1
|
Roush SM, Coelho J, Xu AM, Puranam K, Mponda M, Kasonkanji E, Mulenga M, Tomoka T, Galeotti J, Brownlee A, Ghadially H, Chagomerana M, Damania B, Painschab M, Merchant A, Gopal S, Fedoriw Y. HIV infection and ART exposure affect tumor TCR repertoire of diffuse large B cell lymphoma. JCI Insight 2024; 9:e180771. [PMID: 38781015 DOI: 10.1172/jci.insight.180771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
The most common subtype of lymphoma globally, diffuse large B cell lymphoma (DLBCL), is a leading cause of cancer death in people with HIV. The restructuring of the T cell compartment because of HIV infection and antiretroviral therapy (ART) may have implications for modern treatment selection, but current understanding of these dynamic interactions is limited. Here, we investigated the T cell response to DLBCL by sequencing the T cell receptor (TCR) repertoire in a cohort of HIV-negative (HIV-), HIV+/ART-experienced, and HIV+/ART-naive patients with DLBCL. HIV+/ART-naive tumor TCR repertoires were more clonal and more distinct from each other than HIV- and HIV+/ART-experienced ones. Further, increased overlap between tumor and blood TCR repertoires was associated with improved survival and HIV/ART status. Our study describes TCR repertoire characteristics for the first time to our knowledge in an African DLBCL cohort and demonstrates contributions of HIV infection and ART exposure to the DLBCL TCR repertoire.
Collapse
Affiliation(s)
- Sophia M Roush
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jenny Coelho
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alexander M Xu
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kaushik Puranam
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Marriam Mponda
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Edwards Kasonkanji
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Maurice Mulenga
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Tamiwe Tomoka
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Jonathan Galeotti
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Amy Brownlee
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hormas Ghadially
- Department of Pathology, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Maganizo Chagomerana
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
| | - Blossom Damania
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Department of Microbiology and Immunology and
| | - Matthew Painschab
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
- Division of Hematology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Akil Merchant
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Division of Hematology and Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Satish Gopal
- National Cancer Institute Center for Global Health, Rockville, Maryland, USA
| | - Yuri Fedoriw
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
- University of North Carolina Project Malawi, Lilongwe, Malawi
- University of Malawi College of Medicine, Lilongwe, Malawi
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| |
Collapse
|
2
|
Martínez LE, Magpantay LI, Guo Y, Hegde P, Detels R, Hussain SK, Epeldegui M. Extracellular vesicles as biomarkers for AIDS-associated non-Hodgkin lymphoma risk. Front Immunol 2023; 14:1259007. [PMID: 37809067 PMCID: PMC10556683 DOI: 10.3389/fimmu.2023.1259007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Extracellular vesicles are membrane-bound structures secreted into the extracellular milieu by cells and can carry bioactive molecules. There is emerging evidence suggesting that EVs play a role in the diagnosis, treatment, and prognosis of certain cancers. In this study, we investigate the association of EVs bearing PD-L1 and molecules important in B-cell activation and differentiation with AIDS-NHL risk. Methods EVs were isolated from archived serum collected prior to the diagnosis of AIDS-NHL in cases (N = 51) and matched HIV+ controls (N = 52) who were men enrolled in the Los Angeles site of the MACS/WIHS Combined Cohort Study (MWCCS). Serum specimens of AIDS-NHL cases were collected at a mean time of 1.25 years (range of 2 to 36 months) prior to an AIDS-NHL diagnosis. The expression of PD-L1 and other molecules on EVs (CD40, CD40L, TNF-RII, IL-6Rα, B7-H3, ICAM-1, and FasL) were quantified by Luminex multiplex assay. Results and discussion We observed significantly higher levels of EVs bearing PD-L1, CD40, TNF-RII and/or IL-6Rα in AIDS-NHL cases compared with controls. Using multivariate conditional logistic regression models adjusted for age and CD4+ T-cell count, we found that EVs bearing PD-L1 (OR = 1.93; 95% CI: 1.10 - 3.38), CD40 (OR = 1.97, 95% CI: 1.09 - 3.58), TNF-RII (OR = 5.06; 95% CI: 1.99 - 12.85) and/or IL-6Rα (OR = 4.67; 95% CI: 1.40 - 15.53) were significantly and positively associated with AIDS-NHL risk. In addition, EVs bearing these molecules were significantly and positively associated with non-CNS lymphoma: PD-L1 (OR = 1.94; 95% CI: 1.01 - 3.72); CD40 (OR = 2.66; 95% CI: 1.12 - 6.35); TNF-RII (OR = 9.64; 95% CI: 2.52 - 36.86); IL-6Rα (OR = 8.34; 95% CI: 1.73 - 40.15). These findings suggest that EVs bearing PD-L1, CD40, TNF-RII and/or IL-6Rα could serve as biomarkers for the early detection of NHL in PLWH.
Collapse
Affiliation(s)
- Laura E Martínez
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Larry I Magpantay
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Yu Guo
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Priya Hegde
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roger Detels
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shehnaz K Hussain
- Department of Public Health Sciences, School of Medicine and Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Marta Epeldegui
- UCLA AIDS Institute and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
3
|
Gessese T, Asrie F, Mulatie Z. Human Immunodeficiency Virus Related Non-Hodgkin's Lymphoma. Blood Lymphat Cancer 2023; 13:13-24. [PMID: 37275434 PMCID: PMC10237187 DOI: 10.2147/blctt.s407086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/14/2023] [Indexed: 06/07/2023]
Abstract
Human immunodeficiency virus infection is related with an increased risk of hematological malignancy principally, non-Hodgkin lymphoma. Most non-Hodgkin lymphomas are acquired immunodeficiency syndrome defining and constitute greater than 50% of all acquired immunodeficiency syndrome defining cancers. The main pathogenesis mechanisms are immunodeficiency, chronic antigenic stimulation, and the ability to infect cancer cells causing direct carcinogenesis. Human immunodeficiency virus related non-Hodgkin lymphomas are heterogeneous in immunophenotyping and molecular features; and choice of drug treatments is similar with sporadic types. The main objective is to assess the epidemiology, pathogenesis, and morphology of human immunodeficiency virus related non-Hodgkin lymphoma. The searching strategy was done by searching relevant original and review articles from www.biosemanticjane/org, Google scholar, Google, and PubMed sites using keywords like; Acquired immunodeficiency syndrome, Human immunodeficiency virus, and non-Hodgkin lymphoma. In conclusion, human immunodeficiency virus infected people continue to have elevated risk of non-Hodgkin lymphoma. Diffuse large B-cell lymphomas are the most common and severe subtype. The pathogenesis of this type of lymphoma is associated with chromosomal abnormalities that deregulate the expression of various oncogenes by different viral particles and cytokines. However, the role of these viral particles and cytokines on pathogenesis is not clearly stated, so further study could be required.
Collapse
Affiliation(s)
- Tesfaye Gessese
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Mulatie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
4
|
Daniels-Wells TR, Candelaria PV, Kranz E, Wen J, Wang L, Kamata M, Almagro JC, Martínez-Maza O, Penichet ML. Efficacy of Antibodies Targeting TfR1 in Xenograft Mouse Models of AIDS-Related Non-Hodgkin Lymphoma. Cancers (Basel) 2023; 15:1816. [PMID: 36980702 PMCID: PMC10046321 DOI: 10.3390/cancers15061816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
Transferrin receptor 1 (TfR1), also known as CD71, is a transmembrane protein involved in the cellular uptake of iron and the regulation of cell growth. This receptor is expressed at low levels on a variety of normal cells, but is upregulated on cells with a high rate of proliferation, including malignant cells and activated immune cells. Infection with the human immunodeficiency virus (HIV) leads to the chronic activation of B cells, resulting in high expression of TfR1, B-cell dysfunction, and ultimately the development of acquired immunodeficiency syndrome-related B-cell non-Hodgkin lymphoma (AIDS-NHL). Importantly, TfR1 expression is correlated with the stage and prognosis of NHL. Thus, it is a meaningful target for antibody-based NHL therapy. We previously developed a mouse/human chimeric IgG3 specific for TfR1 (ch128.1/IgG3) and showed that this antibody exhibits antitumor activity in an in vivo model of AIDS-NHL using NOD-SCID mice challenged intraperitoneally with 2F7 human Burkitt lymphoma (BL) cells that harbor the Epstein-Barr virus (EBV). We have also developed an IgG1 version of ch128.1 that shows significant antitumor activity in SCID-Beige mouse models of disseminated multiple myeloma, another B-cell malignancy. Here, we aim to explore the utility of ch128.1/IgG1 and its humanized version (hu128.1) in mouse models of AIDS-NHL. To accomplish this goal, we used the 2F7 cell line variant 2F7-BR44, which is more aggressive than the parental cell line and forms metastases in the brain of mice after systemic (intravenous) administration. We also used the human BL cell line JB, which in contrast to 2F7, is EBV-negative, allowing us to study both EBV-infected and non-infected NHL tumors. Treatment with ch128.1/IgG1 or hu128.1 of SCID-Beige mice challenged locally (subcutaneously) with 2F7-BR44 or JB cells results in significant antitumor activity against different stages of disease. Treatment of mice challenged systemically (intravenously) with either 2F7-BR44 or JB cells also showed significant antitumor activity, including long-term survival. Taken together, our results suggest that targeting TfR1 with antibodies, such as ch128.1/IgG1 or hu128.1, has potential as an effective therapy for AIDS-NHL.
Collapse
Affiliation(s)
- Tracy R. Daniels-Wells
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Pierre V. Candelaria
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Emiko Kranz
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- UCLA AIDS Institute, Los Angeles, CA 90095, USA
- Division of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Jing Wen
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- UCLA AIDS Institute, Los Angeles, CA 90095, USA
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
| | - Lan Wang
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- UCLA AIDS Institute, Los Angeles, CA 90095, USA
| | - Masakazu Kamata
- Department of Microbiology, Heersink School of Medicine, University of Alabama, Birmingham, AL 35294, USA
| | | | - Otoniel Martínez-Maza
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- UCLA AIDS Institute, Los Angeles, CA 90095, USA
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA 90095, USA
| | - Manuel L. Penichet
- Division of Surgical Oncology, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
- UCLA AIDS Institute, Los Angeles, CA 90095, USA
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
- The Molecular Biology Institute, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
| |
Collapse
|
5
|
Clinical Features, Phenotypic Markers and Outcomes of Diffuse Large B-Cell Lymphoma between HIV-Infected and HIV-Uninfected Chinese Patients. Cancers (Basel) 2022; 14:cancers14215380. [PMID: 36358798 PMCID: PMC9655449 DOI: 10.3390/cancers14215380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background: The effect of HIV infection on the clinicopathological characteristics of diffuse large B-cell lymphoma (DLBCL) remains debatable. Methods: Fifty-three HIV-infected and ninety-three HIV-uninfected DLBCL patients were enrolled in the retrospective study by propensity score matching for sex, age, body mass index and international prognostic index (IPI) at a ratio of 1:2. The clinicopathological characteristics were compared between the two groups. Results: HIV-infected DLBCL patients had lower white blood cell counts [×109/L; 4.4 (3.4−5.6) vs. 6.1 (4.2−8.2), p < 0.001], platelet counts (×109/L; 184.7 ± 89.3 vs. 230.0 ± 113.9, p = 0.014) and serum albumin (g/L; 37.3 ± 6.9 vs. 41.3 ± 6.2, p < 0.001) but higher incidences of central nervous system (CNS) involvement (9.4% vs. 1.1%, p = 0.014), bone marrow involvement (24.5% vs. 11.5%, p = 0.044) and Epstein−Barr viremia (61.1% vs. 26.7%, p = 0.002) than HIV-uninfected patients. In terms of histopathology, HIV-infected patients had higher positivity of Epstein−Barr virus-encoded small RNA (EBER) (41.7% vs. 6.7%, p = 0.002), but lower CD20 (90.2% vs. 98.7%, p= 0.029) and CD79a (23.1% vs. 53.7%, p < 0.001) expression. The overall response rate (ORR) at the end of chemotherapy (70.2% vs. 87.8%, p= 0.012) and 1-year overall survival (OS) (61.7% vs. 84.2%, log-rank p = 0.006) in HIV-infected patients were significantly lower than those in HIV-uninfected patients. Multivariate analysis suggested IPI ≤2.0 [adjusted odds ratio (AOR) (95% confidence interval): 5.0 (1.2−21.2), p = 0.030] was associated with ORR, hypoalbuminemia [AOR: 3.3 (1.3−9.1), p = 0.018] and CNS involvement [AOR: 3.3 (1.0−10.5), p = 0.044] were associated with reduced 1-year OS in HIV-infected patients. Conclusion: HIV-infected DLBCL patients have unique blood profiles and phenotypic markers. Low ORR and 1-year OS were observed in HIV-infected DLBCL patients in our study, even in the HAART era.
Collapse
|
6
|
Berhan A, Bayleyegn B, Getaneh Z. HIV/AIDS Associated Lymphoma: Review. Blood Lymphat Cancer 2022; 12:31-45. [PMID: 35517869 PMCID: PMC9063794 DOI: 10.2147/blctt.s361320] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Lymphoma is one of the hematologic malignancies that occur at a higher rate in human immunodeficiency virus-infected individuals. It is one of the most frequent neoplastic causes of death in those individuals. Non-Hodgkin’s lymphoma and Hodgkin’s lymphomas are acquired immunodeficiency syndrome defining lymphoma and non-acquired immunodeficiency syndrome defining lymphoma, respectively. Non-Hodgkin’s lymphoma is the most common type of lymphoma in human immunodeficiency virus-positive people. The lymphoma that develops in patients infected with the human immunodeficiency virus/acquired immunodeficiency syndrome is heterogeneous in terms of morphology, pathogenesis pathways, and cellular derivation. A narrative review was conducted on the basis of relevant literature on the current topic to summarize the current epidemiology, pathogenesis, laboratory diagnosis, and treatment of lymphoma in human immunodeficiency virus-infected patients. The finding showed that although the incidence of non-Hodgkin’s lymphoma has decreased after the advent of highly active antiretroviral therapy, it has remained higher in human immunodeficiency virus-infected people than in the general population. On the other hand, the incidence of Hodgkin’s lymphoma has increased after the introduction of highly active antiretroviral therapy. Therefore, it is recommended that people living with human immunodeficiency virus/ acquired immunodeficiency syndrome be screened for the development of lymphoma to increase their survival time and quality of life, and further research is required regarding the pathogenesis, treatment, and laboratory diagnosis of human immunodeficiency virus/ acquired immunodeficiency syndrome-associated lymphoma.
Collapse
Affiliation(s)
- Ayenew Berhan
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
- Correspondence: Ayenew Berhan, Tel +251910613151, Email
| | - Biruk Bayleyegn
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
7
|
Karcher DS. From HIV to Coronavirus Disease 2019 (COVID-19): Hematologic Complications in Viral Pandemics. Arch Pathol Lab Med 2021; 146:433-439. [PMID: 33946099 DOI: 10.5858/arpa.2021-0097-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— From the onset of the human immunodeficiency virus (HIV) pandemic in the 1980s to the recent coronavirus disease 2019 (COVID-19) pandemic, multiple viral pandemics have occurred and all have been associated with hematologic complications of varying severity. OBJECTIVE.— To review the hematologic complications associated with the HIV and other viral pandemics, the current theories regarding their causation, and the incidence and clinical impact of these complications on infected patients. DATA SOURCES.— Peer-reviewed medical literature and the author's personal experience. CONCLUSIONS.— The HIV and other viral pandemics have been associated with a variety of hematologic complications that often cause significant morbidity and mortality in affected patients. HIV infection is associated with multiple hematologic disorders, many of which have a lower incidence in the era of highly active antiretroviral therapy but still represent a major clinical problem for HIV-infected patients. Our understanding of the pathogenesis of HIV-related hematologic complications, including HIV-associated lymphoproliferative disorders, has evolved in recent years. Other viral pandemics, including H1N1 influenza, severe acute respiratory syndrome (SARS) coronavirus, Middle East respiratory syndrome (MERS) coronavirus, and COVID-19, have also been associated with hematologic complications of varying severity. Our emerging understanding of the pathogenesis of the hematologic complications of HIV, COVID-19, and other viral pandemics may help in prevention, correct diagnosis, and treatment of these complications in current and future pandemics.
Collapse
Affiliation(s)
- Donald S Karcher
- From the Department of Pathology, George Washington University Medical Center, Washington, District of Columbia
| |
Collapse
|
8
|
Noy A. Burkitt Lymphoma — Subtypes, Pathogenesis, and Treatment Strategies. CLINICAL LYMPHOMA MYELOMA AND LEUKEMIA 2020; 20 Suppl 1:S37-S38. [DOI: 10.1016/s2152-2650(20)30455-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
9
|
Atallah-Yunes SA, Murphy DJ, Noy A. HIV-associated Burkitt lymphoma. LANCET HAEMATOLOGY 2020; 7:e594-e600. [PMID: 32735838 DOI: 10.1016/s2352-3026(20)30126-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/08/2020] [Accepted: 04/15/2020] [Indexed: 12/30/2022]
Abstract
Burkitt lymphoma is a rare and aggressive non-Hodgkin lymphoma with three classifications: endemic, sporadic, and immunodeficiency-related. High-intensity chemotherapeutic regimens have considerably improved overall survival for patients with Burkitt lymphoma. In this Review of HIV-associated Burkitt lymphoma, we summarise expert opinion and provide general recommendations for the treatment of Burkitt lymphoma in patients with HIV on the basis of retrospective and prospective studies, taking into consideration immune status, CD4 cell counts, the presence of systemic disease, and the risk of CNS involvement or relapse. We also discuss the role of rituximab and antiretroviral therapy. We highlight the reasons behind the possible different mechanisms of lymphomagenesis in HIV-associated Burkitt lymphoma and endemic Burkitt lymphoma, which indicate that HIV might have either a direct or indirect oncogenic role in Burkitt lymphoma. We discuss the possible mechanisms by which HIV and HIV proteins could directly contribute to lymphomagenesis. Identifying these mechanisms might lead to the development of therapies that have fewer toxic effects than high-intensity chemotherapeutic regimens.
Collapse
Affiliation(s)
- Suheil Albert Atallah-Yunes
- Department of Medicine, University of Massachusetts Medical School-Baystate Medical Center, Springfield, MA, USA
| | - Dermot J Murphy
- Department of Medicine, Mercy Medical Center, Springfield, MA, USA
| | - Ariela Noy
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Medical College of Cornell University, New York, NY, USA.
| |
Collapse
|
10
|
Li C, Romero-Masters JC, Huebner S, Ohashi M, Hayes M, Bristol JA, Nelson SE, Eichelberg MR, Van Sciver N, Ranheim EA, Scott RS, Johannsen EC, Kenney SC. EBNA2-deleted Epstein-Barr virus (EBV) isolate, P3HR1, causes Hodgkin-like lymphomas and diffuse large B cell lymphomas with type II and Wp-restricted latency types in humanized mice. PLoS Pathog 2020; 16:e1008590. [PMID: 32542010 PMCID: PMC7316346 DOI: 10.1371/journal.ppat.1008590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/25/2020] [Accepted: 05/01/2020] [Indexed: 12/15/2022] Open
Abstract
EBV transforms B cells in vitro and causes human B-cell lymphomas including classical Hodgkin lymphoma (CHL), Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). The EBV latency protein, EBNA2, transcriptionally activates the promoters of all latent viral protein-coding genes expressed in type III EBV latency and is essential for EBV's ability to transform B cells in vitro. However, EBNA2 is not expressed in EBV-infected CHLs and BLs in humans. EBV-positive CHLs have type II latency and are largely driven by the EBV LMP1/LMP2A proteins, while EBV-positive BLs, which usually have type I latency are largely driven by c-Myc translocations, and only express the EBNA1 protein and viral non-coding RNAs. Approximately 15% of human BLs contain naturally occurring EBNA2-deleted viruses that support a form of viral latency known as Wp-restricted (expressing the EBNA-LP, EBNA3A/3B/3C, EBNA1 and BHRF1 proteins), but whether Wp-restricted latency and/or EBNA2-deleted EBV can induce lymphomas in humanized mice, or in the absence of c-Myc translocations, is unknown. Here we show that a naturally occurring EBNA2-deleted EBV strain (P3HR1) isolated from a human BL induces EBV-positive B-cell lymphomas in a subset of infected cord blood-humanized (CBH) mice. Furthermore, we find that P3HR1-infected lymphoma cells support two different viral latency types and phenotypes that are mutually exclusive: 1) Large (often multinucleated), CD30-positive, CD45-negative cells reminiscent of the Reed-Sternberg (RS) cells in CHL that express high levels of LMP1 but not EBNA-LP (consistent with type II viral latency); and 2) smaller monomorphic CD30-negative DLBCL-like cells that express EBNA-LP and EBNA3A but not LMP1 (consistent with Wp-restricted latency). These results reveal that EBNA2 is not absolutely required for EBV to form tumors in CBH mice and suggest that P3HR1 virus can be used to model EBV positive lymphomas with both Wp-restricted and type II latency in vivo.
Collapse
MESH Headings
- Animals
- Cell Line
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/metabolism
- Epstein-Barr Virus Infections/pathology
- Epstein-Barr Virus Infections/virology
- Epstein-Barr Virus Nuclear Antigens/genetics
- Epstein-Barr Virus Nuclear Antigens/metabolism
- Gene Deletion
- Herpesvirus 4, Human/pathogenicity
- Herpesvirus 4, Human/physiology
- Hodgkin Disease/genetics
- Hodgkin Disease/metabolism
- Hodgkin Disease/pathology
- Hodgkin Disease/virology
- Humans
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Mice
- Viral Proteins/genetics
- Viral Proteins/metabolism
- Virus Latency
Collapse
Affiliation(s)
- Chunrong Li
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - James C. Romero-Masters
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Shane Huebner
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Makoto Ohashi
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Mitchell Hayes
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jillian A. Bristol
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Scott E. Nelson
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Mark R. Eichelberg
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Nicholas Van Sciver
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Erik A. Ranheim
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Rona S. Scott
- Center for Molecular and Tumor Virology, LSU Health Sciences Center, Shreveport, Louisiana, United States of America
| | - Eric C. Johannsen
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Shannon C. Kenney
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
| |
Collapse
|
11
|
Song M, Bassig BA, Bender N, Goedert JJ, Winkler CA, Brenner N, Waterboer T, Rabkin CS. Associations of Viral Seroreactivity with AIDS-Related Non-Hodgkin Lymphoma. AIDS Res Hum Retroviruses 2020; 36:381-388. [PMID: 31789046 DOI: 10.1089/aid.2019.0208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Infection with human immunodeficiency virus (HIV) is associated with substantially increased incidence of non-Hodgkin lymphoma (NHL). This risk may be driven, in part, by reduced immune control over viral infections in the setting of acquired immunodeficiency syndrome (AIDS), although the lymphomagenic mechanisms are not yet established. We used bead-based multiplex assays to measure antibody seroreactivity to 32 viral antigens representing 22 different viral infections (human herpesviruses 1-8, hepatitis B and C virus, human T-lymphotropic virus type-1, and human polyomaviruses) in two prospective HIV cohorts. Incident (n = 28) and prevalent (n = 38) AIDS-related NHL cases were matched by age, sex, race, and CD4 count to 67 HIV-positive control individuals without AIDS-NHL. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations of AIDS-NHL with the number of different viruses to which an individual was seropositive and seroreactivity to individual antigens. Seropositivity to an increasing number of viruses was inversely associated with AIDS-NHL (OR per virus = 0.84, 95% CI = 0.72-0.98). Seroreactivity to herpes simplex virus 2 2mgG unique antigen (OR = 0.47; 95% CI = 0.23-0.97) and to WU polyomavirus viral capsid protein (OR = 0.26, 95% CI = 0.10-0.65) was significantly lower in AIDS-NHL cases compared to controls. In this evaluation of antibodies to multiple viruses, we observed an inverse association between seropositivity to a larger number of viruses and AIDS-NHL. While in need of further evaluation, our data raise the novel hypothesis that insufficient exposures or impaired humoral immune responses to viral infections may be associated with AIDS-related lymphomagenesis.
Collapse
Affiliation(s)
- Minkyo Song
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Bryan A. Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Noemi Bender
- Infections and Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Cheryl A. Winkler
- Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Frederick, Maryland, USA
- Leidos Biomedical Research, Inc., Frederick National Laboratory, Frederick, Maryland, USA
| | - Nicole Brenner
- Infections and Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Charles S. Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| |
Collapse
|
12
|
Mezger NCS, Feuchtner J, Griesel M, Hämmerl L, Seraphin TP, Zietsman A, Péko JF, Tadesse F, Buziba NG, Wabinga H, Nyanchama M, Borok MZ, Kéita M, N'da G, Lorenzoni CF, Akele-Akpo MT, Gottschick C, Binder M, Mezger J, Jemal A, Parkin DM, Wickenhauser C, Kantelhardt EJ. Clinical presentation and diagnosis of adult patients with non-Hodgkin lymphoma in Sub-Saharan Africa. Br J Haematol 2020; 190:209-221. [PMID: 32181503 DOI: 10.1111/bjh.16575] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 12/24/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is the sixth most common cancer in Sub-Saharan Africa (SSA). Comprehensive diagnostics of NHL are essential for effective treatment. Our objective was to assess the frequency of NHL subtypes, disease stage and further diagnostic aspects. Eleven population-based cancer registries in 10 countries participated in our observational study. A random sample of 516 patients was included. Histological confirmation of NHL was available for 76.2% and cytological confirmation for another 17.3%. NHL subclassification was determined in 42.1%. Of these, diffuse large B cell lymphoma, chronic lymphocytic leukaemia and Burkitt lymphoma were the most common subtypes identified (48.8%, 18.4% and 6.0%, respectively). We traced 293 patients, for whom recorded data were amended using clinical records. For these, information on stage, human immunodeficiency virus (HIV) status and Eastern Cooperative Oncology Group Performance Status (ECOG PS) was available for 60.8%, 52.6% and 45.1%, respectively. Stage at diagnosis was advanced for 130 of 178 (73.0%) patients, HIV status was positive for 97 of 154 (63.0%) and ECOG PS was ≥2 for 81 of 132 (61.4%). Knowledge about NHL subclassification and baseline clinical characteristics is crucial for guideline-recommended treatment. Hence, regionally adapted investments in pathological capacity, as well as standardised clinical diagnostics, will significantly improve the therapeutic precision for NHL in SSA.
Collapse
Affiliation(s)
- Nikolaus C S Mezger
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Jana Feuchtner
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Mirko Griesel
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Lucia Hämmerl
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Tobias P Seraphin
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Annelle Zietsman
- African Cancer Registry Network, Oxford, UK.,Dr AB May Cancer Care Centre, Windhoek, Namibia
| | - Jean-Félix Péko
- African Cancer Registry Network, Oxford, UK.,Registre des Cancers de Brazzaville, Brazzaville, Republic of the Congo
| | - Fisihatsion Tadesse
- African Cancer Registry Network, Oxford, UK.,Division of Hematology, Department of Internal Medicine, University and Black Lion Hospital, Addis Ababa, Ethiopia
| | - Nathan G Buziba
- African Cancer Registry Network, Oxford, UK.,Eldoret Cancer Registry, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Henry Wabinga
- African Cancer Registry Network, Oxford, UK.,Kampala Cancer Registry, Makerere University School of Medicine, Kampala, Uganda
| | - Mary Nyanchama
- African Cancer Registry Network, Oxford, UK.,National Cancer Registry, Kenya Medical Research Institute, Nairobi, Kenya
| | - Margaret Z Borok
- African Cancer Registry Network, Oxford, UK.,Zimbabwe National Cancer Registry, Harare, Zimbabwe
| | - Mamadou Kéita
- African Cancer Registry Network, Oxford, UK.,Service du Laboratoire d'Anatomie et Cytologie Pathologique, CHU du point G, Bamako, Mali
| | - Guy N'da
- African Cancer Registry Network, Oxford, UK.,Registre des Cancers d'Abidjan, Abidjan, Côte d'Ivoire
| | - Cesaltina F Lorenzoni
- African Cancer Registry Network, Oxford, UK.,Departamento de Patologia, Faculdade de Medicina Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Marie-Thérèse Akele-Akpo
- African Cancer Registry Network, Oxford, UK.,Département d'Anatomo-Pathologie, Faculté des Sciences de la Santé, Cotonou, Benin
| | - Cornelia Gottschick
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology and Hematology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | | | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Donald M Parkin
- African Cancer Registry Network, Oxford, UK.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claudia Wickenhauser
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Eva J Kantelhardt
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.,Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| |
Collapse
|
13
|
Romero-Masters JC, Huebner SM, Ohashi M, Bristol JA, Benner BE, Barlow EA, Turk GL, Nelson SE, Baiu DC, Van Sciver N, Ranheim EA, Gumperz J, Sherer NM, Farrell PJ, Johannsen EC, Kenney SC. B cells infected with Type 2 Epstein-Barr virus (EBV) have increased NFATc1/NFATc2 activity and enhanced lytic gene expression in comparison to Type 1 EBV infection. PLoS Pathog 2020; 16:e1008365. [PMID: 32059024 PMCID: PMC7046292 DOI: 10.1371/journal.ppat.1008365] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/27/2020] [Accepted: 01/29/2020] [Indexed: 12/30/2022] Open
Abstract
Humans are infected with two distinct strains (Type 1 (T1) and Type 2 (T2)) of Epstein-Barr virus (EBV) that differ substantially in their EBNA2 and EBNA 3A/B/C latency genes and the ability to transform B cells in vitro. While most T1 EBV strains contain the "prototype" form of the BZLF1 immediate-early promoter ("Zp-P"), all T2 strains contain the "Zp-V3" variant, which contains an NFAT binding motif and is activated much more strongly by B-cell receptor signalling. Whether B cells infected with T2 EBV are more lytic than cells infected with T1 EBV is unknown. Here we show that B cells infected with T2 EBV strains (AG876 and BL5) have much more lytic protein expression compared to B cells infected with T1 EBV strains (M81, Akata, and Mutu) in both a cord blood-humanized (CBH) mouse model and EBV-transformed lymphoblastoid cell lines (LCLs). Although T2 LCLs grow more slowly than T1 LCLs, both EBV types induce B-cell lymphomas in CBH mice. T1 EBV strains (M81 and Akata) containing Zp-V3 are less lytic than T2 EBV strains, suggesting that Zp-V3 is not sufficient to confer a lytic phenotype. Instead, we find that T2 LCLs express much higher levels of activated NFATc1 and NFATc2, and that cyclosporine (an NFAT inhibitor) and knockdown of NFATc2 attenuate constitutive lytic infection in T2 LCLs. Both NFATc1 and NFATc2 induce lytic EBV gene expression when combined with activated CAMKIV (which is activated by calcium signaling and activates MEF2D) in Burkitt Akata cells. Together, these results suggest that B cells infected with T2 EBV are more lytic due to increased activity of the cellular NFATc1/c2 transcription factors in addition to the universal presence of the Zp-V3 form of BZLF1 promoter.
Collapse
Affiliation(s)
- James C. Romero-Masters
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Shane M. Huebner
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Makoto Ohashi
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jillian A. Bristol
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Bayleigh E. Benner
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Elizabeth A. Barlow
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Gail L. Turk
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Scott E. Nelson
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Dana C. Baiu
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Nicholas Van Sciver
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Erik A. Ranheim
- Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jenny Gumperz
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Nathan M. Sherer
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Paul J. Farrell
- Section of Virology, Imperial College Faculty of Medicine, Norfolk Place, London, United Kingdom
| | - Eric C. Johannsen
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Shannon C. Kenney
- Department of Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
| |
Collapse
|
14
|
Montgomery ND, Randall C, Painschab M, Seguin R, Kaimila B, Kasonkanji E, Zuze T, Krysiak R, Sanders MK, Elliott A, Miller MB, Kampani C, Chimzimu F, Mulenga M, Damania B, Tomoka T, Fedoriw Y, Dittmer DP, Gopal S. High pretreatment plasma Epstein-Barr virus (EBV) DNA level is a poor prognostic marker in HIV-associated, EBV-negative diffuse large B-cell lymphoma in Malawi. Cancer Med 2020; 9:552-561. [PMID: 31782984 PMCID: PMC6970037 DOI: 10.1002/cam4.2710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 12/18/2022] Open
Abstract
Plasma Epstein-Barr virus (EBV) DNA measurement has established prognostic utility in EBV-driven lymphomas, where it serves as a circulating tumor DNA marker. The value of plasma EBV measurement may be amplified in sub-Saharan Africa (SSA), where advanced imaging and molecular technologies for risk stratification are not typically available. However, its utility in diffuse large B-cell lymphoma (DLBCL) is less certain, given that only a subset of DLBCLs are EBV-positive. To explore this possibility, we measured plasma EBV DNA at diagnosis in a cohort of patients with DLBCL in Malawi. High plasma EBV DNA at diagnosis (≥3.0 log10 copies/mL) was associated with decreased overall survival (OS) (P = .048). When stratified by HIV status, the prognostic utility of baseline plasma EBV DNA level was restricted to HIV-positive patients. Unexpectedly, most HIV-positive patients with high plasma EBV DNA at diagnosis had EBV-negative lymphomas, as confirmed by multiple methods. Even in these HIV-positive patients with EBV-negative DLBCL, high plasma EBV DNA remained associated with shorter OS (P = .014). These results suggest that EBV reactivation in nontumor cells is a poor prognostic finding even in HIV-positive patients with convincingly EBV-negative DLBCL, extending the potential utility of EBV measurement as a valuable and implementable prognostic marker in SSA.
Collapse
MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/blood
- DNA, Viral/blood
- DNA, Viral/genetics
- Epstein-Barr Virus Infections/blood
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/diagnosis
- Epstein-Barr Virus Infections/virology
- Female
- Follow-Up Studies
- HIV/isolation & purification
- HIV Infections/blood
- HIV Infections/complications
- HIV Infections/diagnosis
- HIV Infections/virology
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Humans
- Lymphoma, AIDS-Related/blood
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/mortality
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/virology
- Malawi/epidemiology
- Male
- Middle Aged
- Prognosis
- Prospective Studies
- Survival Rate
- Young Adult
Collapse
Affiliation(s)
- Nathan D. Montgomery
- Department of Pathology & Laboratory MedicineUniversity of North CarolinaChapel HillNCUSA
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- UNC Project‐MalawiLilongweMalawi
| | - Cara Randall
- Department of Pathology & Laboratory MedicineUniversity of North CarolinaChapel HillNCUSA
- UNC Project‐MalawiLilongweMalawi
| | - Matthew Painschab
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- UNC Project‐MalawiLilongweMalawi
- Department of MedicineDivision of Hematology & OncologyUniversity of North CarolinaChapel HillNCUSA
| | | | | | | | | | | | - Marcia K. Sanders
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
| | | | - Melissa B. Miller
- Department of Pathology & Laboratory MedicineUniversity of North CarolinaChapel HillNCUSA
| | | | | | | | - Blossom Damania
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- Department of Microbiology & ImmunologyUniversity of North CarolinaChapel HillNCUSA
| | | | - Yuri Fedoriw
- Department of Pathology & Laboratory MedicineUniversity of North CarolinaChapel HillNCUSA
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- UNC Project‐MalawiLilongweMalawi
| | - Dirk P. Dittmer
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- Department of Microbiology & ImmunologyUniversity of North CarolinaChapel HillNCUSA
| | - Satish Gopal
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNCUSA
- UNC Project‐MalawiLilongweMalawi
- Department of MedicineDivision of Hematology & OncologyUniversity of North CarolinaChapel HillNCUSA
| |
Collapse
|
15
|
Kamat M, Datar U, Kanitkar S, Byakodi S. Intraoral HIV-associated Burkitt's lymphoma: a rare case report with special emphasis on differential diagnosis. J Korean Assoc Oral Maxillofac Surg 2019; 45:225-229. [PMID: 31508356 PMCID: PMC6728624 DOI: 10.5125/jkaoms.2019.45.4.225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 03/16/2018] [Accepted: 03/22/2018] [Indexed: 12/02/2022] Open
Abstract
Individuals with human immunodeficiency virus (HIV) infection present with unique intraoral manifestations of various neoplasms. Intraoral HIV-associated Burkitt's lymphoma is a rare presentation, especially in patients of Indian origin and may present as an initial sign of HIV. The objective of this paper is to report a rare case of Burkitt's lymphoma in an HIV-positive Indian patient along with a special emphasis on differential diagnosis. A 30-year-old Indian female presented with a solitary, well-defined, exophytic mass extending anteroposteriorly and buccolingually from the 35th to 38th regions with no evidence of intraosseous extension. An incisional biopsy was performed, and histopathology showed sheets of neoplastic lymphoid cells with numerous tingible body macrophages with clear cytoplasm, presenting a starry sky appearance, suggesting a diagnosis of BL. The tumor cells were positive for CD10, CD20, c-myc, and Epstein-Barr virus, with a nearly 100% Ki-67 proliferative index. The patient tested positive for HIV. This report indicates the importance of immunohistochemical analysis to differentiate Burkitt's lymphoma from other similar lesions like diffuse large B-cell lymphoma. Thorough knowledge of the clinical presentation, etiopathogenesis, histopathology, and immunoprofile of intraoral HIV-associated Burkitt's lymphoma is essential among clinicians and pathologists.
Collapse
Affiliation(s)
- Mamata Kamat
- Department of Oral Pathology & Microbiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
| | - Uma Datar
- Department of Oral Pathology & Microbiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
| | | | - Sanjay Byakodi
- Department of Oral & Maxillofacial Surgery, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, India
| |
Collapse
|
16
|
Shepherd L, Ryom L, Law M, Hatleberg CI, de Wit S, Monforte AD, Battegay M, Phillips A, Bonnet F, Reiss P, Pradier C, Grulich A, Sabin C, Lundgren J, Mocroft A. Differences in Virological and Immunological Risk Factors for Non-Hodgkin and Hodgkin Lymphoma. J Natl Cancer Inst 2019; 110:598-607. [PMID: 29267895 DOI: 10.1093/jnci/djx249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/27/2017] [Indexed: 12/18/2022] Open
Abstract
Background Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) are increased in populations with immune dysfunction, including people living with HIV; however, there is little evidence for to what degree immunological and virological factors differently affect NHL and HL risk. Methods Data from the Data Collection on Adverse events of Anti-HIV Drugs Study cohort were analyzed to identify independent risk factors for NHL and HL using hazard ratios (HRs), focusing on current and cumulative area under the curve (AUC) measures of immunological and virological status. Variables with different associations with NHL and HL were identified using marginal Cox models. All statistical tests were two-sided. Results Among 41 420 people followed for 337 020 person-years, 392 developed NHL (incidence rate = 1.17/1000 person-years of follow-up [PYFU], 95% confidence interval [CI] = 1.06 to 1.30) and 149 developed HL (incidence rate = 0.44/1000 PYFU, 95% CI = 0.38 to 0.52). Higher risk of both NHL and HL was associated with lower current CD4 cell count (adjusted HR [aHR] of NHL for CD4 <100 vs > 599 cells/mm3 = 8.08, 95% CI = 5.63 to 11.61; HL = 4.58, 95% CI = 2.22 to 9.45), whereas higher current HIV viral load (aHR of NHL for HIV-VL >1000 vs < 50 copies/mL = 1.97, 95% CI = 1.50 to 2.59) and higher AUC of HIV-VL (aHR of NHL for highest vs lowest quintile = 2.91, 95% CI = 1.92 to 4.41) were associated with NHL only. Both current and AUC of HIV-VL were factors that had different associations with NHL and HL, where the hazard ratio for NHL was progressively higher than for HL with increasing HIV-VL category. Lower current CD4 cell count had a strong but similar association with both NHL and HL. Conclusions CD4 depletion increased risk of both types of lymphomas while current and accumulated HIV-VL was associated with NHL only. This suggests that NHL development is related to both CD4 cell depletion and added immune dysfunction derived from ongoing HIV replication. This latter factor was not associated with HL risk.
Collapse
Affiliation(s)
- Leah Shepherd
- Research Department of Infection and Population Health, UCL, London, UK
| | - Lene Ryom
- CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Matthew Law
- The Kirby Institute, UNSW Australia, Sydney, Australia
| | - Camilla Ingrid Hatleberg
- CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stephane de Wit
- Division of Infectious Diseases, Saint Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Antonella d'Arminio Monforte
- Dipartimento di Scienze della Salute, Clinica di Malattie Infectitive e Tropicali, Azienda Ospedaliera-Polo Universitario San Paolo, Milan, Italy
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrew Phillips
- Research Department of Infection and Population Health, UCL, London, UK
| | - Fabrice Bonnet
- CHU de Bordeaux and INSERM U1219, Université de Bordeaux, Bordeaux, France
| | - Peter Reiss
- Academic Medical Center, Division of Infectious Diseases, Department of Global Health, University of Amsterdam, and HIV Monitoring Foundation, Amsterdam, the Netherlands
| | | | | | - Caroline Sabin
- Research Department of Infection and Population Health, UCL, London, UK
| | - Jens Lundgren
- CHIP, Department of Infectious Diseases, Section 2100, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Amanda Mocroft
- Research Department of Infection and Population Health, UCL, London, UK
| |
Collapse
|
17
|
Zhu W, Mao Y, Tang H, McGoogan JM, Zhang ZF, Detels R, He N, Wu Z. Spectrum of malignancies among the population of adults living with HIV infection in China: A nationwide follow-up study, 2008-2011. PLoS One 2019; 14:e0219766. [PMID: 31344059 PMCID: PMC6657846 DOI: 10.1371/journal.pone.0219766] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/01/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV). METHODS We conducted a nationwide follow-up study using routinely collected data for adult PLHIV diagnosed on or before 31 December 2011 and alive and in care as of 1 January 2008. Participants were observed from 1 January 2008 (study start) to 30 June 2012 (study end). Main outcome measures were gender-stratified age-standardized incidence rates for China (ASIRC) and standardized incidence ratios (SIR) for all malignancy types/sites observed. RESULTS Among 399,451 subjects, a majority was aged 30-44 years (49.3%), male (69.8%), and Han Chinese (67.9%). A total of 3,819 reports of cancer were identified. Overall, ASIRC was 776.4 per 100,000 for males and 486.5 per 100,000 for females. Malignancy sites/types with highest ASIRC among males were lung (226.0 per 100,000), liver (145.7 per 100,000), and lymphoma (63.1 per 100,000), and among females were lung (66.8 per 100,000), lymphoma (48.0 per 100,000), stomach (47.8 per 100,000), and cervix (47.6 per 100,000). Overall SIR for males was 3.4 and for females was 2.6. Highest SIR was observed for Kaposi sarcoma (2,639.8 for males, 1,593.5 for females) and lymphoma (13.9 for males, 16.0 for females). CONCLUSIONS These results provide evidence of substantial AIDS-defining and non-AIDS-defining cancer burden among adult Chinese PLHIV between 2008 and 2011. Although further study is warranted, China should take action to improve cancer screening, diagnosis, and treatment for this vulnerable population.
Collapse
Affiliation(s)
- Weiming Zhu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, United States of America
| | - Yurong Mao
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jennifer M. McGoogan
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, United States of America
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, United States of America
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, Fielding School of Public Health, University of California–Los Angeles, Los Angeles, California, United States of America
| |
Collapse
|
18
|
da Silva Nascimento J, Sérgio Ramos de Araújo P, Romão de Souza Júnior V, Lopes de Melo F, Sá Araújo Lins Carvalho D, Magalhães V. HIV-related lymphomas in adults served in the public health network: An observational study. Medicine (Baltimore) 2019; 98:e16129. [PMID: 31261533 PMCID: PMC6617433 DOI: 10.1097/md.0000000000016129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 04/25/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022] Open
Abstract
Individuals infected with human immunodeficiency virus (HIV) have higher morbidity and mortality due to cancer, which is the third most common cause of death in this group, despite the high effectiveness of antiretroviral therapy (ART). We describe the clinical and laboratory characteristics, initial staging and outcome of HIV-related lymphoma.We included 18 patients in the study, of whom 61.1% were male, mean age 41 years. Nine of the 18 patients (50%) had a diagnosis of HIV infection concurrent with the diagnosis of lymphoma.The most common histological types were diffuse non-Hodgkin B-cell lymphoma, 8 patients (44.4%); and Burkitt lymphoma, 5 (27.8%) cases. The Cotswold revision of the Ann Arbor staging classification in 14 patients (77.7%) was between III and IV. B Symptoms were present in 11 patients (61.1%), bulky mass was observed in 11 cases (61.1%) and had extra-nodal involvement in 8 patients (44.4%).Of the 18 cases analyzed, 8 followed on to second-line treatment, wherein the CODOX-M/IVAC scheme (cyclophosphamide, adriamycin, vincristine, methotrexate/ifosfamide, etoposide, and cytosine arabinoside) was used in 3 of the cases. The second most common scheme was etoposide, doxorubicin, vincristine and cyclophosphamide (EPOCH), used in 2 cases (25%), while in single cases (12.5% each) cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP), ifosfamide, etoposide, and carboplatin (ICE) and dexamethasone, cisplatin, and cytarabine (DHAP) were used.In this series, we observed very high mortality, equivalent to 44.4%, and a complete response in only 11.1%, much lower than that observed by other authors.We found that patients diagnosed with lymphoma associated with HIV had an advanced early clinical staging, and evolved with low response rates to chemotherapy.
Collapse
Affiliation(s)
- Janaíra da Silva Nascimento
- Service of Onco-Hematology of Pernambuco Cancer
- Foundation of Hematology and Hematology of Pernambuco
- Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Fábio Lopes de Melo
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation
- Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Vera Magalhães
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation
- Universidade Federal de Pernambuco, Recife, Brazil
| |
Collapse
|
19
|
Halec G, Waterboer T, Brenner N, Butt J, Hardy DW, D’Souza G, Wolinsky S, Macatangay BJ, Pawlita M, Detels R, Martínez-Maza O, Hussain SK. Serological Assessment of 18 Pathogens and Risk of AIDS-Associated Non-Hodgkin Lymphoma. J Acquir Immune Defic Syndr 2019; 80:e53-e63. [PMID: 30531297 PMCID: PMC6375787 DOI: 10.1097/qai.0000000000001916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND HIV infection is associated with increased susceptibility to common pathogens, which may trigger chronic antigenic stimulation and hyperactivation of B cells, events known to precede the development of AIDS-associated non-Hodgkin lymphoma (AIDS-NHL). METHODS To explore whether cumulative exposure to infectious agents contributes to AIDS-NHL risk, we tested sera from 199 AIDS-NHL patients (pre-NHL, average lead time 3.9 years) and 199 matched HIV-infected controls from the Multicenter AIDS Cohort Study, for anti-IgG responses to 18 pathogens using multiplex serology. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression models. RESULTS We found no association between cumulative exposure to infectious agents and AIDS-NHL risk (OR 1.01, 95% CI: 0.91 to 1.12). However, seropositivity for trichodysplasia spinulosa polyomavirus (TSPyV), defined as presence of antibodies to TSPyV capsid protein VP1, was significantly associated with a 1.6-fold increase in AIDS-NHL risk (OR 1.62, 95% CI: 1.02 to 2.57). High Epstein-Barr virus (EBV) anti-VCA p18 antibody levels closer to the time of AIDS-NHL diagnosis (<4 years) were associated with a 2.6-fold increase in AIDS-NHL risk (OR 2.59, 95% CI: 1.17 to 5.74). In addition, high EBV anti-EBNA-1 and anti-ZEBRA antibody levels were associated with 2.1-fold (OR 0.47, 95% CI: 0.26 to 0.85) and 1.6-fold (OR 0.57, 95% CI: 0.35 to 0.93) decreased risk of AIDS-NHL, respectively. CONCLUSIONS Our results do not support the hypothesis that cumulative exposure to infectious agents contributes to AIDS-NHL development. However, the observed associations with respect to TSPyV seropositivity and EBV antigen antibody levels offer additional insights into the pathogenesis of AIDS-NHL.
Collapse
Affiliation(s)
- Gordana Halec
- University of California Los Angeles (UCLA) AIDS Institute and Department of Obstetrics and Gynecology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicole Brenner
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julia Butt
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David W. Hardy
- Clinical Investigations, Whitman-Walker Health, Washington, DC
| | - Gypsyamber D’Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Steven Wolinsky
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bernard J. Macatangay
- Division of Infectious Diseases, Department of Medicine, University of Pittsburg School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Roger Detels
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Otoniel Martínez-Maza
- University of California Los Angeles (UCLA) AIDS Institute and Department of Obstetrics and Gynecology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Shehnaz K. Hussain
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Samuel Oschin Comprehensive Cancer Institute and Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| |
Collapse
|
20
|
Abstract
Epstein–Barr virus (EBV) contributes to about 1.5% of all cases of human cancer worldwide, and viral genes are expressed in the malignant cells. EBV also very efficiently causes the proliferation of infected human B lymphocytes. The functions of the viral proteins and small RNAs that may contribute to EBV-associated cancers are becoming increasingly clear, and a broader understanding of the sequence variation of the virus genome has helped to interpret their roles. The improved understanding of the mechanisms of these cancers means that there are great opportunities for the early diagnosis of treatable stages of EBV-associated cancers and the use of immunotherapy to target EBV-infected cells or overcome immune evasion. There is also scope for preventing disease by immunization and for developing therapeutic agents that target the EBV gene products expressed in the cancers.
Collapse
Affiliation(s)
- Paul J. Farrell
- Section of Virology, Imperial College Faculty of Medicine, London W2 1PG, United Kingdom
| |
Collapse
|
21
|
Wang Q, Rodriguez R, Marcus JZ, Podolsky L, Campbell D, Heller D. Pitfalls of Frozen Section in Gynecological Pathology: A Rare Case of Ovarian Lymphoma in an HIV-Positive Woman Resembling Dysgerminoma on Frozen Section. Int J Surg Pathol 2018; 27:387-389. [PMID: 30474462 DOI: 10.1177/1066896918813658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary lymphoma of the ovary, particularly in an HIV-positive woman, is exceptionally rare, and ovarian lymphoma may not be considered at the time of intraoperative consultation. In this article, we present a case in an HIV-positive woman thought to be a dysgerminoma at the time of frozen section, but which was found to be a diffuse large B-cell lymphoma of the ovary.
Collapse
Affiliation(s)
- Qing Wang
- 1 Rutgers-New Jersey Medical School, Newark, NJ, USA
| | | | | | - Lisa Podolsky
- 1 Rutgers-New Jersey Medical School, Newark, NJ, USA
| | | | - Debra Heller
- 1 Rutgers-New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
22
|
Mancuso S, Carlisi M, Santoro M, Napolitano M, Raso S, Siragusa S. Immunosenescence and lymphomagenesis. IMMUNITY & AGEING 2018; 15:22. [PMID: 30258468 PMCID: PMC6151062 DOI: 10.1186/s12979-018-0130-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022]
Abstract
One of the most important determinants of aging-related changes is a complex biological process emerged recently and called “immunosenescence”. Immunosenescence refers to the inability of an aging immune system to produce an appropriate and effective response to challenge. This immune dysregulation may manifest as increased susceptibility to infection, cancer, autoimmune disease, and vaccine failure. At present, the relationship between immunosenescence and lymphoma in elderly patients is not defined in a satisfactory way. This review presents a brief overview of the interplay between aging, cancer and lymphoma, and the key topic of immunosenescence is addressed in the context of two main lymphoma groups, namely Non Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL). Epstein Barr Virus (EBV) plays a central role in the onset of neoplastic lymphoproliferation associated with immunological changes in aging, although the pathophysiology varies vastly among different disease entities. The interaction between immune dysfunction, immunosenescence and Epstein Barr Virus (EBV) infection appears to differ between NHL and HL, as well as between NHL subtypes.
Collapse
Affiliation(s)
- Salvatrice Mancuso
- 1Haematology, Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Melania Carlisi
- 2Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Marco Santoro
- 2Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Mariasanta Napolitano
- 1Haematology, Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Simona Raso
- 2Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Sergio Siragusa
- 1Haematology, Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| |
Collapse
|
23
|
Milligan MG, Bigger E, Abramson JS, Sohani AR, Zola M, Kayembe MK, Medhin H, Suneja G, Lockman S, Chabner BA, Dryden-Peterson SL. Impact of HIV Infection on the Clinical Presentation and Survival of Non-Hodgkin Lymphoma: A Prospective Observational Study From Botswana. J Glob Oncol 2018; 4:1-11. [PMID: 30241264 PMCID: PMC6223476 DOI: 10.1200/jgo.17.00084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Botswana has a high prevalence of HIV infection. Currently, there are few data regarding the sociodemographic factors, clinical characteristics, and outcomes of non-Hodgkin lymphoma (NHL)-an AIDS-defining cancer-in the country. PATIENTS AND METHODS This study used a prospective cancer registry to identify patients with a new diagnosis of NHL reporting for specialty cancer care at three hospitals in Botswana between October 2010 and August 2016. Treatment patterns and clinical outcomes were analyzed. RESULTS One hundred four patients with a new diagnosis of NHL were enrolled in this study, 72% of whom had HIV infection. Compared with patients not infected with HIV, patients infected with HIV were younger (median age, 53.9 v 39.1 years; P = .001) and more likely to present with an aggressive subtype of NHL (65.5% v 84.0%; P = .008). All patients infected with HIV received combined antiretroviral therapy throughout the course of the study, and similar chemotherapeutic regimens were recommended for all patients, regardless of subtype or HIV status (six to eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone; or cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab). There was no difference in 1-year mortality among patients not infected with HIV and patients infected with HIV (unadjusted analysis, 52.9% v 37.1%; hazard ratio [HR], 0.73; P = .33; adjusted analysis, HR, 0.57; P = .14). However, when compared with a cohort of patients in the United States matched by subtype, stage, age, sex, and race, patients in Botswana fared worse (1-year mortality, 22.8% v 46.3%; HR, 1.89; P = .001). CONCLUSION Among patients with NHL reporting for specialty cancer care in Botswana, there is no association between HIV status and 1-year survival.
Collapse
Affiliation(s)
- Michael G. Milligan
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Elizabeth Bigger
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Jeremy S. Abramson
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Aliyah R. Sohani
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Musimar Zola
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Mukendi K.A. Kayembe
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Heluf Medhin
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Gita Suneja
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Shahin Lockman
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Bruce A. Chabner
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| | - Scott L. Dryden-Peterson
- Michael G. Milligan, Jeremy S. Abramson,
Aliyah R. Sohani, Shahin Lockman, Bruce A.
Chabner, and Scott L. Dryden-Peterson, Harvard Medical
School; Elizabeth Bigger, Jeremy S. Abramson, and
Aliyah R. Sohani, Massachusetts General Hospital; Shahin
Lockman and Scott L. Dryden-Peterson, Brigham and
Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston,
MA; Michael G. Milligan, Elizabeth Bigger,
Shahin Lockman, Bruce A. Chabner, and Scott
L. Dryden-Peterson, Botswana Harvard AIDS Institute Partnership;
Musimar Zola, Princess Marina Hospital; Mukendi K.A. Kayembe and
Heluf Medhin, Botswana Ministry of Health, Gaborone, Botswana;
and Gita Suneja, Duke University, Durham, NC
| |
Collapse
|
24
|
Möller J, Steyn T, Combrinck N, Joubert G, Sherriff A, van Rensburg JJ. Inter-observer variability influences the Lugano classification when restaging lymphoma. SA J Radiol 2018; 22:1357. [PMID: 31754505 PMCID: PMC6837819 DOI: 10.4102/sajr.v22i1.1357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/20/2018] [Indexed: 11/28/2022] Open
Abstract
Background Lymphoma is an important and potentially curable oncological disease in South Africa. The staging and restaging of lymphoma have evolved over the years, with the latest international consensus guideline being the Lugano classification (LC). Prior to routine implementation of the LC, its robustness in the local setting should be determined. Objectives To determine the Inter-observer variability in response assignment when applying the LC in patients with lymphoma who were staged and restaged with computed tomography. In case of excessive discordance, specific mitigating measures will have to be taken before and during any proposed implementation of the LC. Method A total of 61 computed tomography scans in 21 patients were evaluated independently by four reviewers according to the LC, of which 21 scans were done at baseline, 21 at initial restaging and 19 at follow-up restaging. A retrospective comparative analysis was performed. Kappa values were calculated to determine agreement between observers. Results Only a moderate inter-observer agreement of 52% in the overall response classification was demonstrated. The most important sources of discrepancy were inconsistency in the assessment of target lesion regression to normal, determining the percentage change in the summed cross-sectional area of the target lesions and ascribing new lesions as either due to lymphoma or other causes. Conclusion Implementing the Lugano classification when restaging lymphoma is desirable to improve consistency and to conform to international guidelines. However, our study shows substantial inter-observer variability in response classification, potentially altering the treatment plan. Dedicated training and continuous quality control should, therefore, accompany the process.
Collapse
Affiliation(s)
- Jacobus Möller
- Department of Clinical Imaging Sciences, Universitas Academic Hospital and University of the Free State, South Africa
| | - Tiaan Steyn
- Department of Clinical Imaging Sciences, Universitas Academic Hospital and University of the Free State, South Africa
| | - Nantes Combrinck
- Department of Clinical Imaging Sciences, Universitas Academic Hospital and University of the Free State, South Africa
| | - Gina Joubert
- Department of Biostatistics, University of the Free State, South Africa
| | - Alicia Sherriff
- Department of Oncology, Universitas Academic Hospital and University of the Free State, South Africa
| | | |
Collapse
|
25
|
Shannon-Lowe C, Rickinson AB, Bell AI. Epstein-Barr virus-associated lymphomas. Philos Trans R Soc Lond B Biol Sci 2017; 372:20160271. [PMID: 28893938 PMCID: PMC5597738 DOI: 10.1098/rstb.2016.0271] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 02/06/2023] Open
Abstract
Epstein-Barr virus (EBV), originally discovered through its association with Burkitt lymphoma, is now aetiologically linked to a remarkably wide range of lymphoproliferative lesions and malignant lymphomas of B-, T- and NK-cell origin. Some occur as rare accidents of virus persistence in the B lymphoid system, while others arise as a result of viral entry into unnatural target cells. The early finding that EBV is a potent B-cell growth transforming agent hinted at a simple oncogenic mechanism by which this virus could promote lymphomagenesis. In reality, the pathogenesis of EBV-associated lymphomas involves a complex interplay between different patterns of viral gene expression and cellular genetic changes. Here we review recent developments in our understanding of EBV-associated lymphomagenesis in both the immunocompetent and immunocompromised host.This article is part of the themed issue 'Human oncogenic viruses'.
Collapse
Affiliation(s)
- Claire Shannon-Lowe
- Institute of Immunology and Immunotherapy, The Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Alan B Rickinson
- Institute of Immunology and Immunotherapy, The Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Andrew I Bell
- Institute for Cancer and Genomic Sciences, The Medical School, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| |
Collapse
|
26
|
Moghimi M, Kashkooli Behroozi M, Maghbooli M, Jafari S, Mazloomzadeh S, Pezeshgi A. Association between abnormal serum free light chains ratio and known prognostic factors in lymphoma; a nephrology viewpoint. J Renal Inj Prev 2017; 6:148-152. [PMID: 28497093 PMCID: PMC5423284 DOI: 10.15171/jrip.2017.29] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 12/04/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction: The serum immunoglobulin free light chain (FLC) assay quantities of free kappa (κ) and lambda (λ) light chains. This assay has prognostic value in plasma cell proliferative disorders. There are limited data on serum FLC in B-cell malignancies.
Objectives: The aim of this study was to compare the known prognostic factors in non-Hodgkin’s lymphoma of the type B-cell and Hodgkin disease with an abnormal secretion amount of light chains in these lymphomas.
Patients and Methods: The association of pretreatment FLC and FLC ratio (κ:λ) with previously known prognostic factors for lymphoma such as the international prognostic index (IPI) and B symptoms were evaluated in 50 patients with Hodgkin’s and non-Hodgkin’s lymphoma. IPI is a prognostic score given based on the clinical variables including age, disease stage, serum LDH and extra-nodal involvement. Elevated FLC and an abnormal κ:λ ratio was defined based on the previous publications.
Results: The prevalence of abnormal FLC ratio was 38% in all patients and 40.9% in patients with diffuse large B-cell lymphoma. Abnormal FLC ratio was significantly associated with IPI (P=0.04) and B symptoms (P=0.02) in both groups of the patients with Hodgkin’s and non-Hodgkin’s lymphoma. The stage of the disease in Hodgkin’s lymphoma patients showed a significant relationship with the abnormal FLC ratio (P=0.04). Presence of the B symptoms in patients with Hodgkin’s lymphoma had a modest but not statistically significant association with the abnormal FLC ratio (P=0.07).
Conclusion: Abnormal FLC ratio as a new potent prognostic biomarker has a significant association with IPI which is the most common clinical tool used to predict outcome in lymphoma patients. Since there is a need for developing a reliable and quantitative prognostic biomarker for lymphoma, evaluation of the independent effect of the abnormal serum FLC ratio is suggested to be considered in future prospective studies. The result of these studies will also be useful for nephrologists, while serum immunoglobulin FLC is capable to damage kidney.
Collapse
Affiliation(s)
- Minoosh Moghimi
- Department of Hematology-Oncology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Mehdi Maghbooli
- Department of Neurology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Sattar Jafari
- Department of Hematology-Oncology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Aiyoub Pezeshgi
- Department of Hematology-Oncology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| |
Collapse
|
27
|
Linke-Serinsöz E, Fend F, Quintanilla-Martinez L. Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) related lymphomas, pathology view point. Semin Diagn Pathol 2017; 34:352-363. [PMID: 28506687 DOI: 10.1053/j.semdp.2017.04.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The contribution of Epstein Barr virus (EBV) and Kaposi sarcoma herpes virus (KSHV) to the development of specific types of malignant lymphomas occurring in the human immunodeficiency virus (HIV) setting has been extensively studied since the beginning of the HIV epidemic 35 years ago. The introduction of highly active antiretroviral therapies (HAART) in 1996 has changed dramatically the incidence of HIV-related malignancies. Nevertheless, malignant lymphomas continue to be the major group of malignances observed in HIV infected individuals, and the most common cause of cancer related-deaths. Common features of the predominant B-cell lymphomas in the HIV+ setting are the frequent plasmacytoid morphology of the neoplastic cells, advanced stage, aggressive disease and frequent extranodal involvement. In this article, we review the evolving concepts and definitions of the various EBV-associated lymphomas in HIV+ patients, including diffuse large B-cell lymphoma, Burkitt lymphoma, classical Hodgkin lymphoma, plasmablastic lymphoma and primary effusion lymphoma. The current knowledge regarding the pathogenesis of these malignancies, the interplay between HIV and EBV co-infection in the development of certain HIV related lymphomas, and the emerging paradigm that suggests that HIV may play a direct role in lymphomagenesis are explored as well.
Collapse
Affiliation(s)
- Ebru Linke-Serinsöz
- Institute of Pathology, University Hospital Tübingen, Eberhard-Karls-University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany
| | - Falko Fend
- Institute of Pathology, University Hospital Tübingen, Eberhard-Karls-University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany
| | - Leticia Quintanilla-Martinez
- Institute of Pathology, University Hospital Tübingen, Eberhard-Karls-University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany.
| |
Collapse
|
28
|
Lamers SL, Fogel GB, Liu ES, Nolan DJ, Salemi M, Barbier AE, Rose R, Singer EJ, McGrath MS. Predicted coreceptor usage at end-stage HIV disease in tissues derived from subjects on antiretroviral therapy with an undetectable plasma viral load. INFECTION GENETICS AND EVOLUTION 2017; 51:194-197. [PMID: 28392467 DOI: 10.1016/j.meegid.2017.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 01/05/2023]
Abstract
HIV cure research is increasingly focused on anatomical tissues as sites for residual HIV replication during combined antiretroviral therapy (cART). Tissue-based HIV could contribute to low-level immune activation and viral rebound over the course of infection and could also influence the development of diseases, such as atherosclerosis, neurological disorders and cancers. cART-treated subjects have a decreased and irregular presence of HIV among tissues, which has resulted in a paucity of actual evidence concerning how or if HIV persists, replicates and evolves in various anatomical sites during therapy. In this study, we pooled 1806 HIV envelope V3 loop sequences from twenty-six tissue types (seventy-one total tissues) of six pre-cART subjects, four subjects with an unknown cART history who died with profound AIDS, and five subjects who died while on cART with an undetectable plasma viral load. A computational approach was used to assess sequences for their ability to utilize specific cellular coreceptors (R5, R5 and X4, or X4). We found that autopsied tissues obtained from virally suppressed cART+ subjects harbored both integrated and expressed viruses with similar coreceptor usage profiles to subjects with no or ineffective cART therapy (i.e., significant plasma viral load at death). The study suggests that tissue microenvironments provide a sanctuary for the continued evolution of HIV despite cART.
Collapse
Affiliation(s)
- S L Lamers
- Bioinfoexperts, LLC, Thibodaux, LA, USA.
| | - G B Fogel
- Natural Selection, Inc., San Diego, CA, USA
| | - E S Liu
- Natural Selection, Inc., San Diego, CA, USA
| | - D J Nolan
- Bioinfoexperts, LLC, Thibodaux, LA, USA; The University of Florida Emerging Pathogens Institute and the Department of Pathology and Laboratory Medicine, Gainesville, FL, USA
| | - M Salemi
- The University of Florida Emerging Pathogens Institute and the Department of Pathology and Laboratory Medicine, Gainesville, FL, USA
| | | | - R Rose
- Bioinfoexperts, LLC, Thibodaux, LA, USA
| | - E J Singer
- The National Neurological AIDS Bank, University of California, Los Angeles, CA, USA; David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Pathology and Laboratory Medicine, Los Angeles, USA
| | - M S McGrath
- The AIDS and Cancer Specimen Resource, San Francisco, CA, USA; The University of California Department of Medicine, San Francisco, CA, USA
| |
Collapse
|
29
|
Expression of HIV-1 matrix protein p17 and association with B-cell lymphoma in HIV-1 transgenic mice. Proc Natl Acad Sci U S A 2016; 113:13168-13173. [PMID: 27799525 DOI: 10.1073/pnas.1615258113] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
HIV-1 infection is associated with increased risk for B-cell lymphomas. How HIV infection promotes the development of lymphoma is unclear, but it may involve chronic B-cell activation, inflammation, and/or impaired immunity, possibly leading to a loss of control of oncogenic viruses and reduced tumor immunosurveillance. We hypothesized that HIV structural proteins may contribute to lymphomagenesis directly, because they can persist long term in lymph nodes in the absence of viral replication. The HIV-1 transgenic mouse Tg26 carries a noninfectious HIV-1 provirus lacking part of the gag-pol region, thus constituting a model for studying the effects of viral products in pathogenesis. Approximately 15% of Tg26 mice spontaneously develop leukemia/lymphoma. We investigated which viral proteins are associated with the development of leukemia/lymphoma in the Tg26 mouse model, and performed microarray analysis on RNA from spleen and lymph nodes to identify potential mechanisms of lymphomagenesis. Of the viral proteins examined, only expression of HIV-1 matrix protein p17 was associated with leukemia/lymphoma development and was highly expressed in bone marrow before disease. The tumor cells resembled pro-B cells, and were CD19+IgM-IgD-CD93+CD43+CD21-CD23-VpreB+CXCR4+ Consistent with the pro-B-cell stage of B-cell development, microarray analysis revealed enrichment of transcripts, including Rag1, Rag2, CD93, Vpreb1, Vpreb3, and Igll1 We confirmed RAG1 expression in Tg26 tumors, and hypothesized that HIV-1 matrix protein p17 may directly induce RAG1 in B cells. Stimulation of human activated B cells with p17 enhanced RAG1 expression in three of seven donors, suggesting that intracellular signaling by p17 may lead to genomic instability and transformation.
Collapse
|
30
|
Lamers SL, Rose R, Maidji E, Agsalda-Garcia M, Nolan DJ, Fogel GB, Salemi M, Garcia DL, Bracci P, Yong W, Commins D, Said J, Khanlou N, Hinkin CH, Sueiras MV, Mathisen G, Donovan S, Shiramizu B, Stoddart CA, McGrath MS, Singer EJ. HIV DNA Is Frequently Present within Pathologic Tissues Evaluated at Autopsy from Combined Antiretroviral Therapy-Treated Patients with Undetectable Viral Loads. J Virol 2016; 90:8968-83. [PMID: 27466426 PMCID: PMC5044815 DOI: 10.1128/jvi.00674-16] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/20/2016] [Indexed: 01/05/2023] Open
Abstract
UNLABELLED HIV infection treatment strategies have historically defined effectiveness through measuring patient plasma HIV RNA. While combined antiretroviral therapy (cART) can reduce plasma viral load (pVL) to undetectable levels, the degree that HIV is eliminated from other anatomical sites remains unclear. We investigated the HIV DNA levels in 229 varied autopsy tissues from 20 HIV-positive (HIV(+)) cART-treated study participants with low or undetectable plasma VL and cerebrospinal fluid (CSF) VL prior to death who were enrolled in the National Neurological AIDS Bank (NNAB) longitudinal study and autopsy cohort. Extensive medical histories were obtained for each participant. Autopsy specimens, including at least six brain and nonbrain tissues per participant, were reviewed by study pathologists. HIV DNA, measured in tissues by quantitative and droplet digital PCR, was identified in 48/87 brain tissues and 82/142 nonbrain tissues at levels >200 HIV copies/million cell equivalents. No participant was found to be completely free of tissue HIV. Parallel sequencing studies from some tissues recovered intact HIV DNA and RNA. Abnormal histological findings were identified in all participants, especially in brain, spleen, lung, lymph node, liver, aorta, and kidney. All brain tissues demonstrated some degree of pathology. Ninety-five percent of participants had some degree of atherosclerosis, and 75% of participants died with cancer. This study assists in characterizing the anatomical locations of HIV, in particular, macrophage-rich tissues, such as the central nervous system (CNS) and testis. Additional studies are needed to determine if the HIV recovered from tissues promotes the pathogenesis of inflammatory diseases, such as HIV-associated neurocognitive disorders, cancer, and atherosclerosis. IMPORTANCE It is well-known that combined antiretroviral therapy (cART) can reduce plasma HIV to undetectable levels; however, cART cannot completely clear HIV infection. An ongoing question is, "Where is HIV hiding?" A well-studied HIV reservoir is "resting" T cells, which can be isolated from blood products and succumb to cART once activated. Less-studied reservoirs are anatomical tissue samples, which have unknown cART penetration, contain a comparably diverse spectrum of potentially HIV-infected immune cells, and are important since <2% of body lymphocytes actually reside in blood. We examined 229 varied autopsy specimens from 20 HIV(+) participants who died while on cART and identified that >50% of tissues were HIV infected. Additionally, we identified considerable pathology in participants' tissues, especially in brain, spleen, lung, lymph node, liver, aorta, and kidney. This study substantiates that tissue-associated HIV is present despite cART and can inform future studies into HIV persistence.
Collapse
Affiliation(s)
| | | | - Ekaterina Maidji
- Division of Experimental Medicine, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California, USA
| | - Melissa Agsalda-Garcia
- The University of Hawaii, Department of Tropical Medicine, Medical Microbiology & Pharmacology and Hawaii Center for AIDS, Honolulu, Hawaii, USA
| | - David J Nolan
- Bioinfoexperts, LLC, Thibodaux, Louisiana, USA The University of Florida Emerging Pathogens Institute, Department of Pathology and Laboratory Medicine, Gainesville, Florida, USA
| | - Gary B Fogel
- Natural Selection, Inc., San Diego, California, USA
| | - Marco Salemi
- The University of Florida Emerging Pathogens Institute, Department of Pathology and Laboratory Medicine, Gainesville, Florida, USA
| | - Debra L Garcia
- The AIDS and Cancer Specimen Resource, San Francisco, California, USA University of California, San Francisco, Department of Medicine, San Francisco, California, USA
| | - Paige Bracci
- The AIDS and Cancer Specimen Resource, San Francisco, California, USA University of California, San Francisco, Department of Medicine, San Francisco, California, USA
| | - William Yong
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Pathology and Laboratory Medicine, Los Angeles, California, USA
| | - Deborah Commins
- University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Jonathan Said
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Pathology and Laboratory Medicine, Los Angeles, California, USA
| | - Negar Khanlou
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Pathology and Laboratory Medicine, Los Angeles, California, USA
| | - Charles H Hinkin
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA UCLA School of Medicine, Department of Psychiatry & Biobehavioral Sciences, Los Angeles, California, USA
| | - Miguel Valdes Sueiras
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Neurology, Los Angeles, California, USA
| | - Glenn Mathisen
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Suzanne Donovan
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Bruce Shiramizu
- The University of Hawaii, Department of Tropical Medicine, Medical Microbiology & Pharmacology and Hawaii Center for AIDS, Honolulu, Hawaii, USA
| | - Cheryl A Stoddart
- Division of Experimental Medicine, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California, USA
| | - Michael S McGrath
- The AIDS and Cancer Specimen Resource, San Francisco, California, USA University of California, San Francisco, Department of Medicine, San Francisco, California, USA
| | - Elyse J Singer
- National Neurological AIDS Bank, Department of Neurology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA David Geffen School of Medicine and Olive View-UCLA Medical Center, Department of Neurology, Los Angeles, California, USA
| |
Collapse
|
31
|
Geng L, Wang X. Epstein-Barr Virus-associated lymphoproliferative disorders: experimental and clinical developments. Int J Clin Exp Med 2015; 8:14656-14671. [PMID: 26628948 PMCID: PMC4658837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 09/05/2015] [Indexed: 06/05/2023]
Abstract
Epstein-Barr Virus (EBV), the first human virus related to oncogenesis, was initially identified in a Burkitt lymphoma cell line in 1964. EBV infects over 90% of the world's population. Most infected people maintain an asymptomatic but persistent EBV infection lifelong. However, in some individuals, EBV infection has been involved in the development of cancer and autoimmune disease. Nowadays, oncogenic potential of EBV has been intensively studied in a wide range of human neoplasms, including Hodgkin's lymphoma (HL), non-Hodgkin's lymphoma (NHL), nasopharyngeal carcinoma (NPC), gastric carcinoma (GC), etc. EBV encodes a series of viral protein and miRNAs, promoting its persistent infection and the transformation of EBV-infected cells. Although the exact role of EBV in the oncogenesis remains to be clarified, novel diagnostic and targeted therapeutic approaches are encouraging for the management of EBV-related malignancies. This review mainly focuses on the experimental and clinical advances of EBV-associated lymphoproliferative disorders.
Collapse
Affiliation(s)
- Lingyun Geng
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan 250021, Shandong, P. R. China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan 250021, Shandong, P. R. China
- Department of Diagnostics, Shandong University School of MedicineJinan 250012, Shandong, P. R. China
| |
Collapse
|
32
|
Boons E, Vanstreels E, Jacquemyn M, Nogueira TC, Neggers JE, Vercruysse T, van den Oord J, Tamir S, Shacham S, Landesman Y, Snoeck R, Pannecouque C, Andrei G, Daelemans D. Human Exportin-1 is a Target for Combined Therapy of HIV and AIDS Related Lymphoma. EBioMedicine 2015; 2:1102-13. [PMID: 26501108 PMCID: PMC4588406 DOI: 10.1016/j.ebiom.2015.07.041] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/29/2015] [Accepted: 07/29/2015] [Indexed: 11/12/2022] Open
Abstract
Infection with HIV ultimately leads to advanced immunodeficiency resulting in an increased incidence of cancer. For example primary effusion lymphoma (PEL) is an aggressive non-Hodgkin lymphoma with very poor prognosis that typically affects HIV infected individuals in advanced stages of immunodeficiency. Here we report on the dual anti-HIV and anti-PEL effect of targeting a single process common in both diseases. Inhibition of the exportin-1 (XPO1) mediated nuclear transport by clinical stage orally bioavailable small molecule inhibitors (SINE) prevented the nuclear export of the late intron-containing HIV RNA species and consequently potently suppressed viral replication. In contrast, in CRISPR-Cas9 genome edited cells expressing mutant C528S XPO1, viral replication was unaffected upon treatment, clearly demonstrating the anti-XPO1 mechanism of action. At the same time, SINE caused the nuclear accumulation of p53 tumor suppressor protein as well as inhibition of NF-κB activity in PEL cells resulting in cell cycle arrest and effective apoptosis induction. In vivo, oral administration arrested PEL tumor growth in engrafted mice. Our findings provide strong rationale for inhibiting XPO1 as an innovative strategy for the combined anti-retroviral and anti-neoplastic treatment of HIV and PEL and offer perspectives for the treatment of other AIDS-associated cancers and potentially other virus-related malignancies.
Collapse
MESH Headings
- Acrylates/chemistry
- Acrylates/pharmacology
- Acrylates/therapeutic use
- Active Transport, Cell Nucleus/drug effects
- Animals
- Apoptosis/drug effects
- Base Sequence
- CRISPR-Cas Systems/genetics
- Cell Cycle Checkpoints/drug effects
- Cell Line
- Cell Nucleus/drug effects
- Cell Nucleus/metabolism
- Female
- HIV/drug effects
- HIV/isolation & purification
- Humans
- Karyopherins/antagonists & inhibitors
- Karyopherins/metabolism
- Lymphoma, AIDS-Related/drug therapy
- Mice, Nude
- Molecular Sequence Data
- Molecular Targeted Therapy
- NF-kappa B/metabolism
- Protein Binding/drug effects
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- RNA, Viral/metabolism
- Receptors, Cytoplasmic and Nuclear/antagonists & inhibitors
- Receptors, Cytoplasmic and Nuclear/metabolism
- Reproducibility of Results
- Triazoles/chemistry
- Triazoles/pharmacology
- Triazoles/therapeutic use
- Tumor Suppressor Protein p53/metabolism
- Virus Replication/drug effects
- Xenograft Model Antitumor Assays
- rev Gene Products, Human Immunodeficiency Virus/genetics
- rev Gene Products, Human Immunodeficiency Virus/metabolism
- Exportin 1 Protein
Collapse
Affiliation(s)
- Eline Boons
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Els Vanstreels
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Maarten Jacquemyn
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Tatiane C. Nogueira
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Jasper E. Neggers
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Thomas Vercruysse
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Joost van den Oord
- KU Leuven, Department of Imaging and Pathology, Translational Cell & Tissue Research, B-3000 Leuven, Belgium
| | | | | | | | - Robert Snoeck
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Christophe Pannecouque
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Graciela Andrei
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| | - Dirk Daelemans
- KU Leuven, Department of Microbiology and Immunology, Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, B-3000 Leuven, Belgium
| |
Collapse
|
33
|
HIV-related hematological malignancies: a concise review. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 14 Suppl:S96-103. [PMID: 25486964 DOI: 10.1016/j.clml.2014.06.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/18/2014] [Accepted: 06/04/2014] [Indexed: 01/01/2023]
Abstract
HIV (Human Immunodeficiency Virus) and its consequence, AIDS (acquired immunodeficiency syndrome) are responsible for a human tragedy of incalculable proportions. Patients afflicted by it are susceptible due to an early senescence of the immune system to opportunistic infections and malignancies. Since the introduction in 1996 of highly active anti-retroviral therapy (HAART), the landscape of malignancies associated to HIV/AIDS has changed in a significant manner as a direct result of significant improvement in the morbidity, mortality and life expectancy of HIV infected patients. While there has been a significant decrease in developed countries of malignancies such as Kaposi's sarcoma and Primary CNS lymphomas associated to the pre-HAART HIV-related immunodeficiency, hematological malignancies, particularly non-Hodgkin lymphomas continue to be the most common cancer-related cause of death in HIV infected individuals. This concise review of the subject highlights aspects of the natural history of HIV disease as it relates to the cause of malignancies with emphasis in the management and treatment of HIV-related hematological malignancies.
Collapse
|
34
|
Grewal R, Cucuianu A, Swanepoel C, Dima D, Petrushev B, Pop B, Berindan-Neagoe I, Abayomi EA, Tomuleasa C. The role of microRNAs in the pathogenesis of HIV-related lymphomas. Crit Rev Clin Lab Sci 2015. [PMID: 26218036 DOI: 10.3109/10408363.2015.1030063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The incidence of HIV-related lymphomas (HRLs) is increased by 60-100 times in patients with HIV. When compared to the general population, patients with HRLs often present with extranodal lymphoid proliferation, most frequently of the gastrointestinal tract, central nervous system, liver and bone marrow. MicroRNAs (miRs) are non-coding double-stranded RNA molecules of 18-25 nucleotides that regulate post-translational gene expression by inhibiting translation or promoting degradation of messenger RNA complementary sequences. Before their discovery, tumorigenesis was thought to have been caused by the alteration of protein-coding oncogenes and tumor-suppressor genes, but once identified in B-cell chronic lymphocytic leukemia, miRs function as either oncogenes or tumor-suppressor genes was confirmed in different types of malignancies. Since miRs are clearly involved in tumorigenesis in many cancers, their role in HRLs is now receiving attention. A few studies have been conducted thus far in some HRLs on the involvement of miR in the pathogenesis of lymphoid malignancies. Since B-cell lymphomas arise from various stages of B-cell development in both HIV-infected and HIV-naïve patients, investigators have tried to determine the different miR signatures in B-cell development. As classic immunohistochemistry staining is sometimes not enough for the differential diagnosis of HRLs, in the present review, we have described the potential use of miRs in the prognosis and diagnosis of these diseases.
Collapse
Affiliation(s)
- Ravnit Grewal
- a Division of Hematopathology , Tygerberg Academic Hospital , Tygerberg , South Africa
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Wu SC, Li LS, Kopp N, Montero J, Chapuy B, Yoda A, Christie AL, Liu H, Christodoulou A, van Bodegom D, van der Zwet J, Layer JV, Tivey T, Lane AA, Ryan JA, Ng SY, DeAngelo DJ, Stone RM, Steensma D, Wadleigh M, Harris M, Mandon E, Ebel N, Andraos R, Romanet V, Dölemeyer A, Sterker D, Zender M, Rodig SJ, Murakami M, Hofmann F, Kuo F, Eck MJ, Silverman LB, Sallan SE, Letai A, Baffert F, Vangrevelinghe E, Radimerski T, Gaul C, Weinstock DM. Activity of the Type II JAK2 Inhibitor CHZ868 in B Cell Acute Lymphoblastic Leukemia. Cancer Cell 2015; 28:29-41. [PMID: 26175414 PMCID: PMC4505625 DOI: 10.1016/j.ccell.2015.06.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 05/01/2015] [Accepted: 06/14/2015] [Indexed: 02/05/2023]
Abstract
A variety of cancers depend on JAK2 signaling, including the high-risk subset of B cell acute lymphoblastic leukemias (B-ALLs) with CRLF2 rearrangements. Type I JAK2 inhibitors induce paradoxical JAK2 hyperphosphorylation in these leukemias and have limited activity. To improve the efficacy of JAK2 inhibition in B-ALL, we developed the type II inhibitor CHZ868, which stabilizes JAK2 in an inactive conformation. CHZ868 potently suppressed the growth of CRLF2-rearranged human B-ALL cells, abrogated JAK2 signaling, and improved survival in mice with human or murine B-ALL. CHZ868 and dexamethasone synergistically induced apoptosis in JAK2-dependent B-ALLs and further improved in vivo survival compared to CHZ868 alone. These data support the testing of type II JAK2 inhibition in patients with JAK2-dependent leukemias and other disorders.
Collapse
Affiliation(s)
- Shuo-Chieh Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Loretta S Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Nadja Kopp
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Joan Montero
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Bjoern Chapuy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Akinori Yoda
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Amanda L Christie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Huiyun Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | | | - Diederik van Bodegom
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jordy van der Zwet
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jacob V Layer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Trevor Tivey
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Andrew A Lane
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jeremy A Ryan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Samuel Y Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Daniel J DeAngelo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Richard M Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - David Steensma
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Martha Wadleigh
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Marian Harris
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Emeline Mandon
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Nicolas Ebel
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Rita Andraos
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Vincent Romanet
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Arno Dölemeyer
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Dario Sterker
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Michael Zender
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Scott J Rodig
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Masato Murakami
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Francesco Hofmann
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Frank Kuo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Michael J Eck
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Lewis B Silverman
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Stephen E Sallan
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Fabienne Baffert
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | | | - Thomas Radimerski
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Christoph Gaul
- Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland.
| | - David M Weinstock
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA; Broad Institute, Cambridge, MA 02142, USA.
| |
Collapse
|
36
|
When to use in situ hybridization for the detection of Epstein-Barr virus: a review of Epstein-Barr virus-associated lymphomas. J Hematop 2015. [DOI: 10.1007/s12308-014-0230-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
37
|
Ghosh A, Holland AM, van den Brink MRM. Genetically engineered donor T cells to optimize graft-versus-tumor effects across MHC barriers. Immunol Rev 2014; 257:226-36. [PMID: 24329800 DOI: 10.1111/imr.12142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Hematopoietic stem cell transplantation has been used for more than 50 years to combat hematologic malignancies. In addition to being the first stem cell therapy, transplantation has provided evidence for the potent anti-tumor effects of T cells. Facilitating T-cell-based immunity against malignancies requires a careful balancing act between generating a robust response and avoiding off-target killing of healthy tissues, which is difficult to accomplish using bulk donor T cells. To address these issues, several approaches have been developed, drawing on basic T-cell biology, to potentiate graft-versus-tumor activity while avoiding graft-versus-host disease. Current strategies for anti-tumor cell therapies include: (i) selecting optimal T cells for transfer; (ii) engineering T cells to possess enhanced effector functions; and (iii) generating T-cell precursors that complete development after adoptive transfer. In this review, we assess the current state of the art in T-lineage cell therapy to treat malignancies in the context of allogeneic hematopoietic stem cell transplantation.
Collapse
Affiliation(s)
- Arnab Ghosh
- Department of Medicine and Immunology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | |
Collapse
|
38
|
Carbone A, Vaccher E, Gloghini A, Pantanowitz L, Abayomi A, de Paoli P, Franceschi S. Diagnosis and management of lymphomas and other cancers in HIV-infected patients. Nat Rev Clin Oncol 2014; 11:223-38. [PMID: 24614140 DOI: 10.1038/nrclinonc.2014.31] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Despite the introduction of highly active antiretroviral therapy or combination antiretroviral therapy (HAART and cART, respectively) patients infected with HIV might develop certain types of cancer more frequently than uninfected people. Lymphomas represent the most frequent malignancy among patients with HIV. Other cancer types that have increased in these patients include Kaposi sarcoma, cancer of the cervix, anus, lung and liver. In the post-HAART era, however, patients with HIV have experienced a significant improvement in their morbidity, mortality and life expectancy. This Review focuses on the different types of lymphomas that generally occur in patients with HIV. The combination of cART and antineoplastic treatment has resulted in remarkable prolongation of disease-free survival and overall survival among patients with HIV who develop lymphoma. However, the survival in these patients still lags behind that of patients with lymphoma who are not infected with HIV. We also provide an update of epidemiological data, diagnostic issues, and strategies regarding the most-appropriate management of patients with both HIV and lymphomas.
Collapse
Affiliation(s)
- Antonino Carbone
- Department of Pathology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Emanuela Vaccher
- Department of Medical Oncology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Annunziata Gloghini
- Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori Milano, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, USA
| | - Akin Abayomi
- Department of Pathology, Division of Haematology, Tygerberg Hospital, South Africa
| | - Paolo de Paoli
- Molecular Virology and Scientific Directorate, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, Italy
| | - Silvia Franceschi
- Infections and Cancer Epidemiology Group, International Agency for Research on Cancer, France
| |
Collapse
|