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Lim MS, Foley M, Mussolin L, Siebert R, Turner S. Biopathology of childhood, adolescent and young adult non-Hodgkin lymphoma. Best Pract Res Clin Haematol 2023; 36:101447. [PMID: 36907637 DOI: 10.1016/j.beha.2023.101447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Mature non-Hodgkin lymphomas (NHL) in the childhood, adolescent and young adult (CAYA) population are rare and exhibit unique clinical, immunophenotypic and genetic characteristics. Application of large-scale unbiased genomic and proteomic technologies such as gene expression profiling and next generation sequencing (NGS) have led to enhanced understanding of the genetic basis for many lymphomas in adults. However, studies to investigate the pathogenetic events in CAYA population are relatively sparse. Enhanced understanding of the pathobiologic mechanisms involved in non-Hodgkin lymphomas in this unique population will allow for improved recognition of these rare lymphomas. Elucidation of the pathobiologic differences between CAYA and adult lymphomas will also lead to the design of more rational and much needed, less toxic therapies for this population. In this review, we summarize recent insights gained from the proceedings of the recent 7th International CAYA NHL Symposium held in New York City, New York October 20-23, 2022.
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Affiliation(s)
- Megan S Lim
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center,417 East 68th New York City, NY, USA.
| | - Michelle Foley
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Howard 14, New York City, NY, USA New York City, NY, USA.
| | - Lara Mussolin
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, University Hospital of Padova, via Giustiniani 3, 35128 Padova, Italy.
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University & Ulm University Medical Center, Albert-Einstein-Allee 11, D-89081 Ulm, Germany.
| | - Suzanne Turner
- Department of Pathology, University of Cambridge, Lab Block Level 3, Box 231, Addenbrookes Hospital, Hills Road, Cambridge CB20QQ, UK; CEITEC, Masaryk University, Brno, Czech Republic.
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Minimal Disease Monitoring in Pediatric Non-Hodgkin's Lymphoma: Current Clinical Application and Future Challenges. Cancers (Basel) 2021; 13:cancers13081907. [PMID: 33921029 PMCID: PMC8071445 DOI: 10.3390/cancers13081907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022] Open
Abstract
Minimal residual disease (MRD) detection is established routine practice for treatment stratification in leukemia and used for treatment optimization in adult lymphomas. Minimal disease studies in childhood non-Hodgkin lymphomas are challenged by stratified treatment in different subtypes, high cure rates, low patient numbers, limited initial tumor material, and early progression. Current clinical applications differ between the subtypes. A prognostic value of minimal disseminated disease (MDD) could not yet be clearly established for lymphoblastic lymphoma using flow cytometry and PCR-based methods for T-cell receptor (TCR) or immunoglobulin (IG) rearrangements. MYC-IGH fusion sequences or IG rearrangements enable minimal disease detection in Burkitt lymphoma and -leukemia. An additional prognostic value of MDD in Burkitt lymphoma and early MRD in Burkitt leukemia is implicated by single studies with risk-adapted therapy. MDD and MRD determined by PCR for ALK-fusion transcripts are independent prognostic parameters for patients with ALK-positive anaplastic large cell lymphoma (ALCL). They are introduced in routine clinical practice and used for patient stratification in clinical studies. Early MRD might serve as an endpoint for clinical trials and for guiding individual therapy. Validation of MDD and MRD as prognostic parameters is required for all subtypes but ALCL. Next-generation sequencing-based methods may provide new options and applications for minimal disease evaluation in childhood lymphomas.
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Mussolin L, Lovisa F, Gallingani I, Cavallaro E, Carraro E, Damanti CC, Vinti L, Sala A, Micalizzi C, Santoro N, Piglione M, Cellini M, Buffardi S, Buldini B, D'Amore ESG, Biffi A, Pillon M. Minimal residual disease analysis in childhood mature B-cell leukaemia/lymphoma treated with AIEOP LNH-97 protocol with/without anti-CD20 administration. Br J Haematol 2020; 189:e108-e111. [PMID: 32080837 DOI: 10.1111/bjh.16531] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lara Mussolin
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Federica Lovisa
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Ilaria Gallingani
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
| | - Elena Cavallaro
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
| | - Elisa Carraro
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
| | - Carlotta C Damanti
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
| | - Luciana Vinti
- Department of Pediatric Hemato-Oncology, Ospedale Bambino Gesù, Rome, Italy
| | - Alessandra Sala
- Department of Paediatrics, University of Milano-Bicocca, Fondazione MBBM, Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - Concetta Micalizzi
- Department of Paediatric Haemato-Oncology, IRCCS Istituto 'Giannina Gaslini', Genova, Italy
| | - Nicola Santoro
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Matilde Piglione
- Paediatric Haematology, Department of Paediatrics, University Hospital Città della Salute e della Scienza di Torino, Torino, Italy
| | - Monica Cellini
- Division of Paediatric Oncology-Haematology, Policlinico Hospital, Modena, Italy
| | - Salvatore Buffardi
- Department of Paediatric Haemato-Oncology, Santobono-Pausilipon Children's Hospital, Napoli, Italy
| | - Barbara Buldini
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
| | | | - Alessandra Biffi
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy.,Gene Therapy Program, Dana Farber/Boston Children's Cancer and Blood Disorders Centers, Boston, MA, USA
| | - Marta Pillon
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Women and Child Health, University of Padova, Padova, Italy
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Galimberti S, Genuardi E, Mazziotta F, Iovino L, Morabito F, Grassi S, Ciabatti E, Guerrini F, Petrini M. The Minimal Residual Disease in Non-Hodgkin's Lymphomas: From the Laboratory to the Clinical Practice. Front Oncol 2019; 9:528. [PMID: 31293969 PMCID: PMC6606710 DOI: 10.3389/fonc.2019.00528] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/31/2019] [Indexed: 01/05/2023] Open
Abstract
Minimal residual disease (MRD) in non-Hodgkin's lymphomas (NHLs) still represents matter of interest and debate: indeed, the new available treatments offer higher rates of complete responses and MRD negativity than in the past, with a positive impact on the long-term survival. Furthermore, the introduction of more sensitive and accurate molecular techniques, such as digital PCR (ddPCR) and the next generation sequencing techniques (NGS), increased the possibility of identifying molecular targets to be followed after therapy (such as rearrangement of immunoglobulins, fusion genes, or mutations). This review focused on how molecular biology can help to detect MRD in different types of NHLs and how MRD can change the clinical practice in 2019. In follicular lymphoma (FL), contamination of the grafts and molecular disease persistence after transplantation represent a negative prognostic factors. The combination of Rituximab or Obinutuzumab with Bendamustine seems to be the most effective way to clear MRD in FL patients receiving chemo-immunotherapy (further studies are in progress), and also 90Yttrium-Ibritumomab-Tiuxetan offers a deep clearance of molecular disease. Finally, molecular MRD can further stratify PET-negative cases, with subjects both PET- and MRD-negative presenting the best outcome. In aggressive lymphomas, MRD has a relevant prognostic power and can represent the platform for immunotherapy (such as CAR-T). In diffuse large B-cell lymphoma (DLBCL), the assessment of MRD in the plasma (where cell-free DNA and exosomes circulate) seems to be more predictive than the bone marrow analysis or peripheral blood mononuclear cells. Finally, NGS technologies could be more useful than the classical "patient allele-specific PCR" because they can identify any possible clone emerging during the treatment or follow-up, even if different from that identified at diagnosis, thus predicting relapse. After all, the present available molecular approaches can move MRD from the bench side to the clinical practice.
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Affiliation(s)
- Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Genuardi
- Department of Molecular Biotechnologies and Health Sciences, University of Torino, Turin, Italy
| | - Francesco Mazziotta
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Lorenzo Iovino
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Clinical and Translational Sciences School of Doctorate, University of Pisa, Pisa, Italy
| | - Fortunato Morabito
- Hematology Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel.,Biotechnology Research Unit, Cosenza, Italy
| | - Susanna Grassi
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GeNOMEC School of Doctorate, University of Siena, Siena, Italy
| | - Elena Ciabatti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Guerrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Mario Petrini
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Cairo M, Auperin A, Perkins SL, Pinkerton R, Harrison L, Goldman S, Patte C. Overall survival of children and adolescents with mature B cell non-Hodgkin lymphoma who had refractory or relapsed disease during or after treatment with FAB/LMB 96: A report from the FAB/LMB 96 study group. Br J Haematol 2018; 182:859-869. [PMID: 29984828 DOI: 10.1111/bjh.15491] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/25/2018] [Indexed: 02/04/2023]
Abstract
We determined the risk factors associated with poor survival in children and adolescents with de novo mature B cell non-Hodgkin lymphoma (B-NHL) who had refractory or relapsed disease during or after the French-American-British mature lymphoma B (FAB/LMB) 96 multi-agent chemotherapy. Among the 1 111 registered on study, 104 patients (9·4%) had refractory disease or disease relapse after first complete remission. Among these 104 patients, 28 (27%) patients had refractory disease and 76 (73%) had relapsed disease. The estimated 1- and 2-year overall survival (OS) (95% confidence interval) was 31·5% (23·3-41·0%) and 22·3% (15·3-31·4%), respectively. Prognostic analysis of OS using a Cox multivariate model showed that factors independently associated with OS included lactate dehydrogenase ≥2 upper normal limit [hazard ratio (HR) = 2·86 (1·57-5·2), P = 0·0006]; time to failure (>6 months) [HR = 0·59 (0·36-0·97), P = 0·038]; and failure in bone marrow [HR = 2·78 (1·65-4·68), P = 0·0001]. New therapeutic strategies are required to significantly reduce refractory disease and disease relapse in patients with newly diagnosed mature B-NHL and, more importantly, there is a critical need to develop novel retrieval approaches in patients with chemotherapy-resistant disease.
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Affiliation(s)
- Mitchell Cairo
- Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
| | | | | | | | - Lauren Harrison
- Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, USA
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Cairo MS, Pinkerton R. Childhood, adolescent and young adult non-Hodgkin lymphoma: state of the science. Br J Haematol 2016; 173:507-30. [DOI: 10.1111/bjh.14035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Mitchell S. Cairo
- Department of Pediatrics, Medicine, Pathology, Microbiology & Immunology and Cell Biology & Anatomy; New York Medical College; Valhalla NY USA
| | - Ross Pinkerton
- Department of Oncology; Children's Health Queensland; Brisbane Australia
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Giulino-Roth L, Goldman S. Recent molecular and therapeutic advances in B-cell non-Hodgkin lymphoma in children. Br J Haematol 2016; 173:531-44. [DOI: 10.1111/bjh.13969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Lisa Giulino-Roth
- Department of Pediatrics; Weill Cornell Medical College; New York NY USA
| | - Stanton Goldman
- Department of Pediatrics; Medical City Children's Hospital and Texas Oncology; Dallas TX USA
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