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Senchenko MA, Konovalov DM. [IgD expression in various immunoarchitectural patterns of nodular lymphocyte predominant Hodgkin lymphoma in children]. Arkh Patol 2024; 86:21-26. [PMID: 38319268 DOI: 10.17116/patol20248601121] [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] [Indexed: 02/07/2024]
Abstract
BACKGROUND Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) consist of lymphocyte predominant cell or LP-cell. Despite their origin from active germinal centers, in some cases LP-cells express IgD, which is characteristic of naive B-lymphocytes of the mantle zone. Due to the rarity of NLPHL, assessing the frequency of IgD-positive cases is difficult. This marker can serve not only for differential diagnosis with other diseases, but also indicate the possible heterogeneity of NLPHL, which is currently represented by six immunoarchitectural patterns. OBJECTIVE To determine the frequency of IgD-positive cases of NLPHL in children with subsequent assessment of the association with types of immunoarchitectural patterns. MATERIAL AND METHODS The study included 52 cases of NLPHL, which were divided to typical and atypical patterns. Differences between two groups were compared using Fisher's exact tests. RESULTS IgD expression was found in LP-cells in 26 of 52 cases (50%) and was positively correlated with atypical types (typical - 5/23, 21.7% vs atypical - 21/29, 72.4%, p=0.0003), among which pattern C was most common. CONCLUSION Due to the high incidence of IgD-positive cases in NLPHL, this marker may be useful in differential diagnosis with histologic mimics. At the same time, positive IgD status was associated with atypical patterns, which may likely determine the different biology of neoplastic cells within the same form.
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Affiliation(s)
- M A Senchenko
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - D M Konovalov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
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2
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Ali N, Moussa E, Khorshed E, Zaghloul MS, Elnashar A, Abdalla A. Variant histology of pediatric nodular lymphocyte-predominant Hodgkin lymphoma with IgD and CD30 expression. Pediatr Blood Cancer 2023; 70:e30647. [PMID: 37638819 DOI: 10.1002/pbc.30647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), recently known as nodular lymphocyte-predominant B-cell lymphoma (NLPBL), accounts for 5%-10% of Hodgkin lymphoma (HL). Different morphologic patterns of NLPBL are identified and categorized as typical patterns (type A and B) and variant histologic patterns (types C, D, E, and F). PATIENTS AND METHOD We investigated different morphologic patterns, CD30 and IgD expression in pediatric patients with NLPBL diagnosed at the Children's Cancer Hospital Egypt. RESULTS Forty-six (53%) of the patients exhibited a typical histologic pattern, whereas the remaining (47%) exhibited variant histologic pattern. Variant histology is associated with unfavorable clinical characteristics, such as advanced stages, B-symptoms, and extranodal involvements, particularly bone marrow and bone infiltration, with p-values of .06, .05, and 0.01%, respectively. Additionally, 39% of patients with variant histology experienced disease progression or relapse, compared to only 15.2% of patients with typical patterns (p = .009). Types C and D are related to decreased event-free survival (EFS), as shown by a p-value of .05. The 5-year EFS for patients with variant histology was 94.4% for the rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone (RCHOP) versus 33.3% for the adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). IgD expression in lymphocyte-predominant (LP) cells was detected in 44 (50%) patients, while CD30 expression in LP cells was found in 39 (44%) patients. CONCLUSION Variant histology of NLPBL was associated with advanced disease stages and a poor prognosis, while expression of IgD and CD30 in LP cells was not. The poor outcome of variant histology improved with the RCHOP regimen.
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Affiliation(s)
- Nesreen Ali
- Pediatric Oncology and Hematology Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital, Cairo, Egypt
| | - Emad Moussa
- Clinical Oncology Department, Menoufya University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Eman Khorshed
- Pathology Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Mohamed S Zaghloul
- Radiation Therapy Department, National Cancer Institute (NCI), Cairo University and Children Cancer Hospital Egypt, Cairo, Egypt
| | - Amr Elnashar
- Clinical Research Department, Children Cancer Hospital, Cairo, Egypt
| | - Amr Abdalla
- Pediatric Oncology and Hematology Department, National Cancer Institute (NCI), Cairo University, Egypt and Child Health Department, Sultan Qaboos University, Muscat, Oman
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3
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Zulfiqar A, Zafar F, Yaqub B, Mahmoud HMA, Shah M, Widaa EMA, Nawaz H, Akhtar N, Nishan U. Cobalt oxide modified sulfur and phosphorus Co-doped g-C 3N 4 for screening of urinary human albumin. Mikrochim Acta 2023; 190:355. [PMID: 37594627 DOI: 10.1007/s00604-023-05936-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/27/2023] [Indexed: 08/19/2023]
Abstract
The fabrication of a heteroatom-doped nanocomposite based on cobalt oxide modified sulfur, phosphorus co-doped carbon nitride (Co3O4/SP-CN) with increased active sites is reported. The synthesized nanocomposite offers surprisingly high electrocatalytic oxidation efficacy toward human albumin (HA) despite its agglomeration. This improved efficacy of Co3O4/SP-CN nanocomposite could be attributed to its increased adsorption sites and surface defects, fast charge transportation capability, and conductivity. Additionally, morphological and compositional analysis of the fabricated Co3O4/SP-CN material has been performed through scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photon spectroscopy (XPS), and Raman spectroscopy. The fabricated electrode shows remarkable amperometric response against the HA with a limit of detection of 8.39 nM and linear range of 20-4000 nM at applied potential of 0.25 V versus Ag/AgCl in 0.1 M PBS (pH 8.2). The designed Co3O4/SP-CN electrode has been successfully applied to monitor HA in urine samples of diabetic patient with recovery percentage from 94.1 and 92.1% and with relative standard deviation (RSD) values of 5.8 and 7.8%. According to the best of our knowledge, this is the first report to use a Co3O4/SP-CN-based graphitic pencil (GP) electrode for monitoring of HA for early diagnosis of diabetic nephropathy.
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Affiliation(s)
- Anam Zulfiqar
- Department of Biochemistry, Bahauddin Zakariya University (BZU), Multan, 60800, Pakistan
| | - Farhan Zafar
- Department of Chemistry, COMSATS University Islamabad, Lahore Campus, Lahore, 54000, Pakistan
| | - Bushra Yaqub
- Department of Biochemistry, Bahauddin Zakariya University (BZU), Multan, 60800, Pakistan
| | - HassabAlla M A Mahmoud
- Department of Physics, Faculty of Sciences and Arts, King Khalid University, Muhayil Asir, 63311, Saudi Arabia
| | - Mohibullah Shah
- Department of Biochemistry, Bahauddin Zakariya University (BZU), Multan, 60800, Pakistan.
| | - Einas M A Widaa
- Department of Physics, Turabah University College, Taif University, Box 11099, Taif, PO, 21944, Saudi Arabia
| | - Haq Nawaz
- Department of Biochemistry, Bahauddin Zakariya University (BZU), Multan, 60800, Pakistan
| | - Naeem Akhtar
- Institute of Chemical Sciences, Bahauddin Zakariya University (BZU), Multan, 60800, Pakistan.
| | - Umar Nishan
- Department of Chemistry, Kohat University of Science & Technology, Kohat, Pakistan
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Eichenauer DA, Fuchs M. Treatment of Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Where Do We Stand? Where Do We Go? Cancers (Basel) 2023; 15:3310. [PMID: 37444420 DOI: 10.3390/cancers15133310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare B cell-derived lymphoma entity accounting for ≈5% of all Hodgkin lymphoma (HL) cases. In recent decades, patients with newly diagnosed NLPHL have usually been treated very similarly to classical HL (cHL). The 10-year overall survival rates with HL-directed approaches are in excess of 90%. However, pathological and clinical characteristics of NLPHL resemble indolent B-cell non-Hodgkin lymphoma (B-NHL) in some aspects. Thus, nodular lymphocyte-predominant B-cell lymphoma has been proposed as an alternative name, and the use of B-NHL-directed treatment strategies has become more common in NLPHL despite limited data. Given the often indolent clinical course of NLPHL, even in the case of relapse, the majority of patients with disease recurrence do not require high-dose chemotherapy and autologous stem cell transplantation but are treated sufficiently with low-intensity approaches such as single-agent anti-CD20 antibody treatment. The establishment of novel prognostic scores for NLPHL patients may optimize risk group and treatment allocation in newly diagnosed and relapsed disease.
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Affiliation(s)
- Dennis A Eichenauer
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, D-50937 Cologne, Germany
- German Hodgkin Study Group (GHSG), First Department of Internal Medicine, University Hospital Cologne, D-50937 Cologne, Germany
| | - Michael Fuchs
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, D-50937 Cologne, Germany
- German Hodgkin Study Group (GHSG), First Department of Internal Medicine, University Hospital Cologne, D-50937 Cologne, Germany
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Torabi A, Fromm JR, Naresh KN. MEF2B is the ideal immunohistochemical marker to highlight neoplastic LP cells in nodular lymphocyte-predominant Hodgkin lymphoma. EJHAEM 2023; 4:517-519. [PMID: 37206275 PMCID: PMC10188466 DOI: 10.1002/jha2.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Alireza Torabi
- Department of Laboratory Medicine and PathologyDivision of HematopathologyUniversity of WashingtonSeattleWashingtonUSA
| | - Jonathan R Fromm
- Department of Laboratory Medicine and PathologyDivision of HematopathologyUniversity of WashingtonSeattleWashingtonUSA
| | - Kikkeri N Naresh
- Pathology ProgramTranslational Science and Therapeutics DivisionFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
- Department of Laboratory Medicine and PathologyUniversity of WashingtonSeattleWashingtonUSA
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Hartmann S, Soltani AS, Bankov K, Bein J, Hansmann ML, Rosenwald A, Bernd HW, Feller A, Ott G, Möller P, Stein H, Klapper W, Borchmann P, Engert A, Eichenauer DA. Tumour cell characteristics and microenvironment composition correspond to clinical presentation in newly diagnosed nodular lymphocyte-predominant Hodgkin lymphoma. Br J Haematol 2022; 199:382-391. [PMID: 35880396 DOI: 10.1111/bjh.18376] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 12/21/2022]
Abstract
Different studies have characterized the microenvironment and its prognostic impact in classic Hodgkin lymphoma whereas such analyses are pending for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). We thus investigated characteristics of tumour cells and microenvironment in NLPHL and evaluated possible correlations with the clinical presentation. Lymph node samples from 152 NLPHL patients who had first-line treatment within the randomized German Hodgkin Study Group HD16-HD18 trials were available and analysed with regard to IgD status and nuclear size of the tumour cells as well as presence of PD1-positive follicular T helper cells and CD163-positive macrophages in the microenvironment. While large tumour cell nuclei and high numbers of PD1-positive follicular T helper cells in the microenvironment were more common in patients presenting with early/intermediate stages than in patients with advanced-stage disease (p < 0.0001, unpaired t-test; p = 0.0022, Mann-Whitney test), no differences between risk groups were observed in terms of the IgD status of the tumour cells and the content of CD163-positive macrophages in the microenvironment. PD1-positive follicular T helper cells were present in both cases with typical and variant growth patterns and rosetting around the tumour cells was observed in 96% of patients, indicating an important role of PD1-positive follicular T helper cells in NLPHL.
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Affiliation(s)
- Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ahmad Sajad Soltani
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katrin Bankov
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Martin-Leo Hansmann
- Frankfurt Institute for Advanced Studies, Frankfurt am Main, Germany.,Institute of General Pharmacology and Toxicology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Institute of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Wuppertal, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | | | | | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Peter Möller
- Institute of Pathology, University Hospital Ulm, Ulm, Germany
| | | | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Peter Borchmann
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - Andreas Engert
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - Dennis A Eichenauer
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
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7
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Xia D, Sayed S, Moloo Z, Gakinya SM, Mutuiri A, Wawire J, Okiro P, Courville EL, Hasserjian RP, Sohani AR. Geographic Variability of Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Am J Clin Pathol 2022; 157:231-243. [PMID: 34542569 DOI: 10.1093/ajcp/aqab113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) differs from classic Hodgkin lymphoma (CHL) in terms of clinicopathologic features, including Epstein-Barr virus (EBV) association. CHL geographic variability is well known, with higher frequencies of mixed-cellularity subtype and EBV positivity in low/middle-income countries (LMICs), but there are few well-characterized series of NLPHL from LMICs. METHODS We detail clinicopathologic findings of 21 NLPHL cases received in consultation from Kenya and summarize reports of NLPHL with EBV testing published since 2000. RESULTS Median age of consultation cases was 36 years, and male/female ratio was 3.2. All cases involved peripheral lymph nodes and showed at least some B-cell-rich nodular immunoarchitecture, with prominent extranodular lymphocyte-predominant (LP) cells and T-cell-rich variant patterns most commonly seen. LP cells expressed pan-B-cell markers, including strong OCT2; lacked CD30 and CD15 expression in most cases; and were in a background of expanded/disrupted follicular dendritic cell meshworks and increased T-follicular helper cells. LP cells were EBV negative in 18 cases. Historical cases showed a low rate of EBV positivity with no significant difference between LMICs and high-income countries. CONCLUSIONS Unlike CHL, NLPHL shows few geographic differences in terms of clinicopathologic features and EBV association. These findings have implications for diagnosis, prognostication, and treatment of patients with NLPHL in LMICs.
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Affiliation(s)
- Daniel Xia
- Division of Hematopathology and Transfusion Medicine, University Health Network, Toronto, Canada
| | | | - Zahir Moloo
- Aga Khan University Hospital, Nairobi, Kenya
| | | | | | | | | | | | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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8
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Sidda A, Naleid NK, Manu G, Graffeo V, Jamil MO. Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Review of Current Literature and Case Discussion. J Investig Med High Impact Case Rep 2022; 10:23247096221111767. [PMID: 35861500 PMCID: PMC9309769 DOI: 10.1177/23247096221111767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022] Open
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subset of Hodgkin lymphoma (HL). It has a distinct clinical and pathological presentation. Unlike classic HL, where the predominant malignant cells are Reed Sternberg cells, the malignant cells in NLPHL are known as lymphocyte predominant (LP) cells, with their own unique immunohistochemistry antigen expression and staining pattern. Based on risk stratification and staging of the disease, treatment can range from active surveillance in asymptomatic patients with no organ compromise or bulky disease, to aggressive chemotherapeutic agents in advanced disease. Guidelines on which of these chemotherapy regimens would offer the most benefit to our patients are limited due to lack of randomized-controlled studies. Majority of the current prospective data on treatment were inclusive of both HL and NLPHL. Thus, the regimens employed in treatment of NLPHL are similar to the ones used in HL, though NLPHL is often viewed as its own distinct entity. This article aims to review the current literature and future advances on treatment of this rare disease.
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Affiliation(s)
- Adarsh Sidda
- Department of Hematology & Oncology,
Marshall University, Huntington, WV, USA
| | | | - Gurusidda Manu
- Internal Medicine, University of Texas
Southwestern, Dallas, USA
| | - Vincent Graffeo
- Department of Pathology, Marshall University,
Huntington, WV, USA
| | - Muhammad Omer Jamil
- Department of Hematology & Oncology,
Marshall University, Huntington, WV, USA
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9
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Karpathiou G, Ferrand E, Papoudou-Bai A, Camy F, Honeyman F, Dumollard JM, Peoc'h M. STAT6 and phosphorylated STAT6 are differentially expressed in lymphomas. Pathol Res Pract 2021; 229:153697. [PMID: 34839096 DOI: 10.1016/j.prp.2021.153697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/05/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The STAT6 pathway is implicated in the pathogenesis of various lymphomas; however, its immunohistochemical expression has not been fully investigated. Thus, the aim of this study was to investigate the immunohistochemical expression of the two forms of STAT6, phosphorylated or not, in a series of systemic lymphomas. MATERIALS AND METHODS Immunohistochemical expression of two antibodies, STAT6 (clone YE361) and pSTAT6 (clone Y641), which recognise the phosphorylated form of the molecule was studied in 60 lymphomas. RESULTS STAT6YE361 expression was cytoplasmic, with 23.3% of the cases showing high expression. pSTAT6Y641 expression was mostly nuclear and found in 45% of the cases. pSTAT6Y641 nuclear expression was associated with the lymphoma type (p < 0.0001), as it was seen mostly in follicular, Hodgkin and angioimmunoblastic T cell lymphomas. STAT6YE361 cytoplasmic expression was also associated with lymphoma type (p = 0.001), as it was mostly found in diffuse large B cell and marginal B cell lymphomas. No association with PD-L1 expression, other clinicopathological data or prognosis was found. CONCLUSION The two STAT6 clones are differentially expressed between lymphoma types.
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Affiliation(s)
| | - Elise Ferrand
- Pathology Department, University Hospital of Saint-Etienne, France
| | | | - Florian Camy
- Pathology Department, University Hospital of Saint-Etienne, France
| | - Fressia Honeyman
- Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France
| | | | - Michel Peoc'h
- Pathology Department, University Hospital of Saint-Etienne, France
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10
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Karpathiou G, Ferrand E, Camy F, Babiuc SM, Papoudou-Bai A, Dumollard JM, Cornillon J, Peoc'h M. Expression of STAT6 and Phosphorylated STAT6 in Primary Central Nervous System Lymphomas. J Neuropathol Exp Neurol 2021; 80:830-834. [PMID: 34388250 DOI: 10.1093/jnen/nlab080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The signal transducer and activator of transcription 6 (STAT6) is implicated in the pathogenesis of some lymphomas including primary central nervous system lymphomas (PCNSLs). The aim of this study was to investigate STAT6 expression and clinicopathologic features in 25 PCNSLs using immunohistochemistry with 2 different anti-STAT6 antibodies. One (YE361) recognizes the C-terminus domain of the STAT6 protein and the other (Y641) recognizes the phosphorylated form of the protein. The phosphorylated STAT6 form was not expressed in any of the cases studied whereas the YE361 STAT6 showed only cytoplasmic expression in 14 (56%) cases. This expression did not correlate with age, prognostic score, multiplicity, invasion of deep structures, response to treatment, disease recurrence, overall survival, or BCL6, BCL2, PD-L1, and CD8 expression. A STAT6 expression score showed a trend for correlating with clinical performance status. It also showed a positive correlation with MYC expression. Thus, the phosphorylated form of STAT6 was not found in the current series, while the YE361 STAT6 showed only cytoplasmic expression and was associated with expression of MYC.
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Affiliation(s)
- Georgia Karpathiou
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Elise Ferrand
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Florian Camy
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Silvia-Maria Babiuc
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Alexandra Papoudou-Bai
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Jean Marc Dumollard
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Jerome Cornillon
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
| | - Michel Peoc'h
- From the Pathology Department, University Hospital of Saint-Etienne, France (GK, EF, FC, JMD, MP); Hematology and Cell Therapy Department, Lucien Neuwirth Cancer Institute, France (S-MB, JC); Pathology Department, University Hospital of Ioannina, Ioannina, Greece (AP-B)
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11
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Karpathiou G, Papoudou-Bai A, Ferrand E, Dumollard JM, Peoc'h M. STAT6: A review of a signaling pathway implicated in various diseases with a special emphasis in its usefulness in pathology. Pathol Res Pract 2021; 223:153477. [PMID: 33991851 DOI: 10.1016/j.prp.2021.153477] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 12/17/2022]
Abstract
Signal Transducer and Activator of Transcription 6 (STAT6), belonging to a family of seven similar members is primarily stimulated by interleukin(IL)-4 and IL-13, and acts as a T helper type 2 (Th2)-inducing factor. Thus, it is implicated in the pathophysiology of various allergic conditions, such as asthma, atopic dermatitis, eosinophilic esophagitis and food allergies, but also in tumor microenvironment regulation. Furthermore, certain forms of lymphomas, notably the Hodgkin lymphoma group, the primary mediastinal and primary central nervous system lymphoma, as well as some follicular and T cell lymphomas are associated with dysregulation of the STAT6 pathway. STAT6 immunohistochemical expression also serves as a surrogate marker in the diagnosis of solitary fibrous tumor, despite not directly responsible for the tumorigenic effect. These pathophysiological implications of the STAT6 pathway, its diagnostic or prognostic role in pathology, as well its immunohistochemical detection with different antibodies will be discussed in this review.
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Affiliation(s)
| | | | - Elise Ferrand
- Pathology Department, University Hospital of Saint-Etienne, France
| | | | - Michel Peoc'h
- Pathology Department, University Hospital of Saint-Etienne, France
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12
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Paschold L, Willscher E, Bein J, Vornanen M, Eichenauer DA, Simnica D, Thiele B, Wickenhauser C, Rosenwald A, Bernd HW, Klapper W, Feller AC, Ott G, Fend F, Hartmann S, Binder M. Evolutionary clonal trajectories in nodular lymphocyte predominant Hodgkin lymphoma with high transformation risk. Haematologica 2021; 106:2654-2666. [PMID: 33882641 PMCID: PMC8485677 DOI: 10.3324/haematol.2021.278427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Indexed: 11/09/2022] Open
Abstract
The B cell architecture of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is complex since it is composed of malignant lymphocyte-predominant (LP) cells along with a B cell rich bystander environment. To gain insight into molecular determinants of transformation, we studied B cell evolutionary trajectories in lymphoma tissue from diagnosis to relapse or transformation to non-Hodgkin lymphoma by immunoglobulin heavy chain next-generation sequencing. NLPHL cases that later transformed showed higher age, IgD negativity, absence of the characteristic IGHV3/IGHD3/IGHJ6 LP rearrangement and high repertoire clonality. We constructed phylogenetic trees within the compartment of the malignant clone to investigate clonal evolution. In all relapsing cases, the LP rearrangement was identical at diagnosis and relapse. NLPHL cases with transformation showed more complex trajectories with strong intraclonal diversification. The dominant founder clone in transformations showed clonal evolution, if derived from the same cell of origin, or originated from a different cell of origin. Together, our data point to a significant role of antigenic drive in NLHPL transformations and identify high B cell repertoire clonality with dominant intraclonal LP cell diversification as a hallmark of transformation. Sequencing of the initial paraffin-embedded tissue may therefore be diagnostically applied to identify NLPHL cases with high transformation risk.
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Affiliation(s)
- Lisa Paschold
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Edith Willscher
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Hospital of Frankfurt Main, Theodor-Stern-Kai 7, D-60590 Frankfurt a. Main
| | - Martine Vornanen
- Department of Pathology, Tampere University Hospital and University of Tampere, Tampere 33520
| | - Dennis A Eichenauer
- University of Cologne, First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, and German Hodgkin Study Group, University Hospital Cologne, Cologne
| | - Donjete Simnica
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Benjamin Thiele
- Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Claudia Wickenhauser
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg
| | | | - Wolfram Klapper
- Department of Pathology, Division of Hematopathology and Lymph Node Registry, Schleswig-Holstein Medical Center, Campus Kiel, Kiel
| | | | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus and Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart
| | - Falko Fend
- Institute of Pathology, Eberhard Karls University Tübingen, Tübingen
| | - Sylvia Hartmann
- Institute of Pathology, Eberhard Karls University Tübingen, Tübingen, Germany; Reference and Consultation Center for Lymph Node and Lymphoma Pathology, Goethe University, Frankfurt am Main
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale).
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13
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Diagnostic utility of STAT6 YE361 expression in classical Hodgkin lymphoma and related entities. Mod Pathol 2020; 33:834-845. [PMID: 31822802 PMCID: PMC8191386 DOI: 10.1038/s41379-019-0428-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
Although the distinction of classical Hodgkin lymphoma from nodular lymphocyte predominant Hodgkin lymphoma using morphology and immunostains is straightforward in most instances, occasional cases pose diagnostic challenge. We sought to determine the utility of the novel YE361 STAT6 rabbit monoclonal antibody in Hodgkin lymphoma and diagnostically challenging B- and T-cell non-Hodgkin lymphoma entities with Hodgkin-like features. Cases from seven institutions included: 57 classical Hodgkin lymphomas (31% EBV+), 34 nodular lymphocyte predominant Hodgkin lymphomas, 34 mimicking B- and T-cell non-Hodgkin lymphomas, and 7 reactive lymphoproliferations. After review of histology, STAT6YE361 immunostaining was performed. The intensity and spatial localization of immunopositivity was assessed in neoplastic cells. Additional FISH for programmed death ligand-1 (PD-L1) was performed in one patient in paired treatment-naive and relapse biopsy tissues. Two STAT6YE361 immunopositive cases were examined by whole-exome sequencing after flow sorting to assess mutations in STAT6 pathway genes. Most classical Hodgkin lymphomas showed nuclear staining for STAT6YE361 [46/57 cases (80%)] on Hodgkin cells. Staining was exclusively nuclear in a minority [12/46 (26%)], while dual nuclear and cytoplasmic localization was more common [34/46 (74%)]. In contrast, all nodular lymphocyte predominant Hodgkin lymphomas [0/34 (0%)] were negative for nuclear STAT6YE361 staining on the lymphocyte predominant cells. Within B- and T-cell non-Hodgkin lymphomas, nuclear STAT6YE361 was seen in: B-cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, and in primary mediastinal large B-cell lymphoma. Strong PD-L1 gene amplification was noted in the paired cHL and relapse B-cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma, although STAT6YE361 was negative in both biopsies. Whole-exome sequencing identified mutations in B2M, XPO1, and ITPKB as well CISHP213L (in the STAT pathway) in one classical Hodgkin lymphoma patient positive for nuclear STAT6YE361 although no underlying STAT6 mutations were observed in either sample examined. STAT6YE361 nuclear staining has 100% positive predictive value and 85.7% negative predictive value in confirming or excluding classical Hodgkin lymphoma diagnosis in the distinction from nodular lymphocyte predominant Hodgkin lymphoma and other benign and malignant entities.
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14
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Hartmann S, Plütschow A, Mottok A, Bernd H, Feller AC, Ott G, Cogliatti S, Fend F, Quintanilla‐Martinez L, Stein H, Klapper W, Möller P, Rosenwald A, Engert A, Hansmann M, Eichenauer DA. The time to relapse correlates with the histopathological growth pattern in nodular lymphocyte predominant Hodgkin lymphoma. Am J Hematol 2019; 94:1208-1213. [PMID: 31396979 DOI: 10.1002/ajh.25607] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 07/17/2019] [Accepted: 08/05/2019] [Indexed: 01/03/2023]
Abstract
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) can present with different histopathological growth patterns. The impact of these histopathological growth patterns on relapse characteristics is unknown. We therefore analyzed paired biopsies obtained at initial diagnosis and relapse from 33 NLPHL patients who had received first-line treatment within German Hodgkin Study Group (GHSG) trial protocols, and from a second cohort of 41 relapsed NLPHL patients who had been treated outside GHSG studies. Among the 33 GHSG patients, 21 patients presented with a typical growth pattern at initial diagnosis, whereas 12 patients had a variant histology. The histopathological growth patterns at initial diagnosis and at relapse were consistent in 67% of cases. A variant histology at initial diagnosis was associated with a shorter median time to lymphoma recurrence (2.8 vs 5.2 years; P = .0219). A similar tendency towards a shorter median time to lymphoma recurrence was observed for patients presenting with a variant histology at relapse, irrespective of the growth pattern at initial diagnosis. Results obtained from the 41 NLPHL patients who had been treated outside GHSG studies were comparable (median time to lymphoma recurrence for variant histology vs typical growth pattern at initial diagnosis: 1.5 vs 7.0 years). In conclusion, the histopathological growth pattern remains consistent at relapse in the majority of NLPHL cases, and has major impact on the time of relapse.
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Affiliation(s)
- Sylvia Hartmann
- Senckenberg Institute of PathologyGoethe University Frankfurt am Main Germany
- Reference and Consultation Center for Lymph Node and Lymphoma PathologyGoethe University Frankfurt am Main Germany
| | - Annette Plütschow
- First Department of Internal MedicineCenter for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne Cologne Germany
- German Hodgkin Study GroupUniversity Hospital Cologne Cologne Germany
| | - Anja Mottok
- Institute of PathologyUniversity of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken Würzburg Germany
- Institute of Human GeneticsUlm University and Ulm University Medical Center Ulm Germany
| | | | | | - German Ott
- Department of Clinical PathologyRobert‐Bosch‐Krankenhaus and Dr Margarete Fischer‐Bosch Institute of Clinical Pharmacology Stuttgart Germany
| | - Sergio Cogliatti
- Institute of PathologyKantonsspital St. Gallen St. Gallen Switzerland
| | - Falko Fend
- Institute of PathologyEberhard Karls University Tübingen Tübingen Germany
| | | | - Harald Stein
- Pathodiagnostic Berlin, Berlin Reference Center for Lymphoma and Hematopathology Berlin Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node RegistryUniversity Hospital Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Peter Möller
- Institute of PathologyUniversity Hospital Ulm Ulm Germany
| | - Andreas Rosenwald
- Institute of PathologyUniversity of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken Würzburg Germany
| | - Andreas Engert
- First Department of Internal MedicineCenter for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne Cologne Germany
- German Hodgkin Study GroupUniversity Hospital Cologne Cologne Germany
| | - Martin‐Leo Hansmann
- Senckenberg Institute of PathologyGoethe University Frankfurt am Main Germany
- Reference and Consultation Center for Lymph Node and Lymphoma PathologyGoethe University Frankfurt am Main Germany
- Frankfurt Institute of Advanced Studies Frankfurt am Main Germany
| | - Dennis A. Eichenauer
- First Department of Internal MedicineCenter for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne Cologne Germany
- German Hodgkin Study GroupUniversity Hospital Cologne Cologne Germany
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15
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Abstract
Radiation therapy plays a critical role in the management of a wide range of hematologic malignancies. The optimal radiation dose and target volume, and safe and effective ways of integrating radiation with systemic agents, vary depending on the histologic subtypes, stage at presentation, patient performance status, response to systemic therapy if given, treatment intent, and patient preferences. Limiting doses to surrounding organs without sacrificing disease control is of paramount importance. Reducing radiation doses and treatment volume in selected cases, and the use of advanced radiotherapy technology, can improve the therapeutic ratio of patients receiving radiation therapy for hematologic malignancies.
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Affiliation(s)
- Yolanda D Tseng
- Department of Radiation Oncology, Seattle Cancer Care Alliance Proton Therapy Center, University of Washington School of Medicine, 1570 North 115th Street, Seattle, WA 98133, USA
| | - Andrea K Ng
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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16
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Spinner MA, Varma G, Advani RH. Modern principles in the management of nodular lymphocyte-predominant Hodgkin lymphoma. Br J Haematol 2018; 184:17-29. [DOI: 10.1111/bjh.15616] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Michael A. Spinner
- Division of Oncology; Department of Medicine; Stanford University; Stanford CA USA
| | - Gaurav Varma
- Department of Medicine; New York-Presbyterian Hospital/Weill Cornell Medicine; New York NY USA
| | - Ranjana H. Advani
- Division of Oncology; Department of Medicine; Stanford University; Stanford CA USA
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17
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Incidence and survival of Hodgkin lymphoma patients in Girona (Spain) over three decades: a population-based study. Eur J Cancer Prev 2018; 26 Joining forces for better cancer registration in Europe:S164-S169. [PMID: 28590273 DOI: 10.1097/cej.0000000000000383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Hodgkin lymphoma (HL) is characterized by heterogeneous histologic findings, clinical presentation and outcomes. Using the Girona population-based cancer registry data we sought to explore the incidence of HL over three decades in Girona Province (Spain) and examine the relationship between clinical features at diagnosis and survival. From 1985 to 2013, 459 cases were recorded. Patients were stratified by sex, age group, stage at diagnosis, histological subtypes and the presence of B-symptoms. The crude incidence rate (CR) was 2.7 and the corresponding European age-adjusted rate was 2.6, being higher in men than in women (sex ratio=1.6). Incidence remained constant throughout the period of study. Nodular sclerosis was the most frequent histology and showed an increasing incidence over time [estimated annual percentage change=+2.4, 95% confidence interval (CI): 0.8-4.0]. The 5-year observed survival and relative survival of patients diagnosed with HL were 73.1% (95% CI: 69.0-77.5) and 74.6% (95% CI: 70.0-79.4), respectively. No statistical differences in observed survival were observed across the three decades of study (P=0.455). Clinical parameters negatively influencing 5-year relative survival in the multivariate analysis were as follows: age at diagnosis at least 65 years; clinical stage IV; and presence of B-symptoms. These current patterns of presentation and outcomes of HL help delineate key populations in order to explore risk factors for HL and strategies to improve treatment outcomes.
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18
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Untanu RV, Back J, Appel B, Pei Q, Chen L, Buxton A, Hodgson DC, Ehrlich PF, Constine LS, Schwartz CL, Hutchison RE. Variant histology, IgD and CD30 expression in low-risk pediatric nodular lymphocyte predominant Hodgkin lymphoma: A report from the Children's Oncology Group. Pediatr Blood Cancer 2018; 65:10.1002/pbc.26753. [PMID: 28802087 PMCID: PMC5699946 DOI: 10.1002/pbc.26753] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/30/2017] [Accepted: 07/15/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Histologic prognostic factors have been described for nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). This study examines histologic and immunophenotypic variants in a clinical trial for pediatric NLPHL. PROCEDURE One hundred sixty-eight cases of localized NLPHL were examined for histologic variants, CD30 and immunoglobulin D (IgD) expression, and outcome. Histologic types were scored categorically as 0 = 0, 1 ≤ 25%, and 2 > 25% of the sample. RESULTS Fifty-eight (35.1%) cases showed only typical nodular with or without serpiginous histology (types A and B). The remainder showed mixtures of histologies. The numbers of patients with score 2 are 85 (50.6%) type A, 21 (12.5%) type B, 46 (27.4%) with extranodular large B cells (type C), 3 with T-cell-rich nodular pattern (type D), 55 (32.7%) with diffuse T-cell-rich (type E) pattern, and 2 (1.2%) with diffuse B-cell pattern (type F). Higher level of types C (P = 0.048) and D (P = 0.033) resulted in lower event-free survival (EFS). Cytoplasmic IgD was found in 65 of 130 tested (50%), did not significantly associate with EFS but positively correlated with types C and E histology (P < 0.0001) and negatively correlated with types A (P = 0.0003) and B (P = 0.006). Seventeen (10%) expressed CD30, with no adverse effect. CONCLUSIONS Variant histology is common in pediatric NLPHL, especially types C and E, which are associated with IgD expression. Type C variant histology and possibly type D are associated with decreased EFS, but neither IgD nor CD30 are adverse features. Variant histology may warrant increased surveillance, but did not affect overall survival.
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Affiliation(s)
- Ramona Vesna Untanu
- Division of Clinical Pathology, Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
| | - Jason Back
- Division of Clinical Pathology, Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
- Department of Pathology, Chatham-Kent Health Alliance, Chatham, Ontario, Canada
| | - Burton Appel
- Hematology/Oncology, Institute for Pediatric Cancer & Blood Disorders, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, New Jersey
| | - Qinglin Pei
- Children’s Oncology Group, Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Lu Chen
- Department of Information Sciences, City of Hope, Duarte, California
| | - Allen Buxton
- Statistics, Children’s Oncology Group, Monrovia, California
| | - David C. Hodgson
- Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Peter F. Ehrlich
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Louis S. Constine
- Department of Radiation Oncology, University of Rochester, Rochester, New York
| | - Cindy L. Schwartz
- Children’s Hospital of Wisconsin, Department of Oncology, Milwaukee, WI, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert E. Hutchison
- Division of Clinical Pathology, Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York
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19
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Della Pepa R, Picardi M, Giordano C, Zacheo I, Pugliese N, Cerchione C, Raimondo M, Di Perna M, Troncone G, Ciancia G, Intrieri M, Pane F. Rituximab in a risk-adapted treatment strategy gives excellent therapeutic results in nodular lymphocyte-predominant Hodgkin lymphoma. Br J Haematol 2017; 182:715-718. [PMID: 28737231 DOI: 10.1111/bjh.14856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Roberta Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marco Picardi
- Department of Advanced Biomedical Science, Federico II University, Naples, Italy
| | - Claudia Giordano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Irene Zacheo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Novella Pugliese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudio Cerchione
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marta Raimondo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria Di Perna
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giancarlo Troncone
- Department of Advanced Biomedical Science, Federico II University, Naples, Italy
| | - Giuseppe Ciancia
- Department of Advanced Biomedical Science, Federico II University, Naples, Italy
| | - Mariano Intrieri
- Dipartimento di Medicina e Scienze per la Salute "V. Tiberio", Università degli studi del Molise, Campobasso, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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20
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Gemici A, Aydogdu I, Terzi H, Sencan M, Aslan A, Kaya AH, Dal MS, Akay MO, Dogu MH, Ayyildiz O, Sahin F, Cagliyan GA, Yilmaz M, Gokgoz Z, Bilen Y, Demir C, Sevindik OG, Korkmaz S, Eser B, Altuntas F. Nodular lymphocyte predominant Hodgkin's lymphoma in daily practice: A multicenter experience. Hematol Oncol 2017; 36:116-120. [PMID: 28707314 DOI: 10.1002/hon.2460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/01/2017] [Accepted: 06/19/2017] [Indexed: 01/01/2023]
Abstract
Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare subtype of Hodgkin's lymphoma. In this study, we aimed to investigate the clinical features and therapeutic outcomes of patients with NLPHL who were diagnosed at different institutes in Turkey. We retrospectively reviewed the records of the patients diagnosed with NLPHL. Adult patients who were diagnosed after 2005 with histological confirmation were selected for the study. Forty-three patients were included in the study. Median age of patients was 37.5 years (18-70) at the time of diagnosis. About 60.5% patients were diagnosed as stage I and II NLPHL, and remaining 39.5% had stage III and IV disease. Median follow-up was 46 months. During follow-up, none of the patients died. Seven patients relapsed or progressed after initial therapy at a median of 12 months. Five of 7 relapsed/refractory patients (71.4%) were salvaged with chemotherapy only (DHAP, ICE), and the remaining 2 (28.6%) were salvaged with chemoimmunotherapy. All of relapsed/refractory patients were able to achieve complete remission after salvage therapy. Lactate dehydrogenase levels were significantly higher in patients with progressive disease compared with nonprogressive disease. Our study showed an excellent outcome with all patients alive at last contact with a median follow up of 46 months despite a wide range of different therapeutic approaches. All relapsed and refractory patients were successfully salvaged despite a low frequency of patients received immunotherapy in conjunction with chemotherapy. Our results suggest that immunotherapy may be reserved for further relapses.
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Affiliation(s)
- Aliihsan Gemici
- Division of Hematology, Sanliurfa Mehmet AkifInan Training and Research Hospital, Sanliurfa, Turkey
| | - Ismet Aydogdu
- Department of Hematology, Celal Bayar University, Manisa, Turkey
| | - Hatice Terzi
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Mehmet Sencan
- Department of Hematology, Cumhuriyet University, Sivas, Turkey
| | - Alma Aslan
- Department of Medical Oncology, Hacettepe University, Ankara, Turkey
| | - Ali Hakan Kaya
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Sinan Dal
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Meltem Olga Akay
- Department of Hematology, Osmangazi University, Eskisehir, Turkey
| | - Mehmet Hilmi Dogu
- Division of Hematology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Orhan Ayyildiz
- Department of Hematology, Dicle University, Diyarbakir, Turkey
| | - Fahri Sahin
- Department of Hematology, Ege University, Izmir, Turkey
| | | | - Mehmet Yilmaz
- Department of Hematology, Gaziantep University, Gaziantep, Turkey
| | - Zafer Gokgoz
- Ordu State Hospital, Division of Hematology, Ordu, Turkey
| | - Yusuf Bilen
- Department of Hematology, Ataturk University, Erzurum, Turkey
| | - Cengiz Demir
- Department of Hematology, YuzuncuYil University, Van, Turkey
| | | | - Serdal Korkmaz
- Division of Hematology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Bulent Eser
- Department of Hematology, Erciyes University, Kayseri, Turkey
| | - Fevzi Altuntas
- Hematology and Stem Cell Transplantation Clinic, Ankara Oncology Training and Research Hospital, Ankara, Turkey
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21
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Hartmann S, Hansmann ML. [Update on nodular lymphocyte predominant Hodgkin's lymphoma and related lesions]. DER PATHOLOGE 2016; 38:3-10. [PMID: 27999937 DOI: 10.1007/s00292-016-0257-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present article gives an overview of novel developments in the diagnosis of nodular lymphocyte predominant Hodgkin's lymphoma with reference to the revised WHO classification from 2016. Differential diagnoses that are discussed are progressively transformed germinal centers, T cell/histiocyte-rich large B cell lymphoma as well as transformation into a diffuse large B cell lymphoma.
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Affiliation(s)
- S Hartmann
- Dr. Senckenbergisches Institut für Pathologie, Klinikum der Goethe Universität Frankfurt, Theodor-Stern-Kai 7, Frankfurt am Main, Deutschland.
| | - M-L Hansmann
- Dr. Senckenbergisches Institut für Pathologie, Klinikum der Goethe Universität Frankfurt, Theodor-Stern-Kai 7, Frankfurt am Main, Deutschland.
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22
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Shankar AG, Kirkwood AA, Depani S, Bianchi E, Hayward J, Ramsay AD, Hall GW. Relapsed or poorly responsive nodular lymphocyte predominant Hodgkin lymphoma in children and adolescents - a report from the United Kingdom's Children's Cancer and Leukaemia Study Group. Br J Haematol 2016; 173:421-31. [PMID: 26996288 DOI: 10.1111/bjh.13979] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/21/2015] [Indexed: 01/02/2023]
Abstract
There is a paucity of data on the treatment outcome in children with relapsed or poorly responsive nodular lymphocyte predominant Hodgkin lymphoma (nLPHL). This retrospective report evaluates the treatment outcome in a national cohort of children with relapsed or poorly responsive nLPHL. A total of 37 patients, 22 with relapsed and 15 with poorly responding disease, are the subjects of this report. Of the 22 patients with relapsed nLPHL, 11 had relapsed after primary excision biopsy, 10 after chemotherapy and 1 after chemotherapy and involved field radiotherapy. The majority had localized disease at relapse. The median time to relapse was 8 months after chemotherapy and 11 months after excision biopsy. Seven of the 15 patients with poorly responding nLPHL had variant histology. Three patients with initial poor response did not receive any further treatment and have had no disease progression. Transformation to diffuse large B cell lymphoma, in addition to evolution from typical to variant nLPHL occurred in one patient each. Thirty-four patients have been successfully re-treated with second chemotherapy or radiotherapy. Multiple relapses were uncommon but treatable. Relapse or poorly responsive nLPHL is fully salvageable with either additional chemotherapy and or radiotherapy.
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Affiliation(s)
- Ananth G Shankar
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Amy A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | - Sarita Depani
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Eleonora Bianchi
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Janis Hayward
- Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | - Alan D Ramsay
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Georgina W Hall
- Department of Paediatric Oncology and Haematology, Children's Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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23
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Parikh RR, Grossbard ML, Harrison LB, Yahalom J. Early-stage nodular lymphocyte-predominant Hodgkin lymphoma: the impact of radiotherapy on overall survival. Leuk Lymphoma 2016; 57:320-327. [PMID: 26110882 PMCID: PMC5593757 DOI: 10.3109/10428194.2015.1065978] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to use the National Cancer Database to examine the association between radiation therapy (RT) and overall survival (OS) in early-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) using standard and propensity score (PS)-adjusted Cox proportional hazards models. From 1998-2011, 1915 patients with stage I/II NLPHL were studied, with a median follow-up of 6.6 years (median age = 44). Of the cohort, 1224(64%) received RT (alone or with chemotherapy) to a median dose of 30.6 Gy. Patients were more likely to receive RT if male, younger age, lower stage, no "B"-symptoms, favorably insured, and treatment at comprehensive centers (all p < 0.05). Patients administered RT had an improved 5-year OS (HR = 0.62; 95%CI, 0.43-0.89, p = 0.01). After PS-matching (n = 868) based on all known co-variates, RT use trended towards improved OS (HR = 0.49; 95%CI, 0.23-1.05, p = 0.06). This study represents one of the largest prospective datasets examining the role of RT for stage I/II NLPHL and inclusion of RT may be considered.
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Affiliation(s)
- Rahul R. Parikh
- Mount Sinai Beth Israel Medical Center & Mount Sinai St. Luke’s-Roosevelt Hospitals, Mount Sinai Health System, Department of Radiation Oncology, New York, NY
| | - Michael. L. Grossbard
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, Division of Hematology and Oncology, New York, NY
| | - Louis. B. Harrison
- Moffitt Cancer Center and Research Institute, Department of Radiation Oncology, Tampa, FL
| | - Joachim Yahalom
- Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY
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24
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Satou A, Asano N, Kato S, Katsuya H, Ishitsuka K, Elsayed AA, Nakamura S. FoxP3-positive T cell lymphoma arising in non-HTLV1 carrier: clinicopathological analysis of 11 cases of PTCL-NOS and 2 cases of mycosis fungoides. Histopathology 2015; 68:1099-108. [PMID: 26426838 DOI: 10.1111/his.12885] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/27/2015] [Indexed: 02/05/2023]
Abstract
AIMS Forkhead box protein 3-positive (FoxP3(+) ) T cell lymphoma, in the absence of human T cell lymphotrophic virus type 1 (HTLV-1) infection, is rare and its clinicopathological characteristics still remain unclear. The aim of this study was to elucidate its characteristics. METHODS AND RESULTS We describe here 11 cases of peripheral T cell lymphoma not otherwise specified (PTCL-NOS) and two cases of mycosis fingoides (MF) which were positive for FoxP3. The median age of the 11 PTCL-NOS cases was 65 years (range: 48-80 years), and all the patients were male. Eight patients (80%) showed stages III/IV disease, and six (60%) were categorized as high-intermediate/high-risk groups according to the International Prognostic Index. Two cases of MF were 57- and 59-year-old males. Both cases were categorized as stage IA, according to International Society for Cutaneous Lymphomas/European Organization of Research and Treatment of Cancer (ISCL/EORTC) classification. Immunohistochemically, all the cases were negative for cytotoxic molecule marker, and nine (75%) were αβ T cell type. Scattered Epstein-Barr virus (EBV)-infected cells were detected in four cases of PTCL-NOS, implying the reactivation of EBV caused by the immunodeficient status of the patients. CONCLUSIONS FoxP3(+) PTCL-NOS constitute a minor phenotypical subtype with poor prognosis and EBV reactivation in some. Conversely, two cases of MF showed an indolent clinical course which was different from previously reported cutaneous T cell lymphoma (CTCL) cases.
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Affiliation(s)
- Akira Satou
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Naoko Asano
- Department of Clinical Laboratory, Nagano Prefectural Suzaka Hospital, Suzaka, Japan
| | - Seiichi Kato
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Hiroo Katsuya
- Division of Oncology, Hematology and Infectious Diseases, Fukuoka University, Fukuoka, Japan
| | - Kenji Ishitsuka
- Division of Oncology, Hematology and Infectious Diseases, Fukuoka University, Fukuoka, Japan
| | - Ahmed A Elsayed
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
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25
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Eladl AE, Satou A, Elsayed AA, Suzuki Y, Shimizu-Kohno K, Kato S, Tomita A, Kinoshita T, Nakamura S, Asano N. Nodular lymphocyte predominant Hodgkin lymphoma: Clincopathological study of 25 cases from Japan with a reappraisal of tissue associated macrophages. Pathol Int 2015; 65:652-60. [PMID: 26538151 DOI: 10.1111/pin.12357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/06/2015] [Indexed: 01/03/2023]
Abstract
Clinicopathological features of 25 nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) patients in Japan were analysed. To investigate the clinicopathological significance of tissue associated macrophages (TAM) in NLPHL, CD68 and CD163 expression were investigated. The median age at onset was 56 years (range: 6-82 years) with male predominance (64%). All patients presented with lymph node enlargement with predilection for cervical LNs. Seven cases (28%) had mediastinal lesion and four (16%) had extranodal involvement. Most cases (76%) presented with early clinical stages. After median follow up of 44 months, both of overall and progression free survival rates were 95%. The presence of >5% CD68+ TAM in NLPHL was significantly associated with older age at diagnosis (median, 71 vs 52.5 years; P = 0.048), lower hemoglobin level (33.3% vs 0%; P = 0.037) and lower CR rate after initial treatment (42.9% vs 91.7%; P = 0.038). The presence of >5% CD163+ TAM was significantly correlated with presence of B symptoms (40% vs 0%; P = 0.036). In conclusion, NLPHL is rare among Japanese and appears to present at an older age than among Western patients. In our series, the presence of >5% CD68+ TAM in NLPHL was associated with lower CR rate, but with no impact on patients' survival.
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Affiliation(s)
- Ahmed E Eladl
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Akira Satou
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ahmed Ali Elsayed
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Yuka Suzuki
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Shimizu-Kohno
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiichi Kato
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihiro Tomita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Kinoshita
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoko Asano
- Department of Molecular Diagnostics, Nagano Prefectural Suzaka Hospital, Suzaka, Japan
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26
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Shankar AG, Kirkwood AA, Hall GW, Hayward J, O'Hare P, Ramsay AD. Childhood and Adolescent nodular lymphocyte predominant Hodgkin lymphoma - A review of clinical outcome based on the histological variants. Br J Haematol 2015; 171:254-262. [PMID: 26115355 DOI: 10.1111/bjh.13540] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 05/12/2015] [Indexed: 01/08/2023]
Abstract
Nodular lymphocyte predominant Hodgkin lymphoma (nLPHL) comprises approximately 10-12% of all childhood Hodgkin lymphoma. As the majority have low stage disease recent years have seen a de-escalation of treatment intensity to avoid treatment-related morbidity. This report evaluates treatment outcome in children with histopathological variants of nLPHL after therapy de-escalation. Biopsies from 60 patients were reviewed and histology categorized as typical (n = 47; 78%) or variant nLPHL (n = 13; 22%). Furthermore, presence of immunoglobulin D (IgD) expression by the lymphocyte predominant (LP) cells was assessed in 41 patients. Treatment outcomes were compared according to treatment received and histopathology of nLPHL. Compared to typical nLPHL, children with variant nLPHL had higher stage disease at diagnosis (stage III: 3/13; 23% vs. 3/47; 6%, P = 0·11), lower complete response rates (6/13; 46% vs. 38/47; 81%, P = 0·029) and higher relapse rates (2/13; 15% vs. 2/47; 4%, P = 0·20). Additionally, IgD expression by LP cells was associated with poorer treatment response and was more commonly seen in patients with variant nLPHL. (11/13; 85% vs. 15/28; 54%, P = 0·08). Variant histology appears to be indicative of a poorer prognosis in patients with early stage disease, and may be an important factor to take into account when moving towards reduced intensity treatment for nLPHL.
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Affiliation(s)
- Ananth G Shankar
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Amy A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | - Georgina W Hall
- Department of Paediatric and Adolescent Oncology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, London, UK
| | - Janis Hayward
- School of Cancer Sciences, Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Patricia O'Hare
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Alan D Ramsay
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK
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27
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Management of Nodular Lymphocyte Predominant Hodgkin Lymphoma in the Modern Era. Int J Radiat Oncol Biol Phys 2015; 92:67-75. [DOI: 10.1016/j.ijrobp.2015.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/15/2015] [Accepted: 02/02/2015] [Indexed: 11/22/2022]
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28
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Lymphocyte-Predominant Hodgkin's Disease in Children: A Case Study and Review of the Literature. Case Rep Oncol Med 2015; 2015:351431. [PMID: 25878913 PMCID: PMC4388010 DOI: 10.1155/2015/351431] [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: 01/02/2015] [Revised: 02/26/2015] [Accepted: 03/10/2015] [Indexed: 11/18/2022] Open
Abstract
A three-year-old boy presented with an enlarging neck mass. Biopsy demonstrated IgD-positive nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), which was staged as IIa. The patient received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with rituximab and had excellent results. NLPHL is a relatively rare disease that is biologically distinct from classic Hodgkin lymphoma (cHL). NLPHL is a B-cell malignancy likely of germinal center origin that has an overall good prognosis and favorable response to treatment. Unlike cHL, NLPHL is ubiquitously CD20-positive. Recent evidence supports the efficacy of targeted anti-CD20 therapy in NLPHL, though prospective data is limited. This case demonstrates several unique features of NLPHL and further supports the use of rituximab in front-line therapy. The clinical characteristics among patients at various ages are discussed with a special focus on the IgD-positive subtype. A thorough literature search demonstrates this to be the youngest patient with NLPHL yet described.
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29
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Gloghini A, Bosco A, Ponzoni M, Spina M, Carbone A. Immunoarchitectural patterns in nodular lymphocyte predominant Hodgkin lymphoma: pathologic and clinical implications. Expert Rev Hematol 2014; 8:217-23. [DOI: 10.1586/17474086.2015.991388] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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