1
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Shatkin S, Shatkin M, Smith K, Beland LE, Oppenheimer AJ. Diffuse Large B-cell Lymphoma Occurring with Rhinophyma: A Case Report. Cureus 2018; 10:e2536. [PMID: 29946504 PMCID: PMC6017160 DOI: 10.7759/cureus.2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Rhinophyma is the final stage in the evolution of acne rosacea, a common vasoactive dermatosis. Individuals with rhinophyma present with a typical, disfiguring nasal appearance consisting of bulbous enlargement, erythema, and telangiectasia with a sebaceous, oily skin surface. This classic appearance permits a facile diagnosis but may also lead the physician to overlook a coexistent malignancy. We report the occurrence of a diffuse large B-cell lymphoma (DLBCL) arising synchronously with a marked rhinophyma. A wide local excision of the malignancy was performed, and the defect was reconstructed with forehead flaps. The rhinophyma was treated with a skin graft and cheek flaps. Following surgery, chemotherapy was used to manage the systemic disease. This case demonstrates the necessity for clinical scrutiny in the diagnosis and treatment of rhinophyma. It is imperative to entertain a high degree of suspicion when non-typical changes are observed within a rhinophymatous lesion or in adjacent areas of the nose.
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Affiliation(s)
- Samuel Shatkin
- Department of Plastic Surgery, Aesthetic Associates Centre, Buffalo, USA
| | - Michael Shatkin
- Department of Plastic & Reconstructive Surgery, Aesthetic Associates Centre, Buffalo, USA
| | - Katherine Smith
- Medical Education, University of Central Florida College of Medicine, Orlando, USA
| | - Leah E Beland
- Medical Education, University of Central Florida College of Medicine, Orlando, USA
| | - Adam J Oppenheimer
- Department of Plastic & Reconstructive Surgery, Oppenheimer Plastic Surgery, Orlando, USA
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2
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Tzankov A, Went P, Dirnhofer S. Prognostic Significance of in situ Phenotypic Marker Expression in Diffuse Large B-cell Lymphomas. Biomark Insights 2017. [DOI: 10.1177/117727190700200009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Diffuse large B-cell lymphomas (DLBCL) are the most common lymphoid malignancies, and encompass all malignant lymphomas characterized by large neoplastic cells and B-cell derivation. In the last decade, DLBCL has been subjected to intense clinical, phenotypic and molecular studies, and were found to represent a heterogeneous group of tumors. These studies suggested new disease subtypes and variants with distinct clinical characteristics, morphologies, immunophenotypes, genotypes or gene expression profiles, associated with distinct prognoses or unique sensitivities to particular therapy regimens. Unfortunately, the reliability and reproducibility of the molecular results remains unclear due to contradictory reports in the literature resulting from small sample sizes, referral and selection biases, and variable methodologies and cut-off levels used to determine positivity. Here, we review phenotypic studies on the prognostic significance of protein expression profiles in DLBCL and reconsider our own retrospective data on 301 primary DLBCL cases obtained on a previously validated tissue microarray in light of powerful statistical methods of determining optimal cut-off values of phenotypic factors for prediction of outcome.
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Affiliation(s)
| | - Philip Went
- Department of Pathology, University Hospital Basel, Switzerland
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3
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Translocation of the proto-oncogene Bcl-6 in human glioblastoma multiforme. Cancer Lett 2014; 353:41-51. [DOI: 10.1016/j.canlet.2014.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/26/2014] [Accepted: 06/29/2014] [Indexed: 01/13/2023]
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4
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Chastain EC, Duncavage EJ. Clinical Prognostic Biomarkers in Chronic Lymphocytic Leukemia and Diffuse Large B-Cell Lymphoma. Arch Pathol Lab Med 2014; 139:602-7. [DOI: 10.5858/arpa.2014-0086-ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context
Diffuse large B-cell lymphoma and chronic lymphocytic leukemia are 2 of the most common B-cell lymphomas in adults. Both diffuse large B-cell lymphoma and chronic lymphocytic leukemia share heterogeneous outcomes, and the use of prognostic biomarkers to better stratify risk in these patients has now become commonplace.
Objective
To review chronic lymphocytic leukemia and diffuse large B-cell lymphoma biomarkers commonly used in the clinical laboratory, which can be divided into the following 3 main groups by testing methodology: chromosomal based (including fluorescence in situ hybridization and cytogenetics), expression based (including immunohistochemistry and flow cytometry), and DNA based (including gene sequencing for somatic mutations and IGVH mutational status).
Data Sources
Review of recent literature.
Conclusions
In chronic lymphocytic leukemia, important biomarkers include expression of CD38 and ZAP-70, IGVH mutational status, somatic mutations in TP53 and NOTCH1, and abnormalities in chromosomes 11, 12, 13q, and 17. In diffuse large B-cell lymphoma, important biomarkers include chromosomal rearrangement of BCL2, BCL6, and MYC and expression of CD5, BCL2, and CD43, as well as somatic mutations in TP53 and BCL6.
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Affiliation(s)
- Elizabeth C. Chastain
- From the Department of Pathology and Immunology, Washington University, St Louis, Missouri
| | - Eric J. Duncavage
- From the Department of Pathology and Immunology, Washington University, St Louis, Missouri
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5
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Novak R, Zeng Y, Shuga J, Venugopalan G, Fletcher DA, Smith MT, Mathies RA. Single-cell multiplex gene detection and sequencing with microfluidically generated agarose emulsions. Angew Chem Int Ed Engl 2011; 50:390-5. [PMID: 21132688 DOI: 10.1002/anie.201006089] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Richard Novak
- Center for Exposure Biology, University of California, Berkeley, 307 Lewis Hall, Berkeley, CA 94720, USA
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6
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Novak R, Zeng Y, Shuga J, Venugopalan G, Fletcher DA, Smith MT, Mathies RA. Single-Cell Multiplex Gene Detection and Sequencing with Microfluidically Generated Agarose Emulsions. Angew Chem Int Ed Engl 2010. [DOI: 10.1002/ange.201006089] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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7
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Smith SD, Bolwell BJ, Rybicki LA, Kang T, Dean R, Advani A, Thakkar S, Sobecks R, Kalaycio M, Pohlman B, Sweetenham JW. Comparison of outcomes after auto-SCT for patients with relapsed diffuse large B-cell lymphoma according to previous therapy with rituximab. Bone Marrow Transplant 2010; 46:262-6. [DOI: 10.1038/bmt.2010.95] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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8
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BCL6 expression correlates with monomorphic histology in children with posttransplantation lymphoproliferative disease. J Pediatr Hematol Oncol 2008; 30:684-8. [PMID: 18776761 PMCID: PMC2652168 DOI: 10.1097/mph.0b013e31817eb7ca] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Posttransplantation lymphoproliferative disease (PTLD) is a complication of organ transplantation with high mortality. Predicting response to first-line therapy, reduction of immune suppression, is difficult because of the heterogeneity of lesions and disease behavior. We sought to determine if BCL6 protein expression in PTLD cells is associated with poor outcome. In a cohort of 25 children with PTLD, 9 of the patients' tumor specimens were positive for BCL6 protein expression. Eight of 13 monomorphic lesions were BCL6 positive, compared with 1 of 11 evaluable polymorphic lesions (P=0.01). Only 1 of the patients with BCL6 expression responded to reduced immune suppression (P=0.19). Recipients of heart transplants who developed PTLD had reduced overall survival rates compared with recipients of other organ transplants who developed PTLD (P=0.04).
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9
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Iqbal J, Greiner TC, Patel K, Dave BJ, Smith L, Ji J, Wright G, Sanger WG, Pickering DL, Jain S, Horsman DE, Shen Y, Fu K, Weisenburger DD, Hans CP, Campo E, Gascoyne RD, Rosenwald A, Jaffe ES, Delabie J, Rimsza L, Ott G, Müller-Hermelink HK, Connors JM, Vose JM, McKeithan T, Staudt LM, Chan WC. Distinctive patterns of BCL6 molecular alterations and their functional consequences in different subgroups of diffuse large B-cell lymphoma. Leukemia 2007; 21:2332-43. [PMID: 17625604 PMCID: PMC2366166 DOI: 10.1038/sj.leu.2404856] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gene expression profiling of diffuse large B-cell lymphoma (DLBCL) has revealed biologically and prognostically distinct subgroups: germinal center B-cell-like (GCB), activated B-cell-like (ABC) and primary mediastinal (PM) DLBCL. The BCL6 gene is often translocated and/or mutated in DLBCL. Therefore, we examined the BCL6 molecular alterations in these DLBCL subgroups, and their impact on BCL6 expression and BCL6 target gene repression. BCL6 translocations at the major breakpoint region (MBR) were detected in 25 (18.8%) of 133 DLBCL cases, with a higher frequency in the PM (33%) and ABC (24%) subgroups than in the GCB (10%) subgroup. Translocations at the alternative breakpoint region (ABR) were detected in five (6.4%) of 78 DLBCL cases, with three cases in ABC and one case each in the GCB and the unclassifiable subgroups. The translocated cases involved IgH and non-IgH partners in about equal frequency and were not associated with different levels of BCL6 mRNA and protein expression. BCL6 mutations were detected in 61% of DLBCL cases, with a significantly higher frequency in the GCB and PM subgroups (>70%) than in the ABC subgroup (44%). Exon-1 mutations were mostly observed in the GCB subgroup. The repression of known BCL6 target genes correlated with the level of BCL6 mRNA and protein expression in GCB and ABC subgroups but not with BCL6 translocation and intronic mutations. No clear inverse correlation between BCL6 expression and p53 expression was observed. Patients with higher BCL6 mRNA or protein expression had a significantly better overall survival. The biological role of BCL6 in translocated cases where repression of known target genes is not demonstrated is intriguing and warrants further investigation.
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Affiliation(s)
- J Iqbal
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - TC Greiner
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - K Patel
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - BJ Dave
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - L Smith
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - J Ji
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - G Wright
- Metabolism Branch and Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - WG Sanger
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - DL Pickering
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - S Jain
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - DE Horsman
- Departments of Pathology and British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Y Shen
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - K Fu
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - DD Weisenburger
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - CP Hans
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - E Campo
- Department of Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - RD Gascoyne
- Departments of Pathology and British Columbia Cancer Agency, Vancouver, BC, Canada
| | - A Rosenwald
- Department of Pathology, University of Würzburg, Würzburg, Germany
| | - ES Jaffe
- Metabolism Branch and Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Delabie
- Norwegian Radium Hospital, Oslo, Norway
| | - L Rimsza
- Department of Pathology, University of Arizona, Tucson, Arizona, USA
| | - G Ott
- Department of Pathology, University of Würzburg, Würzburg, Germany
| | | | - JM Connors
- Departments of Pathology and British Columbia Cancer Agency, Vancouver, BC, Canada
| | - JM Vose
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - T McKeithan
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - LM Staudt
- Metabolism Branch and Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - WC Chan
- Departments of Pathology and Microbiology, Pediatrics, Internal Medicine, and Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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10
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Jardin F, Ruminy P, Bastard C, Tilly H. The BCL6 proto-oncogene: a leading role during germinal center development and lymphomagenesis. ACTA ACUST UNITED AC 2006; 55:73-83. [PMID: 16815642 DOI: 10.1016/j.patbio.2006.04.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 04/04/2006] [Indexed: 10/24/2022]
Abstract
The BCL6 proto-oncogene encodes a nuclear transcriptional repressor, with pivotal roles in germinal center (GC) formation and regulation of lymphocyte function, differentiation, and survival. BCL6 suppresses p53 in GCB-cells and its constitutive expression can protect B-cell lines from apoptosis induced by DNA damage. BCL6-mediated expression may allow GCB-cells to sustain the low levels of physiological DNA breaks related to somatic mutation (SM) and immunoglobulin class switch recombination which physiologically occur in GCB-cells. Three types of genetic events occur in the BCL6 locus and involve invariably the 5' non-coding region and include translocations, deletions and SM actively targeted to the 5' untranslated region. These acquired mutations occur independently of translocations but may be involved in the deregulation of the gene and/or translocation mechanisms. The favorable prognostic value of high levels of BCL6 gene expression in NHL seems well-established. By contrast, the relevance of SM or translocation of the gene remains unclear. However, it is likely that non-Hodgkin's lymphomas (NHL) harboring the most frequent translocation involving BCL6, i.e. t(3;14), are characterized by a common cell of origin and similar oncogenic mechanisms. Several experiments and mouse models mimicking BCL6 translocation occurring in human lymphoma have demonstrated the oncogenic role of BCL6 and constitute a rational to consider BCL6 as a new therapeutic target in NHL. BCL6 blockade can be achieved by different strategies which include siRNA, interference by specific peptides or regulation of BCL6 acetylation by pharmacological agents such as SAHA or niacinamide and would be applicable to most type of B-cell NHL.
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MESH Headings
- 5' Untranslated Regions
- Animals
- Antineoplastic Agents/pharmacology
- Apoptosis/genetics
- B-Lymphocytes/cytology
- Cell Transformation, Neoplastic/genetics
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 14/ultrastructure
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 3/ultrastructure
- DNA Damage
- DNA-Binding Proteins/antagonists & inhibitors
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/physiology
- Genes, Neoplasm
- Germinal Center/cytology
- Humans
- Immunoglobulin Class Switching/genetics
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Mice
- Mice, Transgenic
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Prognosis
- Proto-Oncogene Mas
- Proto-Oncogene Proteins c-bcl-6
- Proto-Oncogenes
- Sequence Deletion
- Somatic Hypermutation, Immunoglobulin/genetics
- Translocation, Genetic
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Affiliation(s)
- Fabrice Jardin
- Département d'Hématologie Clinique, Centre Henri-Becquerel, Rouen, France.
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11
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Jardin F, Ruminy P, Parmentier F, Picquenot JM, Courel MN, Bertrand P, Buchonnet G, Tilly H, Bastard C. Clinical and biological relevance of single-nucleotide polymorphisms and acquired somatic mutations of the BCL6 first intron in follicular lymphoma. Leukemia 2005; 19:1824-30. [PMID: 16094416 DOI: 10.1038/sj.leu.2403915] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genetic modifications of the BCL6 gene in lymphoma include translocations, deletions, and somatic mutations (SM) of the 5' noncoding region. Three single-nucleotide polymorphisms (SNPs) of the major mutation cluster region (MMC) have been reported, including two substitutions (397G/C, 502G/A) and one deletion (520DeltaT). Clinical and biological relevance of these SNPs are unknown. Based on a case-control study, BCL6 SNPs frequencies were assessed in 97 t(14;18) follicular lymphomas (FL) and in 54 lymphomas with 3q27 rearrangement. Allele frequencies were similar in the FL and controls groups. The 397 G/C genotype was correlated to a higher-grade transformation risk (P=0.02). SM were observed in 39.1% of FL and were characterized by a clustering distribution (hot spots spanning position 420-435, 106-127, and 590-600). No correlation between genotypes or acquired mutational status and BCL6 expression was demonstrated. However, gel mobility-shift assays, using SNPs containing probes show results representative for protein/DNA complexes. This study demonstrates that the first BCL6 intron is a highly variable region as a consequence of both SNP and SM, which may contribute to biology and outcome of FL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Case-Control Studies
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 3/genetics
- DNA/genetics
- DNA/metabolism
- DNA Mutational Analysis
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Electrophoretic Mobility Shift Assay
- Female
- Gene Expression Regulation, Neoplastic
- Gene Rearrangement
- Humans
- Introns/genetics
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/metabolism
- Lymphoma, Large B-Cell, Diffuse/genetics
- Male
- Middle Aged
- Mutation
- Polymorphism, Single Nucleotide/genetics
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-bcl-6
- Transcription Factors/genetics
- Transcription Factors/metabolism
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Affiliation(s)
- F Jardin
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France.
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12
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Margalit O, Amram H, Amariglio N, Simon AJ, Shaklai S, Granot G, Minsky N, Shimoni A, Harmelin A, Givol D, Shohat M, Oren M, Rechavi G. BCL6 is regulated by p53 through a response element frequently disrupted in B-cell non-Hodgkin lymphoma. Blood 2005; 107:1599-607. [PMID: 16249378 DOI: 10.1182/blood-2005-04-1629] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The BCL6 transcriptional repressor mediates survival, proliferation, and differentiation blockade of B cells during the germinal-center reaction and is frequently misregulated in B-cell non-Hodgkin lymphoma (BNHL). The p53 tumor-suppressor gene is central to tumorigenesis. Microarray analysis identified BCL6 as a primary target of p53. The BCL6 intron 1 contains a region in which 3 types of genetic alterations are frequent in BNHL: chromosomal translocations, point mutations, and internal deletions. We therefore defined it as TMDR (translocations, mutations, and deletions region). The BCL6 gene contains a p53 response element (p53RE) residing within the TMDR. This p53RE contains a motif known to be preferentially targeted by somatic hypermutation. This p53RE is evolutionarily conserved only in primates. The p53 protein binds to this RE in vitro and in vivo. Reporter assays revealed that the BCL6 p53RE can confer p53-dependent transcriptional activation. BCL6 mRNA and protein levels increased after chemotherapy/radiotherapy in human but not in murine tissues. The increase in BCL6 mRNA levels was attenuated by the p53 inhibitor PFT-alpha. Thus, we define the BCL6 gene as a new p53 target, regulated through a RE frequently disrupted in BNHL.
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Affiliation(s)
- Ofer Margalit
- Pediatric Hematology-Oncology, Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
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13
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Jardin F, Sahota SS. Targeted somatic mutation of the BCL6 proto-oncogene and its impact on lymphomagenesis. Hematology 2005; 10:115-29. [PMID: 16019457 DOI: 10.1080/10245330400026105] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Cloning translocation breakpoints which cluster suspiciously to specific chromosomal loci has proved fruitful, leading to the identification of genes implicated in the onset of hematological malignancy. One of the most notable is BCL6, located on chromosome 3q27. The BCL6 is now known to encode a nuclear transcriptional repressor, with pivotal roles in germinal center (GC) formation and regulation of lymphocyte function, differentiation and survival. Unusually, the BCL6 gene locus is also actively targeted by the somatic mutation (SM) mechanism, at a rate indicative of specific, regulated events in both normal and malignant B-cells. These mutations occur in approximately 30% of normal centrocytes and centroblasts, but not in naive or pre-GC B-cells. They are also observed in approximately 70% of diffuse large B-cells lymphomas, approximately 30% of follicular lymphomas (FL) and at various frequencies in many lymphoma subtypes. Mutations are generated in the 5' proximity of the BCL6 promoter, including the first intron and are mainly single nucleotide substitutions, but with insertions and deletions also observed. Mutations in BCL6 occur independently of translocations, although mutational levels can be dramatically influenced by aberrantly translocated chromosomal elements, which map in the vicinity of the gene. Indeed, SMs are directly implicated in the generation of chromosomal translocations, as suggested by the overlap of the breakpoint cluster region and the mutational cluster domain. The prognostic value of the overall level of BCL6 mutations in specific lymphoma populations is, in the main, not as yet fully resolved. The accumulation of mutations in BCL6 during high grade transformation of FL, a mutational clustering and specific recurrent mutations suggest that some mutations may be selected for by their effect on the survival of the tumoral clone. In fact, it is now clear that SM can target and disrupt regulatory motifs in BCL6 to result in upregulated gene expression. Exogenous factors can also perturbate SM in BCL6. Viral infection elevates BCL6 mutational activity, suggesting a potential link with onset of virus-associated lymphoma. These findings to date reveal several mechanisms which can influence specific mutations targeting BCL6, and which may contribute to lymphomagenesis by dysregulating control of BCL6 expression.
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Affiliation(s)
- Fabrice Jardin
- Département d'Hématologie Clinique and Groupe d'étude des proliférations lymphoïdes, Centre Henri Becquerel, Rouen, France.
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14
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Min DL, Zhou XY, Yang WT, Lu HF, Zhang TM, Zhen AH, Cao PZ, Shi DR. Point mutation of 5’ noncoding region of BCL-6 gene in primary gastric lymphomas. World J Gastroenterol 2005; 11:51-5. [PMID: 15609396 PMCID: PMC4205383 DOI: 10.3748/wjg.v11.i1.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the mutations of the 5’ noncoding region of BCL-6 gene in Chinese patients with primary gastric lymphomas.
METHODS: PCR and direct DNA sequencing were used to identify BCL-6 gene mutations in the 5’ noncoding region in 29 cases of gastric diffuse large B-cell lymphoma (DLBCL) and 18 cases of gastric mucosa-associated lymphoid tissue (MALT) lymphoma as well as 10 cases of reactive hyperplasia of lymph node (LRH).
RESULTS: Six of 29 gastric DLBCLs (20.7%), 4 of 18 gastric MALT lymphomas (22.2%) and 1 of 10 LRHs(10%) were found to have mutations. All mutations were single-base substitutions and the frequency of single-base changes was 0.20×10-2 -1.02×10-2 per bp.
CONCLUSION: Point mutations in the 5’ noncoding region of BCL-6 gene are found in Chinese patients with primary gastric DLBCLs and MALT lymphomas, suggesting that they may, in some extent, participate in the pathogenesis of primary gastric DLBCLs and MALT lymphomas.
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Affiliation(s)
- Da-Liu Min
- Laboratory of Molecular Pathology, Cancer Hospital of Fudan University, Shanghai 200032, China
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15
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Rossi D, Gaidano G. Molecular heterogeneity of diffuse large B-cell lymphoma: implications for disease management and prognosis. ACTA ACUST UNITED AC 2004; 7:239-52. [PMID: 14972786 DOI: 10.1080/1024533021000024058] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 40% of all B-cell non-Hodgkin lymphomas of the Western world. According to the "WHO classification of tumours of the haematopoietic and lymphoid tissues", the term DLBCL is likely to include more than one disease entity, as suggested by the marked variability of the clinical presentation and response to treatment of this disease. Such heterogeneity may reflect the occurrence of distinct molecular subtypes of DLBCL as well as differences in the host's immune function. In immunocompetent hosts, approximately 50% DLBCL carry one of two primary molecular lesions defining two distinct genotypic subgroups, characterized by activation of either the BCL-6 or the BCL-2 proto-oncogene. Conversely, the remaining DLBCL of immunocompetent hosts display one of several molecular lesions, each associated with a small subset of cases and including activation of the proto-oncogenes REL, MUC-1, BCL-8 and c-MYC. The molecular pathogenesis of immunodeficiency-associated DLBCL differs substantially from that of DLBCL in immunocompetent hosts. In fact, EBV infection is present in a large fraction of immunodeficiency-associated DLBCL, whereas it is consistently negative in DLBCL of immunocompetent hosts, probably reflecting the critical role of disruption of the immune system in this disease. Finally, the application of DNA microarray technology to DLBCL has led to the distinction of two disease variants: a germinal center like DLBCL and an activated peripheral B-cell like DLBCL. Overall the molecular features of DLBCL may identify prognostic categories of the disease and may represent a powerful tool for therapeutic stratification.
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MESH Headings
- Adult
- B-Lymphocytes/metabolism
- B-Lymphocytes/pathology
- DNA-Binding Proteins/genetics
- Genes, bcl-2
- Genes, myc
- Genes, rel
- Genetic Heterogeneity
- Germinal Center/pathology
- Humans
- Immunocompetence
- Immunocompromised Host
- Lymphoma, AIDS-Related/genetics
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Mucin-1/genetics
- Neoplasm Proteins/genetics
- Postoperative Complications
- Prognosis
- Proto-Oncogene Mas
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins c-bcl-6
- Proto-Oncogenes
- Somatic Hypermutation, Immunoglobulin
- Transcription Factors/genetics
- Transplantation
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Affiliation(s)
- Davide Rossi
- Hematology Unit, Division of Internal Medicine, Department of Medical Sciences and IRCAD, Amedeo Avogadro University of Eastern Piedmont, Via Solaroli 17, I-28100, Novara, Italy
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16
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Jardin F, Bastard C, Contentin N, Parmentier F, Picquenot JM, Tilly H, Stevenson FK, Sahota SS. Intronic BCL-6 mutations are preferentially targeted to the translocated allele in t(3;14)(q27;q32) non-Hodgkin B-cell lymphoma. Blood 2003; 102:1872-6. [PMID: 12775568 DOI: 10.1182/blood-2002-12-3630] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Translocations and somatic mutations are common genetic alterations of the BCL-6 gene on chromosome 3q27 in B-cell lymphoma, with implications for lymphomagenesis. The 2 events may have linked origins and can influence juxtaposed loci. To evaluate this further, we compared mutations occurring within the major mutation cluster region of the translocated and untranslocated BCL-6 alleles in 7 t(3;14)(q27;14q32) lymphomas. In 6 of 7 cases, the translocated allele revealed significantly higher mutations (mean, 5.8 x 10-2 bp-1) than did the untranslocated allele (mean, 5.3 x 10-3 bp-1; P <.01). The increase mapped to der(14q32), which retains the BCL-6 promoter and is transcriptionally active, as revealed by fusion transcripts and ongoing somatic mutations, absent in the der(3q27) region. These results indicate that enhanced mutational activity at the translocated allele may be a consequence of loss of cis regulatory elements or gain of IgH enhancer elements. Junctional sequences indicate translocation origins from earlier BCL-6 mutations and switch recombinase events.
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Affiliation(s)
- Fabrice Jardin
- Department of Haematology, Centre Henri Becquerel, 76000 Rouen, France.
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17
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Pileri SA, Dirnhofer S, Went P, Ascani S, Sabattini E, Marafioti T, Tzankov A, Leoncini L, Falini B, Zinzani PL. Diffuse large B-cell lymphoma: one or more entities? Present controversies and possible tools for its subclassification. Histopathology 2002; 41:482-509. [PMID: 12460202 DOI: 10.1046/j.1365-2559.2002.01538.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the commonest type of lymphoid tumour world-wide. This category was included both in the REAL and WHO Classification aiming to lump together all malignant lymphomas characterized by the large size of the neoplastic cells, B-cell derivation, aggressive clinical presentation, and the need for highly effective chemotherapy regimens. These tumours are detected as primary or secondary forms both at the nodal and extranodal levels, in immunocompetent hosts as well as in patients with different types of immunosuppression. They display a significant variability in terms of cell morphology and clinical findings, which justifies the identification of variants and subtypes. Among the latter, the primary mediastinal one does actually correspond to a distinct clinicopathological entity. Immunophenotypic, tissue microarray and molecular studies underline the extreme heterogeneity of DLBCLs and suggest a subclassification of the tumour, based on the identification of different pathogenic pathways, which might have much greater relevance than pure morphology for precise prognostic previsions and adoption of ad hoc therapies. The more recent acquisitions on the pathobiology of DLBCLs are reviewed in the light of the authors' experience, aiming to contribute to the existing debate on the topic.
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MESH Headings
- Animals
- Antigens, Neoplasm/biosynthesis
- Diagnosis, Differential
- Gene Expression Profiling
- Genotype
- Humans
- Immunohistochemistry
- Immunophenotyping
- Lymphoma/pathology
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Phenotype
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Affiliation(s)
- S A Pileri
- Chair of Pathologic Anatomy & Lymphoma Unit, L. & A. Seràgnoli Institute of Haematology and Clinical Oncology, Bologna University, Via Massarenti 9, 40138 Bologna, Italy.
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18
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Jardin F, Buchonnet G, Parmentier F, Contentin N, Leprêtre S, Lenain P, Picquenot JM, Laberge S, Bertrand P, Stamatoullas A, D'Anjou J, Tilly H, Bastard C. Follicle center lymphoma is associated with significantly elevated levels of BCL-6 expression among lymphoma subtypes, independent of chromosome 3q27 rearrangements. Leukemia 2002; 16:2318-25. [PMID: 12399978 DOI: 10.1038/sj.leu.2402657] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2002] [Accepted: 05/22/2002] [Indexed: 11/09/2022]
Abstract
The BCL-6 gene, located on chromosome 3q27, is implicated in the normal germinal center formation and is frequently rearranged in a wide spectrum of lymphomas. However the links between genetic alterations and expression of the gene are not clearly determined. We established a quantitative RT-PCR assay based on TaqMan technology to quantify BCL-6 mRNA expression in different subtypes of lymphomas and to compare the level of expression in lymphomas characterized by the presence or absence of BCL-6 translocation. Total RNA was extracted from 105 nodes biopsies (35 diffuse large B cell lymphomas (DLBCL); 26 follicle center lymphomas (FCL); 7 marginal zone lymphomas (MZL); 6 mantle cell lymphomas (MCL); 6 chronic lymphocytic leukemia (CLL); 5 T cell lymphomas (TCL); 7 classical Hodgkin diseases (HD); 6 nodal metastasis (NM); and 7 reactive hyperplasia (RH)). BCL-6 gene rearrangement was assessed by Southern blot analysis in 75% of 3q27(+) DLBCL (n = 20) cases and 67% of 3q27(+) cases (n = 10). The highest level of relative BCL-6 expression was observed in FCL (9.12 +/- 7.28) comparatively to the other lymphoma subtypes including DLBCL (2.53 +/- 1.82; P < 0.001), MCL (1.23 +/- 0.73), MZL (1.49 +/- 1.3), HD (1.60 +/- 1.00), TCL (1.75 +/- 1.64), but also RH (3.91 +/- 3.12) or NM (1.95 +/- 2.6). Among the 26 FCL cases, we observed a lower expression in grade 3 (n = 8) than in grade 1/2 (P < 0.001). Conversely, we failed to show any difference between 3q27(+) DLBCL and 3q27(-)DLBCL cases (P = 0.42). Paradoxically BCL-6 expression in 3q27(+) FCL (n = 10) was significantly lower than in 3q27(-) FCL cases (P = 0.035). Finally, this study showed that BCL-6 expression in lymphoma is largely independent of chromosome 3q27 rearrangement and is more related to the histological subtype. Clinical implication and alternative deregulation pathways of BCL-6 expression remain to be determined.
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MESH Headings
- Biopsy
- Blotting, Southern
- Chromosome Aberrations
- Chromosomes, Human, Pair 3/genetics
- DNA Primers/chemistry
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Gene Expression Regulation, Leukemic/genetics
- Gene Rearrangement
- Hodgkin Disease/genetics
- Hodgkin Disease/metabolism
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Lymph Nodes/metabolism
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/metabolism
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/metabolism
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-bcl-6
- RNA, Messenger/metabolism
- RNA, Neoplasm/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription Factors/genetics
- Transcription Factors/metabolism
- Translocation, Genetic
- Tumor Cells, Cultured/pathology
- Up-Regulation
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Affiliation(s)
- F Jardin
- Department of Haematology and EMI 9906-IRFMP No. 23, Centre Henri Becquerel, Rouen, France
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19
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Zhou G, Ono SJ. Transcriptional Regulation of the BCL-6 Gene: Mechanistic Dissection Using Mutant Cell Lines. Mol Med 2002. [DOI: 10.1007/bf03402175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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Recent publications in hematology oncology. Hematol Oncol 2002; 20:147-54. [PMID: 12360948 DOI: 10.1002/hon.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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