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Martynchyk A, Chowdhury R, Hawkes EA, Keane C. Prognostic Markers within the Tumour Microenvironment in Classical Hodgkin Lymphoma. Cancers (Basel) 2023; 15:5217. [PMID: 37958391 PMCID: PMC10649036 DOI: 10.3390/cancers15215217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Classical Hodgkin lymphoma (cHL) accounts for 0.4% of all new cancer cases globally. Despite high cure rates with standard treatment, approximately 15% of patients still experience relapsed or refractory (RR) disease, and many of these eventually die from lymphoma-related causes. Exciting new targeted agents such as anti-PD-1 agents and brentuximab vedotin have changed the therapeutic paradigm beyond chemotherapy and radiotherapy alone. Advances in understanding of the molecular biology are providing insights in the context of novel therapies. The signature histology of cHL requires the presence of scant malignant Hodgkin Reed-Sternberg cells (HRSCs) surrounded by a complex immune-rich tumour microenvironment (TME). The TME cellular composition strongly influences outcomes, yet knowledge of the precise characteristics of TME cells and their interactions with HRSCs is evolving. Novel high-throughput technologies and single-cell sequencing allow deeper analyses of the TME and mechanisms elicited by HRSCs to propagate growth and avoid immune response. In this review, we explore the evolution of knowledge on the prognostic role of immune cells within the TME and provide an up-to-date overview of emerging prognostic data on cHL from new technologies that are starting to unwind the complexity of the cHL TME and provide translational insights into how to improve therapy in the clinic.
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Affiliation(s)
- Arina Martynchyk
- Olivia Newton-John Cancer Research & Wellness Centre, Austin Health, 145 Studley Rd., Heidelberg, VIC 3084, Australia; (A.M.); (E.A.H.)
| | - Rakin Chowdhury
- Princess Alexandra Hospital, 199 Ipswich Rd., Woolloongabba, QLD 4102, Australia;
- Frazer Institute, University of Queensland, St. Lucia, QLD 4072, Australia
| | - Eliza A. Hawkes
- Olivia Newton-John Cancer Research & Wellness Centre, Austin Health, 145 Studley Rd., Heidelberg, VIC 3084, Australia; (A.M.); (E.A.H.)
- School of Public Health & Preventive Medicine, Monash University, 553 St Kilda Rd., Melbourne, VIC 3004, Australia
| | - Colm Keane
- Princess Alexandra Hospital, 199 Ipswich Rd., Woolloongabba, QLD 4102, Australia;
- Frazer Institute, University of Queensland, St. Lucia, QLD 4072, Australia
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2
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Georgoulis V, Papoudou-Bai A, Makis A, Kanavaros P, Hatzimichael E. Unraveling the Immune Microenvironment in Classic Hodgkin Lymphoma: Prognostic and Therapeutic Implications. BIOLOGY 2023; 12:862. [PMID: 37372147 DOI: 10.3390/biology12060862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/06/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Classic Hodgkin lymphoma (cHL) is a lymphoid neoplasm composed of rare neoplastic Hodgkin and Reed-Sternberg (HRS) cells surrounded by a reactive tumor microenvironment (TME) with suppressive properties against anti-tumor immunity. TME is mainly composed of T cells (CD4 helper, CD8 cytotoxic and regulatory) and tumor-associated macrophages (TAMs), but the impact of these cells on the natural course of the disease is not absolutely understood. TME contributes to the immune evasion of neoplastic HRS cells through the production of various cytokines and/or the aberrant expression of immune checkpoint molecules in ways that have not been fully understood yet. Herein, we present a comprehensive review of findings regarding the cellular components and the molecular features of the immune TME in cHL, its correlation with treatment response and prognosis, as well as the potential targeting of the TME with novel therapies. Among all cells, macrophages appear to be a most appealing target for immunomodulatory therapies, based on their functional plasticity and antitumor potency.
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Affiliation(s)
- Vasileios Georgoulis
- Department of Hematology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45 500 Ioannina, Greece
| | - Alexandra Papoudou-Bai
- Department of Pathology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45 500 Ioannina, Greece
| | - Alexandros Makis
- Department of Child Health, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45 500 Ioannina, Greece
| | - Panagiotis Kanavaros
- Department of Anatomy-Histology-Embryology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45 000 Ioannina, Greece
| | - Eleftheria Hatzimichael
- Department of Hematology, School of Health Sciences, Faculty of Medicine, University of Ioannina, 45 500 Ioannina, Greece
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3
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Mandal D, Kushwaha K, Gupta J. Emerging nano-strategies against tumour microenvironment (TME): a review. OPENNANO 2023. [DOI: 10.1016/j.onano.2022.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Upregulation of EMID1 Accelerates to a Favorable Prognosis and Immune Infiltration in Lung Adenocarcinoma. JOURNAL OF ONCOLOGY 2022; 2022:5185202. [PMID: 36245990 PMCID: PMC9553514 DOI: 10.1155/2022/5185202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/27/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022]
Abstract
Lung cancer is a difficult-to-treat cancer. Lung adenocarcinoma (LUAD) is the main subtype of lung cancer. Although there are many ways to treat lung cancer, the survival rate of patients is low. Therefore, novel molecules need to be identified to diagnose and treat LUAD. This study utilized The Cancer Genome Atlas (TCGA) LUAD data to analyze and validate the value of EMID1 as a LUAD diagnostic surface marker and overall survival prognostic marker. Differential expression analysis formally confirmed that decreased EMID1 expression was significantly associated with advanced stage and metastasis of lung cancer. Kaplan–Meier survival analysis showed that the patients with low EMID expression are dismal. The relationship between clinicopathological features and EMID1 was scored using Wilcoxon signed-rank test and R (v.3.5.1) logistic regression and suggested that patients with low EMID1 expression had a worse prognosis than patients with high EMID1 expression. (Gene Ontology) GO, Kyoto Encyclopedia of Genes and Genomes(KEGG), and gene set enrichment analysis (GSEA) were performed to investigate the potential mechanism of EMID1 expression on the prognosis of LUAD and suggested that Notch signaling pathway may be an important biological pathway for EMID1 to play a role in LUAD. Further, combined with univariate and multivariate Cox regression analysis, it was speculated that high and low levels of EMID1 expression and the logistic regression analysis of related clinical variables had significant clinical significance to verify the underlying mechanism of LUAD focus and prognosis. EMID1 plays an important role in the immune milieu of LUAD. Meanwhile, the correlation between tumor-infiltrating immune cells and genes was assessed using CIBERSORT, and it was found that the level of B cell infiltration was positively correlated with the expression of EMID1, all of which were validated in the GEO and GEPIA databases. In all, this study helps to understand the immune microenvironment of LUAD and improve the survival of patients with LUAD. Thus, EMID1 may be a novel immune-related prognostic marker of LUAD.
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5
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Zawati I, Adouni O, Manai M, Nagara M, Tacam M, Reduzzi C, Gamoudi A, Manai M. FOXP3+/CD68+ ratio within the tumor microenvironment may serve as a potential prognostic factor in classical Hodgkin lymphoma. Hum Immunol 2022; 83:843-856. [PMID: 36068099 DOI: 10.1016/j.humimm.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022]
Abstract
Classical Hodgkin lymphoma (CHL) is characterized by extensive inflammatory immune cells, which predict the disease prognosis. Therefore, this study aimed to explore the significance of different tumor-infiltrated immune cells and subpopulation ratios observed in the tumor microenvironment of CHL, particularly relating to the disease's prognosis-focusing on overall survival (OS) and event-free survival (EFS). Utilizing immunohistochemistry, the quantification and exploration of selected immune cells' subsets, including CD3+, CD4+, CD8+, FOXP3+, CD20+, and CD68+ were conducted on 102 histological samples with primary CHL. Eosinophils were pathologically assessed. Besides, we determined the ratios between different tumor-infiltrated immune cells for each patient. Kaplan-Meier method and Cox regression modeling were used for survival analysis. We demonstrated that among all ratios and immune cells individually, only a higher FOXP3+/CD68+ ratio (≥1.36 cutoff) displayed a tendency towards a favorable OS (p = 0.057, HR = 0.43 [0.18-1.02]) and EFS (p = 0.067, HR = 0.44 [0.18-1.06]) using Cox regression modeling. Moreover, the Kaplan-Meier method showed an association of a higher FOXP3+/CD68+ ratio with a longer 5-years OS (p = 0.037) and a tendency to a better EFS (p = 0.051); however, neither the combined FOXP3+ and CD68+ nor FOXP3+ or CD68+ separately was correlated to the CHL survival. Together, these results demonstrated that the FOXP3+/CD68+ ratio could predict the outcomes of CHL, providing more informative significance than FOXP3+ and CD68+ combined or FOXP3+ and CD68+ individually and might be a potential indicator of risk stratification, which has an important value for guiding the clinical treatment.
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Affiliation(s)
- Imen Zawati
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Department of Biology, Mycology, Pathologies, and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia.
| | - Olfa Adouni
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Department of Biology, Mycology, Pathologies, and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia
| | - Maroua Manai
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Laboratory of Human Genetics (LR99ES10), Faculty of Medicine of Tunis, University of Tunis El Manar, 2092 Tunis, Tunisia; Department of Medicine, Division of Hematology-Oncology, Weill Cornell Medicine, 1300 York Ave, 10021 NY, NY, USA
| | - Majdi Nagara
- Inserm, UMR-S 1251, MMG, Faculty of Medicine Timone, Aix Marseille University, Marseille, France
| | - Moisis Tacam
- Department of OB/Gyn, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Carolina Reduzzi
- Department of Medicine, Division of Hematology-Oncology, Weill Cornell Medicine, 1300 York Ave, 10021 NY, NY, USA
| | - Amor Gamoudi
- Department of Immuno-Histo-Cytology, Salah Azaiez Institute, 1006 Tunis, Tunisia
| | - Mohamed Manai
- Department of Biology, Mycology, Pathologies, and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia
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Checkpoint protein expression in the tumor microenvironment defines the outcome of classical Hodgkin lymphoma patients. Blood Adv 2021; 6:1919-1931. [PMID: 34941990 PMCID: PMC8941476 DOI: 10.1182/bloodadvances.2021006189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/28/2021] [Indexed: 11/20/2022] Open
Abstract
Emerging evidence indicates a major impact for the tumor microenvironment (TME) and immune escape in the pathogenesis and clinical course of classical Hodgkin lymphoma (cHL). We used gene expression profiling (n=88), CIBERSORT, and multiplex immunohistochemistry (n=131) to characterize the immunoprofile of cHL TME, and correlated the findings with survival. Gene expression analysis divided tumors into subgroups with T cell-inflamed and non-inflamed TME. Several macrophage-related genes were upregulated in samples with the non-T cell-inflamed TME, and based on the immune cell proportions, the samples clustered according to the content of T cells and macrophages. A cluster with high proportions of checkpoint protein (PD-1, PD-L1, IDO-1, LAG-3, and TIM-3) positive immune cells translated to unfavorable overall survival (OS) (5-year OS 76% vs. 96%, P=0.010), and remained as an independent prognostic factor for OS in multivariable analysis (HR 4.34, 95% CI 1.05-17.91, P=0.043). cHLs with high proportions of checkpoint proteins overexpressed genes coding for cytolytic factors, proposing paradoxically that they were immunologically active. This checkpoint molecule gene signature translated to inferior survival in a validation cohort of 290 diagnostic cHL samples (P<0.001) and in an expansion cohort of 84 cHL relapse samples (P=0.048). Our findings demonstrate the impact of T cell- and macrophage-mediated checkpoint system on the survival of patients with cHL.
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Structural Biology of the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1350:91-100. [PMID: 34888845 DOI: 10.1007/978-3-030-83282-7_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cancers can be described as "rogue organs" (Balkwill FR, Capasso M, Hagemann T, J Cell Sci 125:5591-5596, 2012) because they are composed of multiple cell types and tissues. The transformed cells can recruit and alter healthy cells from surrounding tissues for their own benefit. It is these interactions that create the tumor microenvironment (TME). The TME describes the cells, factors, and extracellular matrix proteins that make up the tumor and the area around it; the biology of the TME influences tumor progression. Changes in the TME can lead to the growth and development of the tumor, the death of the tumor, or tumor metastasis. Metastasis is the process by which cancer spreads from its initial site to a different part of the body. Metastasis occurs when cancer cells enter the circulatory system or lymphatic system after they break away from a tumor. Once the cells leave, they can travel to a different part of the body and form new tumors. Therefore, understanding the TME is critical to fully understand cancer and find a way to successfully combat it. Knowledge of the TME can better inform researchers of the ability of potential therapies to reach tumor cells. It can also give researchers potential targets to kill the tumor. Instead of directly killing the cancer cells, therapies can target an aspect of the TME which could then halt tumor development or lead to tumor death. In other cases, targeting another aspect of the TME could make it easier for another therapy to kill the cancer cells, for example, using nanoparticles with collagenases to target the collagen in the surrounding environment to expose the cancer cells to drugs (Zinger A, et al, ACS Nano 13(10):11008-11021, 2019).The TME can be split simply into cells and the structural matrix. Within these groups are fibroblasts, structural proteins, immune cells, lymphocytes, bone marrow-derived inflammatory cells, blood vessels, and signaling molecules (Spill F, et al, Curr Opin Biotechnol 40:41-48, 2016; Del Prete A, et al, Curr Opin Pharmacol 35:40-47, 2017; Arneth B, Medicina (Kaunas) 56(1), 2019). From structure to providing nutrients for growth, each of these components plays a critical role in tumor maintenance. Together these components impact cancer growth, development, and resistance to therapies (Hanahan D, Coussens LM, Cancer Cell 21:309-322, 2012). In this chapter, we will describe the TME and express the importance of the cellular and structural elements of the TME.
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8
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McCaffrey TA, Toma I, Yang Z, Katz R, Reiner J, Mazhari R, Shah P, Tackett M, Jones D, Jepson T, Falk Z, Wargodsky R, Shtakalo D, Antonets D, Ertle J, Kim JH, Lai Y, Arslan Z, Aledort E, Alfaraidy M, Laurent GS. RNA sequencing of blood in coronary artery disease: involvement of regulatory T cell imbalance. BMC Med Genomics 2021; 14:216. [PMID: 34479557 PMCID: PMC8414682 DOI: 10.1186/s12920-021-01062-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiovascular disease had a global prevalence of 523 million cases and 18.6 million deaths in 2019. The current standard for diagnosing coronary artery disease (CAD) is coronary angiography. Surprisingly, despite well-established clinical indications, up to 40% of the one million invasive cardiac catheterizations return a result of 'no blockage'. The present studies employed RNA sequencing of whole blood to identify an RNA signature in patients with angiographically confirmed CAD. METHODS Whole blood RNA was depleted of ribosomal RNA (rRNA) and analyzed by single-molecule sequencing of RNA (RNAseq) to identify transcripts associated with CAD (TRACs) in a discovery group of 96 patients presenting for elective coronary catheterization. The resulting transcript counts were compared between groups to identify differentially expressed genes (DEGs). RESULTS Surprisingly, 98% of DEGs/TRACs were down-regulated ~ 1.7-fold in patients with mild to severe CAD (> 20% stenosis). The TRACs were independent of comorbid risk factors for CAD, such as sex, hypertension, and smoking. Bioinformatic analysis identified an enrichment in transcripts such as FoxP1, ICOSLG, IKZF4/Eos, SMYD3, TRIM28, and TCF3/E2A that are likely markers of regulatory T cells (Treg), consistent with known reductions in Tregs in CAD. A validation cohort of 80 patients confirmed the overall pattern (92% down-regulation) and supported many of the Treg-related changes. TRACs were enriched for transcripts associated with stress granules, which sequester RNAs, and ciliary and synaptic transcripts, possibly consistent with changes in the immune synapse of developing T cells. CONCLUSIONS These studies identify a novel mRNA signature of a Treg-like defect in CAD patients and provides a blueprint for a diagnostic test for CAD. The pattern of changes is consistent with stress-related changes in the maturation of T and Treg cells, possibly due to changes in the immune synapse.
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Affiliation(s)
- Timothy A McCaffrey
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA.
- The St. Laurent Institute, Vancouver, WA, USA.
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, DC, 20037, USA.
- True Bearing Diagnostics, Washington, DC, 20037, USA.
| | - Ian Toma
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
- Department of Clinical Research and Leadership, The George Washington University, Washington, DC, 20037, USA
- True Bearing Diagnostics, Washington, DC, 20037, USA
| | - Zhaoquing Yang
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Richard Katz
- Division of Cardiology, Department of Medicine, The George Washington University , Washington, DC, 20037, USA
| | - Jonathan Reiner
- Division of Cardiology, Department of Medicine, The George Washington University , Washington, DC, 20037, USA
| | - Ramesh Mazhari
- Division of Cardiology, Department of Medicine, The George Washington University , Washington, DC, 20037, USA
| | - Palak Shah
- Inova Heart and Vascular Institute, Fairfax, VA, USA
| | | | | | - Tisha Jepson
- SeqLL, Inc., Woburn, MA, USA
- The St. Laurent Institute, Vancouver, WA, USA
- True Bearing Diagnostics, Washington, DC, 20037, USA
| | - Zachary Falk
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Richard Wargodsky
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Dmitry Shtakalo
- A.P. Ershov Institute of Informatics Systems SB RAS, 6, Acad. Lavrentjeva Ave, Novosibirsk, Russia, 630090
| | - Denis Antonets
- A.P. Ershov Institute of Informatics Systems SB RAS, 6, Acad. Lavrentjeva Ave, Novosibirsk, Russia, 630090
| | - Justin Ertle
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Ju H Kim
- Division of Cardiology, Department of Medicine, The George Washington University , Washington, DC, 20037, USA
| | - Yinglei Lai
- Department of Statistics, Biostatistics Center, The George Washington University, Washington, DC, 20037, USA
| | - Zeynep Arslan
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Emily Aledort
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
| | - Maha Alfaraidy
- Division of Genomic Medicine, Department of Medicine, The George Washington Medical Center, The George Washington University, 2300 I Street NW, Ross Hall 443A, Washington, DC, 20037, USA
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Abstract
The development of tumors requires an initiator event, usually exposure to DNA damaging agents that cause genetic alterations such as gene mutations or chromosomal abnormalities, leading to deregulated cell proliferation. Although the mere stochastic accumulation of further mutations may cause tumor progression, it is now clear that an inflammatory microenvironment has a major tumor-promoting influence on initiated cells, in particular when a chronic inflammatory reaction already existed before the initiated tumor cell was formed. Moreover, inflammatory cells become mobilized in response to signals emanating from tumor cells. In both cases, the microenvironment provides signals that initiated tumor cells perceive by membrane receptors and transduce via downstream kinase cascades to modulate multiple cellular processes and respond with changes in cell gene expression, metabolism, and morphology. Cytokines, chemokines, and growth factors are examples of major signals secreted by immune cells, fibroblast, and endothelial cells and mediate an intricate cell-cell crosstalk in an inflammatory microenvironment, which contributes to increased cancer cell survival, phenotypic plasticity and adaptation to surrounding tissue conditions. Eventually, consequent changes in extracellular matrix stiffness and architecture, coupled with additional genetic alterations, further fortify the malignant progression of tumor cells, priming them for invasion and metastasis. Here, we provide an overview of the current knowledge on the composition of the inflammatory tumor microenvironment, with an emphasis on the major signals and signal-transducing events mediating different aspects of stromal cell-tumor cell communication that ultimately lead to malignant progression.
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Autio M, Leivonen SK, Brück O, Mustjoki S, Mészáros Jørgensen J, Karjalainen-Lindsberg ML, Beiske K, Holte H, Pellinen T, Leppä S. Immune cell constitution in the tumor microenvironment predicts the outcome in diffuse large B-cell lymphoma. Haematologica 2021; 106:718-729. [PMID: 32079690 PMCID: PMC7927991 DOI: 10.3324/haematol.2019.243626] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Indexed: 12/12/2022] Open
Abstract
The tumor microenvironment (TME) and limited immune surveillance
play important roles in lymphoma pathogenesis. Here we
aimed to characterize immunological profiles of diffuse large B-cell
lymphoma (DLBCL) and predict the outcome in response to
immunochemotherapy. We profiled the expression of 730 immune-related
genes in tumor tissues of 81 patients with DLBCL utilizing the Nanostring
platform, and used multiplex immunohistochemistry to characterize T-cell
phenotypes, including cytotoxic T cells (CD8, Granzyme B, OX40, Ki67),
T-cell immune checkpoint (CD3, CD4, CD8, PD1, TIM3, LAG3), as well as
regulatory T-cells and Th1 effector cells (CD3, CD4, FOXP3, TBET) in 188
patients. We observed a high degree of heterogeneity at the transcriptome
level. Correlation matrix analysis identified gene expression signatures
with highly correlating genes, the main cluster containing genes for cytolytic
factors, immune checkpoint molecules, T cells and macrophages, together
named a TME immune cell signature. Immunophenotyping of the distinct
cell subsets revealed that a high proportion of immune checkpoint positive
T cells translated to unfavorable survival. Together, our results demonstrate
that the immunological profile of DLBCL TME is heterogeneous and clinically
meaningful. This highlights the potential impact of T-cell immune
checkpoint in regulating survival and resistance to immunochemotherapy.
(Registered at clinicaltrials.gov identifiers: NCT01502982 and NCT01325194.)
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Affiliation(s)
- Matias Autio
- Applied Tumor Genomics Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland,iCAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland
| | - Suvi-Katri Leivonen
- Applied Tumor Genomics Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland,iCAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland
| | - Oscar Brück
- iCAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland,Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, Helsinki, Finland,Hematology Research Unit Helsinki, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - Satu Mustjoki
- iCAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland,Translational Immunology Research Program and Department of Clinical Chemistry and Hematology, University of Helsinki, Helsinki, Finland,Hematology Research Unit Helsinki, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | | | | | - Klaus Beiske
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Harald Holte
- Department of Oncology, and KG Jebsen Centre for B Cell Malignancies, Oslo University Hospital, Oslo, Norway
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Sirpa Leppä
- Applied Tumor Genomics Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland,iCAN Digital Precision Cancer Medicine Flagship, Helsinki, Finland
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11
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Abstract
Background and Objectives: The tumor microenvironment has been widely implicated in tumorigenesis because it harbors tumor cells that interact with surrounding cells through the circulatory and lymphatic systems to influence the development and progression of cancer. In addition, nonmalignant cells in the tumor microenvironment play critical roles in all the stages of carcinogenesis by stimulating and facilitating uncontrolled cell proliferation. Aim: This study aims to explore the concept of the tumor microenvironment by conducting a critical review of previous studies on the topic. Materials and Methods: This review relies on evidence presented in previous studies related to the topic. The articles included in this review were obtained from different medical and health databases. Results and Discussion: The tumor microenvironment has received significant attention in the cancer literature, with a particular focus on its role in tumor development and progression. Previous studies have identified various components of the tumor microenvironment that influence malignant behavior and progression. In addition to malignant cells, adipocytes, fibroblasts, tumor vasculature, lymphocytes, dendritic cells, and cancer-associated fibroblasts are present in the tumor microenvironment. Each of these cell types has unique immunological capabilities that determine whether the tumor will survive and affect neighboring cells. Conclusion: The tumor microenvironment harbors cancer stem cells and other molecules that contribute to tumor development and progression. Consequently, targeting and manipulating the cells and factors in the tumor microenvironment during cancer treatment can help control malignancies and achieve positive health outcomes.
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Affiliation(s)
- Borros Arneth
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, University Hospital of the Universities of Giessen and Marburg UKGM, Justus Liebig University Giessen, Giessen, Germany, Feulgenstr. 12, 35392 Giessen, Germany
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12
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Batorov EV, Pronkina NV, Tikhonova MA, Kryuchkova IV, Sergeevicheva VV, Sizikova SA, Ushakova GY, Aristova TA, Batorova DS, Shishkova IV, Gilevich AV, Shevela EY, Ostanin AA, Chernykh ER. Increased circulating CD3 + T cells are associated with early relapse following autologous hematopoietic stem cell transplantation in patients with classical Hodgkin lymphoma. Leuk Lymphoma 2019; 60:2488-2497. [PMID: 31609150 DOI: 10.1080/10428194.2019.1581934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Non-malignant host immune cells are the main substrate in classical Hodgkin lymphoma (HL) microenvironment. Reconstitution of lymphocyte populations following the high-dose chemotherapy (HDC) with autologous hematopoietic stem cell transplantation (auto-HSCT) can support tumor growth in HL patients. We investigated recovery dynamics of circulating CD3+, CD4+, CD8+, CD16+/CD56+, CD19+, CD4+FOXP3+ lymphocytes following auto-HSCT in 79 HL patients and assessed relationship between these populations and the development of early relapse. Studied populations were not statistically significant between patients with high or standard/intermediate risk of relapse. CD3+ T cells at the time of engraftment were increased in patients with the early relapse of HL compared to non-relapsed patients (PU = 0.0028). Area under the curve was 0.76 (р = .0037). In logistic regression models, CD3+ T cell count was associated with early relapse/progression as a trend. These findings elucidate several interactions between early systemic T cell recovery and tumor progression following HDC with auto-HSCT.
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Affiliation(s)
- Egor V Batorov
- Laboratory of Cellular Immunotherapy, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Natalia V Pronkina
- Laboratory of Clinical Immunology, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Marina A Tikhonova
- Laboratory of Cellular Immunotherapy, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Irina V Kryuchkova
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Vera V Sergeevicheva
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Svetlana A Sizikova
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Galina Y Ushakova
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Tatiana A Aristova
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Dariya S Batorova
- Department of Hematology and Bone Marrow Transplantation, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Irina V Shishkova
- Laboratory of Clinical Immunology, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Andrey V Gilevich
- Intensive Care Unit, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Ekaterina Y Shevela
- Laboratory of Cellular Immunotherapy, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Alexander A Ostanin
- Laboratory of Cellular Immunotherapy, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
| | - Elena R Chernykh
- Laboratory of Cellular Immunotherapy, Research Institute of Fundamental and Clinical Immunology , Novosibirsk , Russia
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Abstract
Classic Hodgkin lymphoma (cHL) is one of the most common lymphomas in the Western world. Advances in the management of cHL have led to high cure rates exceeding 80%. Nevertheless, relapse or refractory disease in a subset of patients and treatment-related toxicity still represents unsolved clinical problems. The introduction of targeted treatments such as PD-1 blockade and the CD30 antibody drug conjugate, brentuximab vedotin, has broadened treatment options in cHL, emphasizing the critical need to identify biomarkers with the goal to provide rationales for treatment selection, increase effective drug utilization, and minimize toxicity. The unique biology of cHL featuring low abundant tumor cells and numerous nonmalignant immune cells in the tumor microenvironment can provide various types of promising biomarkers related to the tumor cells directly, tumor microenvironment cross-talk, and host immune response. Here, we comprehensively review novel biomarkers including circulating tumor DNA and gene expression-based prognostic models that might guide the ideal management of cHL in the future.
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Broccoli A, Zinzani PL. The role of transplantation in Hodgkin lymphoma. Br J Haematol 2018; 184:93-104. [DOI: 10.1111/bjh.15639] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alessandro Broccoli
- Institute of Haematology; “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
| | - Pier Luigi Zinzani
- Institute of Haematology; “L. e A. Seràgnoli”; University of Bologna; Bologna Italy
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15
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Budak G, Dash S, Srivastava R, Lachke SA, Janga SC. Express: A database of transcriptome profiles encompassing known and novel transcripts across multiple development stages in eye tissues. Exp Eye Res 2018; 168:57-68. [PMID: 29337142 DOI: 10.1016/j.exer.2018.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 01/23/2023]
Abstract
Advances in sequencing have facilitated nucleotide-resolution genome-wide transcriptomic profiles across multiple mouse eye tissues. However, these RNA sequencing (RNA-seq) based eye developmental transcriptomes are not organized for easy public access, making any further analysis challenging. Here, we present a new database "Express" (http://www.iupui.edu/∼sysbio/express/) that unifies various mouse lens and retina RNA-seq data and provides user-friendly visualization of the transcriptome to facilitate gene discovery in the eye. We obtained RNA-seq data encompassing 7 developmental stages of lens in addition to that on isolated lens epithelial and fibers, as well as on 11 developmental stages of retina/isolated retinal rod photoreceptor cells from publicly available wild-type mouse datasets. These datasets were pre-processed, aligned, quantified and normalized for expression levels of known and novel transcripts using a unified expression quantification framework. Express provides heatmap and browser view allowing easy navigation of the genomic organization of transcripts or gene loci. Further, it allows users to search candidate genes and export both the visualizations and the embedded data to facilitate downstream analysis. We identified total of >81,000 transcripts in the lens and >178,000 transcripts in the retina across all the included developmental stages. This analysis revealed that a significant number of the retina-expressed transcripts are novel. Expression of several transcripts in the lens and retina across multiple developmental stages was independently validated by RT-qPCR for established genes such as Pax6 and Lhx2 as well as for new candidates such as Elavl4, Rbm5, Pabpc1, Tia1 and Tubb2b. Thus, Express serves as an effective portal for analyzing pruned RNA-seq expression datasets presently collected for the lens and retina. It will allow a wild-type context for the detailed analysis of targeted gene-knockout mouse ocular defect models and facilitate the prioritization of candidate genes from Exome-seq data of eye disease patients.
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Affiliation(s)
- Gungor Budak
- Department of BioHealth Informatics, School of Informatics and Computing, Indiana University Purdue University, 719 Indiana Ave Ste 319, Walker Plaza Building, Indianapolis, IN 46202, United States
| | - Soma Dash
- Department of Biological Sciences, University of Delaware, Newark, DE 19716, United States
| | - Rajneesh Srivastava
- Department of BioHealth Informatics, School of Informatics and Computing, Indiana University Purdue University, 719 Indiana Ave Ste 319, Walker Plaza Building, Indianapolis, IN 46202, United States
| | - Salil A Lachke
- Department of Biological Sciences, University of Delaware, Newark, DE 19716, United States; Center for Bioinformatics and Computational Biology, University of Delaware, Newark, DE 19716, United States
| | - Sarath Chandra Janga
- Department of BioHealth Informatics, School of Informatics and Computing, Indiana University Purdue University, 719 Indiana Ave Ste 319, Walker Plaza Building, Indianapolis, IN 46202, United States; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, 5021 Health Information and Translational Sciences (HITS), 410 West 10th Street, Indianapolis, IN, 46202, United States; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Medical Research and Library Building, 975 West Walnut Street, Indianapolis, IN, 46202, United States.
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16
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Regulatory T Cells and Their Prognostic Relevance in Hematologic Malignancies. J Immunol Res 2017; 2017:1832968. [PMID: 29430466 PMCID: PMC5752970 DOI: 10.1155/2017/1832968] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/14/2017] [Indexed: 11/18/2022] Open
Abstract
Regulatory T cells (Tregs) have a fundamental function in monitoring the immune homeostasis in healthy individuals. In cancer and, in particular, in hematological malignancies, Tregs exert a major immunosuppressive activity, thus playing a critical role in tumor cell growth, proliferation, and survival. Here, we summarize published data on the prognostic significance of Tregs in hematological malignancies and show that they are highly conflicting. The heterogeneity of the experimental approaches that were used explains-at least in part-the discordant results reported by different groups that have investigated the role of Tregs in cancer. In fact, different tissues have been studied (i.e., peripheral blood, bone marrow, and lymph node), applying different methods (i.e., flow cytometry versus immunohistochemistry, whole blood versus isolated peripheral blood mononuclear cells versus depletion of CD25+ cells, various panels of monoclonal antibodies, techniques of fixation and permeabilization, and gating strategies). This is of relevance in order to stress the need to apply standardized approaches in the study of Tregs in hematological malignancies and in cancer in general.
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17
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Hollander P, Rostgaard K, Smedby KE, Molin D, Loskog A, de Nully Brown P, Enblad G, Amini RM, Hjalgrim H, Glimelius I. An anergic immune signature in the tumor microenvironment of classical Hodgkin lymphoma is associated with inferior outcome. Eur J Haematol 2017; 100:88-97. [PMID: 29064587 DOI: 10.1111/ejh.12987] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The classical Hodgkin lymphoma (cHL) tumor microenvironment shows an ongoing inflammatory response consisting of varying degrees of infiltrating eosinophils, mast cells, macrophages, regulatory T lymphocytes (Tregs), and activated lymphocytes surrounding the malignant cells. Herein, different immune signatures are characterized and correlated with treatment outcome. METHODS Tumor-infiltrating leukocytes were phenotyped in biopsies from 459 patients with cHL. Time to progression (TTP) (primary progression, relapse, or death from cHL) and overall survival were analyzed using Cox proportional hazards regression. RESULTS The leukocyte infiltration in the microenvironment was highly diverse between patients and was categorized in 4 immune signatures (active, anergic, innate, or mixed). A high proportion of Tregs (anergic) resulted in shorter TTP (median 12.9-year follow-up) in age-adjusted analyses (hazard ratio = 1.82; 95% confidence interval 1.05-3-15). Epstein-Barr virus (EBV)-positive cases had higher proportions of macrophages and activated lymphocytes than EBV negative, but neither of those leukocytes predicted prognosis. CONCLUSIONS Abundant Tregs (anergic signature) indicate a shorter TTP, particularly in younger patients. This is probably due to a reduced ability of the immune system to attack the tumor cells. Our data warrant further investigation if these suggested immune signatures could predict outcome of immunotherapy such as immune checkpoint inhibitors.
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Affiliation(s)
- Peter Hollander
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Karin E Smedby
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Molin
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Angelica Loskog
- Clinical immunology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Gunilla Enblad
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Rose-Marie Amini
- Clinical and Experimental Pathology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.,Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | - Ingrid Glimelius
- Experimental and Clinical Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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18
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Chan FC, Mottok A, Gerrie AS, Power M, Nijland M, Diepstra A, van den Berg A, Kamper P, d'Amore F, d'Amore AL, Hamilton-Dutoit S, Savage KJ, Shah SP, Connors JM, Gascoyne RD, Scott DW, Steidl C. Prognostic Model to Predict Post-Autologous Stem-Cell Transplantation Outcomes in Classical Hodgkin Lymphoma. J Clin Oncol 2017; 35:3722-3733. [PMID: 28898161 DOI: 10.1200/jco.2017.72.7925] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Purpose Our aim was to capture the biology of classical Hodgkin lymphoma (cHL) at the time of relapse and discover novel and robust biomarkers that predict outcomes after autologous stem-cell transplantation (ASCT). Materials and Methods We performed digital gene expression profiling on a cohort of 245 formalin-fixed, paraffin-embedded tumor specimens from 174 patients with cHL, including 71 with biopsies taken at both primary diagnosis and relapse, to investigate temporal gene expression differences and associations with post-ASCT outcomes. Relapse biopsies from a training cohort of 65 patients were used to build a gene expression-based prognostic model of post-ASCT outcomes (RHL30), and two independent cohorts were used for validation. Results Gene expression profiling revealed that 24% of patients exhibited poorly correlated expression patterns between their biopsies taken at initial diagnosis and relapse, indicating biologic divergence. Comparative analysis of the prognostic power of gene expression measurements in primary versus relapse specimens demonstrated that the biology captured at the time of relapse contained superior properties for post-ASCT outcome prediction. We developed RHL30, using relapse specimens, which identified a subset of high-risk patients with inferior post-ASCT outcomes in two independent external validation cohorts. The prognostic power of RHL30 was independent of reported clinical prognostic markers (both at initial diagnosis and at relapse) and microenvironmental components as assessed by immunohistochemistry. Conclusion We have developed and validated a novel clinically applicable prognostic assay that at the time of first relapse identifies patients with unfavorable post-ASCT outcomes. Moving forward, it will be critical to evaluate the clinical use of RHL30 in the context of positron emission tomography-guided response assessment and the evolving cHL treatment landscape.
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Affiliation(s)
- Fong Chun Chan
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Anja Mottok
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Alina S Gerrie
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Maryse Power
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Marcel Nijland
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Arjan Diepstra
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Anke van den Berg
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Kamper
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Francesco d'Amore
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Alexander Lindholm d'Amore
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Stephen Hamilton-Dutoit
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerry J Savage
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Sohrab P Shah
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Joseph M Connors
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Randy D Gascoyne
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - David W Scott
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Steidl
- Fong Chun Chan, Anja Mottok, Alina S. Gerrie, Maryse Power, Kerry J. Savage, Sohrab P. Shah, Joseph M. Connors, Randy D. Gascoyne, David W. Scott, and Christian Steidl, British Columbia Cancer Agency; Fong Chun Chan, Anja Mottok, Sohrab P. Shah, and Christian Steidl, University of British Columbia, Canada; Marcel Nijland, Arjan Diepstra, and Anke van den Berg, University Medical Center Groningen, Groningen, the Netherlands; and Peter Kamper, Francesco d'Amore, Alexander Lindholm d'Amore, and Stephen Hamilton-Dutoit, Aarhus University Hospital, Aarhus, Denmark
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Expression of TIA1 and PAX5 in Classical Hodgkin Lymphoma at Initial Diagnosis May Predict Clinical Outcome. Appl Immunohistochem Mol Morphol 2017; 24:383-91. [PMID: 26067141 DOI: 10.1097/pai.0000000000000200] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although the expression of T-cell antigens and proteins associated with tumor-infiltrating T-lymphocytes (TILs), regulatory T cells (T-regs), and B-cell development have been evaluated in classical Hodgkin lymphoma (cHL), few studies correlate these proteins' expression patterns with clinical outcome. The purpose of this study was to evaluate proteins expressed in the Reed-Sternberg cells (RSCs) and TILs of cHLs at initial diagnosis to determine their prognostic significance. The expression of 12 proteins in RSCs and TILs from 88 diagnostic cHL biopsies was quantitated and correlated to overall survival (OS) and progression-free survival (PFS). CD2, CD3, CD4, CD5, CD7, CD25, PD1, TIA1, MUM1, and ZAP70 expression in RSCs did not correlate with OS or PFS, nor did programmed death 1 (PD1) expression in TILs. High numbers of TIA1-positive TILs (≥50%) correlated with OS (P=0.027), but not PFS (P=0.993) in univariate analysis. Expression of CD2, CD3, CD4, CD5, and/or TIA1 (6%) in RSCs was associated with lymphocyte-rich/mixed-cellularity subtype (P=0.032). High International Prognostic Score (IPS; P=0.036), and high stage (P=0.046) were independent predictors of worse PFS in univariate analysis. Low IPS (P=0.003) and nodular sclerosing subtype (P=0.022) were associated with better OS in univariate analysis. Only the IPS predicted OS in multivariate (P=0.009) analysis. High TIA1+ TILs correlated with worse clinical outcomes for cHLs, as did PAX5-RSCs (P=0.024), although only 2/74 cases were shown to be negative for this marker, suggesting that the tumor microenvironment and a transcription factor crucial for B-cell development are critical biological determinants of the disease course.
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Aldinucci D, Celegato M, Casagrande N. Microenvironmental interactions in classical Hodgkin lymphoma and their role in promoting tumor growth, immune escape and drug resistance. Cancer Lett 2016; 380:243-52. [DOI: 10.1016/j.canlet.2015.10.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 12/22/2022]
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21
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Insights into the molecular roles of heparan sulfate proteoglycans (HSPGs—syndecans) in autocrine and paracrine growth factor signaling in the pathogenesis of Hodgkin’s lymphoma. Tumour Biol 2016; 37:11573-11588. [DOI: 10.1007/s13277-016-5118-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 06/09/2016] [Indexed: 12/25/2022] Open
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22
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Gunduz E, Sermet S, Musmul A. Peripheral blood regulatory T cell levels are correlated with some poor prognostic markers in newly diagnosed lymphoma patients. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:449-54. [PMID: 26444991 DOI: 10.1002/cyto.b.21330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/18/2015] [Accepted: 09/29/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Regulatory T cells (Tregs) are a specialized subpopulation of CD4+ T cells which maintain the immune system homeostasis. They may increase during cancer progression and have been correlated with a worse prognosis in many malignancies. However, the role of Treg cells in lymphoma is debated. METHODS In this study, we assessed the peripheral blood levels of CD4+ CD25+ FOXP3+ Tregs in newly diagnosed patients with lymphoma and tried to find a relationship with patient characteristics. Twenty one patients with Hodgkin lymphoma (HL), 40 patients with non Hodgkin lymphoma (NHL) and 30 healthy sex matched controls were included in the study. Analysis were done by 3-color flow cytometry and only helper T cells were selected directly using CD4perCP as a gating strategy. RESULTS In HL group; there was a positive correlation with IPS, CRP, LDH and negative correlation with albumin, absolute lymphocyte count. Tregs were higher in male HL patients. In NHL group; there was a positive correlation with stage, IPI, CRP, LDH and a negative correlation with albumin ve absolute lymphocyte count. CONCLUSIONS There is a relationship between peripheral blood Treg levels and some poor prognostic parameters in newly diagnosed lymphoma patients. This relationship suggests a possible prognostic role of Tregs in lymphoma. Further research is needed in determining how to use Tregs as a prognostic factor. © 2015 International Clinical Cytometry Society.
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Affiliation(s)
- Eren Gunduz
- Department of Hematology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey.
| | - Serap Sermet
- Department of Internal Medicine, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Ahmet Musmul
- Department of Biostatistics, , Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
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Abstract
Hodgkin’s lymphoma is an example for a tumor with an extremely tight interaction of tumor cells with cells from the tumor micro-environment. These so-called bystander cells are not inert but interact actively with the tumor cells. Some of these cells support tumor growth by delivery of co-stimulating and anti-apoptotic signals (“helper cells”). Other cells (“killer cells”) are involved in the anti-tumor immune response which is obviously not efficient enough for tumor elimination. The activity of both helper cells and killer cells is regulated by additional cells in the stroma (“regulatory cells”). The dynamic behavior of such multi-component systems is difficult to predict. In the present paper we propose a model that can be used for simulation of essential features of this system. In this model, tumor growth depends on (i) presence of few cancer stem cells, (ii) co-stimulation of cancer cells by the tumor stroma, (iii) activity of regulatory cells that suppress killer cells without suppression of helper cells. The success of cytotoxic/cytostatic therapy in this model varies depending on the therapy-related toxicity for each of the cell populations. The model also allows the analysis of immunotherapeutic interventions. Under certain conditions, paradox enhancement of tumor growth can occur after therapeutic intervention. The model might be useful for the design of new treatment strategies for Hodgkin’s lymphoma and other tumors with prominent tumor-stroma interaction.
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24
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Lymphomagenesis in Hodgkin lymphoma. Semin Cancer Biol 2015; 34:14-21. [PMID: 25725205 DOI: 10.1016/j.semcancer.2015.02.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/06/2015] [Accepted: 02/10/2015] [Indexed: 02/07/2023]
Abstract
Hodgkin lymphoma (HL) accounts for approximately 0.6% of all new cancer cases, 10% of all lymphomas in the USA, leading to an approximate 9000 new cases per year. It is very unique in that the neoplastic Hodgkin and Reed-Sternberg (HRS) cells of classical HL account for only 1% of the tumor tissue in most cases, with various inflammatory cells including B-cells, T-cells, mast cells, macrophages, eosinophils, neutrophils, and plasma cells comprising the tumor microenvironment. Recent research has identified germinal center B-cells to be the cellular origin of HRS cells. Various transcription factor dysregulation in these neoplastic cells that explains for the loss of B-cell phenotype as well as acquisition of survival and anti-apoptotic features of HRS cells has been identified. Aberrant activation of nuclear factor-kappa B (NF-κB), Janus kinase (JAK)/signal transducer and activator of transcription (STAT), and phosphoinositide 3-kinase (PI3K) pathways play a central role in HL pathogenesis. Both intrinsic genetic mechanisms as well as extrinsic signals have been identified to account for the constitutive activation of these pathways. The extrinsic factors that regulate the activation of transcription pathways in HRS cells have also been studied in detail. Cytokines and chemokines produced both by the HRS cells as well as cells of the microenvironment of HL work in an autocrine and/or paracrine manner to promote survival of HRS cells as well as providing mechanisms for immune escape from the body's antitumor immunity. The understanding of various mechanisms involved in the lymphomagenesis of HL including the importance of its microenvironment has gained much interest in the use of these microenvironmental features as prognostic markers as well as potential treatment targets. In this article, we will review the pathogenesis of HL starting with the cellular origin of neoplastic cells and the mechanisms supporting its pathogenesis, especially focusing on the microenvironment of HL and its associated cytokines.
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25
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Pinheiro D, Chang YM, Bryant H, Szladovits B, Dalessandri T, Davison LJ, Yallop E, Mills E, Leo C, Lara A, Stell A, Polton G, Garden OA. Dissecting the regulatory microenvironment of a large animal model of non-Hodgkin lymphoma: evidence of a negative prognostic impact of FOXP3+ T cells in canine B cell lymphoma. PLoS One 2014; 9:e105027. [PMID: 25119018 PMCID: PMC4132014 DOI: 10.1371/journal.pone.0105027] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 07/19/2014] [Indexed: 02/06/2023] Open
Abstract
The cancer microenvironment plays a pivotal role in oncogenesis, containing a number of regulatory cells that attenuate the anti-neoplastic immune response. While the negative prognostic impact of regulatory T cells (Tregs) in the context of most solid tissue tumors is well established, their role in lymphoid malignancies remains unclear. T cells expressing FOXP3 and Helios were documented in the fine needle aspirates of affected lymph nodes of dogs with spontaneous multicentric B cell lymphoma (BCL), proposed to be a model for human non-Hodgkin lymphoma. Multivariable analysis revealed that the frequency of lymph node FOXP3+ T cells was an independent negative prognostic factor, impacting both progression-free survival (hazard ratio 1.10; p = 0.01) and overall survival (hazard ratio 1.61; p = 0.01) when comparing dogs showing higher than the median FOXP3 expression with those showing the median value of FOXP3 expression or less. Taken together, these data suggest the existence of a population of Tregs operational in canine multicentric BCL that resembles thymic Tregs, which we speculate are co-opted by the tumor from the periphery. We suggest that canine multicentric BCL represents a robust large animal model of human diffuse large BCL, showing clinical, cytological and immunophenotypic similarities with the disease in man, allowing comparative studies of immunoregulatory mechanisms.
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Affiliation(s)
- Dammy Pinheiro
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Yu-Mei Chang
- Research Office, The Royal Veterinary College, London, United Kingdom
| | - Hannah Bryant
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Balazs Szladovits
- Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Tim Dalessandri
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
| | - Lucy J. Davison
- Henry Wellcome Building, Centre for Cellular and Molecular Physiology, University of Oxford, Oxford, United Kingdom
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Elizabeth Yallop
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Emily Mills
- Clinical Investigation Centre, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Chiara Leo
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Ana Lara
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Anneliese Stell
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
| | - Gerry Polton
- Oncology Service, North Downs Specialist Referrals, Bletchingley, Surrey, United Kingdom
| | - Oliver A. Garden
- Department of Clinical Sciences and Services, Immune Regulation Laboratory, The Royal Veterinary College, London, United Kingdom
- Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom
- * E-mail:
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26
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Venkataraman G, Mirza MK, Eichenauer DA, Diehl V. Current status of prognostication in classical Hodgkin lymphoma. Br J Haematol 2014; 165:287-99. [DOI: 10.1111/bjh.12759] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Girish Venkataraman
- Department of Pathology; Section of Hematopathology; The University of Chicago Medicine; Chicago IL USA
| | - M. Kamran Mirza
- Department of Pathology; Section of Hematopathology; The University of Chicago Medicine; Chicago IL USA
| | - Dennis A. Eichenauer
- First Department of Internal Medicine; University Hospital Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Volker Diehl
- German Hodgkin Study Group (GHSG); Cologne Germany
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27
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Classical Hodgkin lymphoma arising in the setting of iatrogenic immunodeficiency: a clinicopathologic study of 10 cases. Am J Surg Pathol 2013; 37:1290-7. [PMID: 23774171 DOI: 10.1097/pas.0b013e31828e6564] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Iatrogenic immunodeficiency-associated lymphoproliferative disorders are rare. A small subset of these lesions resembles classical Hodgkin lymphoma (CHL), but there are few data in the literature about these lesions. We describe 10 patients with autoimmune diseases treated with immunomodulator therapeutic agents who developed CHL. The autoimmune diseases included rheumatoid arthritis (n=5), systemic lupus erythematosus (n=2), dermatomyositis (n=1), autoimmune hepatitis (n=1), and Crohn disease (n=1), and the immunomodulatory therapies were methotrexate, azathioprine, tumor necrosis factor-α inhibitors, and thalidomide alone or in various combinations. The study group included 9 women and 1 man with a median age of 50 years (range, 25 to 77 y). The histologic features supported CHL in all cases with Reed-Sternberg (RS) and Hodgkin (H) cells in an inflammatory cell background, although the neoplasm could only be subclassified in 3 patients: 2 nodular sclerosis and 1 mixed cellularity. Immunohistochemical analysis supported the diagnosis of CHL. In all cases the RS-H cells were CD30. Nine of 10 cases were CD15, whereas CD20 was expressed variably in 4/10 cases. CD45/LCA was negative in 8 cases assessed. In situ hybridization for Epstein-Barr virus-encoded RNA was positive in the RS-H cells in 8/10 cases. The microenvironment of these lesions depicted a predominance of T-regulatory cells and M2 histiocytes. Clinical follow-up data were available for 7 patients, with a median posttreatment period of 27 months (range, 12 mo to 7 y). In all 7 patients immunomodulatory drug therapy was discontinued, and chemotherapy for CHL was administered; 2 patients also received local radiation. All 7 patients achieved complete remission and are alive. We conclude that iatrogenic immunodeficiency-associated CHL is highly associated with Epstein-Barr virus infection, and patients usually have a good outcome after discontinuation of immunomodulatory agents and chemotherapy for CHL.
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28
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Affiliation(s)
- Frances R Balkwill
- Centre for Cancer and Inflammation, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
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29
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Głowala-Kosińska M, Chwieduk A, Nieckula J, Saduś-Wojciechowska M, Grosicki S, Rusin A, Nowara E, Giebel S. Association of circulating regulatory T cell number with the incidence and prognosis of diffuse large B-cell lymphoma. Eur J Haematol 2013; 91:122-8. [DOI: 10.1111/ejh.12144] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Magdalena Głowala-Kosińska
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Agata Chwieduk
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Jarosław Nieckula
- Department of Clinical and Experimental Oncology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Maria Saduś-Wojciechowska
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | | | - Aleksandra Rusin
- Center for Translational Research and Molecular Biology of Cancer; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Elżbieta Nowara
- Department of Clinical and Experimental Oncology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology; Gliwice; Poland
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30
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Gerecitano J, Gounder S, Teruya-Feldstein J, Arcila M, Ogilvie S, Gonzalez C, Lin D, Zheng J, Zhang Z, McDonald A, Mulligan G, O'Connor OA. Tissue microarray analysis reveals protein expression patterns and potential biomarkers of clinical benefit to bortezomib in relapsed/refractory non-Hodgkin lymphoma. Br J Haematol 2012; 158:290-292. [PMID: 22533368 DOI: 10.1111/j.1365-2141.2012.09137.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- John Gerecitano
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill-Cornell Medical College, New York, NY, USA
| | | | | | - Maria Arcila
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Shahiba Ogilvie
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Camille Gonzalez
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Dorothy Lin
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill-Cornell Medical College, New York, NY, USA
| | - Junting Zheng
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Zhigang Zhang
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Alice McDonald
- Millennium Pharmaceuticals, The Takeda Oncology Company, Cambridge, MA, USA
| | - George Mulligan
- Millennium Pharmaceuticals, The Takeda Oncology Company, Cambridge, MA, USA
| | - Owen A O'Connor
- NYU Langone Medical Center, NYU Cancer Institute, New York, NY, USA
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31
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Lindqvist CA, Loskog ASI. T regulatory cells in B-cell malignancy - tumour support or kiss of death? Immunology 2012; 135:255-60. [PMID: 22112044 DOI: 10.1111/j.1365-2567.2011.03539.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
It is well established that T regulatory (Treg) cells counteract tumour immunity. However, conflicting results describing the role of Treg cells in haematological tumours warrant further investigations to clarify the interactions between Treg cells and the tumour. B-cell malignancy derives from different stages of B-cell development and differentiation in which T cells play a profound role. The transformed B cell may still be in need of T-cell help to thrive but simultaneously they may be recognized and destroyed by cytotoxic lymphocytes. Recent reports demonstrate that Treg cells can suppress and even kill B cells as part of their normal function to rescue the body from autoimmunity. An emerging body of evidence points out that Treg cells not only inhibit tumour-specific T cells but may also have a role in suppressing the progression of the B-cell tumour. In this review, we discuss the origin and function of Treg cells and their role in patients with B-cell tumours.
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Affiliation(s)
- Camilla A Lindqvist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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32
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Lindqvist CA, Christiansson LH, Thörn I, Mangsbo S, Paul-Wetterberg G, Sundström C, Tötterman TH, Simonsson B, Enblad G, Frisk P, Olsson-Strömberg U, Loskog ASI. Both CD4+ FoxP3+ and CD4+ FoxP3- T cells from patients with B-cell malignancy express cytolytic markers and kill autologous leukaemic B cells in vitro. Immunology 2011; 133:296-306. [PMID: 21463298 DOI: 10.1111/j.1365-2567.2011.03439.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Cytotoxic CD4(+) T cells have been found in patients with chronic lymphocytic leukaemia (CLL) and seem to be involved in the regulation of malignant B cells. The CD4(+) T regulatory cells (Tregs) can regulate various immune cells, including B cells, by inducing their apoptosis. Hence, different subgroups of CD4(+) T cells may be involved in the regulation of malignant B cells. In this study, the cytotoxic phenotype and function of various CD4(+) T-cell subgroups were investigated in patients with B-cell malignancies. Peripheral blood was collected from patients with CLL, various B-cell lymphomas, healthy adult donors, children with precursor B-cell acute lymphoblastic leukaemia (pre-B ALL) and from healthy children. CD4(+) T cells (CD3(+) CD4(+) FoxP3(-)), Tregs (CD3(+) CD4(+) CD127(low) FoxP3(+)) and CD127(high) FoxP3(+) T cells (CD3(+) CD4(+) CD127(high) FoxP3(+)) were analysed for their expression of the cytolytic markers CD107a and Fas ligand. Patients with CLL had increased CD107a expression on all tested T-cell subgroups compared with healthy donors. Similar results were found in patients with B-cell lymphomas whereas the CD107a expression in children with pre-B ALL was no different from that in healthy controls. Fas ligand expression was similar between patient cells and cells of healthy donors. CD4(+) T cells and Tregs from patients with CLL and healthy donors were subsequently purified and cultured in vitro with autologous B cells. Both subgroups lysed B cells and killing was confirmed by granzyme ELISAs. In conclusion, cytotoxic populations of CD4(+) T cells, including Tregs, are present in patients with B-cell malignancy and may be an important factor in immune-related disease control.
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Affiliation(s)
- Camilla A Lindqvist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
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T-Cell Traffic Jam in Hodgkin's Lymphoma: Pathogenetic and Therapeutic Implications. Adv Hematol 2010; 2011:501659. [PMID: 20975771 PMCID: PMC2957104 DOI: 10.1155/2011/501659] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 09/27/2010] [Indexed: 11/17/2022] Open
Abstract
In hematologic malignancies, the microenvironment is often characterized by nonneoplastic cells with peculiar phenotypic and functional features. This is particularly true in Hodgkin's lymphoma (HL), in which T lymphocytes surrounding Hodgkin's Reed-Sternberg cells are essentially polarized towards a memory T-helper type 2 phenotype. In this paper we will first evaluate the main processes modulating T-cell recruitment towards the lymph node microenvironment in HL, especially focusing on the role played by cytokines. We will then consider the most relevant mechanisms of immune escape exerted by neoplastic cells in order to evade antitumor immunity. The potential pathogenetic and prognostic impact of regulatory T cells in such a context will be also described. We will finally overview some of the strategies of cellular immunotherapy applied in patients with HL.
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