific for HBsAg, and the majority (45/50, 90%) of IgHV and IgLV genes were mutated. We conclude that 13.8% of DLBCL cases are HBV-associated in HBV-endemic China and show unique clinical features and poor outcomes. Furthermore, our study strongly suggests that HBV-associated DLBCL might arise from HBV antigen-selected B cells.
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48
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Traverse-Glehen A, Verney A, Gazzo S, Jallades L, Chabane K, Hayette S, Coiffier B, Callet-Bauchu E, Ffrench M, Felman P, Berger F, Baseggio L, Salles G. Splenic diffuse red pulp lymphoma has a distinct pattern of somatic mutations amongst B-cell malignancies. Leuk Lymphoma 2016; 58:666-675. [PMID: 27347751 DOI: 10.1080/10428194.2016.1196813] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Splenic Diffuse Red Pulp Lymphoma (SDRPL) has been recently introduced as a provisional entity but differential diagnosis with other splenic lymphomas is needed to be clarified since the therapeutic approaches are distinct. Recently described recurrent mutations or CD180 expression appear useful for differential diagnosis. We completed our previous description in a larger cohort including 53 patients selected on the presence of characteristic villous cells in peripheral blood (PB) and a specific immunophenotype. Immunoglobulin heavy variable (IGHV), BRAF, MYD88, and NOTCH2 mutations were determined and CD180 and BRAF expressions were assessed. Most cases (79%) were IGHV mutated with an overrepresentation of IGHV3-23 (19%) and IGHV4-34 (21%). MYD88 L265P and NOTCH2 mutations were observed in one case each, whereas no BRAF V600E mutation or expression was found. All cases demonstrated a high CD180 expression. Those results strengthen the concept that SDRPL does emerge as a new lymphoma entity distinct from the other splenic lymphomas with circulating lymphocytes.
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Affiliation(s)
- Alexandra Traverse-Glehen
- a Service d'Anatomie Pathologique, Hospices Civils de Lyon , Lyon , France.,b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France
| | - Aurélie Verney
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France
| | - Sophie Gazzo
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,c Laboratoire de Cytogénétique , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Laurent Jallades
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Kaddour Chabane
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Sandrine Hayette
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Bertrand Coiffier
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,e Service d'Hématologie, Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Evelyne Callet-Bauchu
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,c Laboratoire de Cytogénétique , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Martine Ffrench
- d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Pascale Felman
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Françoise Berger
- a Service d'Anatomie Pathologique, Hospices Civils de Lyon , Lyon , France.,b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France
| | - Lucile Baseggio
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,d Laboratoire d'Hématologie cellulaire , Centre Hospitalier Lyon Sud , Pierre Bénite , France
| | - Gilles Salles
- b UMR CNRS 5239 Equipe Pathologie des Cellules Lymphoïdes, Université Lyon 1 , Lyon , France.,e Service d'Hématologie, Centre Hospitalier Lyon Sud , Pierre Bénite , France
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NOTCH1, TP53, and MAP2K1 Mutations in Splenic Diffuse Red Pulp Small B-cell Lymphoma Are Associated With Progressive Disease. Am J Surg Pathol 2016; 40:192-201. [PMID: 26426381 DOI: 10.1097/pas.0000000000000523] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Splenic diffuse red pulp small B-cell lymphoma (SDRPL) is considered an indolent neoplasm and its pathogenesis is not well known. We investigated the molecular characteristics of 19 SDRPL patients, 5 of them with progressive disease. IGHV genes were mutated in 9/13 (69%). Cytogenetic and molecular studies identified complex karyotypes in 2 cases, and IGH rearrangements in 3, with PAX5 and potentially TCL1 as partners in each one of them. Copy number arrays showed aberrations in 69% of the tumors, including recurrent losses of 10q23, 14q31-q32, and 17p13 in 3, and 9p21 in 2 cases. Deletion of 7q31.3-q32.3 was present in only 1 case and no trisomies 3 or 18 were detected. NOTCH1 and MAP2K1 were mutated in 2 cases each, whereas BRAF, TP53, and SF3B1 were mutated each in single cases. No mutations were found in NOTCH2 or MYD88. Four of the 5 patients with aggressive disease had mutations in NOTCH1 (2 cases), TP53 (1 case), and MAP2K1 (1 case). The progression-free survival of patients with mutated genes was significantly shorter than in the unmutated (P=0.011). These findings show that SDRPL share some mutated genes but not chromosomal alterations, with other splenic lymphomas, that may confer a more aggressive behavior.
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50
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Splenic marginal zone lymphoma: from genetics to management. Blood 2016; 127:2072-81. [DOI: 10.1182/blood-2015-11-624312] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 03/07/2016] [Indexed: 12/16/2022] Open
Abstract
AbstractSplenic marginal zone lymphoma (SMZL) is a rare B-cell malignancy involving the spleen, bone marrow, and frequently the blood. SMZL lymphomagenesis involves antigen and/or superantigen stimulation and molecular deregulation of genes (NOTCH2 and KLF2) involved in the physiological differentiation of spleen marginal zone B cells. Diagnosis requires either spleen histology or, alternatively, the documentation of a typical cell morphology and immunophenotype on blood cells coupled with the detection of intrasinusoidal infiltration by CD20+ cells in the bone marrow. Among B-cell tumors, deletion of 7q and NOTCH2 mutations are almost specific lesions of SMZL, thus representing promising diagnostic biomarkers of this lymphoma. Although the majority of SMZLs show an indolent course with a median survival of approximately 10 years, nearly 30% of patients experience a poor outcome. No randomized trials are reported for SMZL, and few prospective trials are available. A watch-and-wait approach is advisable for asymptomatic patients. Treatment options for symptomatic patients ranges from splenectomy to rituximab alone or combined with chemotherapy. In some geographic areas, a subset of patients with SMZL associates with hepatitis C virus infection, prompting virus eradication as an effective lymphoma treatment. It would be worthwhile to explore deregulated cellular programs of SMZL as therapeutic targets in the future; improved clinical and biological prognostication will be essential for identifying patients who may benefit from novel approaches.
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