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Uzoma IC, Taiwo IA, Granai M, Di Stefano G, Sorrentino E, Mannucci S, Durosinmi MA, Lazzi S, Leoncini L, Akinloye O. Distinct pattern of lymphoid neoplasms characterizations according to the WHO classification (2016) and prevalence of associated Epstein-Barr virus infection in Nigeria population. Infect Agent Cancer 2021; 16:36. [PMID: 34030716 PMCID: PMC8142647 DOI: 10.1186/s13027-021-00378-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background The present study aimed to classify lymphoid neoplasms according to the latest World Health Organization (WHO) classification and outlining the distribution in Nigeria of different entities. Additionally, the study describes the prevalence of lymphoid neoplasms associated with Epstein-Barr virus (EBV) infection in the Nigerian population. Methods We collected 152 formalin-fixed paraffin-embedded (FFPE) tissues diagnosed as lymphoma from 2008 to 2018, coming from three different institutions located within three geopolitical zone in Nigeria. These institutions included the University College Hospital (UCH), Ibadan, Oyo State, the Enugu State University of Science and Technology Teaching Hospital (ESUTH), Enugu, Enugu State, and the Meena Histopathology and Cytology Laboratory (MHCL), Jos, Plateau State. Results From the total 152 cases retrieved, 50 were excluded due to insufficient tissue materials or inconclusive antigen reactivity. We confirmed 66 (64.7%) cases as lymphomas out of the remaining 102 FFPE with a male to female ratio of 2:1 and a mean age of 44.4 years. Ten entities were identified, and of these, chronic lymphocytic leukemia (CLL) was the most prevalent category (34.8%). For the diffuse large B-cell lymphomas not otherwise specified (DLBCL, NOS), the germinal centre B–cell type was the most common (71.4%). Ten lymphoma cases (15.2%) were positive for Epstein-Barr virus (EBV), most of which were Hodgkin lymphoma (HL). CLL was common in the Hausa ethnic group, HL in the Yoruba ethnic group, while the Igbo ethnic group had an equal distribution of CLL, HL, and DLBCL diagnosis. Conclusion Although the distribution of lymphomas in Nigeria shares some similarities with those of other countries, we described distinct features of some subtypes of lymphomas. Also, the study underscores the need for a more precise diagnosis and classification of lymphoid neoplasms in Nigeria using the latest WHO classification. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00378-z.
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Affiliation(s)
- Ijeoma C Uzoma
- Molecular-Haematology Laboratory, Department of Medical Laboratory Science, College of Medicine, College of Medicine, University of Nigeria Nsukka, Enugu Campus, Enugu, Nigeria.,Genetics Laboratory, Department of Cell Biology and Genetics, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Idowu A Taiwo
- Genetics Laboratory, Department of Cell Biology and Genetics, Faculty of Science, University of Lagos, Lagos, Nigeria.,Centre for Genomics of Non-communicable Diseases and Personalized Healthcare (CGNPH), University of Lagos, Lagos, Nigeria
| | - Massimo Granai
- Institute of Pathology, University Hospital of Tübingen, Tübingen, Germany
| | - Gioia Di Stefano
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Ester Sorrentino
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Sussana Mannucci
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Muheez A Durosinmi
- Department of Haematology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria
| | - Stefano Lazzi
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Lorenzo Leoncini
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy.
| | - Oluyemi Akinloye
- Centre for Genomics of Non-communicable Diseases and Personalized Healthcare (CGNPH), University of Lagos, Lagos, Nigeria. .,Clinical Chemistry and Molecular Diagnostics Laboratory, Department of Medical Laboratory Sciences, Faculty of Basic Medical Centre, College of Medicine, University of Lagos, Lagos, Nigeria.
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2
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Inflammatory Cells in Diffuse Large B Cell Lymphoma. J Clin Med 2020; 9:jcm9082418. [PMID: 32731512 PMCID: PMC7463675 DOI: 10.3390/jcm9082418] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Diffuse large B cell lymphoma (DLBCL), known as the most common non-Hodgkin lymphoma (NHL) subtype, is characterized by high clinical and biological heterogeneity. The tumor microenvironment (TME), in which the tumor cells reside, is crucial in the regulation of tumor initiation, progression, and metastasis, but it also has profound effects on therapeutic efficacy. The role of immune cells during DLBCL development is complex and involves reciprocal interactions between tumor cells, adaptive and innate immune cells, their soluble mediators and structural components present in the tumor microenvironment. Different immune cells are recruited into the tumor microenvironment and exert distinct effects on tumor progression and therapeutic outcomes. In this review, we focused on the role of macrophages, Neutrophils, T cells, natural killer cells and dendritic cells in the DLBCL microenvironment and their implication as target for DLBCL treatment. These new therapies, carried out by the induction of adaptive immunity through vaccination or passive of immunologic effectors delivery, enhance the ability of the immune system to react against the tumor antigens inducing the destruction of tumor cells.
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3
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Oliveira MCL, Sampaio KC, Brito AC, Campos MK, Murao M, Gusmão R, Fernandes AAL, Viana MB. 30 Years of Experience with Non-Hodgkin Lymphoma in Children and Adolescents: a retrospective cohort study. ACTA ACUST UNITED AC 2020; 66:25-30. [PMID: 32130377 DOI: 10.1590/1806-9282.66.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Describe the clinical and demographic characteristics of pediatric patients with non-Hodgkin's lymphoma (NHL) enrolled in a tertiary unit of Pediatric Hematology between 1982-2015. PATIENTS AND METHODS A retrospective cohort study of 140 patients aged 16 years or less with NHL. Demographic characteristics, data on diagnosis, and outcomes were analyzed. The overall survival (OS) analysis and stratification by the most frequent histological subtypes were performed using the Kaplan-Meier method. RESULTS One hundred and thirty-six patients with de novo NHL and four with NHL as a second malignancy were analyzed. The median age at diagnosis was 6.4 years (interquartile range, 4.2 to 11.1 years); 101 patients were males. Four patients had primary immunodeficiency, four had human immunodeficiency virus, two post-liver transplantation, and one had autoimmune lymphoproliferative syndrome. The most frequent histological type was NHL of mature B- cell (B-NHL-B; 67.1%), with Burkitt's lymphoma being the most frequent subtype, and lymphoblastic lymphoma (LBL, 21.4%). The main clinical manifestation at the diagnosis was abdominal tumors (41.4%). During the follow-up time, 13 patients relapsed, but five of them reached a second remission. Thirty-five patients died, and 103 remained alive in clinical remission. No contact was possible for two patients. The OS at 5 years was 74.5% (± 3.8%). The OS estimated for patients with LBL, NHL-B, and the remaining was 80.4%±7.9%, 72.8%±4.7%, and 74.5%±11%, respectively (P = 0.58). CONCLUSION Our results are comparable with cohorts from other middle-income countries.
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Affiliation(s)
- Maria Christina L Oliveira
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Keyla C Sampaio
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Andrea C Brito
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Marcia K Campos
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Mitiko Murao
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Rebeca Gusmão
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Ana Angélica L Fernandes
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcos B Viana
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
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Swerdlow SH, Cook JR. As the world turns, evolving lymphoma classifications–past, present and future. Hum Pathol 2020; 95:55-77. [DOI: 10.1016/j.humpath.2019.08.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 08/24/2019] [Indexed: 12/20/2022]
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5
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White VA. Understanding and Classification of Ocular Lymphomas. Ocul Oncol Pathol 2019; 5:379-386. [PMID: 31768360 PMCID: PMC6872993 DOI: 10.1159/000499845] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/20/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Lymphomas that involve the tissues of the ocular adnexae and the eye itself can be confusing for both the new and seasoned learner alike. In this review, I present a simple way of classifying these disorders that will help to facilitate understanding of these myriad entities. SUMMARY Classifications of lymphomas have changed significantly over the last 40 years, but in recent decades, the basic structure of the WHO classification has remained the same, facilitating understanding. KEY MESSAGES The ocular lymphomas can be divided into those that are external to the eye (ocular adnexae) and those that are internal (vitreoretinal and uveal). At each of these sites specific subtypes of lymphoma are common. Focusing on these common subtypes can aid the learner to create a scaffold that enables current understanding and upon which they can build for the future.
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Affiliation(s)
- Valerie A. White
- WHO/IARC Classification of Tumours Group, International Agency for Research on Cancer, Lyon, France
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6
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Toner K, Bollard CM, Dave H. T-cell therapies for T-cell lymphoma. Cytotherapy 2019; 21:935-942. [PMID: 31320195 DOI: 10.1016/j.jcyt.2019.04.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 01/05/2023]
Abstract
T-cell lymphomas represent a subpopulation of non-Hodgkin lymphomas with poor outcomes when treated with conventional chemotherapy. A variety of novel agents have been introduced as new treatment strategies either as first-line treatment or in conjunction with chemotherapy. Immunotherapy has been demonstrated to be a promising area for new therapeutics, including monoclonal antibodies and adoptive cellular therapeutics. T-cell therapeutics have been shown to have significant success in the treatment of B-cell malignancies and are rapidly expanding as potential treatment options for other cancers including T-cell lymphomas. Although treating T-cell lymphomas with T-cell therapeutics has unique challenges, multiple targets are currently being studied both preclinically and in clinical trials.
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Affiliation(s)
- Keri Toner
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA; The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Hema Dave
- Center for Cancer and Immunology Research, Children's National Health System, Washington, DC, USA; The George Washington School of Medicine and Health Sciences, Washington, DC, USA.
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8
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Grewal RK, Chetty M, Abayomi EA, Tomuleasa C, Fromm JR. Use of flow cytometry in the phenotypic diagnosis of hodgkin's lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:116-127. [PMID: 30350336 DOI: 10.1002/cyto.b.21724] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/18/2018] [Accepted: 06/26/2018] [Indexed: 12/22/2022]
Abstract
Hodgkin's lymphoma (HL) has a unique immunophenotype derived from immunohistochemistry (positive for CD15, CD30, and Pax-5; negative for CD3, CD20 in most cases, and CD45). The knowledge gained over recent years enables better diagnosis, prognosis, and treatment of HL. Flow cytometry as a tool for the diagnosis of classic HL has not been useful in the past due to the difficulty in isolating Reed-Sternberg cells as they are admixed in a rich inflammatory background which consists mainly of T cells, B cells, eosinophils, histiocytes, and plasma cells. However, in the recent past, several studies have tried to identify Reed-Sternberg cells using flow cytometry on fine needle aspiration or tissue biopsy of lymph nodes to confirm or supplement immunohistochemistry staining in diagnosis. Newer and more sensitive tools such as flow cytometry can be used for diagnosis, technology that may have been difficult in the past for diagnosis of this lymphoma subtype. Using flow cytometry, diagnosis is faster and could lead to point-of-care technology especially where we have typical immunophenotype signatures. © 2018 International Clinical Cytometry Society.
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Affiliation(s)
- Ravnit-Kaur Grewal
- MBCHB South African National Bioinformatics Institute, University of the Western Cape, Bellville, South Africa
| | - Manogari Chetty
- Department of Oral and Molecular Biology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | | | - Ciprian Tomuleasa
- Department of Hematology/Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy-Ion Chiricuta Oncology Institute, Cluj Napoca, Romania
| | - Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
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Barroca H, Bode-Lesniewska B, Cozzolino I, Zeppa P. Management of cytologic material, preanalytic procedures and biobanking in lymph node cytopathology. Cytopathology 2018; 30:17-30. [DOI: 10.1111/cyt.12609] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 06/06/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Helena Barroca
- Serviço de Anatomia Patológica; Hospital S João-Porto; Porto Portugal
| | - Beata Bode-Lesniewska
- Institute of Pathology and Molecular Pathology; University Hospital; Zurich Switzerland
| | - Immacolata Cozzolino
- Dipartimento di Salute Mentale e Fisica e Medicina; Università degli studi della Campania Luigi Vanvitelli; Napoli Italy
| | - Pio Zeppa
- Dipartimento di Medicina e Chirurgia; Università di Salerno; Salerno Italy
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10
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Sorigue M, Tuset V, Sancho JM. Treatment of localized-stage follicular lymphoma. Eur J Haematol 2018; 101:245-256. [PMID: 29754401 DOI: 10.1111/ejh.13093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2018] [Indexed: 12/15/2022]
Abstract
Follicular lymphoma (FL) is the most common indolent lymphoma, and it most frequently presents in an advanced stage. Therapeutic considerations for advanced stage are different from those of localized-stage FL, in which radiotherapy (RT) is generally recommended. However, the available evidence suffers from shortcomings that are relatively specific to this clinical entity due to its rarity and long survival with all available treatment modalities, including that most of the existing evidence originated at a time when diagnostic classifications, staging procedures and radiotherapeutic standards were different from those available today and when anti-CD20 monoclonal antibodies were not available. Available treatment modalities include observation, systemic therapy only, RT only and RT in combination with systemic therapy. We review the evidence available with each of them and the data from present-day clinical practice studies as well as briefly discuss what diagnostic and therapeutic developments may take place in the next few years.
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Victòria Tuset
- Department of Radiation Oncology, ICO Badalona, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
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11
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Ultrasensitive automated RNA in situ hybridization for kappa and lambda light chain mRNA detects B-cell clonality in tissue biopsies with performance comparable or superior to flow cytometry. Mod Pathol 2018; 31:385-394. [PMID: 29052600 PMCID: PMC5843495 DOI: 10.1038/modpathol.2017.142] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/30/2017] [Accepted: 08/31/2017] [Indexed: 12/17/2022]
Abstract
The assessment of B-cell clonality is a critical component of the evaluation of suspected lymphoproliferative disorders, but analysis from formalin-fixed, paraffin-embedded tissues can be challenging if fresh tissue is not available for flow cytometry. Immunohistochemical and conventional bright field in situ hybridization stains for kappa and lambda are effective for evaluation of plasma cells but are often insufficiently sensitive to detect the much lower abundance of light chains present in B-cells. We describe an ultrasensitive RNA in situ hybridization assay that has been adapted for use on an automated immunohistochemistry platform and compare results with flow cytometry in 203 consecutive tissues and 104 consecutive bone marrows. Overall, in 203 tissue biopsies, RNA in situ hybridization identified light chain-restricted B-cells in 85 (42%) vs 58 (29%) by flow cytometry. Within 83 B-cell non-Hodgkin lymphomas, RNA in situ hybridization identified restricted B-cells in 74 (89%) vs 56 (67%) by flow cytometry. B-cell clonality could be evaluated in only 23/104 (22%) bone marrow cases owing to poor RNA preservation, but evaluable cases showed 91% concordance with flow cytometry. RNA in situ hybridization allowed for recognition of biclonal/composite lymphomas not identified by flow cytometry and highlighted unexpected findings, such as coexpression of kappa and lambda RNA in 2 cases and the presence of lambda light chain RNA in a T lymphoblastic lymphoma. Automated RNA in situ hybridization showed excellent interobserver reproducibility for manual evaluation (average K=0.92), and an automated image analysis system showed high concordance (97%) with manual evaluation. Automated RNA in situ hybridization staining, which can be adopted on commonly utilized immunohistochemistry instruments, allows for the interpretation of clonality in the context of the morphological features in formalin-fixed, paraffin-embedded tissues with a clinical sensitivity similar or superior to flow cytometry.
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12
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Zhao S, Zhang L, Gu Z, Zhu C, Fang S, Yang N, Wang F, Guan L, Luo L, Gao C. Clinical manifestations of pulmonary mucosa-associated lymphoid tissue lymphoma: single-center experience with 18 patients. Onco Targets Ther 2018; 11:555-561. [PMID: 29416356 PMCID: PMC5790107 DOI: 10.2147/ott.s147275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is a rare entity. To date, the optimal treatment for this disease is still under debate. The aim of this study was to analyze and summarize the clinical manifestations and therapeutic experience of 18 pulmonary MALT lymphoma patients to collect information about the optimal treatment modality. Patients and methods A retrospective analysis was performed in patients who were diagnosed with pulmonary MALT lymphoma at the Chinese People’s Liberation Army General Hospital from April 1995 to April 2016. Results Clinical data of 18 patients were available. The median age was 55 (range, 34–67) years. Also, 61.1% of the patients were male. Only 33.3% had a history of smoking and 27.8% of the patients had tuberculosis. Treatment modalities included surgery alone in 1 patient (5.6%), chemotherapy in 10 patients (55.5%), surgery in combination with chemotherapy in 6 patients (33.3%) and observation in 1 patient (5.6%). Over the median observation period of 93 months, 2 patients died, the median progression-free survival was 6 years, and the estimated 5- and 10-year overall survival rates were 94.1% and 83.7%, respectively. The survival data confirmed the indolent nature of the disease. There was no difference in progression-free survival between the chemotherapy group and the surgery in combination with chemotherapy group. Conclusion Pulmonary MALT lymphoma tended to be an indolent disease. In order to preserve the lung function and reduce the risks associated with surgery, chemotherapy might be an optimal choice for the treatment of pulmonary MALT lymphoma.
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Affiliation(s)
- Shasha Zhao
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Lin Zhang
- Department of Hematology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Zhenyang Gu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Chengying Zhu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Shu Fang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Nan Yang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Feiyan Wang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing.,School of Medicine, Nankai University, Tianjin
| | - Lixun Guan
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Lan Luo
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
| | - Chunji Gao
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Beijing
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An Unsuspected Finding of t(9;22): A Rare Case of Philadelphia Chromosome-Positive B-Lymphoblastic Lymphoma. Case Rep Hematol 2017; 2017:2413587. [PMID: 29075538 PMCID: PMC5624137 DOI: 10.1155/2017/2413587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023] Open
Abstract
While rare, cases of isolated extramedullary disease of B-cell Lymphoblastic Lymphoma (B-LBL) without morphologic bone marrow involvement have been described. In this report, we illustrate the case of an elderly gentleman who presented with isolated testicular and vertebral LBL involvement but had no morphologic bone marrow involvement. The initial plan of treatment was to treat along the lines of Philadelphia negative B-ALL/LBL. During this time, fluorescence in situ hybridization (FISH) and PCR testing for BCR-ABL1 rearrangements were being performed on the marrow specimens as a part of routine diagnostic workup. While the FISH returned negative, PCR testing unexpectedly detected BCR-ABL1 fusion transcripts at a low level of 0.48%. Given their presence, we performed FISH for BCR/ABL1 rearrangement in both testicular and L5 vertebral specimens which were 80–90% positive. He subsequently received rituximab, hyper-CVAD, and dasatinib, along with prophylactic intrathecal prophylactic chemotherapy. The patient achieved a prolonged remission but eventually relapsed, 4 years later. Had it not been for this fortuitous discovery, the patient would not have been treated with tyrosine kinase inhibitors. We emphasize that FISH and PCR testing for BCR-ABL1 rearrangement are integral to arriving at an accurate diagnosis and should be routinely tested on B-LBL biopsy specimens.
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Argnani L, Broccoli A, Zinzani PL. Cutaneous T-cell lymphomas: Focusing on novel agents in relapsed and refractory disease. Cancer Treat Rev 2017; 61:61-69. [PMID: 29102679 DOI: 10.1016/j.ctrv.2017.10.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 10/16/2017] [Accepted: 10/21/2017] [Indexed: 11/24/2022]
Abstract
Patients with relapsed or refractory cutaneous T-cell lymphoma (CTCL) display a dismal prognosis and their therapy represents an unmet medical need, as the best treatment strategy is yet to be determined. Exciting data on novel targeted agents are now emerging from recently concluded and ongoing clinical trials in patients with relapsed and refractory CTCL. Three FDA approved compounds are used as single agents including the oral retinoid bexarotene and histone deacetylase inhibitors romidepsin and vorinostat. Brentuximab vedotin, an anti-CD30 drug-conjugated monoclonal antibody, has received from European Commission the orphan designation but has not been approved by EMA yet. Several other molecules have demonstrated their activity in the same context and combination strategies are being explored. Participation in a well designed clinical trial is encouraged, as the introduction of novel agents will continue to expand the therapeutics options available in the management of CTCL.
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Affiliation(s)
- Lisa Argnani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Alessandro Broccoli
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Pier Luigi Zinzani
- Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
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15
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Han CH, Batchelor TT. Diagnosis and management of primary central nervous system lymphoma. Cancer 2017; 123:4314-4324. [DOI: 10.1002/cncr.30965] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Catherine H. Han
- Department of Neurology, Division of Hematology/Oncology; Massachusetts General Hospital Cancer Center and Harvard Medical School; Boston Massachusetts
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Tracy T. Batchelor
- Department of Neurology, Division of Hematology/Oncology; Massachusetts General Hospital Cancer Center and Harvard Medical School; Boston Massachusetts
- Department of Radiation Oncology, Division of Hematology/Oncology; Massachusetts General Hospital Cancer Center and Harvard Medical School; Boston Massachusetts
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16
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The influence of rituximab-containing chemotherapy on HCV load in patients with HCV-associated non-Hodgkin's lymphomas. Ann Hematol 2017; 96:1501-1507. [PMID: 28669008 DOI: 10.1007/s00277-017-3058-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 06/24/2017] [Indexed: 01/14/2023]
Abstract
Efficacy and safety of rituximab treatment in patients with Hepatitis C virus (HCV) infection associated non-Hodgkin's lymphoma (NHL) are still disputable. The aim of this study was to evaluate the influence of rituximab-containing chemotherapy on HCV load. Fifty-four patients with both HCV infection and NHL were identified between 2000 and 2016 at our institution. We retrospectively analyzed patients' demographic characteristics, treatment, and kinetics of HCV load before and after treatment with rituximab-containing chemotherapy. In the total group of 54 patients, 29 (54%) received rituximab. Both HCV load pre rituximab and maximal HCV load post rituximab were available in 16 patients. Overall, we observed no significant difference between HCV load pre rituximab and the maximal HCV load post rituximab (P = 0.19). In a patient who was treated simultaneously with direct-acting antivirals (DAAs) and rituximab-containing chemotherapy, HCV load decreased below the sensitivity level (≤12 IU/ml) during treatment. When regarding the influence of rituximab-containing chemotherapy alone on HCV load, we observed a significant elevation of HCV load (P = 0.04). Rituximab-containing chemotherapy may lead to an increase of HCV load in patients with HCV-associated NHL. However, this finding is based on small patient cohort and should be confirmed in larger clinical trials.
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Pata G, Bartoli M, Damiani E, Solari S, Anastasia A, Pagani C, Tucci A. Still a role for surgery as first-line therapy of splenic marginal zone lymphoma? Results of a prospective observational study. Int J Surg 2017; 41:143-149. [DOI: 10.1016/j.ijsu.2017.03.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/13/2017] [Accepted: 03/28/2017] [Indexed: 02/07/2023]
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18
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England CG, Rui L, Cai W. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies. Eur J Nucl Med Mol Imaging 2016; 44:517-532. [PMID: 27844106 DOI: 10.1007/s00259-016-3560-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
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Interim PET Scans in Diffuse Large B-Cell Lymphoma: Is It Ready for Prime Time? CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2016; 16:655-661. [PMID: 27693134 DOI: 10.1016/j.clml.2016.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 08/17/2016] [Accepted: 08/26/2016] [Indexed: 12/22/2022]
Abstract
Prognostication of patients with diffuse large B-cell lymphoma (DLBCL) has improved in the past decade with a variety of clinical, morphologic, molecular, and radiographic methods. Comparable to data on the value of interim positron emission tomography (I-PET) in Hodgkin lymphoma, several retrospective and prospective studies are attempting to assess the value of I-PET scanning in DLBCL patients. In this review, we briefly describe and analyze the various prognostic methods in DLBCL with specific focus on the value of I-PET scanning in this disease. This is a timely analysis, as tailoring therapies based on prognosis at diagnosis are becoming of increased investigational interest.
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21
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Gifford GK, Gill AJ, Stevenson WS. Molecular subtyping of diffuse large B-cell lymphoma: update on biology, diagnosis and emerging platforms for practising pathologists. Pathology 2016; 48:5-16. [DOI: 10.1016/j.pathol.2015.11.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/02/2015] [Accepted: 10/12/2015] [Indexed: 01/04/2023]
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22
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Sammassimo S, Pruneri G, Andreola G, Montoro J, Steffanoni S, Nowakowski GS, Gandini S, Negri M, Habermann TM, Raderer M, Li ZM, Zinzani PL, Adam P, Zucca E, Martinelli G. A retrospective international study on primary extranodal marginal zone lymphoma of the lung (BALT lymphoma) on behalf of International Extranodal Lymphoma Study Group (IELSG). Hematol Oncol 2015; 34:177-183. [PMID: 26152851 DOI: 10.1002/hon.2243] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/21/2015] [Accepted: 05/31/2015] [Indexed: 11/10/2022]
Abstract
Primary lymphoma of the lung is a rare entity. Clinical features, optimal treatment, role of surgery and outcomes are not well defined, and the follow-up is variable in published data. Clinical data of 205 patients who were confirmed to have bronchus mucosa-associated lymphoid tissue lymphoma from December 1986 to December 2011 in 17 different centres worldwide were evaluated. Fifty-five per cent of the patients were female. The median age at diagnosis was 62 (range 28-88) years. Only 9% had a history of exposure to toxic substances, while about 45% of the patients had a history of smoking. Ten per cent of the patients had autoimmune disease at presentation, and 19% patients had a reported preexisting lung disease. Treatment modalities included surgery alone in 63 patients (30%), radiotherapy in 3 (2%), antibiotics in 1 (1%) and systemic treatment in 128 (62%). Patients receiving a local approach, mainly surgical resection, experienced significantly improved progression-free survival (p = 0.003) versus those receiving a systemic treatment. There were no other significant differences among treatment modalities. The survival data confirm the indolent nature of the disease. Local therapy (surgery or radiotherapy) results in long-term disease-free survival for patients with localized disease. Systemic treatment, including alkylating-containing regimens, can be reserved to patients in relapse after incomplete surgical excision or for patients with advanced disease. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Simona Sammassimo
- Haematoncology Division, European Institute of Oncology, Milan, Italy
| | | | - Giovanna Andreola
- Haematoncology Division, European Institute of Oncology, Milan, Italy
| | - Juan Montoro
- Haematoncology Division, European Institute of Oncology, Milan, Italy
| | - Sara Steffanoni
- Haematoncology Division, European Institute of Oncology, Milan, Italy
| | | | - Sara Gandini
- Epidemiology and Biostatistics Department, European Institute of Oncology, Milan, Italy
| | - Mara Negri
- Haematoncology Division, European Institute of Oncology, Milan, Italy
| | | | | | - Zhi-Ming Li
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | | | - Patrick Adam
- Pathologisches Institut der Universität, Würzburg, Germany
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23
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Caraway NP. Evolving role of FNA biopsy in diagnosing lymphoma: Past, present, and future. Cancer Cytopathol 2015; 123:389-93. [DOI: 10.1002/cncy.21551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 01/09/2023]
Affiliation(s)
- Nancy P. Caraway
- Section of Cytopathology; Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston Texas
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24
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Parekh P, Kamble S, Zhao N, Zeng Z, Wen J, Yuan B, Zu Y. Biostable ssDNA aptamers specific for Hodgkin lymphoma. SENSORS (BASEL, SWITZERLAND) 2013; 13:14543-57. [PMID: 24233078 PMCID: PMC3871109 DOI: 10.3390/s131114543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 02/07/2023]
Abstract
As a "chemical antibody", oligonucleotide aptamers can specifically bind to their target molecules. However, clinical potential of aptamers in disease diagnosis is not yet fully explored. Using a tumor cell-based selection protocol, we developed single-stranded DNA aptamers for Hodgkin lymphoma (HL) tumor cells. The aptamers specifically bound to HL cells with a high affinity, reaching maximal cell binding at 10 nM final concentration. Importantly, the aptamers were able to selectively detect HL cells and did not react to other tumor or blood cells in mixed samples, indicating that the aptamers can be used as a specific probe for in vitro analysis of HL cells. Moreover, due to the inherent properties of DNA, the aptamers were stable in human serum, suggesting potential for in vivo detection of HL tumor cells.
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Affiliation(s)
- Parag Parekh
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Sanchit Kamble
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Nianxi Zhao
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Zihua Zeng
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Jianguo Wen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Bin Yuan
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Youli Zu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
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