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Afify Z, Orjuela-G rimm M, Smith CM, Dalal M, Ford JB, Pillai P, Robles JM, Reddy S, McCormack S, Ehrhardt MJ, Ureda T, Alperstein W, Edington H, Miller TP, Rubinstein JD, Kavanaugh M, Bukowinski AJ, Friehling E, Rivers JM, Chisholm KM, Marks LJ, Mason CC. Burkitt lymphoma after solid-organ transplant: Treatment and outcomes in the paediatric PTLD collaborative. Br J Haematol 2023; 200:297-305. [PMID: 36454546 PMCID: PMC11195532 DOI: 10.1111/bjh.18498] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 12/05/2022]
Abstract
Burkitt lymphoma arising in paediatric post-solid-organ transplantation-Burkitt lymphoma (PSOT-BL) is a clinically aggressive malignancy and a rare form of post-transplant lymphoproliferative disorder (PTLD). We evaluated 35 patients diagnosed with PSOT-BL at 14 paediatric medical centres in the United States. Median age at organ transplantation was 2.0 years (range: 0.1-14) and age at PSOT-BL diagnosis was 8.0 years (range: 1-17). All but one patient had late onset of PSOT-BL (≥2 years post-transplant), with a median interval from transplant to PSOT-BL diagnosis of 4.0 years (range: 0.4-12). Heart (n = 18 [51.4%]) and liver (n = 13 [37.1%]) were the most frequently transplanted organs. No patients had loss of graft or treatment-related mortality. A variety of treatment regimens were used, led by intensive Burkitt lymphoma-specific French-American-British/Lymphomes Malins B (FAB/LMB), n = 13 (37.1%), and a low-intensity regimen consisting of cyclophosphamide, prednisone and rituximab (CPR) n = 12 (34.3%). Median follow-up was 6.7 years (range: 0.5-17). Three-year event-free and overall survival were 66.2% and 88.0%, respectively. Outcomes of PSOT-BL patients receiving BL-specific intensive regimens are comparable to reported BL outcomes in immunocompetent children. Multi-institutional collaboration is feasible and provides the basis of prospective data collection to determine the optimal treatment regimen for PSOT-BL.
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Affiliation(s)
- Zeinab Afify
- Pediatric Hematology Oncology, Primary Children’s Med. Ctr, Salt Lake City, Utah, USA
| | - Manuela Orjuela-G rimm
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, and Department of Epidemiology, Columbia University Medical Center, New York, New York City, USA
| | | | - Mansi Dalal
- University of Florida, Gainesville, Florida, USA
| | - James B. Ford
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Pallavi Pillai
- Mount Sinai Kravis Children’s Hospital, New York, New York City, USA
| | - Joanna M. Robles
- Department of Pediatrics, Division of Hematology/Oncology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sonika Reddy
- Division of Pediatric Hematology Oncology and Stem Cell Transplantation, and Department of Epidemiology, Columbia University Medical Center, New York, New York City, USA
| | - Sarah McCormack
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical center, Cincinnati, Ohio, USA
- Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | - Tonya Ureda
- Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Warren Alperstein
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Holly Edington
- Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Tamara P. Miller
- Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jeremy D. Rubinstein
- Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical center, Cincinnati, Ohio, USA
- Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Madison Kavanaugh
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrew J. Bukowinski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Erika Friehling
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Julie M. Rivers
- Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Karen M. Chisholm
- Department of Laboratories, Seattle Children’s Hospital, Seattle, Washington, USA
| | - Lianna J. Marks
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Clinton C. Mason
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, University of Utah, Salt Lake City, Utah, USA
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Panda D, Das N, Thakral D, Gupta R. Genomic landscape of mature B-cell non-Hodgkin lymphomas - an appraisal from lymphomagenesis to drug resistance. J Egypt Natl Canc Inst 2022; 34:52. [PMID: 36504392 DOI: 10.1186/s43046-022-00154-z] [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: 11/09/2021] [Accepted: 09/27/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Mature B-cell non-Hodgkin lymphomas are one of the most common hematological malignancies with a divergent clinical presentation, phenotype, and course of disease regulated by underlying genetic mechanism. MAIN BODY Genetic and molecular alterations are not only critical for lymphomagenesis but also largely responsible for differing therapeutic response in these neoplasms. In recent years, advanced molecular tools have provided a deeper understanding regarding these oncogenic drives for predicting progression as well as refractory behavior in these diseases. The prognostic models based on gene expression profiling have also been proved effective in various clinical scenarios. However, considerable overlap does exist between the genotypes of individual lymphomas and at the same time where additional molecular lesions may be associated with each entity apart from the key genetic event. Therefore, genomics is one of the cornerstones in the multimodality approach essential for classification and risk stratification of B-cell non-Hodgkin lymphomas. CONCLUSION We hereby in this review discuss the wide range of genetic aberrancies associated with tumorigenesis, immune escape, and chemoresistance in major B-cell non-Hodgkin lymphomas.
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Affiliation(s)
- Devasis Panda
- Department of Laboratory Oncology, Dr. BRAIRCH, AIIMS, New Delhi, 110029, India
| | - Nupur Das
- Department of Laboratory Oncology, Dr. BRAIRCH, AIIMS, New Delhi, 110029, India
| | - Deepshi Thakral
- Department of Laboratory Oncology, Dr. BRAIRCH, AIIMS, New Delhi, 110029, India
| | - Ritu Gupta
- Department of Laboratory Oncology, Dr. BRAIRCH, AIIMS, New Delhi, 110029, India.
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Iglesias Cardenas F, Agarwal AM, Vagher J, Maese L, Fluchel M, Afify Z. Two Clonally Distinct B-Cell Lymphomas Reveal the Diagnosis of XLP1 in a Male Child and His Asymptomatic Male Relatives: Case Report and Review of the Literature. J Pediatr Hematol Oncol 2021; 43:e1210-e1213. [PMID: 33448720 DOI: 10.1097/mph.0000000000002049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
X-linked lymphoproliferative disease type 1 (XLP1) is a primary immunodeficiency disorder caused by pathogenic variants in the SH2D1A gene (SH2 domain containing protein 1A). Patients with XLP1 may present acutely with fulminant infectious mononucleosis, hemophagocytic lymphohistiocytosis, and/or B-cell non-Hodgkin lymphoma (B-NHL). We report a boy who developed 2 clonally distinct B-NHL 4 years apart and was found to have previously unrecognized XLP1. The report highlights the importance of clonal analysis and XLP1 testing in males with presumed late recurrences of B-NHL, and the role of allogeneic stem cell transplant (allo-SCT) in XLP1 patients and their affected male relatives.
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Affiliation(s)
- Fiorella Iglesias Cardenas
- Department of Pediatrics, University of Utah and Primary Children's Hospital
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York City, NY
| | | | - Jennie Vagher
- Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Luke Maese
- Department of Pediatrics, University of Utah and Primary Children's Hospital
| | - Mark Fluchel
- Department of Pediatrics, University of Utah and Primary Children's Hospital
| | - Zeinab Afify
- Department of Pediatrics, University of Utah and Primary Children's Hospital
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Penther D, Viailly PJ, Latour S, Etancelin P, Bohers E, Vellemans H, Camus V, Menard AL, Coutant S, Lanic H, Lemasle E, Drieux F, Veresezan L, Ruminy P, Raimbault A, Soulier J, Frebourg T, Tilly H, Jardin F. A recurrent clonally distinct Burkitt lymphoma case highlights genetic key events contributing to oncogenesis. Genes Chromosomes Cancer 2019; 58:595-601. [PMID: 30779244 PMCID: PMC6790587 DOI: 10.1002/gcc.22743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 01/07/2023] Open
Abstract
Burkitt lymphoma (BL) is characterized by a translocation of the MYC oncogene that leads to the upregulation of MYC expression, cell growth and proliferation. It is well-established that MYC translocation is not a sufficient genetic event to cause BL. Next-generation sequencing has recently provided a comprehensive analysis of the landscape of additional genetic events that contribute to BL lymphomagenesis. Refractory BL or relapsing BL are almost always incurable as a result of the selection of a highly chemoresistant clonally related cell population. Conversely, a few BL recurrence cases arising from clonally distinct tumors have been reported and were associated with a favorable outcome similar to that reported for first-line treatment. Here, we used an unusual case of recurrent but clonally distinct EBV+ BL to highlight the key genetic events that drive BL lymphomagenesis. By whole exome sequencing, we established that ID3 gene was targeted by distinct mutations in the two clonally unrelated diseases, highlighting the crucial role of this gene during lymphomagenesis. We also detected a heterozygous E1021K PIK3CD mutation, thus increasing the spectrum of somatic mutations altering the PI3K signaling pathway in BL. Interestingly, this mutation is known to be associated with activated phosphoinositide 3-kinase delta syndrome (APDS). Finally, we also identified an inherited heterozygous truncating c.5791CT FANCM mutation that may contribute to the unusual recurrence of BL.
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Affiliation(s)
| | | | - Sylvain Latour
- INSERM UMR_S1163, Institut Imagine Université Paris Descartes, Paris, France
| | | | - Elodie Bohers
- INSERM U1245, Centre Henri Becquerel and Rouen University, Rouen, France
| | - Hélène Vellemans
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Vincent Camus
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Anne Lise Menard
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Sophie Coutant
- Department of Genetics, Rouen University Hospital, F76000 and Normandie Univ, UNIROUEN, Inserm U1245, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Hélène Lanic
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Emilie Lemasle
- Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Fanny Drieux
- Department of Biopathology, Centre Henri Becquerel, Rouen, France
| | - Liana Veresezan
- Department of Biopathology, Centre Henri Becquerel, Rouen, France
| | - Philippe Ruminy
- INSERM U1245, Centre Henri Becquerel and Rouen University, Rouen, France
| | - Anna Raimbault
- INSERM U944/CNRS UMR7212, Saint Louis Hospital, Paris, France
| | - Jean Soulier
- INSERM U944/CNRS UMR7212, Saint Louis Hospital, Paris, France
| | - Thierry Frebourg
- Department of Genetics, Rouen University Hospital, F76000 and Normandie Univ, UNIROUEN, Inserm U1245, Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Hervé Tilly
- INSERM U1245, Centre Henri Becquerel and Rouen University, Rouen, France.,Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
| | - Fabrice Jardin
- INSERM U1245, Centre Henri Becquerel and Rouen University, Rouen, France.,Department of Clinical Hematology, Centre Henri Becquerel, Rouen, France
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