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Chisca M, Larouche JD, Xing Q, Kassiotis G. Antibodies against endogenous retroviruses. Immunol Rev 2024. [PMID: 39152687 DOI: 10.1111/imr.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
The human genome harbors hundreds of thousands of integrations of ancient retroviruses, amassed over millions of years of evolution. To reduce further amplification in the genome, the host prevents transcription of these now endogenous retroviruses (ERVs) through epigenetic repression and, with evolutionary time, ERVs are incapacitated by accumulating mutations and deletions. However, several members of recently endogenized ERV groups still retain the capacity to produce viral RNA, retroviral proteins, and higher order structures, including virions. The retention of viral characteristics, combined with the reversible nature of epigenetic repression, particularly as seen in cancer, allow for immunologically unanticipated ERV expression, perceived by the adaptive immune system as a genuine retroviral infection, to which it has to respond. Accordingly, antibodies reactive with ERV antigens have been detected in diverse disorders and, occasionally, in healthy individuals. Although they are part of self, the retroviral legacy of ERV antigens, and association with and, possibly, causation of disease states may set them apart from typical self-antigens. Consequently, the pathogenic or, indeed, host-protective capacity of antibodies targeting ERV antigens is likely to be context-dependent. Here, we review the immunogenicity of typical ERV proteins, with emphasis on the antibody response and its potential disease implications.
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Affiliation(s)
- Mihaela Chisca
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
| | | | - Qi Xing
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
| | - George Kassiotis
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
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2
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Preda OD, Bădeliță S, Ursuleac I, Irimia RM, Balanica S, Cojocaru M, Cotruta C, Dobrea C, Coriu D. Complications of Brentuximab Therapy in Patients with Hodgkin's Lymphoma and Concurrent Autoimmune Pathology-A Case Series. Hematol Rep 2024; 16:299-307. [PMID: 38804283 PMCID: PMC11130784 DOI: 10.3390/hematolrep16020030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Background: Brentuximab Vedotin (BV) has revolutionized the treatment landscape for Hodgkin's lymphoma, yet its effects on pre-existing autoimmune disorders remain elusive. Methods: Here, we present four cases of patients with concurrent autoimmune conditions-Crohn's disease, vitiligo, type I diabetes, and minimal change disease-undergoing BV therapy for Hodgkin's lymphoma. The patients were treated with A-AVD instead of ABVD due to advanced-stage disease with high IPI scores. Results: Our findings reveal the surprising and complex interplay between BV exposure and autoimmune manifestations, highlighting the need for multidisciplinary collaboration in patient management. Notably, the exacerbation of autoimmune symptoms was observed in the first three cases where T-cell-mediated autoimmunity predominated. Additionally, BV exposure precipitated autoimmune thrombocytopenia in the vitiligo patient, underscoring the profound disruptions in immune regulation. Conversely, in the minimal change disease case, a disease characterized by a blend of B- and T-cell-mediated immunity, the outcome was favorable. Conclusions: This paper underscores the critical importance of vigilance toward autoimmune flare-ups induced by BV in patients with concurrent autoimmune conditions, offering insights for tailored patient care.
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Affiliation(s)
- Oana Diana Preda
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sorina Bădeliță
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
| | - Iulia Ursuleac
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Ruxandra Maria Irimia
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sonia Balanica
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Monica Cojocaru
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Cristina Cotruta
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
| | - Camelia Dobrea
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Daniel Coriu
- University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania; (S.B.); (R.M.I.)
- Fundeni Clinical Institute, 022328 Bucharest, Romania
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3
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Gokhale S, Victor E, Tsai J, Spirollari E, Matracz B, Takatsuka S, Jung J, Kitamura D, Xie P. Upregulated Expression of the IL-9 Receptor on TRAF3-Deficient B Lymphocytes Confers Ig Isotype Switching Responsiveness to IL-9 in the Presence of Antigen Receptor Engagement and IL-4. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2023; 210:1059-1073. [PMID: 36883978 PMCID: PMC10073299 DOI: 10.4049/jimmunol.2200563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023]
Abstract
The pleiotropic cytokine IL-9 signals to target cells by binding to a heterodimeric receptor consisting of the unique subunit IL-9R and the common subunit γ-chain shared by multiple cytokines of the γ-chain family. In the current study, we found that the expression of IL-9R was strikingly upregulated in mouse naive follicular B cells genetically deficient in TNFR-associated factor 3 (TRAF3), a critical regulator of B cell survival and function. The highly upregulated IL-9R on Traf3-/- follicular B cells conferred responsiveness to IL-9, including IgM production and STAT3 phosphorylation. Interestingly, IL-9 significantly enhanced class switch recombination to IgG1 induced by BCR crosslinking plus IL-4 in Traf3-/- B cells, which was not observed in littermate control B cells. We further demonstrated that blocking the JAK-STAT3 signaling pathway abrogated the enhancing effect of IL-9 on class switch recombination to IgG1 induced by BCR crosslinking plus IL-4 in Traf3-/- B cells. Our study thus revealed, to our knowledge, a novel pathway that TRAF3 suppresses B cell activation and Ig isotype switching by inhibiting IL-9R-JAK-STAT3 signaling. Taken together, our findings provide (to our knowledge) new insights into the TRAF3-IL-9R axis in B cell function and have significant implications for the understanding and treatment of a variety of human diseases involving aberrant B cell activation such as autoimmune disorders.
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Affiliation(s)
- Samantha Gokhale
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
- Graduate Program in Cellular and Molecular Pharmacology, Rutgers University, Piscataway, New Jersey 08854
| | - Eton Victor
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
| | - Jemmie Tsai
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
| | - Eris Spirollari
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
| | - Brygida Matracz
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
| | - Shogo Takatsuka
- Division of Molecular Biology, Research Institute for Biomedical Sciences (RIBS), Tokyo University of Science, Noda, Japan
| | - Jaeyong Jung
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
- Graduate Program in Cellular and Molecular Pharmacology, Rutgers University, Piscataway, New Jersey 08854
| | - Daisuke Kitamura
- Division of Molecular Biology, Research Institute for Biomedical Sciences (RIBS), Tokyo University of Science, Noda, Japan
| | - Ping Xie
- Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, New Jersey 08854
- Rutgers Cancer Institute of New Jersey
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Williams MV, Mena-Palomo I, Cox B, Ariza ME. EBV dUTPase: A Novel Modulator of Inflammation and the Tumor Microenvironment in EBV-Associated Malignancies. Cancers (Basel) 2023; 15:855. [PMID: 36765813 PMCID: PMC9913121 DOI: 10.3390/cancers15030855] [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: 12/12/2022] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
There is increasing evidence that put into question the classical dogma that the Epstein-Barr virus (EBV) exists in cells as either a lytic virus in which new progeny is produced or in a latent state in which no progeny is produced. Notably, a third state has now been described, known as the abortive-lytic phase, which is characterized by the expression of some immediate early (IE) and early (E) genes, but no new virus progeny is produced. While the function of these IE and E gene products is not well understood, several recent studies support the concept they may contribute to tumor promotion by altering the tumor microenvironment (TME). The mechanisms by which these viral gene products may contribute to tumorigenesis remain unclear; however, it has been proposed that some of them promote cellular growth, immune evasion, and/or inhibit apoptosis. One of these EBV early gene products is the deoxyuridine triphosphate nucleotidohydrolase (dUTPase) encoded by BLLF3, which not only contributes to the establishment of latency through the production of activin A and IL-21, but it may also alter the TME, thus promoting oncogenesis.
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Affiliation(s)
- Marshall V. Williams
- Department of Cancer Biology and Genetics (CBG), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
- Institute for Behavioral Medicine Research (IBMR), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Irene Mena-Palomo
- Institute for Behavioral Medicine Research (IBMR), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Brandon Cox
- Institute for Behavioral Medicine Research (IBMR), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Maria Eugenia Ariza
- Department of Cancer Biology and Genetics (CBG), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
- Institute for Behavioral Medicine Research (IBMR), The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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5
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Jain P, Wang ML. Mantle cell lymphoma in 2022-A comprehensive update on molecular pathogenesis, risk stratification, clinical approach, and current and novel treatments. Am J Hematol 2022; 97:638-656. [PMID: 35266562 DOI: 10.1002/ajh.26523] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 12/21/2022]
Abstract
The field of mantle cell lymphoma (MCL) has witnessed remarkable progress due to relentless advances in molecular pathogenesis, prognostication, and newer treatments. MCL consists of a spectrum of clinical subtypes. Rarely, atypical cyclin D1-negative MCL and in situ MCL neoplasia are identified. Prognostication of MCL is further refined by identifying somatic mutations (such as TP53, NSD2, KMT2D), methylation status, chromatin organization pattern, SOX-11 expression, minimal residual disease (MRD), and genomic clusters. Lymphoid tissue microenvironment studies demonstrated the role of B-cell receptor signaling, nuclear factor kappa B (NF-kB), colony-stimulating factor (CSF)-1, the CD70-SOX-11 axis. Molecular mechanism of resistance, mutation dynamics, and pathogenic pathways (B-cell receptor (BCR), oxidative phosphorylation, and MYC) were identified in mediating resistance to various treatments (bruton tyrosine kinase (BTK) inhibitors [ibrutinib, acalabrutinib]. Treatment options range from conventional chemoimmunotherapy and stem cell transplantation (SCT) to targeted therapies against BTK (covalent and noncovalent), Bcl2, ROR1, cellular therapy such as anti-CD19 chimeric antigen receptor therapy (CAR-T), and most recently bispecific antibodies against CD19 and CD20. MCL patients frequently relapse. Complex pathogenesis and the management of patients with progression after treatment with BTK/Bcl2 inhibitors and CAR-T (triple-resistant MCL) remain a challenge. Next-generation clinical trials incorporating newer agents and concurrent translational and molecular investigations are ongoing.
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Affiliation(s)
- Preetesh Jain
- Department of Lymphoma/Myeloma. Mantle cell lymphoma center of excellence The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Michael L. Wang
- Department of Lymphoma/Myeloma. Mantle cell lymphoma center of excellence The University of Texas MD Anderson Cancer Center Houston Texas USA
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6
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Porpaczy E, Jäger U. How I manage autoimmune cytopenias in patients with lymphoid cancer. Blood 2022; 139:1479-1488. [PMID: 34517415 PMCID: PMC11017954 DOI: 10.1182/blood.2019003686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/29/2021] [Indexed: 11/20/2022] Open
Abstract
Autoimmune conditions can occur in a temporary relationship with any malignant lymphoma. In many instances, treatment at diagnosis is not required, but symptomatic autoimmune conditions represent an indication for treatment, particularly in chronic lymphoproliferative diseases. Treatment is selected depending on the predominant condition: autoimmune disease (immunosuppression) or lymphoma (antilymphoma therapy). Steroids and anti-CD20 antibodies are effective against both conditions and may suppress the autoimmune complication for a prolonged period. The efficacy of B-cell receptor inhibitors has provided us with novel insights into the pathophysiology of antibody-producing B cells. Screening for underlying autoimmune conditions is part of the lymphoma workup, because other drugs, such as immunomodulators and checkpoint inhibitors, should be avoided or used with caution. In this article, we discuss diagnostic challenges and treatment approaches for different situations involving lymphomas and autoimmune cytopenias.
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Affiliation(s)
- Edit Porpaczy
- Department of Medicine I, Division of Hematology and Hemostaseology
| | - Ulrich Jäger
- Department of Medicine I, Division of Hematology and Hemostaseology
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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7
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Sheng L, Fu D, Cao Y, Huo Y, Wang S, Shen R, Xu P, Cheng S, Wang L, Zhao W. Integrated Genomic and Transcriptomic Analyses of Diffuse Large B-Cell Lymphoma With Multiple Abnormal Immunologic Markers. Front Oncol 2022; 12:790720. [PMID: 35237512 PMCID: PMC8882913 DOI: 10.3389/fonc.2022.790720] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/17/2022] [Indexed: 12/29/2022] Open
Abstract
Background Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive subtype of lymphoma and related to autoimmune diseases (AIDs). Primary B-cell receptor-mediated AIDs are associated with poor clinical outcome of DLBCL. To further determine the role of immunological alterations on disease progression, our study integrated genomic and transcriptomic analyses on DLBCL with multiple abnormal immunologic markers. Methods The clinical data of 1,792 patients with newly diagnosed DLBCL were collected, with DNA- and RNA-sequencing conducted for 164 and 127 patients, respectively. Frequent gene mutations and the involved dysregulated pathways, along with gene expression pattern and tumor microenvironment alternations, were analyzed and compared based on the immune status of the patients. Results DLBCL with multiple abnormal immunologic markers demonstrated a variety of characteristics including elevated serum lactic dehydrogenase level, inferior prognosis, and dysregulated cell cycle and immune response, as well as activated oxidative phosphorylation pathway and increased Th1/Th2 and Th17/Treg ratios, which were highly similar as those that occur in AIDs. Conclusions We piloted the description of the clinical and genetic features of DLBCL with multiple abnormal immunologic markers, illustrated possible mechanisms of disease progression, and provided a clinical rationale of mechanism-based targeted therapy in this subset of DLBCL.
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8
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Gavazzi F, Fraser JL, Bloom M, Tochen L, Rhee J, Kwan M, Victoria T, Teachey DT, Ho CY, Vanderver A, Linn RL. Hodgkin lymphoma in an individual with TREX1-mediated Aicardi Goutières syndrome. Pediatr Blood Cancer 2022; 69:e29322. [PMID: 34490982 PMCID: PMC11348674 DOI: 10.1002/pbc.29322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Francesco Gavazzi
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Jamie L. Fraser
- Rare Disease Institute, Division of Genetics and Metabolism, Children’s National Hospital, Washington, District of Columbia, USA
| | - Miriam Bloom
- Department of Pediatrics, Children’s National Hospital, Washington, District of Columbia, USA
| | - Laura Tochen
- Department of Neurology, Children’s National Hospital, Washington, District of Columbia, USA
| | - Jullie Rhee
- Department of Neurology, Children’s National Hospital, Washington, District of Columbia, USA
| | - Megan Kwan
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Teresa Victoria
- Division of Radiology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - David T. Teachey
- Divisions of Hematology and Oncology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Divisions of Hematology and Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Cheng-Ying Ho
- Department of Pathology and Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Adeline Vanderver
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca L. Linn
- Department of Pathology and Lab Medicine at Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Gorodetskiy V, Probatova N, Obukhova T, Vasilyev V. Analysis of prognostic factors in diffuse large B-cell lymphoma associated with rheumatic diseases. Lupus Sci Med 2021; 8:8/1/e000561. [PMID: 34785569 PMCID: PMC8596057 DOI: 10.1136/lupus-2021-000561] [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: 08/14/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022]
Abstract
Objective The risk of developing diffuse large B-cell lymphoma (DLBCL) is increased in many rheumatic diseases (RDs). It is possible that RD-associated DLBCL is a distinct subset within the category of ‘DLBCL’, exhibiting characteristic biological features and clinical behaviour. However, information on RD-associated DLBCL is limited. Methods We searched the V.A. Nasonova Research Institute of Rheumatology (Russia) database from 1996 to 2021 for patients with RDs and coexisting DLBCL. Prognostic factors including the International Prognostic Index (IPI), bulk disease and c-MYC/8q24 gene rearrangements were analysed. Furthermore, we stratified DLBCLs as germinal centre B-cell (GCB) subtype and non-GCB subtype based on Hans’ immunohistochemical algorithm and also examined Epstein-Barr virus (EBV) status. Results Twenty-seven patients with RD-associated DLBCL were identified. Twenty patients had primary Sjogren’s syndrome, three had systemic lupus erythematosus, two had rheumatoid arthritis and two had systemic sclerosis. Secondary Sjogren’s syndrome was found in four patients. The median age at the time of diagnosis of DLBCL was 59 years with a female predominance (26:1). Based on IPI, 16 patients were assigned to the intermediate-high and high-risk groups. Bulk disease was detected in 29% of patients. Of the 20 examined cases, 4 (20%) were classified as the GCB subtype and 16 (80%) were classified as the non-GCB subtype. EBV was detected in 2 of the 21 tested cases (10%), and the c-MYC/8q24 gene rearrangement was not found in any of the 19 examined cases. After the lymphoma diagnosis, the median overall survival (OS) was 10 months (range: 0–238 months). Conclusions Except for the more common non-GCB subtype, we did not identify any other prognostic factor that could influence the prognosis of patients with RD-associated DLBCL. We believe that short OS in our patients was predominantly associated with decreased tolerance to lymphoma treatment.
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Affiliation(s)
- Vadim Gorodetskiy
- Department of Intensive Methods of Therapy, V A Nasonova Research Institute of Rheumatology, Moscow, Russian Federation
| | - Natalya Probatova
- Department of Pathology, N N Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Tatiana Obukhova
- Cytogenetic Laboratory, National Research Center for Hematology, Moscow, Russian Federation
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10
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Broadening the Differential for Unilateral Knee Pain: A Diagnostic Case Study. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kedra J, Seror R, Dieudé P, Constantin A, Toussirot E, Kfoury E, Masson C, Cornec D, Dubost JJ, Marguerie L, Ottaviani S, Grados F, Belkhir R, Fain O, Goupille P, Sordet C, Fautrel B, Philippe P, Piperno M, Combe B, Lambotte O, Richez C, Sellam J, Sené T, Denis G, Lequerre T, Lazure T, Mariette X, Nocturne G. Lymphoma complicating rheumatoid arthritis: results from a French case-control study. RMD Open 2021; 7:rmdopen-2021-001698. [PMID: 34470830 PMCID: PMC8413949 DOI: 10.1136/rmdopen-2021-001698] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/12/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives To study the characteristics of B-cell non-Hodgkin’s lymphoma (NHL) or Hodgkin lymphoma complicating rheumatoid arthritis (RA) and to identify RA-related factors associated with their occurrence. Methods A multicentre case–control study was performed in France. Cases were patients with RA fulfilling ACR-EULAR 2010 criteria in whom B-cell NHL or Hodgkin lymphoma developed after the diagnosis of RA. For each case, 2 controls were assigned at random from the ESPOIR cohort and were matched on age at lymphoma diagnosis (cases)/age at the 10-year follow-up visit in the cohort (controls). Case and control characteristics were compared to identify parameters associated with the occurrence of lymphoma. Results 54 cases were included and matched to 108 controls. Lymphomas were mostly diffuse large B-cell lymphoma (DLBCL, n=27, 50.0%). On immunochemistry, 4 of 27 (14.8%) lymphoma cases were positive for Epstein-Barr virus. On univariate analysis, factors associated with the occurrence of lymphoma were male sex (OR 3.3, 95% CI 1.7 to 6.7), positivity for ACPA (OR 5.1, 95% CI 2.0 to 15.7) and rheumatoid factor (OR 3.9, 95% CI 1.6 to 12.2), and erosions on radiographs (OR 3.8, 95% CI 1.7 to 8.3) and DAS28 (OR 2.0, 95% CI 1.5 to 2.7), both at the time of matching. Methotrexate, TNF blockers and a number of previous biologics were not associated with the occurrence of lymphoma. On multivariable analysis, erosions and DAS28 remained significantly associated with increased risk of lymphoma. Conclusion Lymphomas complicating RA are mostly DLBCL. Risk of lymphoma in patients with RA was increased with markers of disease activity and severity, which supports the paradigm of a continuum between autoimmunity and lymphomagenesis in RA.
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Affiliation(s)
- Joanna Kedra
- Department of Rheumatology, FHU CARE, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France.,INSERM UMR1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
| | - Raphaele Seror
- Department of Rheumatology, FHU CARE, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France.,INSERM UMR1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
| | - Philippe Dieudé
- Rheumatology Department, Bichat Hospital, APHP, Paris, France
| | | | - Eric Toussirot
- Clinical Investigation Center Biotherapy INSERM CBT-506, University Hospital of Besançon, Besançon, France.,Rheumatology, University Hospital of Besançon, Besançon, France
| | - Elias Kfoury
- Hematology Department, Centre Hospitalier General Dubois, Brive-la-Gaillarde, Limousin, France
| | - Charles Masson
- Rheumatology, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | | | | | | | | | - Franck Grados
- Rheumatology, University Hospital Centre Amiens-Picardie, Amiens, Hauts-de-France, France
| | - Rakiba Belkhir
- Department of Rheumatology, FHU CARE, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France
| | - Olivier Fain
- Service de Médecine Interne, DHUi2B, Hôpital Saint Antoine, AP HP, Université Pierre et Marie Curie, Paris, France
| | | | - Christelle Sordet
- Rheumatology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Bruno Fautrel
- Rheumatology, Assistance Publique - Hopitaux de Paris, Paris, France.,GRC08 - IPLESP, UPMC Faculte de Medecine, Paris, France
| | | | | | - Bernard Combe
- Department of Rheumatology, University of Montpellier, Montpellier, Languedoc-Roussillon, France
| | | | - Christophe Richez
- Service de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Jérémie Sellam
- Rheumatology, INSERM UMRS_938, Sorbonnes Université UPMC Univ Paris 06, St-Antoine Hospital, DHU i2B, Paris, France
| | - Thomas Sené
- Internal Medicine, The Fondation Adolphe de Rothschild Hospital, Paris, France
| | - Guillaume Denis
- Hematology department, Rochefort Hospital, Groupe Hospitalier Littoral Atlantique, Rochefort, France
| | - Thierry Lequerre
- Rheumatology Department & Inserm 905, Rouen University Hospital, Rouen, France
| | - Thierry Lazure
- Anatomical Pathology Department, Bicêtre Hospital, Assistance Publique - Hopitaux de Paris, Le Kremlin-Bicêtre, Île-de-France, France
| | - Xavier Mariette
- Department of Rheumatology, FHU CARE, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France.,INSERM UMR1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
| | - Gaetane Nocturne
- Department of Rheumatology, FHU CARE, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicetre, Île-de-France, France .,INSERM UMR1184, Center for Immunology of Viral Infections and Autoimmune Diseases, Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, Île-de-France, France
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Sima A, Hollander P, Baecklund E, Smedby KE, Enblad G, Amini RM. Superior outcome for splenectomised patients in a population-based study of splenic marginal zone lymphoma in Sweden. Br J Haematol 2021; 194:568-579. [PMID: 34109612 DOI: 10.1111/bjh.17577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/06/2021] [Indexed: 12/11/2022]
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare low-grade B-cell lymphoma where associations with viral hepatitis and autoimmune and inflammatory diseases (AID) have been indicated. We aimed at assessing the prevalence of viral hepatitis and AID at SMZL diagnosis and outcome by treatment in a Swedish population-based study. A total of 277 SMZL patients registered in the Swedish Lymphoma Register in 2007-2017 were included. A history of viral hepatitis was reported in five (2%) patients and AID prior to SMZL in 72/240 (30%) patients. Treatment was given up front for 207 (75%) patients. Splenectomy with or without systemic treatment was performed in 119 (57%) and was associated with statistically significantly better overall survival [hazard ratio, HR = 0·47 (95% confidence interval, CI: 0·23-0·93), P = 0·03] and progression-free survival (HR = 0·55, 95% CI: 0·35-0·86, P = 0·008) compared to non-splenectomised patients in multivariable analyses. The up-front splenectomised group was younger and generally had a lower Ann Arbor stage, but also more frequently B symptoms and high lactate dehydrogenase than the non-splenectomised group. Viral hepatitis and AID history did not affect SMZL outcome. We report high incidence of AIDs and low incidence of viral hepatitis in this population-based study of SMZL. Splenectomy up front was associated with a favourable outcome.
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Affiliation(s)
- Andreea Sima
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter Hollander
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Eva Baecklund
- Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Karin E Smedby
- Division of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Enblad
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Rose-Marie Amini
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
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13
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Kim JS, Kim IH, Byun JM, Chang JH. Population-based study on the association between autoimmune disease and lymphoma: National Health Insurance Service-National Sample Cohort 2002-2015 in Korea. J Autoimmun 2021; 121:102647. [PMID: 33991884 DOI: 10.1016/j.jaut.2021.102647] [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: 02/18/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to evaluate the association between autoimmune disease (AID) and lymphoma incidence in the Korean population. We also aimed to compare the overall survival (OS) in patients with AID-associated lymphoma (AAL) with that in patients with lymphoma without AID. MATERIAL AND METHODS We used National Sample Cohort 2002-2015 provided by National Health Insurance Service. Among 1,011,638 patients, 994,496 were recruited for the final cohort: 130,987 patients (13.2%) in the AID group and 863,509 (86.8%) in control. Lymphoma was diagnosed in 1162 patients and 322 patients with accompanying AID, irrespective of the time point of diagnosis, were defined as AAL. Of those, patients who experienced lymphoma development at least one year after AID diagnosis were defined as post-AID lymphoma (N = 155). RESULTS The median follow-up duration was 13.7 years. AAL accounted for 0.03% of total and 27.7% of lymphoma cases. AID patients experienced more Epstein-Barr virus (0.02 vs. 0.01%, P = 0.027) or Helicobacter pylori infection (63.9 vs. 41.4%, P < 0.001) than the control group did. AID was associated with a 1.45-fold increased risk of lymphoma. The median time interval from AID to AAL was 10.9 months. The risk of lymphoma increased in the order of: psoriasis (adjusted odds ratio [AOR] 1.61), systemic lupus erythematosus (AOR 3.99), multiple sclerosis (AOR 4.52), and sarcoidosis (AOR 26.37). Sjogren syndrome was not related to lymphoma in this cohort. The 5-year OS in AAL was not different from that in lymphoma patients without AID (60.9 vs. 61.5%, P = 0.970). CONCLUSIONS The association patterns in AAL in Korean population were different from those of Western countries. Further studies on lymphomatogenesis from distinct baseline characteristics (e.g. chronic infection status) would elucidate the difference based on race and ethnicity.
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Affiliation(s)
- Jae Sik Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea; Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea
| | - Il Han Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Ja Min Byun
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Ji Hyun Chang
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea; Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea.
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Taylor PC, Atzeni F, Balsa A, Gossec L, Müller-Ladner U, Pope J. The Key Comorbidities in Patients with Rheumatoid Arthritis: A Narrative Review. J Clin Med 2021; 10:509. [PMID: 33535498 PMCID: PMC7867048 DOI: 10.3390/jcm10030509] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 02/06/2023] Open
Abstract
Comorbidities in patients with rheumatoid arthritis (RA) are often associated with poor health outcomes and increased mortality. Treatment decisions should take into account these comorbidities due to known or suspected associations with certain drug classes. In clinical practice, it is critical to balance potential treatment benefit against the possible risks for comorbidities as well as the articular manifestations of RA. This review summarises the current literature relating to prevalence and risk factors for the important comorbidities of cardiovascular disease, infections, lymphomas and nonmelanoma skin cancers in patients with RA. The impact on patient outcomes and the interplay between these comorbidities and the therapeutic options currently available, including tumour necrosis factor inhibitors and newer biological therapies, are also explored. As newer RA therapies are developed, and patients gain wider and earlier access to advanced therapies, in part due to the emergence of biosimilars, it is important to consider the prevention or treatment of comorbidities as part of the overall management of RA.
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Affiliation(s)
- Peter C. Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 7LD, UK
| | - Fabiola Atzeni
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Alejandro Balsa
- Rheumatology Unit, Hospital Universitario La Paz, La Paz Institute for Health Research IdiPAZ, Universidad Autónoma de Madrid, Paseo de la Castellana, 261, 28046 Madrid, Spain;
| | - Laure Gossec
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, 75006 Paris, France;
- Rheumatology Department, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, 75013 Paris, France
| | - Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus Liebig University Gießen, Campus Kerckhoff, 61231 Bad Nauheim, Germany;
| | - Janet Pope
- St. Joseph’s Health Care, Schulich School of Medicine, University of Western Ontario, London, ON N6A 5C1, Canada;
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15
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Chean CS, Sovani V, Boden A, Knapp C. Lacrimal gland extranodal marginal zone B-cell lymphoma in the presence of amyloidosis. Orbit 2020; 41:350-353. [PMID: 33213206 DOI: 10.1080/01676830.2020.1852578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Amyloidosis is a protein metabolism disorder characterised by extracellular deposition of insoluble amorphous hyaline material. Orbital and ocular amyloid lesions account for only 4% of localised disease affecting the head and neck. Ocular adnexal lymphoma accounts for 1-2% of lymphoma, with lacrimal gland lymphomas being relatively uncommon. The most common form affecting the orbit is extranodal marginal zone lymphoma (EMZL) of mucosa-associated lymphoid tissue (MALT lymphoma). We report an extremely rare case of co-existent EMZL and amyloidosis of the lacrimal gland. Initial biopsy of the right lacrimal gland confirmed an EMZL with amyloid deposit, and a course of radiotherapy treatment was given. Recurrent lacrimal gland swelling developed within a year. Subsequent biopsy identified amyloidosis with scanty lymphoid tissue. To our knowledge, this is the first reported case of localised lacrimal gland amyloidosis of uncertain type with previous EMZL; the association described in this case report is not yet fully understood.
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Affiliation(s)
- Chung Shen Chean
- United Lincolnshire Hospitals NHS Trust, Lincoln County Hospital, Lincoln, UK
| | - Vishakha Sovani
- Department of Histopatholog, Nottingham University Hospitals NHS Trust (City Campus), Nottingham, UK
| | - Ali Boden
- United Lincolnshire Hospitals NHS Trust, Lincoln County Hospital, Lincoln, UK
| | - Christopher Knapp
- United Lincolnshire Hospitals NHS Trust, Lincoln County Hospital, Lincoln, UK
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16
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Kikuchi-Fujimoto disease associated with primary Sjögren's syndrome - literature review based on a case report. Reumatologia 2020; 58:251-256. [PMID: 32921833 PMCID: PMC7477469 DOI: 10.5114/reum.2020.98438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/04/2020] [Indexed: 12/17/2022] Open
Abstract
Primary Sjögren’s syndrome (pSS) is a chronic, autoimmune disease predominantly involving exocrine glands. Lymphadenopathy is one of the possible symptoms of pSS. It may also suggest development of non-Hodgkin lymphoma (NHL), the most severe complication of pSS, or be a symptom of less common diseases, such as Kikuchi-Fujimoto disease (KFD), presented in this paper. Kikuchi-Fujimoto disease is an extremely rare, benign and self-limiting disorder, characterized by regional lymphadenopathy. This paper presents a case of previously unreported association of pSS, KFD and renal cancer in a patient with recurrent cervical lymphadenopathy, as well as a discussion on the coexistence of these diseases based on available literature searching for PubMed, Scopus and Google Scholar databases, particularly in this subject. These three clinical entities may manifest lymphadenopathy each, causing a diagnostic dilemma. The treatment is also challenging under such circumstances. In this particular situation, it was a combination of immunosuppressive therapy and surgery.
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17
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Choi S, Kim JH, Kim K, Kim M, Choi HJ, Kim YM, Suh JH, Seo MJ, Cha HJ. Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. J Pathol Transl Med 2020; 54:340-345. [PMID: 32702946 PMCID: PMC7385263 DOI: 10.4132/jptm.2020.03.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), is one of the specific type of low-grade B-cell lymphoma not infrequently found worldwide. It typically involves mucosal sites such as stomach and conjunctiva; however, primary hepatic MALT lymphoma has been extremely rarely reported. We describe a case of hepatic MALT lymphoma in a 70-year-old male patient who underwent left hepatectomy due to the incidentally detected liver masses at a medical checkup. The resected specimen revealed multinodular masses consisting of small-to-intermediate-sized lymphoid cells with serpentine pattern and focal lymphoepithelial lesions. The tumor cells were diffusely positive for CD20 and Bcl-2 but negative for CD3, CD10, CD5, CD23, CD43, and cyclinD1. The Ki-67 labeling index was 10% and immunoglobulin heavy chain gene rearrangement study confirmed monoclonal proliferation. In this paper, we discuss several unique clinicopathologic characteristics which will be helpful to the differential diagnosis of hepatic MALT lymphoma.
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Affiliation(s)
- Soyeon Choi
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
| | - Ji Hye Kim
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
| | - Kyungbin Kim
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
| | - Misung Kim
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
| | - Hye Jeong Choi
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
- Department of Pathology, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Min Kim
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
- Department of Pathology, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jae Hee Suh
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
- Department of Pathology, University of Ulsan College of Medicine, Ulsan, Korea
| | - Min Jung Seo
- Department of Pathology, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Nuclear Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Hee Jeong Cha
- Department of Pathology, Ulsan University Hospital, Ulsan, Korea
- Department of Pathology, University of Ulsan College of Medicine, Ulsan, Korea
- Corresponding Author: Hee Jeong Cha, MD, Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan 44033, Korea Tel: +82-52-250-7261, Fax: +82-52-252-3024, E-mail:
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18
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Rodriguez-Pinilla SM, Domingo-Domenech E, Climent F, Sanchez J, Perez Seoane C, Lopez Jimenez J, Garcia-Cosio M, Caballero D, Blanco Muñez OJ, Carpio C, Castellvi J, Martinez Pozo A, Gonzalez Farre B, Bendaña A, Aliste C, Gonzalez AJ, Gonzalez de Villambrosia S, Piris MA, Gomez Codina J, Mayordomo-Aranda E, Navarro B, Bellas C, Rodriguez G, Borrero JJ, Ruiz-Zorrilla A, Grande M, Montoto C, Cordoba R. Clinical and pathological characteristics of peripheral T-cell lymphomas in a Spanish population: a retrospective study. Br J Haematol 2020; 192:82-99. [PMID: 32426847 PMCID: PMC7818499 DOI: 10.1111/bjh.16741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
We investigated the clinicopathological features and prognostic factors of patients with peripheral T‐cell lymphoma (PTCL) in 13 sites across Spain. Relevant clinical antecedents, CD30 expression and staining pattern, prognostic indices using the International Prognostic Index and the Intergruppo Italiano Linfomi system, treatments, and clinical outcomes were examined. A sizeable proportion of 175 patients had a history of immune‐related disorders (autoimmune 16%, viral infections 17%, chemo/radiotherapy‐treated carcinomas 19%). The median progression‐free survival (PFS) and overall survival (OS) were 7·9 and 15·8 months, respectively. Prognostic indices influenced PFS and OS, with a higher number of adverse factors resulting in shorter survival (P < 0·001). Complete response (CR) to treatment was associated with better PFS (62·6 vs. 4 months; P < 0·001) and longer OS (67·0 vs. 7·3 months; P < 0·001) compared to no CR. CD30 was expressed across all subtypes; >15% of cells were positive in anaplastic lymphoma kinase‐positive and ‐negative anaplastic large‐cell lymphoma and extranodal natural killer PTCL groups. We observed PTCL distribution across subtypes based on haematopathological re‐evaluation. Poor prognosis, effect of specific prognostic indices, relevance of histopathological sub‐classification, and response level to first‐line treatment on outcomes were confirmed. Immune disorders amongst patients require further examination involving genetic studies and identification of associated immunosuppressive factors.
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Affiliation(s)
| | - Eva Domingo-Domenech
- Hematology Department, Institut Català d'Oncologia L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Fina Climent
- Pathology Department, Hospital Universitari de Bellvitge. IDIBELL, L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Joaquin Sanchez
- Hematology Department and Pathology Department, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - Carlos Perez Seoane
- Hematology Department and Pathology Department, Hospital Universitario Reina Sofía, Cordoba, Spain
| | | | - Monica Garcia-Cosio
- Anatomical Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, CIBERONC, Madrid, Spain
| | - Dolores Caballero
- Hematology Department, Hospitalario Universitario de Salamanca (HUS/IBSAL) and CIBERONC, Salamanca, Spain
| | | | - Cecilia Carpio
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Castellvi
- Pathology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonio Martinez Pozo
- Pathology Department, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Universitat de Barcelona, Barcelona, Spain
| | - Blanca Gonzalez Farre
- Hematopathology Unit, Hospital Clínic Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) CIBERONC Universitat de Barcelona, Barcelona, Spain
| | - Angeles Bendaña
- Hematology Department, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña,, Spain
| | - Carlos Aliste
- Hematology Department, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña,, Spain
| | - Ana Julia Gonzalez
- Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Miguel A Piris
- Hospital Universitario Fundación Jiménez Díaz, Madrid, CIBERONC, Madrid, Spain
| | - Jose Gomez Codina
- Medical Oncology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Belen Navarro
- Hematology Department, Hospital Universitario Puerta de Hierro, Madrid, CIBERONC, Madrid, Spain
| | - Carmen Bellas
- Pathology Department, Hospital Universitario Puerta de Hierro, Madrid, CIBERONC, Madrid, Spain
| | - Guillermo Rodriguez
- Anatomical Pathology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/Universidad de Sevilla, Sevilla, Spain
| | - Juan Jose Borrero
- Anatomical Pathology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/Universidad de Sevilla, Sevilla, Spain
| | | | - Marta Grande
- Medical Department, Takeda Farmacéutica España S.A, Madrid, Spain
| | - Carmen Montoto
- Medical Department, Takeda Farmacéutica España S.A, Madrid, Spain
| | - Raul Cordoba
- Hematology Department, Fundación Jiménez Díaz, Madrid, CIBERONC, Madrid, Spain
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19
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Jones SJ, Stroshein S, Williams AM, Liu D, Spinelli JJ, Connors JM, Brooks-Wilson AR. Birth Order, Sibship Size, Childhood Environment and Immune-Related Disorders, and Risk of Lymphoma in Lymphoid Cancer Families. Cancer Epidemiol Biomarkers Prev 2020; 29:1168-1178. [PMID: 32169998 DOI: 10.1158/1055-9965.epi-19-1204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/04/2019] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Familial aggregation of lymphoid cancers and immune-related disorders suggests a role for genetic susceptibility; however, few studies examine environmental factors. According to the hygiene hypothesis, adult-onset immune-related diseases may be a consequence of reduced childhood infectious exposures and aberrant immune development. In a cohort of 196 multiple-case lymphoid cancer families, we analyzed environmental factors related to the hygiene hypothesis. METHODS Family structure, childhood environment, and immune-related disorders were examined among 196 lymphoid cancer families, in relation to risk of lymphoid cancer. We report on 450 lymphoid cancer cases and 1,018 unaffected siblings using logistic regression models with generalized estimating equations to estimate ORs and 95% confidence intervals (CI) for association. RESULTS The risk of lymphoma tended to decrease with later birth order (OR = 0.83; 95% CI, 0.78-0.89) and larger sibship size (OR = 0.82; 95% CI, 0.79-0.85). High maternal education, above average family income during childhood, allergies (OR = 2.25; 95% CI, 1.44-3.51), and tonsillectomy (OR = 1.78; 95% CI, 1.14-2.78) were independent risk factors for lymphoma. Familial lymphoid cancer cases were more likely to report environment (OR = 1.90; 95% CI, 1.21-2.98) and drug (OR = 2.30; 95% CI, 1.41-3.73) allergies. CONCLUSIONS These associations underscore the complex etiology of familial lymphoma. To our knowledge, this is the largest multiple-case family-based study that supports the hygiene hypothesis contributing to lymphoid cancer risk. IMPACT Understanding the mechanism by which environmental and lifestyle factors affect lymphoid cancer risk may advance cancer prevention, even in the familial context.
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Affiliation(s)
- Samantha J Jones
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer, Vancouver, British Columbia, Canada.,Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sumara Stroshein
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Amy M Williams
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Dongmeng Liu
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia, Canada
| | - John J Spinelli
- Population Oncology, British Columbia Cancer, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph M Connors
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Angela R Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer, Vancouver, British Columbia, Canada. .,Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
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20
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Liu XC, Jia ZW, Weng Y, Yang LJ, Wang J, Peng H. Ileocecal junction perforation by colonic T-cell lymphoma in a patient with primary Sjögren's syndrome. J Int Med Res 2019; 48:300060519894434. [PMID: 31875742 PMCID: PMC7686621 DOI: 10.1177/0300060519894434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Primary Sjögren’s syndrome (pSS) is associated with an increased risk of lymphoma,
especially non-Hodgkin’s lymphoma. The rarest pathological subtype is T-cell lymphoma. We
herein report a case of a 52-year-old man with a 17-year history of pSS who was admitted
to our hospital with chronic epigastric pain and a positive fecal occult blood test.
Colonoscopy revealed multiple colonic ulcers, and histological and immunological studies
demonstrated the T-cell origin of this lymphoma. However, the patient rejected all
treatments. He developed recurrent intestinal obstruction and infection for 3 years until
an intestinal perforation occurred. The right half of the colon was resected and colostomy
was performed. However, the patient died of an intestinal fistula and intraperitoneal
infection 40 days postoperatively. This case highlights the rarity of the correlation
between T-cell lymphoma and pSS.
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Affiliation(s)
- Xiao-Chuan Liu
- Department of Gastroenterology, Meitan General Hospital, Peking, China
| | - Zhi-Wei Jia
- Department of Gastroenterology, Meitan General Hospital, Peking, China
| | - Yan Weng
- Department of Gastroenterology, Meitan General Hospital, Peking, China
| | - Lian-Jun Yang
- Department of Pathology, Meitan General Hospital, Peking, China
| | - Jing Wang
- Department of Gastroenterology, Meitan General Hospital, Peking, China
| | - Hao Peng
- Department of Gastrointestinal Surgery, Emergency General Hospital, Peking, China
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21
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Mörth C, Valachis A, Abu Sabaa A, Marshall K, Hedström G, Flogegård M, Baecklund E, Enblad G. Autoimmune disease in patients with diffuse large B-cell lymphoma: occurrence and impact on outcome. Acta Oncol 2019; 58:1170-1177. [PMID: 31131659 DOI: 10.1080/0284186x.2019.1619936] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: Patients with certain autoimmune diseases (AID) have an increased risk of developing diffuse large B-cell lymphoma (DLBCL). However, the occurrence of AID in patients with DLBCL as well as the impact of AID on outcome has not been extensively studied. The main purpose of this study was to establish the occurrence of AIDs in a population-based cohort of DLBCL patients and to compare outcomes in patients with or without AID treated with rituximab(R)-CHOP/CHOP-like treatment. We also aimed to analyse gender differences and the potential role of different AIDs on outcome and the frequency of treatment-associated neutropenic fever. Patients and methods: All adult patients treated 2000-2013 with R-CHOP/CHOP-like treatment for DLBCL in four counties of Sweden were included (n = 612). Lymphoma characteristics, outcome and the presence of AID were obtained through medical records. Results: The number of patients with AID was 106 (17.3%). Thyroid disease dominated (n = 33, 31.1%) followed by rheumatoid arthritis (RA) (n = 24, 22.6%). The proportion of AID was significantly higher in females (59/254, 23.2%) vs. in males (47/358, 13.1%) (p = .001). In the whole cohort there was no difference in event free survival (EFS) or overall survival (OS) between patients with or without AID. However, patients with an AID primarily mediated by B-cell responses (thyroid disorders excluded) had a worse OS (p = .037), which seemed to affect only women. The AID group more often had neutropenic fever after first treatment (16.0% vs 8.7%, p = .034) and those with neutropenic fever had a worse OS (p = .026) in Kaplan-Meier analyses. Conclusion: There is a high prevalence of AID among patients with DLBCL. AIDs categorized as primarily B-cell mediated (in this study mainly RA, systemic lupus erythematosus and Sjögren's syndrome) may be associated with inferior OS. AID patients may be more prone to neutropenic fever compared to patients without concomitant AID.
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Affiliation(s)
- Charlott Mörth
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Experimental and Clinical Oncology, Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Antonios Valachis
- Department of Oncology, Faculty of Medicine and health, Örebro University, Örebro, Sweden
| | - Amal Abu Sabaa
- Experimental and Clinical Oncology, Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Katharina Marshall
- Experimental and Clinical Oncology, Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Gustaf Hedström
- Experimental and Clinical Oncology, Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
| | - Max Flogegård
- Department of Internal Medicine, Falun General Hospital, Falun, Sweden
| | - Eva Baecklund
- Section of Rheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunilla Enblad
- Experimental and Clinical Oncology, Department of Immunology, Genetics, and Pathology, Uppsala University, Uppsala, Sweden
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Jain P, Wang M. Mantle cell lymphoma: 2019 update on the diagnosis, pathogenesis, prognostication, and management. Am J Hematol 2019; 94:710-725. [PMID: 30963600 DOI: 10.1002/ajh.25487] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 12/16/2022]
Abstract
Unprecedented advances in our understanding of the pathobiology, prognostication, and therapeutic options in mantle cell lymphoma (MCL) have taken place in the last few years. Heterogeneity in the clinical course of MCL-indolent vs aggressive-is further delineated by a correlation with the mutational status of the variable region of immunoglobulin heavy chain, methylation status, and SOX-11 expression. Cyclin-D1 negative MCL, in situ MCL neoplasia, and impact of the karyotype on prognosis are distinguished. Apart from Ki-67% and morphology pattern (classic vs blastoid/pleomorphic), the proliferation gene signature has helped to further refine prognostication. Studies focusing on mutational dynamics and clonal evolution on Bruton's tyrosine kinase (BTK) inhibitors (ibrutinib, acalabrutinib) and/or Bcl2 antagonists (venetoclax) have further clarified the prognostic impact of somatic mutations in TP53, BIRC3, CDKN2A, MAP3K14, NOTCH2, NSD2, and SMARCA4 genes. In therapy, long-term follow-up on chemo-immunotherapy studies has demonstrated durable remissions in some patients; however, long-term toxicities, especially from second cancers, are a serious concern with chemotherapy. The therapeutic options in MCL are constantly evolving, with dramatic responses from nonchemotherapeutic agents (ibrutinib, acalabrutinib, and venetoclax). Chimeric antigen receptor therapy and combinations of nonchemotherapeutic agents are actively being studied and our focus is shifting toward making the treatment of MCL chemotherapy-free. Still, MCL remains incurable. The following aspects of MCL continue to pose a challenge: disease transformation, role of the cytokine-microenvironmental milieu, incorporation of positron emission tomography-computerized tomography imaging, minimal residual disease in the prognosis, circulating tumor DNA testing for clonal evolution, predicting resistance to BTK inhibitors, and optimal management of patients who progress on BTK/Bcl2 inhibitors. Next-generation clinical trials should incorporate nonchemotherapeutic agents and personalize the treatment based upon the genomic profile of individual patient. Recent advances in the field of MCL are reviewed.
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Affiliation(s)
- Preetesh Jain
- Division of Cancer Medicine, Department of Lymphoma/MyelomaThe University of Texas MD Anderson Cancer Center Houston Texas
| | - Michael Wang
- Division of Cancer Medicine, Department of Lymphoma/MyelomaThe University of Texas MD Anderson Cancer Center Houston Texas
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Kane E, Painter D, Smith A, Crouch S, Oliver S, Patmore R, Roman E. The impact of rheumatological disorders on lymphomas and myeloma: a report on risk and survival from the UK's population-based Haematological Malignancy Research Network. Cancer Epidemiol 2019; 59:236-243. [PMID: 30844679 PMCID: PMC6452783 DOI: 10.1016/j.canep.2019.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Autoimmune inflammatory disease increases the risk of diffuse large B-cell lymphoma (DLBCL) and marginal zone lymphoma (MZL), but findings for other mature B-cell malignancies are equivocal. Furthermore, it has been suggested that the increase in DLBCL is due to the activated B-cell (ABC) subtype; but data on this, and the impact of inflammatory co-morbidities on survival, are sparse and contradictory. METHODS Data are from an established UK population-based cohort. Patients (n = 6834) diagnosed between 01/2009 and 08/2015 are included; DLBCL (n = 1771), myeloma (n = 1760), chronic lymphocytic leukaemia (CLL, n = 1580), MZL (n = 936), and follicular lymphoma (FL, n = 787). Information on rheumatological disorders and deaths was obtained by record-linkage to nationally compiled Hospital Episode Statistics, with age-and sex-matched individuals (n = 68,340) from the same catchment population (˜4 million people) providing the comparator. RESULTS Significantly increased risks for DLBCL (OR = 2.3, 95% CI 1.8-2.8) and MZL (OR = 2.0, 95% CI 1.5-2.7) were found for those with rheumatological disorders; the site distribution of those with/without rheumatological conditions differing for DLBCL (p = 0.007) and MZL (p = 0.002). No increases in risk were observed for the remaining mature B-cell malignancies, and no associations with survival were detected for DLBCL (age-adjusted HR = 1.2, 95% CI 0.9-1.6) or MZL (age-adjusted HR = 1.0, 95% CI 0.6-1.9). Furthermore, whilst our findings provide evidence for an association with rheumatological disease severity for DLBCL, they offer little support for the notion that the association is driven by an increase in the incidence of the ABC subtype. CONCLUSION Our findings support the hypothesis that the chronic activation and proliferation of specific B-cell populations which characterize autoimmune disease increase the potential for the lymphomagenic events that lead to DLBCL and MZL in both males and females; but have no impact on the development of CLL, FL or MM, or on survival.
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MESH Headings
- Aged
- Aged, 80 and over
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell
- Lymphoma/epidemiology
- Lymphoma/mortality
- Lymphoma/pathology
- Lymphoma, B-Cell, Marginal Zone/epidemiology
- Lymphoma, B-Cell, Marginal Zone/mortality
- Lymphoma, Follicular/epidemiology
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Multiple Myeloma/epidemiology
- Multiple Myeloma/mortality
- Multiple Myeloma/pathology
- Rheumatic Diseases/epidemiology
- Rheumatic Diseases/mortality
- Rheumatic Diseases/pathology
- United Kingdom/epidemiology
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Affiliation(s)
- Eleanor Kane
- Department of Health Sciences, University of York, York, UK.
| | - Daniel Painter
- Department of Health Sciences, University of York, York, UK
| | | | - Simon Crouch
- Department of Health Sciences, University of York, York, UK
| | - Steven Oliver
- Department of Health Sciences, University of York, York, UK; Hull York Medical School, York, UK
| | | | - Eve Roman
- Department of Health Sciences, University of York, York, UK
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