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El Mahdaoui C, Hda N, Oukkache B, Dehbi H, Khoubila N, Madani A, Cherkaoui S. t(1;4) translocation in a child with acute lymphoblastic leukemia: a case report. J Med Case Rep 2023; 17:537. [PMID: 38082322 PMCID: PMC10714495 DOI: 10.1186/s13256-023-04270-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Acute lymphoblastic leukemia is the most common childhood cancer, with an 80% frequency in children between 1 and 10 years old. The outcome and prognosis of acute lymphoblastic leukemia in children depends on various factors, such as age, clinical and biological features, and cytogenetic factors. CASE PRESENTATION We report the case of a pediatric patient, a 4-year-old Moroccan female who was referred to the Hematology and Oncology Department of 20 August 1953 Hospital in Casablanca and diagnosed with B-cell acute lymphoblastic leukemia associated with a rare genetic chromosomal abnormality. CONCLUSION Translocation (1;4)(p21;p15) is a relatively rare chromosomal abnormality found in human leukemia and was never described isolated in pediatric B-cell acute lymphoblastic leukemia patients. It showed a good evolution by complete remission and recovery of this patient after receiving all chemotherapy and after 8 years of follow-up.
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Affiliation(s)
- Chaimae El Mahdaoui
- Laboratory of Cellular and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
| | - Nezha Hda
- Hda Laboratories of Medical Biology Analysis, Casablanca, Morocco
| | - Bouchra Oukkache
- Hematology Laboratory, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Hind Dehbi
- Laboratory of Cellular and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
- Laboratory of Medical Genetics, Ibn Rochd University Hospital, Casablanca, Morocco
- Hematology and Pediatric Oncology Department of August 20 Hospital, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Nisrine Khoubila
- Hematology and Pediatric Oncology Department of August 20 Hospital, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Abdellah Madani
- Hematology and Pediatric Oncology Department of August 20 Hospital, Ibn Rochd University Hospital, Casablanca, Morocco
| | - Siham Cherkaoui
- Laboratory of Cellular and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
- Hematology and Pediatric Oncology Department of August 20 Hospital, Ibn Rochd University Hospital, Casablanca, Morocco
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2
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Is tumour-expressed aminopeptidase N (APN/CD13) structurally and functionally unique? Biochim Biophys Acta Rev Cancer 2021; 1876:188641. [PMID: 34695533 DOI: 10.1016/j.bbcan.2021.188641] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 12/14/2022]
Abstract
Aminopeptidase N (APN/CD13) is a multifunctional glycoprotein that acts as a peptidase, receptor, and signalling molecule in a tissue-dependent manner. The activities of APN have been implicated in the progression of many cancers, pointing toward significant therapeutic potential for cancer treatment. However, despite the tumour-specific functions of this protein that have been uncovered, the ubiquitous nature of its expression in normal tissues as generally reported remains a limitation to the potential utility of APN as a target for cancer therapeutics and drug discovery. With this in mind, we have extensively explored the literature, and present a comprehensive review that for the first-time provides evidence to support the suggestion that tumour-expressed APN may in fact be unique in structure, function, substrate specificity and activity, contrary to its nature in normal tissues. The review also focuses on the biology of APN, and its "moonlighting" functional roles in both normal physiology and cancer development. Several APN-targeting approaches that have been explored over recent decades as therapeutic strategies in cancer treatment, including APN-targeting agents reported both in preclinical and clinical studies, are also extensively discussed. This review concludes by posing critical questions about APN that remain unanswered and unexplored, hence providing opportunities for further research.
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3
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Raimbault A, Machherndl-Spandl S, Itzykson R, Clauser S, Chapuis N, Mathis S, Lauf J, Alary AS, Burroni B, Kosmider O, Fontenay M, Béné MC, Durrieu F, Bettelheim P, Bardet V. CD13 expression in B cell malignancies is a hallmark of plasmacytic differentiation. Br J Haematol 2018; 184:625-633. [PMID: 30198568 DOI: 10.1111/bjh.15584] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/24/2018] [Indexed: 11/30/2022]
Abstract
The diagnosis of Waldenström Macroglobulinaemia (WM)/lymphoplasmacytic lymphoma (LPL) remains one of exclusion because other B-cell lymphoproliferative disorders (B-LPD), such as marginal zone lymphoma (MZL), can fulfil similar criteria, including MYD88 L265P mutation. It has been suggested that expression of the myeloid marker CD13 (also termed ANPEP) is more frequent in LPL than in other B-LPD and has also been described on normal and malignant plasma cells. Here, CD13 expression was tested in a cohort of 1037 B-LPD patients from 3 centres by flow cytometry. The percentage of CD13-expressing cells was found to be variable among B-LPD but significantly higher in WM/LPL (median 31% vs. 0% in non-WM/LPL, P < 0·001). In multivariate linear regression, CD13 expression remained significantly associated with a diagnosis of WM/LPL (P < 0·001). A cut-off value of 2% of CD19+ cells co-expressing CD13 yielded the best diagnostic performance for WM/LPL assertion. This was further improved by association with the presence or absence of IgM paraprotein. Finally, given that previously published transcriptomic data revealed no difference in CD13 (also termed ANPEP) mRNA between normal and pathological B-cells, the hypothesis of some post-transcriptional regulation must be favoured. These results suggest that testing for CD13 expression in routine flow cytometry panels could help to discriminate WM/LPL from other B-LPD.
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Affiliation(s)
- Anna Raimbault
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Sigrid Machherndl-Spandl
- Department of Haematology, Internal Oncology and Stem Cell Transplantation, Ordensklinikum Linz Elisabethinen Hospital, Linz, Austria
| | - Raphaël Itzykson
- Service d'Hématologie Clinique, Hôpitaux Universitaires Saint Louis, Lariboisière, Fernand Widal, Université Paris Diderot, Paris, France
| | - Sylvain Clauser
- Service d'Hématologie-Immunologie-Transfusion, Hôpitaux Universitaires Paris Ile De France Ouest, Université Versailles Saint Quentin, Boulogne, France
| | - Nicolas Chapuis
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Stéphanie Mathis
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France.,Service d'Hématologie Clinique, Hôpitaux Universitaires Saint Louis, Lariboisière, Fernand Widal, Université Paris Diderot, Paris, France
| | - Jeroen Lauf
- Department of Haematology, Internal Oncology and Stem Cell Transplantation, Ordensklinikum Linz Elisabethinen Hospital, Linz, Austria
| | - Anne-Sophie Alary
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Barbara Burroni
- Service d'Anatomopathologie, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Olivier Kosmider
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Michaela Fontenay
- Service d'Hématologie Biologique, Hôpitaux Universitaires Paris Centre, Université Paris Descartes, Paris, France
| | - Marie C Béné
- Service d'Hématologie Biologique, CHU et Université de Nantes, Nantes, France
| | | | - Peter Bettelheim
- Department of Haematology, Internal Oncology and Stem Cell Transplantation, Ordensklinikum Linz Elisabethinen Hospital, Linz, Austria
| | - Valérie Bardet
- Service d'Hématologie-Immunologie-Transfusion, Hôpitaux Universitaires Paris Ile De France Ouest, Université Versailles Saint Quentin, Boulogne, France
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4
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Bennett AL, Williams LE, Ferguson MW, Hauck ML, Suter SE, Lanier CB, Hess PR. Canine acute leukaemia: 50 cases (1989-2014). Vet Comp Oncol 2016; 15:1101-1114. [PMID: 27402031 DOI: 10.1111/vco.12251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 12/15/2022]
Abstract
Acute leukaemia (AL) is a bone marrow malignancy of hematopoietic progenitors that historically is poorly responsive to treatment. With the widespread adoption of dose-intense chemotherapy, more human patients attain long-term survivals, but whether comparable progress has been made in canine AL is unknown. To investigate this question, medical records from three academic veterinary hospitals were reviewed. Fifty dogs met the criteria for AL, having excess circulating or marrow blasts, a major cytopenia(s), and no substantial lymphadenopathy. Thirty-six dogs received cytotoxic chemotherapy; 23 achieved a complete or partial response for a median of 56 days (range, 9-218). With failure or relapse, 14 dogs were rescued. Median survival with treatment was poor at 55 days (range, 1-300). Untreated (n = 6) and palliatively-treated (n = 8) dogs lived a median of 7.5 days. Most dogs developed chemoresistance within weeks of initiating treatment, and consequently, survival times for AL remain disappointingly short.
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Affiliation(s)
- A L Bennett
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - L E Williams
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - M W Ferguson
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - M L Hauck
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - S E Suter
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - C B Lanier
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - P R Hess
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
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5
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Gupta S, Chatterjee T, Sharma S, Sharma A, Ganguly P, Singh J, Das S. Flowcytometric comparative analysis in acute leukemias between Indian and proposed minimal screening panel. Med J Armed Forces India 2016; 72:220-30. [PMID: 27546960 PMCID: PMC4982965 DOI: 10.1016/j.mjafi.2016.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 01/06/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia and acute lymphoid leukemia differ substantially in response to therapy and course, and accurate differentiation of the two is fundamental to therapeutic decisions. Immunophenotyping is used for this purpose, and various guidelines have been proposed regarding a minimal screening antibody panel. Most of them have been found inefficient. METHODS Eighty-two cases of consecutive acute leukemias reporting to this hospital over a period of two years were included in the study. Peripheral blood smear, bone marrow aspirate, and bone marrow biopsy were studied using morphology, cytochemical stains, and relevant immunohistochemical stains on selected biopsy specimens. Flowcytometry analysis was carried out using Indian consensus screening panel and our proposed minimal screening panel (PMSP) for comparison. RESULT Immunophenotyping using PMSP resulted in 95.12% accurate diagnosis versus Indian consensus minimal screening panel (ICMSP) with an accuracy of 92.68%. This result was statistically significant as per Chi Square tests. CONCLUSION PMSP can be used as a substitute for ICMSP, since it includes lineage-specific cytoplasmic antibodies, as well as lesser number of monoclonal antibodies, and enables us to diagnose mixed lineage leukemia. Fewer markers can be linked to a lower cost as well, which is relevant in a developing economy.
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Affiliation(s)
- Srishti Gupta
- Resident (Pathology), Army Hospital (R&R), New Delhi 110010, India
| | | | - Sanjeevan Sharma
- Senior Adviser (Med & Hematology), Command Hospital (Southern Command), Pune 411040, India
| | - Ajay Sharma
- Consultant & Head (Hematology), Army Hospital (R&R), New Delhi 110010, India
| | - Prosenjit Ganguly
- Senior Adviser (Pathology), Command Hospital (Eastern Command), Kolkata, India
| | - Jasjit Singh
- Senior Adviser (Med & Hematology), Army Hospital (R&R), New Delhi 110010, India
| | - Satyaranjan Das
- Senior Adviser (Paediatrics & Hematology), INHS Asvini, Colaba, Mumbai, India
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6
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Shin JS, Stopyra GA, Warhol MJ, Multhaupt HA. Plasmacytoma with Aberrant Expression of Myeloid Markers, T-cell Markers, and Cytokeratin. J Histochem Cytochem 2016; 49:791-2. [PMID: 11373326 DOI: 10.1177/002215540104900613] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Plasmacytomas are localized neoplastic proliferations of monoclonal plasma cells. When multifocal, the process is referred to as multiple myeloma. These lesions exhibit a pattern of antigen expression and cytomorphology that usually leads to a ready diagnosis. However, potentially troublesome variations in immunophenotype occur. We describe a case of a plasmacytoma from a patient who presented with sudden onset of pain and a lytic lesion of the left proximal humerus. Hematoxylin and eosin-stained sections showed a lymphoproliferative lesion composed of large lymphoid cells, some with plasmacytoid and immunoblastic features. The lesion also showed significant mitotic activity. Immunohistochemical staining was positive for CD45 (LCA), CD56 (N-CAM), CD43 (MT1), and cytokeratin CAM5.2. There was also clonal staining for λ light chains. In addition, flow cytometric analysis showed positivity for myeloid markers such as CD13, CD33, CD38, and CD138. Significant negative markers include CD20 (L26), CD45RO (UCHL-1), and CD79α. The unusual phenotypic features of this plasmacytoma illustrate potential diagnostic pitfalls. It is important to fully study such lesions to correctly classify them, because this has significant impact on prognosis and management.
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Affiliation(s)
- J S Shin
- Department of Pathology, Pennsylvania Hospital, Philadelphia, Pennsylvania, USA
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7
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Paulus A, Chitta KS, Wallace PK, Advani PP, Akhtar S, Kuranz-Blake M, Ailawadhi S, Chanan-Khan AA. Immunophenotyping of Waldenströms macroglobulinemia cell lines reveals distinct patterns of surface antigen expression: potential biological and therapeutic implications. PLoS One 2015; 10:e0122338. [PMID: 25853860 PMCID: PMC4390194 DOI: 10.1371/journal.pone.0122338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/10/2015] [Indexed: 11/19/2022] Open
Abstract
Waldenströms macroglobulinemia (WM) is a subtype of Non-Hodgkin's lymphoma in which the tumor cell population is markedly heterogeneous, consisting of immunoglobulin-M secreting B-lymphocytes, plasmacytoid lymphocytes and plasma cells. Due to rarity of disease and scarcity of reliable preclinical models, many facets of WM molecular and phenotypic architecture remain incompletely understood. Currently, there are 3 human WM cell lines that are routinely used in experimental studies, namely, BCWM.1, MWCL-1 and RPCI-WM1. During establishment of RPCI-WM1, we observed loss of the CD19 and CD20 antigens, which are typically present on WM cells. Intrigued by this observation and in an effort to better define the immunophenotypic makeup of this cell line, we conducted a more comprehensive analysis for the presence or absence of other cell surface antigens that are present on the RPCI-WM1 model, as well as those on the two other WM cell lines, BCWM.1 and MWCL-1. We examined expression of 65 extracellular and 4 intracellular antigens, comprising B-cell, plasma cell, T-cell, NK-cell, myeloid and hematopoietic stem cell surface markers by flow cytometry analysis. RPCI-WM1 cells demonstrated decreased expression of CD19, CD20, and CD23 with enhanced expression of CD28, CD38 and CD184, antigens that were differentially expressed on BCWM.1 and MWCL-1 cells. Due to increased expression of CD184/CXCR4 and CD38, RPCI-WM1 represents a valuable model in which to study the effects anti-CXCR4 or anti-CD38 targeted therapies that are actively being developed for treatment of hematologic cancers. Overall, differences in surface antigen expression across the 3 cell lines may reflect the tumor clone population predominant in the index patients, from whom the cell lines were developed. Our analysis defines the utility of the most commonly employed WM cell lines as based on their immunophenotype profiles, highlighting unique differences that can be further studied for therapeutic exploit.
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Affiliation(s)
- Aneel Paulus
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Kasyapa S. Chitta
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Paul K. Wallace
- Department of Flow and Image Cytometry, Roswell Park Cancer Institute, Buffalo, New York, United States of America
| | - Pooja P. Advani
- Division of Hematology and Oncology, Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Sharoon Akhtar
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Maja Kuranz-Blake
- Department of Cancer Biology, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Sikander Ailawadhi
- Division of Hematology and Oncology, Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
| | - Asher A. Chanan-Khan
- Division of Hematology and Oncology, Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida, United States of America
- * E-mail:
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Sobol-Milejska G, Mizia-Malarz A, Wos H. Expression of myeloid antigens on lymphoblast surface in childhood acute lymphoblastic leukemia at diagnosis and its effect on early response to treatment: a preliminary report. Int J Hematol 2013; 98:331-6. [PMID: 23881645 DOI: 10.1007/s12185-013-1397-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/07/2013] [Accepted: 07/09/2013] [Indexed: 01/18/2023]
Abstract
Immunodiagnosis of acute lymphoblastic leukemia (ALL) is based on the assessment of surface antigens. There are also cases in which both lymphoid and myeloid antigens can be found on the surface of lymphoblasts. The purpose of our research was to assess the expression of myeloid and lymphoblastic antigens in children with ALL, and to determine the impact of surface antigens on early response to treatment. 58 children [33 girls (56.9 %), 25 boys (43.2 %)] with ALL were studied. Response to treatment was assessed on days 8, 15, and 33. Univariate logistic regression analysis of the effect of myeloid antigens (MyAg) on response to treatment on days 8 and 33 revealed expression of any MyAg on lymphoblast surface as a factor associated with poor response to treatment. The multivariate logistic regression analysis of treatment response on day 33, showed that the expression of CD13 antigen on lymphoblast surface is a key factor affecting delayed remission (p = 0.03; odds ratio 0.12; 95 % CI 0.01-0.81). The expression of MyAg in childhood ALL adversely affects early response to treatment. The expression of CD13 antigen on day 33 is a key factor affecting complete remission in ALL patients.
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Affiliation(s)
- Grazyna Sobol-Milejska
- Department of Pediatric Oncology, Hematology and Chemotherapy, Upper Silesia Children's Care Health Centre, Medical University of Silesia, 16 Medykow Str., 40-752, Katowice, Poland
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9
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Guenova ML, Michova A, Balatzenko GN, Yosifov DY, Stoyanov N, Taskov H, Berger MR, Konstantinov SM. A particular expression pattern of CD13 epitope 7H5 in chronic lymphocytic leukaemia – a possible new therapeutic target. Hematology 2013; 17:132-9. [DOI: 10.1179/102453312x13376952196296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Margarita L. Guenova
- Laboratory of Haematopathology and ImmunologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
| | - Antoaneta Michova
- Laboratory of Haematopathology and ImmunologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Department of ImmunologyNational Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Gueorgui N. Balatzenko
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Laboratory of Cytogenetics and Molecular BiologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Bulgaria
| | - Deyan Y. Yosifov
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Laboratory for Experimental ChemotherapyMedical University of Sofia, Sofia, Bulgaria
| | - Nikolay Stoyanov
- Laboratory of Haematopathology and ImmunologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
| | - Hristo Taskov
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Department of ImmunologyNational Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Martin R. Berger
- German Cancer Research CenterToxicology and Chemotherapy Unit, Heidelberg, Germany
| | - Spiro M. Konstantinov
- Center of Excellence – Translational Research in HaematologyNational Specialised Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria
- Laboratory for Experimental ChemotherapyMedical University of Sofia, Sofia, Bulgaria
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Riley RS, Williams D, Ross M, Zhao S, Chesney A, Clark BD, Ben-Ezra JM. Bone marrow aspirate and biopsy: a pathologist's perspective. II. interpretation of the bone marrow aspirate and biopsy. J Clin Lab Anal 2010; 23:259-307. [PMID: 19774631 DOI: 10.1002/jcla.20305] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Bone marrow examination has become increasingly important for the diagnosis and treatment of hematologic and other illnesses. Morphologic evaluation of the bone marrow aspirate and biopsy has recently been supplemented by increasingly sophisticated ancillary assays, including immunocytochemistry, cytogenetic analysis, flow cytometry, and molecular assays. With our rapidly expanding knowledge of the clinical and biologic diversity of leukemia and other hematologic neoplasms, and an increasing variety of therapeutic options, the bone marrow examination has became more critical for therapeutic monitoring and planning optimal therapy. Sensitive molecular techniques, in vitro drug sensitivity testing, and a number of other special assays are available to provide valuable data to assist these endeavors. Fortunately, improvements in bone marrow aspirate and needle technology has made the procurement of adequate specimens more reliable and efficient, while the use of conscious sedation has improved patient comfort. The procurement of bone marrow specimens was reviewed in the first part of this series. This paper specifically addresses the diagnostic interpretation of bone marrow specimens and the use of ancillary techniques.
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Affiliation(s)
- Roger S Riley
- Medical College of Virginia Hospitals of Virginia Commonwealth University, Richmond, Virginia, USA.
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11
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Mina-Osorio P. The moonlighting enzyme CD13: old and new functions to target. Trends Mol Med 2008; 14:361-71. [PMID: 18603472 PMCID: PMC7106361 DOI: 10.1016/j.molmed.2008.06.003] [Citation(s) in RCA: 292] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 06/06/2008] [Accepted: 06/06/2008] [Indexed: 12/13/2022]
Abstract
Aminopeptidase N (CD13) is a widely expressed ectoenzyme with functions that do not always depend on its enzymatic activity: an aspect that has been overlooked. Numerous CD13-targeting tools have been developed in the last few years. Several of them are already undergoing clinical trials, and there are promising reports on the effectiveness of others in animal models of disease. However, their efficacy might be obscured by their effects on unrecognized functions of CD13, resulting in unexpected complications. The purpose of this review is (i) to discuss the various functions ascribed to CD13 and the possible mechanisms behind them and (ii) to consider some of the questions that need to be answered to achieve a better understanding of the biological relevance of these functions, a more precise interpretation of the results obtained after their manipulation and a more rational design of CD13-targeting agents.
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Affiliation(s)
- Paola Mina-Osorio
- The Feinstein Institute for Medical Research, Autoimmune Disease Center, 350 Community Drive, Manhasset, NY 11030, USA.
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12
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Abstract
Flow cytometric immunophenotyping remains an indispensable tool for the diagnosis, classification, staging, and monitoring of hematologic neoplasms. The last 10 years have seen advances in flow cytometry instrumentation and availability of an expanded range of antibodies and fluorochromes that have improved our ability to identify different normal cell populations and recognize phenotypic aberrancies, even when present in a small proportion of the cells analyzed. Phenotypically abnormal populations have been documented in many hematologic neoplasms, including lymphoma, chronic lymphoid leukemias, plasma cell neoplasms, acute leukemia, paroxysmal nocturnal hemoglobinuria, mast cell disease, myelodysplastic syndromes, and myeloproliferative disorders. The past decade has also seen refinement of the criteria used to identify distinct disease entities with widespread adoption of the 2001 World Health Organization (WHO) classification. This classification endorses a multiparametric approach to diagnosis and outlines the morphologic, immunophenotypic, and genotypic features characteristic of each disease entity. When should flow cytometric immunophenotyping be applied? The recent Bethesda International Consensus Conference on flow cytometric immunophenotypic analysis of hematolymphoid neoplasms made recommendations on the medical indications for flow cytometric testing. This review discusses how flow cytometric testing is currently applied in these clinical situations and how the information obtained can be used to direct other testing.
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13
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Abstract
Evaluation of B-lymphocytes is one of the most well-established clinical applications of flow cytometric immunophenotyping. This article addresses general principles of the flow cytometric evaluation of B-cell lymphoid neoplasms, followed by discussion of how flow cytometric data can assist in determining a list of diagnostic possibilities and directing additional testing.
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Affiliation(s)
- Fiona E Craig
- Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, UPMC-Presbyterian Hospital Room C604, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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14
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Wilkerson MJ, Dolce K, Koopman T, Shuman W, Chun R, Garrett L, Barber L, Avery A. Lineage differentiation of canine lymphoma/leukemias and aberrant expression of CD molecules. Vet Immunol Immunopathol 2005; 106:179-96. [PMID: 15963817 DOI: 10.1016/j.vetimm.2005.02.020] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 01/26/2005] [Accepted: 02/04/2005] [Indexed: 10/25/2022]
Abstract
Multiparameter flow cytometry analysis and specific cluster differentiation (CD) molecules were used to determine the expression profiles of B- and T-cell antigens on lymph node preparations from 59 dogs with generalized or multisystemic lymphoma. Lymph node samples from 11 healthy dogs were labeled to validate the specificity of antibodies and to formulate guidelines for interpretation of the results obtained from lymphoma samples. In normal lymph nodes, T-lymphocytes expressing CD3, CD4, or CD8 beta represented 59+/-11%, 43+/-8%, or 16+/-5% of the total cells, whereas B-lymphocytes expressing either CD21 or surface IgM (IgM) represented 37+/-9% or 14+/-5%, respectively. Small lymphocytes could be distinguished from large lymphocytes by forward light scatter. Of the patient samples 29 different breeds were represented with Golden and Labrador retriever being the most common. The lymphoma samples segregated into three groups based on CD antigen expression. Thirty cases predominantly expressed one or more combinations of CD79a, IgM, and CD21 representing a B-cell lineage. Three B-cell cases also expressed the stem cell antigen, CD34. Sixteen cases expressed one or more combinations of CD3, CD4, and CD8 consistent with a T-cell lineage and CD3+CD4+CD8--phenotype was the most common. Thirteen cases showed a mixed expression profile for T- and B-cell antigens and in three cases CD14 was highly expressed. Clinical response was poorest for T-cell lymphomas. Leukemic states occurred in all three phenotypes; but mixed cell cases had the greatest proportion. Dual immunofluorescence staining confirmed co-expression of T-cell (CD3) and B-cell antigens (CD79a or CD21) on neoplastic lymphocytes of six mixed cell cases. In one mixed cell case, dual immunostaining identified lymphocyte populations that stained mutually exclusive for CD79a and CD3. Six mixed cell lymphomas tested by PCR showed clonality for rearranged antigen receptor. Four cases that were CD79a+CD3+ had TCRgamma chain gene rearrangements, whereas two cases that were CD3+CD8+CD21+ had Ig heavy chain rearrangement. One case expressing multiple CD molecules (CD3+CD8+CD21+CD14+) was PCR negative for both Ig and TCRgamma gene rearrangement and could not be classified into a B- or T-cell lineage. We show for the first time co-expression of B- and T-cell markers on lymphoma cells that had specific T- or B-cell gene rearrangements. These findings suggest that aberrant CD molecule expression is not an uncommon finding in canine lymphomas and is a useful diagnostic marker for malignancy.
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Affiliation(s)
- M J Wilkerson
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS 66506, USA.
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15
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Foà R, Vitale A, Chiaretti S, Guarini A. A broad and integrated diagnostic work-up for a modern management of Acute Lymphoblastic Leukemia (ALL). ACTA ACUST UNITED AC 2005; 10 Suppl 1:55-62. [PMID: 16188637 DOI: 10.1080/10245330512331390041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Robin Foà
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, University La Sapienza of Rome, Italy.
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16
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Abstract
BACKGROUND Much progress has been made in understanding the biology of acute lymphoblastic leukemia (ALL). This has translated into the recognition of several subgroups of ALL and the institution of risk-adapted therapies. New therapies are emerging based on the definition of specific cytogenetic-molecular abnormalities. METHODS A review from the English literature, including original articles and related reviews from Medline (Pubmed) and abstracts based on publication of meeting material, was performed. RESULTS Changes in the pathologic classification of ALL have led to therapeutic consequences. Adaptation of successful treatment strategies in children with ALL has resulted in similar complete response rates in adults. Prognosis has especially improved in mature-B-cell and T-lineage ALL. The role of tyrosine kinase inhibitors in Philadelphia chromosome-positive ALL was evaluated in the current study. However, regardless of the ALL subgroup, long-term survival of adults is still inferior to that in children. CONCLUSIONS Intense clinical and laboratory research is attempting to close the gap in outcome between children and adults with ALL. Investigations are focusing on 1) refinement of the basic treatment stratagem of induction, consolidation, and maintenance; 2) expansion of risk-based, subgroup-oriented therapies; 3) assessment of minimal residual disease, its impact on disease recurrence, and its practical implications in clinical practice; 4) salvage strategies; 5) the role of stem cell transplantation in ALL; and 6) the development of new drugs based on a better understanding of disease biology.
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Affiliation(s)
- Stefan Faderl
- Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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17
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Foa R, Vitale A. Towards an integrated classification of adult acute lymphoblastic leukemia. REVIEWS IN CLINICAL AND EXPERIMENTAL HEMATOLOGY 2002; 6:181-99; discussion 200-2. [PMID: 12196215 DOI: 10.1046/j.1468-0734.2002.00070.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Acute lymphoblastic leukemia (ALL) represents a biologically and clinically heterogeneous group of diseases characterized by the abnormal proliferation and accumulation of immature lymphoid cells within the bone marrow and lymphoid tissues. Following a diagnostic work-up, prognostic data are routinely achieved through physical examination, serum biochemical profiles, peripheral blood count and bone marrow morphology. Over the years, information obtained through karyotype, molecular genetics, extensive immunophenotype, multidrug resistance and, more recently, genomic profiling is progressively contributing to a better understanding of the biology of this complex disease, to the identification of subgroups of patients with a different clinical outcome, to the more precise monitoring of minimal residual disease, to the use of different therapeutic protocols based on prognostic indicators and, recently, also to the design of innovative and specific treatment strategies. In the present review, we will discuss how an integrated approach is now mandatory for the optimal management of adult ALL.
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Affiliation(s)
- Robin Foa
- Dipartimento di Biotecnologie Cellulari ed Ematologia, University La Sapienza, Rome, Italy.
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18
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Dunphy CH, Gardner LJ, Manes JL, Bee CS, Taysi K. CD30+ anaplastic large-cell lymphoma with aberrant expression of CD13: Case report and review of the literature. J Clin Lab Anal 2001. [DOI: 10.1002/1098-2825(20001212)14:6<299::aid-jcla9>3.0.co;2-g] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Brinkman-Van der Linden EC, Varki A. New aspects of siglec binding specificities, including the significance of fucosylation and of the sialyl-Tn epitope. Sialic acid-binding immunoglobulin superfamily lectins. J Biol Chem 2000; 275:8625-32. [PMID: 10722702 DOI: 10.1074/jbc.275.12.8625] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The siglecs (sialic acid-binding immunoglobulin superfamily lectins) are immunoglobulin superfamily members recognizing sialylated ligands. Most prior studies of siglec specificities focused on alpha2-3- and alpha2-6-sialyllactos(amin)es and on one or two of the siglecs at a time. Here, we explore several new aspects of specificities of the first six reported siglecs, using sialylated glycans presented in multivalent form, on synthetic polyacrylamide backbones, or on mucin polypeptides. First, we report that binding of siglec-1 (sialoadhesin), siglec-3 (CD33), siglec-4a (myelin-associated glycoprotein), and siglec-5 to alpha2-3 sialyllactosamine is affected markedly by the presence of an alpha1-3-linked fucose. Thus, while siglecs may not interfere with selectin-mediated recognition, fucosylation could negatively regulate siglec binding. Second, in contrast to earlier studies, we find that siglec-3 prefers alpha2-6-sialyllactose. Third, siglec-5 binds alpha2-8-linked sialic acid, making it the siglec least specific for linkage recognition. Fourth, siglecs-2 (CD22), -3, -5, and -6 (obesity-binding protein 1) showed significant binding to sialyl-Tn (Neu5Acalpha2-6-GalNAc), a tumor marker associated with poor prognosis. Fifth, siglec-6 is an exception among siglecs in not requiring the glycerol side chain of sialic acid for recognition. Sixth, all siglecs require the carboxyl group of sialic acid for binding. Finally, the presentation of the sialyl-Tn epitope and/or more extended structures that include this motif may be important for optimal recognition by the siglecs. This was concluded from studies using ovine, bovine, and porcine submaxillary mucins and Chinese hamster ovary cells transfected with ST6GalNAc-I and/or the mucin polypeptide MUC1.
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Affiliation(s)
- E C Brinkman-Van der Linden
- Glycobiology Research and Training Center and Department of Medicine, University of California San Diego, La Jolla, California 92093, USA
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20
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Callea V, Morabito F, Oliva BM, Stelitano C, Levato D, Dattilo A, Gangemi F, Iorfida A, Iacopino P, Nobile F, Molica S, Brugiatelli M. Surface CD14 positivity in B-cell chronic lymphocytic leukaemia is related to clinical outcome. Br J Haematol 1999; 107:347-52. [PMID: 10583223 DOI: 10.1046/j.1365-2141.1999.01695.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aberrant expression of the myelomonocytic antigen CD14 was investigated in 128 untreated patients diagnosed with B-cell chronic lymphocytic leukaemia (B-CLL). A cut-off value of 5 x 10(9)/l CD14-positive cells was chosen for statistical analysis because it showed the best discriminating power among patients with different clinical features. 56 cases had a CD14+ cell count >5 x 10(9)/l. A significant correlation was found between Rai and Binet stages and total tumour mass (TTM) score on one hand, and the absolute CD14+ cell cut-off, on the other. This relationship was more evident in Rai 0-II and Binet A-B stages, where a CD14+ cell count >5 x 10(9)/l was preferentially distributed among patients with a higher tumoral mass. In univariate analysis the survival probability at 5 and 10 years showed a significant correlation with Rai and Binet stages, TTM score, CD14+ absolute cell count and median age. The median overall survival (OS) was 63 months for patients with a CD14+ cell count >5 x 10(9)/l and 136 months for those with a CD14+ cell count < 5 x 10(9)/l. In the multivariate Cox regression model, Rai stage, age and CD14+ cell count were independent significant factors for the prediction of OS. Finally, when the same analysis was restricted to Rai stages 0-II, CD14+ cell count was the only significant independent parameter influencing OS, with a relative death risk of 3.8. In conclusion, these data reveal that CD14+ represents an important marker for predicting OS in B-CLL patients and, therefore, we suggest that it should be included in the immunological characterization of B-CLL.
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MESH Headings
- Female
- Follow-Up Studies
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lipopolysaccharide Receptors/immunology
- Male
- Middle Aged
- Multivariate Analysis
- Prognosis
- Survival Rate
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Affiliation(s)
- V Callea
- Dipartimento Emato-Oncologia, Azienda Ospedaliera 'Bianchi-Melacrino-Morelli', Reggio Calabria, Italy.
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