1
|
Pophali PA, Fein JA, Ahn KW, Allbee-Johnson M, Ahmed N, Awan FT, Farhan S, Grover NS, Hilal T, Iqbal M, Maakaron J, Modi D, Nasrollahi E, Schachter LG, Sauter C, Hamadani M, Herrera A, Shouval R, Shadman M. CD19-directed CART therapy for T-cell/histiocyte-rich large B-cell lymphoma. Blood Adv 2024; 8:5290-5296. [PMID: 38985302 DOI: 10.1182/bloodadvances.2024013863] [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: 06/04/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
ABSTRACT T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare histologic variant of LBCL. Limited data regarding CD19-directed chimeric antigen receptor T-cell (CART) therapy in relapsed/refractory (R/R) THRLBCL suggest poor efficacy. We investigated CART outcomes for R/R THRLBCL through the Center for International Blood and Marrow Transplant Research registry. A total of 58 adult patients with R/R THRLBCL who received commercial CD19-CART therapy between 2018 and 2022 were identified. Most patients (67%) had early relapse of disease (45% primary refractory) with a median of 3 (range, 1-7) prior therapies and were treated with axicabtagene ciloleucel (69%). At median follow-up of 23 months after CART therapy, 2-year overall and progression-free survival were 42% (95% confidence interval [CI], 27-57) and 29% (95% CI, 17-43), respectively. In univariable analysis, poor performance status before CART therapy was associated with higher mortality (hazard ratio, 2.35; 95%CI, 1.02-5.5). The 2-year cumulative incidences of relapse/progression and nonrelapse mortality were 69% and 2%, respectively. Grade ≥3 cytokine release syndrome and immune effector cell-associated neurologic syndrome occurred in 7% and 15% of patients, respectively. In this largest analysis of CD19-CART therapy for R/R THRLBCL, ∼30% of patients were alive and progression free 2 years after CART therapy. Despite a high incidence of progression (69% at 2 years), these results suggest a subset of patients with R/R THRLBCL may have durable responses with CARTs.
Collapse
MESH Headings
- Humans
- Male
- Middle Aged
- Female
- Antigens, CD19/immunology
- Antigens, CD19/therapeutic use
- Adult
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Aged
- Immunotherapy, Adoptive/adverse effects
- Immunotherapy, Adoptive/methods
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Histiocytes/pathology
- Treatment Outcome
- Receptors, Chimeric Antigen/therapeutic use
- Young Adult
Collapse
Affiliation(s)
- Priyanka A Pophali
- Division of Hematology, Medical Oncology and Palliative Care, University of Wisconsin, Carbone Cancer Center, Madison, WI
| | - Joshua A Fein
- Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY
| | - Kwang W Ahn
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Molly Allbee-Johnson
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
| | - Nausheen Ahmed
- Division of Hematologic Malignancies and Cellular Therapeutics, The University of Kansas Cancer Center, Kansas City, KS
| | - Farrukh T Awan
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shatha Farhan
- Henry Ford Health System Stem Cell Transplant & Cellular Therapy Program, Detroit, MI
| | - Natalie S Grover
- Division of Hematology, University of North Carolina, Chapel Hill, NC
| | - Talal Hilal
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ
| | - Madiha Iqbal
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
| | - Joseph Maakaron
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
| | - Dipenkumar Modi
- Karmanos Cancer Institute, Wayne State University, Detroit, MI
| | - Elham Nasrollahi
- Department of Internal Medicine, University of Pittsburgh Medical Center in Central Pa., Harrisburg, PA
| | | | - Craig Sauter
- Department of Hematology and Medical Oncology, Blood and Marrow Transplant Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Mehdi Hamadani
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI
- Department of Medicine, Blood and Marrow Transplant and Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI
| | - Alex Herrera
- Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Roni Shouval
- Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Mazyar Shadman
- Fred Hutchinson Cancer Center and University of Washington, Seattle, WA
| |
Collapse
|
2
|
Sahin TK, Akin S. Immune checkpoint blockade and CAR T-cell therapy in T-cell/histiocyte-rich large B-cell lymphoma: Challenges and opportunities. Heliyon 2024; 10:e38023. [PMID: 39328551 PMCID: PMC11425163 DOI: 10.1016/j.heliyon.2024.e38023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/07/2024] [Accepted: 09/16/2024] [Indexed: 09/28/2024] Open
Abstract
T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a highly aggressive large B-cell lymphoma defined by a paucity of malignant B cells amidst a dense infiltrate of reactive T cells and histiocytes. The unique tumor microenvironment (TME) of THRLBCL, marked by extensive immune infiltration and high PD-L1 expression, poses significant challenges for immunotherapies. This review explores the therapeutic potential and resistance mechanisms of immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T-cell therapy in THRLBCL. While ICIs show promise due to the immune-suppressive nature of the TME, CAR T-cell therapy has demonstrated limited efficacy, often hindered by primary resistance and early relapse. Combining CAR T-cell therapy with ICIs and Bruton tyrosine kinase (BTK) inhibitors and developing novel CAR constructs targeting multiple antigens are potential strategies to enhance treatment outcomes. Further prospective studies are essential to corroborate these strategies and improve the prognosis for this challenging lymphoma subtype.
Collapse
Affiliation(s)
- Taha Koray Sahin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Serkan Akin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| |
Collapse
|
3
|
Medeiros LJ, Chadburn A, Natkunam Y, Naresh KN. Fifth Edition of the World Health Classification of Tumors of the Hematopoietic and Lymphoid Tissues: B-cell Neoplasms. Mod Pathol 2024; 37:100441. [PMID: 38309432 DOI: 10.1016/j.modpat.2024.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
We review B-cell neoplasms in the 5th edition of the World Health Organization classification of hematolymphoid tumors (WHO-HEM5). The revised classification is based on a multidisciplinary approach including input from pathologists, clinicians, and other experts. The WHO-HEM5 follows a hierarchical structure allowing the use of family (class)-level definitions when defining diagnostic criteria are partially met or a complete investigational workup is not possible. Disease types and subtypes have expanded compared with the WHO revised 4th edition (WHO-HEM4R), mainly because of the expansion in genomic knowledge of these diseases. In this review, we focus on highlighting changes and updates in the classification of B-cell lymphomas, providing a comparison with WHO-HEM4R, and offering guidance on how the new classification can be applied to the diagnosis of B-cell lymphomas in routine practice.
Collapse
Affiliation(s)
- L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Yasodha Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Kikkeri N Naresh
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle; Section of Pathology, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle
| |
Collapse
|
4
|
Panayi C, Akarca AU, Ramsay AD, Shankar AG, Falini B, Piris MA, Linch D, Marafioti T. Microenvironmental immune cell alterations across the spectrum of nodular lymphocyte predominant Hodgkin lymphoma and T-cell/histiocyte-rich large B-cell lymphoma. Front Oncol 2023; 13:1267604. [PMID: 37854674 PMCID: PMC10579566 DOI: 10.3389/fonc.2023.1267604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
Background The clinicopathological spectrum of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), also known as nodular lymphocyte predominant B-cell lymphoma, partially overlaps with T-cell/histiocyte-rich large B-cell lymphoma (THRLCBL). NLPHL histology may vary in architecture and B-cell/T-cell composition of the tumour microenvironment. However, the immune cell phenotypes accompanying different histological patterns remain poorly characterised. Methods We applied a multiplexed immunofluorescence workflow to identify differential expansion/depletion of multiple microenvironmental immune cell phenotypes between cases of NLPHL showing different histological patterns (as described by Fan et al, 2003) and cases of THRLBCL. Results FOXP3-expressing T-regulatory cells were conspicuously depleted across all NLPHL cases. As histology progressed to variant Fan patterns C and E of NLPHL and to THRLBCL, there were progressive expansions of cytotoxic granzyme-B-expressing natural killer and CD8-positive T-cells, PD1-expressing CD8-positive T-cells, and CD163-positive macrophages including a PDL1-expressing subset. These occurred in parallel to depletion of NKG2A-expressing natural killer and CD8-positive T-cells. Discussion These findings provide new insights on the immunoregulatory mechanisms involved in NLPHL and THLRBCL pathogenesis, and are supportive of an increasingly proposed biological continuum between these two lymphomas. Additionally, the findings may help establish new biomarkers of high-risk disease, which could support a novel therapeutic program of immune checkpoint interruption targeting the PD1:PDL1 and/or NKG2A:HLA-E axes in the management of high-risk NLPHL and THRLBCL.
Collapse
Affiliation(s)
- Christos Panayi
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Ayse U. Akarca
- University College London (UCL) Cancer Institute, University College London, London, United Kingdom
| | - Alan D. Ramsay
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Ananth G. Shankar
- Children and Young People’s Cancer Services, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Brunangelo Falini
- Institute of Hematology and Center for Haemato-Oncological Research (CREO), University of Perugia and Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Miguel A. Piris
- Pathology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - David Linch
- Research Department of Haematology, Cancer Institute, University College London, London, United Kingdom
| | - Teresa Marafioti
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- University College London (UCL) Cancer Institute, University College London, London, United Kingdom
| |
Collapse
|
5
|
Ahmad TY, Al Houri HN, Jomaa S, Assad W, Addeen SZ. Primary splenic T-cell/histiocyte-rich B-cell lymphoma in a patient with recurrent hairy cell leukemia: a case report. Oxf Med Case Reports 2022; 2022:omac123. [DOI: 10.1093/omcr/omac123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/16/2022] [Accepted: 09/25/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT
T-cell/histiocyte-rich B-cell lymphoma is a high-grade, morphologic variant of diffuse large B-cell lymphoma. T-cell/histiocyte-rich B-cell lymphoma. It is rare as a primary splenic involvement and is usually reported as a second malignancy after hairy cell leukemia. Here, we report the first case that describes the occurrence of primary splenic T-cell/histiocyte-rich B-cell lymphoma in a patient with a previous diagnosis of recurrent hairy cell leukemia. A 53-year-old male patient was diagnosed with hairy cell leukemia in 1996 and achieved complete remission with Pentostatin. Then, recurrence of hairy cell leukemia was diagnosed in 2015 and treated with Cladribine. In 2016, he presented with B symptoms and hypersplenism. Therapeutic and diagnostic splenectomy was performed. Histopathological study with immunohistochemistry evaluation revealed the presence of T-cell/histiocyte-rich B-cell lymphoma. Therefore, second malignancies should be considered in patients with a previous neoplasm when symptoms recur or develop.
Collapse
Affiliation(s)
- Tagrid Younes Ahmad
- Tishreen Military Hospital Neurology Department, , Damascus, Syria
- Syrian Private University Faculty of Medicine, , Damascus, Syria
| | - Hasan Nabil Al Houri
- Syrian Private University Faculty of Medicine, , Damascus, Syria
- Damascus University Internal Medicine Department, , Damascus, Syria
| | - Sami Jomaa
- Damascus University Faculty of Medicine, , Damascus, Syria
| | - Wisam Assad
- Syrian Private University Faculty of Medicine, , Damascus, Syria
- Al Mouwasat University Hospital Pathology Department, , Damascus, Syria
| | - Sarah Zaher Addeen
- Al Mouwasat University Hospital, Damascus University Ophthalmology Department, , Damascus, Syria
| |
Collapse
|
6
|
Naresh KN. Proposal of 'reactive-lymphocyte/histiocyte rich large B-cell lymphoma' as an alternate term for 'nodular lymphocyte predominant Hodgkin lymphoma' that would also address its overlap with T-cell/histiocyte rich large B-cell lymphoma. EJHAEM 2022; 3:1449-1451. [PMID: 36467810 PMCID: PMC9713046 DOI: 10.1002/jha2.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Kikkeri N. Naresh
- Section of Pathology, Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
- Department of Laboratory Medicine and PathologyUniversity of WashingtonSeattleWashingtonUSA
| |
Collapse
|
7
|
Samueli B, Nalbandyan K, Benharroch D, Levi I. Splenic Micronodular T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: The Corticosteroid Pretreatment Hypothesis. Acta Haematol 2021; 145:310-317. [PMID: 34753138 DOI: 10.1159/000520791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
Splenic micronodular T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is derived from diffuse large B-cell lymphoma N.O.S., perhaps with some affinity with nodal THRLBCL. Of note, in contrast with the latter, the only lymph nodes involved in association with the splenic micronodular pattern of the disease are the splenic hilar lymph nodes. The possibility that corticosteroids, when prescribed prior to splenectomy, cause histopathological and functional modulations, apoptosis, necrosis, tissue shrinkage, which may obscure the diagnostic morphological features of this variant lymphoma and cause an underdiagnosis of this condition. The indications for glucocorticoid therapy are either related to the lymphoma itself, or else to other comorbidities, like asthma and autoimmune disorders. We propose that patients with the splenic subset of the disease are likely to have been prescribed corticosteroids prior to histopathologic examination of the involved spleen, causing disparate morphologies. However, a reviewer might accidentally dismiss the corticosteroid pretreatment which is thus overlooked. Apoptosis, induced by corticosteroids, is hypothesized as the major mechanism initiating the histopathological and functional changes in the splenic micronodular variant of the lymphoma.
Collapse
Affiliation(s)
- Benzion Samueli
- Department of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel,
| | - Karen Nalbandyan
- Department of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Daniel Benharroch
- Department of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Itai Levi
- Division of Hematology, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
8
|
Sato D, Moriya K, Nakano T, Miyagawa C, Katayama S, Niizuma H, Sasahara Y, Kure S. Refractory T-cell/histiocyte-rich large B-cell lymphoma in a patient with ataxia-telangiectasia caused by novel compound heterozygous variants in ATM. Int J Hematol 2021; 114:735-741. [PMID: 34424493 DOI: 10.1007/s12185-021-03203-w] [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: 03/30/2021] [Revised: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Ataxia-telangiectasia (A-T) is an autosomal recessive chromosomal breakage syndrome caused by mutation of the ATM (A-T mutated) gene, which encodes a protein kinase that has a major role in the cellular response to DNA damage. Approximately, 10% of A-T patients develop lymphoid malignancies. Deaths caused by extreme sensitivity to chemotherapy for malignancy have been reported, and cancer treatment in A-T is extraordinarily difficult, needing careful monitoring and individualized protocols. We report the case of a 12-year-old girl with A-T diagnosed at the age of 3 in association with IgA deficiency and recurrent pulmonary infections. Sanger sequencing revealed compound heterozygosity of the ATM gene, which bore two novel mutations. At the age of 12, she developed stage IV T-cell/histiocyte-rich large B-cell lymphoma. The tumor was resistant to chemotherapy, and she unfortunately died of cardiac insufficiency and multiple organ failure induced by rapid progression of the disease. The treatment approach for children with A-T and advanced-stage B-non-Hodgkin lymphoma must be refined.
Collapse
Affiliation(s)
- Daichi Sato
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Kunihiko Moriya
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan.
| | - Tomohiro Nakano
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Chihiro Miyagawa
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Saori Katayama
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Hidetaka Niizuma
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Shigeo Kure
- Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| |
Collapse
|
9
|
Lumer L, Wurzel P, Scharf S, Schäfer H, Ackermann J, Koch I, Hansmann ML. 3D connectomes of reactive and neoplastic CD30 positive lymphoid cells and surrounding cell types. Acta Histochem 2021; 123:151750. [PMID: 34233254 DOI: 10.1016/j.acthis.2021.151750] [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: 02/07/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
Classical Hodgkin lymphoma (cHL) is one of the most common malignant lymphomas in Western Europe. It is diagnosed on the basis of histological sections by pathologists using a light microscope. The tumor cells, the Hodgkin- and Reed Sternberg cells (HRS), are visualized by morphology and positive response for the CD30-antigen. The same antigen can also be detected by immunohistochemistry on a reactive counterpart, showing CD30+ cells in special immunoreactions, such as inflammations of lymph nodes (lymphadenitis). CD30+ cells in reactive and neoplastic conditions are surrounded by lymphocytes and histiocytes, forming a micromilieu that enables the survival of the tumor cells, as well as their reactive counterparts. This study deals with an investigation of CD30+-surrounding cells using a confocal laser technology, visualizing the contacts of reactive and neoplastic CD30+ cells with CD68+ macrophages and CD163+ macrophages as well as to PD1+ lymphocytes and B cells (CD20+). CD4 immunostains were not included, because CD4+ cells were too numerous for clear dissection of single cells. 3D images visualized the, so-called, connectomes. Clear differences in the number of contacts between CD30-reactive and neoplastic cells (HRS) with macrophages and B lymphocytes were visible. Lymphadenitis and Mixed Cellularity type of classical Hodgkin Lymphoma (cHL) differed in that Mixed Cellularity (MC) cHL had more connections to macrophages (CD163+) and lower number of connections to B cells (CD20+). The connectomes of both Hodgkin variants MCcHL and Nodular Sclerosis cHL (NScHL) mainly differed in the number of contacts to CD163+ macrophages, which was higher in MCcHL. Investigating the volumes of CD30+ -reactive and neoplastic cells, we found out that reactive cells showed lesser volumes, which correlated with the number of contacts. The comparison between 2D and 3D images, including 3D prints, demonstrated clear advantages of the 3D method. 3D images visualized significantly more and clearly defined intercellular contacts. Complicated cellular networks and their contacts became especially evident in volume and surface evaluations, as well as in 3D prints.
Collapse
|
10
|
Primary resistance to CD19-directed chimeric antigen receptor T-cell therapy in T-cell/histiocyte-rich large B-cell lymphoma. Blood 2021; 137:3454-3459. [PMID: 33881502 DOI: 10.1182/blood.2020009148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/10/2021] [Indexed: 11/20/2022] Open
|