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Blanchard M, Morren MA, Busschots AM, Hauben E, Alberti-Violetti S, Berti E, Avallone G, Tavoletti G, Panzone M, Quaglino P, Colonna C, Melchers RC, Vermeer MH, Gniadecki R, Mitteldorf C, Gosmann J, Stadler R, Jonak C, Oren-Shabtai M, Hodak E, Friedland R, Gordon E, Geskin LJ, Scarisbrick JJ, Mayo Martínez F, Noguera Morel L, Pehr K, Amarov B, Faouzi M, Nicolay JP, Kempf W, Blanchard G, Guenova E. Paediatric-onset lymphomatoid papulosis: results of a multicentre retrospective cohort study on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG). Br J Dermatol 2024; 191:233-242. [PMID: 38595050 DOI: 10.1093/bjd/ljae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. OBJECTIVES To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. METHODS This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. RESULTS Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0-14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0-19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01-88.99). CONCLUSIONS We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.
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Affiliation(s)
- Maël Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gabriela Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
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2
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Khoubila N, Sraidi S, Madani A, Tazi I. Anaplastic Large-cell Lymphoma in Children: State of the Art in 2023. J Pediatr Hematol Oncol 2024; 46:217-224. [PMID: 38912833 DOI: 10.1097/mph.0000000000002875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 04/04/2024] [Indexed: 06/25/2024]
Abstract
Anaplastic large-cell lymphoma is a rare disease and account for approximately 10% to 15% of pediatric non-Hodgkin lymphomas. They are characterized by extended stages, a high frequency of B signs and extra nodal involvement. Multiagent chemotherapy cures ∽60% to 75% of patients and relapse occurs in 35% of cases. For relapsed patients, various treatments ranging from vinblastine monotherapy to therapeutic intensification with hematopoietic stem cell transplantation have been evaluated, but there is currently no consensus on the optimal therapeutic strategy. New therapeutic perspectives are being evaluated for relapses and refractory forms as well as high-risk forms including monoclonal antibodies (Anti CD30), ALK inhibitors, and CART cells.
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Affiliation(s)
- Nisrine Khoubila
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Sofia Sraidi
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Abdellah Madani
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Illias Tazi
- Department of Clinical Hematology, CHU Mohamed VI, Cadi Ayyad University, Marrakech, Morocco
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3
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Sungwan P, Panaampon J, Kariya R, Kamio S, Nakagawa R, Hirozane T, Ogura Y, Abe M, Hirabayashi K, Fujiwara Y, Kikuta K, Okada S. Establishment and characterization of TK-ALCL1: a novel NPM-ALK-positive anaplastic large-cell lymphoma cell line. Hum Cell 2024; 37:1215-1225. [PMID: 38755432 DOI: 10.1007/s13577-024-01077-8] [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: 02/10/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024]
Abstract
TK-ALCL1, a novel anaplastic lymphoma kinase (ALK)-positive anaplastic large-cell lymphoma (ALK+ ALCL) cell line, was established from the primary tumor site of a 59-year-old Japanese male patient. The immune profile of TK-ALCL1 corresponds to that seen typically in primary ALCL cells, i.e., positive for ALK, CD30, EMA, and CD4, but negative for CD2, CD3, CD5, CD8a, and EBV-related antigens. The rearrangement of the T cell receptor-gamma locus shows that TK-ALCL1 is clonally derived from T-lineage lymphoid cells. FISH and RT-PCR analysis revealed that TK-ALCL1 has the nucleophosmin (NPM)-ALK fusion transcript, which is typical for ALK+ ALCL cell lines. When TK-ALCL1 was subcutaneously inoculated into 6-week-old BALB/c Rag2-/-/Jak3-/- (BRJ) mice, it formed tumor masses within 4-6 weeks. Morphological, immunohistochemical, and molecular genetic investigations confirmed that the xenograft and the original ALCL tumor were identical. The ALK inhibitors Alectinib and Lorlatinib suppressed proliferation in a dose-dependent manner. Thus, TK-ALCL1 provides a useful in vitro and in vivo model for investigation of the biology of ALK+ ALCL and of novel therapeutic approaches targeting ALK.
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Affiliation(s)
- Prin Sungwan
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection & Graduate, School of Medical Sciences, Kumamoto University, 2-2-1 Honjo, Chuou-ku, Kumamoto, 860-0811, Japan
| | - Jutatip Panaampon
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection & Graduate, School of Medical Sciences, Kumamoto University, 2-2-1 Honjo, Chuou-ku, Kumamoto, 860-0811, Japan
- Division of Hematologic Neoplasia, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Ryusho Kariya
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection & Graduate, School of Medical Sciences, Kumamoto University, 2-2-1 Honjo, Chuou-ku, Kumamoto, 860-0811, Japan
- Institute of Industrial Nanomaterials, Kumamoto University, 2-39-1 Kurokami, Chuou-ku, Kumamoto, 860-8555, Japan
| | - Satoshi Kamio
- Division of Musculoskeletal Oncology and Orthopaedics Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Rumi Nakagawa
- Division of Musculoskeletal Oncology and Orthopaedics Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Toru Hirozane
- Division of Musculoskeletal Oncology and Orthopaedics Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Yukiko Ogura
- Clinical Laboratory Center, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Makoto Abe
- Division of Diagnostic Pathology, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Kaoru Hirabayashi
- Division of Diagnostic Pathology, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Yukio Fujiwara
- Department of Cell Pathology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuou-ku, Kumamoto, 860-0556, Japan
| | - Kazutaka Kikuta
- Division of Musculoskeletal Oncology and Orthopaedics Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Seiji Okada
- Division of Hematopoiesis, Joint Research Center for Human Retrovirus Infection & Graduate, School of Medical Sciences, Kumamoto University, 2-2-1 Honjo, Chuou-ku, Kumamoto, 860-0811, Japan.
- Institute of Industrial Nanomaterials, Kumamoto University, 2-39-1 Kurokami, Chuou-ku, Kumamoto, 860-8555, Japan.
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Kouchaki H, Kamyab P, Darbeheshti F, Gharezade A, Fouladseresht H, Tabrizi R. miR-939, as an important regulator in various cancers pathogenesis, has diagnostic, prognostic, and therapeutic values: a review. J Egypt Natl Canc Inst 2024; 36:16. [PMID: 38679648 DOI: 10.1186/s43046-024-00220-8] [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: 11/01/2023] [Accepted: 04/06/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND MicroRNAs (miRNAs or miRs) are highly conserved non-coding RNAs with a short length (18-24 nucleotides) that directly bind to a complementary sequence within 3'-untranslated regions of their target mRNAs and regulate gene expression, post-transcriptionally. They play crucial roles in diverse biological processes, including cell proliferation, apoptosis, and differentiation. In the context of cancer, miRNAs are key regulators of growth, angiogenesis, metastasis, and drug resistance. MAIN BODY This review primarily focuses on miR-939 and its expanding roles and target genes in cancer pathogenesis. It compiles findings from various investigations. MiRNAs, due to their dysregulated expression in tumor environments, hold potential as cancer biomarkers. Several studies have highlighted the dysregulation of miR-939 expression in human cancers. CONCLUSION Our study highlights the potential of miR-939 as a valuable target in cancer diagnosis, prognosis, and treatment. The aberrant expression of miR-939, along with other miRNAs, underscores their significance in advancing our understanding of cancer biology and their promise in personalized cancer care.
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Affiliation(s)
- Hosein Kouchaki
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parnia Kamyab
- USERN Office, Fasa University of Medical Sciences, Fasa, Iran
| | - Farzaneh Darbeheshti
- Department of Radiation Oncology, Dana Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Arezou Gharezade
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Fouladseresht
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Reza Tabrizi
- Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran.
- Noncommunicable Diseases Research Center, Fasa University of Medical Science, Fasa, Iran.
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5
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Fukano R, Iijima-Yamashita Y, Iwafuchi H, Nakazawa A, Saito AM, Takimoto T, Sekimizu M, Suehiro Y, Yamasaki T, Hasegawa S, Mori T, Horibe K. Prognostic value of minimal disseminated disease assessed using digital polymerase chain reaction for 3' ALK assays in pediatric anaplastic lymphoma kinasepositive anaplastic large cell lymphoma. Haematologica 2024; 109:652-656. [PMID: 37675509 PMCID: PMC10828787 DOI: 10.3324/haematol.2023.282812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi.
| | - Yuka Iijima-Yamashita
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya
| | - Hideto Iwafuchi
- Department of Pathology, Shizuoka Children's Hospital, Shizuoka
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya
| | - Tetsuya Takimoto
- Department of Childhood Cancer Data Management, National Center for Child Health and Development, Tokyo
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi
| | - Takahiro Yamasaki
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Yamaguchi
| | - Shunji Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya
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6
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Kawasoe K, Watanabe T, Yoshida-Sakai N, Yamamoto Y, Kurahashi Y, Kidoguchi K, Ureshino H, Kamachi K, Fukuda-Kurahashi Y, Kimura S. A Combination of Alectinib and DNA-Demethylating Agents Synergistically Inhibits Anaplastic-Lymphoma-Kinase-Positive Anaplastic Large-Cell Lymphoma Cell Proliferation. Cancers (Basel) 2023; 15:5089. [PMID: 37894456 PMCID: PMC10605931 DOI: 10.3390/cancers15205089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/07/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The recent evolution of molecular targeted therapy has improved clinical outcomes in several human malignancies. The translocation of anaplastic lymphoma kinase (ALK) was originally identified in anaplastic large-cell lymphoma (ALCL) and subsequently in non-small cell lung carcinoma (NSCLC). Since ALK fusion gene products act as a driver of carcinogenesis in both ALCL and NSCLC, several ALK tyrosine kinase inhibitors (TKIs) have been developed. Crizotinib and alectinib are first- and second-generation ALK TKIs, respectively, approved for the treatment of ALK-positive ALCL (ALK+ ALCL) and ALK+ NSCLC. Although most ALK+ NSCLC patients respond to crizotinib and alectinib, they generally relapse after several years of treatment. We previously found that DNA-demethylating agents enhanced the efficacy of ABL TKIs in chronic myeloid leukemia cells. Moreover, aberrant DNA methylation has also been observed in ALCL cells. Thus, to improve the clinical outcomes of ALK+ ALCL therapy, we investigated the synergistic efficacy of the combination of alectinib and the DNA-demethylating agent azacytidine, decitabine, or OR-2100 (an orally bioavailable decitabine derivative). As expected, the combination of alectinib and DNA-demethylating agents synergistically suppressed ALK+ ALCL cell proliferation, concomitant with DNA hypomethylation and a reduction in STAT3 (a downstream target of ALK fusion proteins) phosphorylation. The combination of alectinib and OR-2100 markedly altered gene expression in ALCL cells, including that of genes implicated in apoptotic signaling, which possibly contributed to the synergistic anti-ALCL effects of this drug combination. Therefore, alectinib and OR-2100 combination therapy has the potential to improve the outcomes of patients with ALK+ ALCL.
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Affiliation(s)
- Kazunori Kawasoe
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Tatsuro Watanabe
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Nao Yoshida-Sakai
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Yuta Yamamoto
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Yuki Kurahashi
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- OHARA Pharmaceutical Co., Ltd., Koka 520-3403, Japan
| | - Keisuke Kidoguchi
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Hiroshi Ureshino
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Kazuharu Kamachi
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
| | - Yuki Fukuda-Kurahashi
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- OHARA Pharmaceutical Co., Ltd., Koka 520-3403, Japan
| | - Shinya Kimura
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga 849-8501, Japan
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
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7
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Caddeo G, Tecchio C, Chinello M, Balter R, Zaccaron A, Vitale V, Pezzella V, Bonetti E, Pillon M, Carraro E, Mussolin L, Cesaro S. Refractory Anaplastic Large Cell Lymphoma Rescued by the Combination of the Second-Generation ALK Inhibitor Brigatinib, High-dose Chemotherapy and Allogeneic Stem Cell Transplantation: A Case Report and Review of the Literature. Clin Hematol Int 2023:10.1007/s44228-023-00038-6. [PMID: 37072555 DOI: 10.1007/s44228-023-00038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/14/2023] [Indexed: 04/20/2023] Open
Abstract
The treatment of pediatric patients with refractory or relapsed anaplastic large cell lymphoma (ALCL) is still a major challenge. In addition to conventional chemotherapy and stem cell transplantation, new therapeutic options such as anti-CD30 drugs and anaplastic lymphoma kinase (ALK) inhibitors have been recently introduced in this setting. Among ALK inhibitors, only the first-generation molecule crizotinib is approved for pediatric use, while second-generation molecules, such as brigatinib, are still under investigation. Here we report the case of a 13-year-old boy diagnosed with stage IV ALCL, refractory to first-line conventional chemotherapy and second-line therapy with the anti CD30 antibody-drug conjugate brentuximab-vedotin, who finally achieved remission after a combination of conventional high-dose chemotherapy and the second-generation ALK inhibitor brigatinib. The latter was chosen for its ability to penetrate through the blood-brain barrier, due to the persistent involvement of the patient's cerebral nervous system. The remission was then consolidated with an allogeneic hematopoietic stem cell transplantation (HSCT) from an unrelated donor using myeloablative conditioning with total body irradiation. At 24 months after HSCT, the patient is in complete remission, alive and well. An updated review regarding the use of ALK inhibitors in ALCL patients is provided.
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Affiliation(s)
- Giulia Caddeo
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
| | - Cristina Tecchio
- Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, Verona University Verona, Verona, Italy
| | - Matteo Chinello
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Rita Balter
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Ada Zaccaron
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Virginia Vitale
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Vincenza Pezzella
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Elisa Bonetti
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Marta Pillon
- Department of Women's and Children's Health, Clinic of Pediatric Hematology-Oncology, University of Padova, Padua, Italy
| | - Elisa Carraro
- Department of Women's and Children's Health, Clinic of Pediatric Hematology-Oncology, University of Padova, Padua, Italy
| | - Lara Mussolin
- Department of Women's and Children's Health, Clinic of Pediatric Hematology-Oncology, University of Padova, Padua, Italy
- Pediatric Research Institute, Fondazione Città Della Speranza, Padua, Italy
| | - Simone Cesaro
- Pediatric Hematology-Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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8
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Xu S, Duarte LS, Baqir AW, Lyo S, Gupta R, Zhang Y. When a Lump is More Than Just a Lump: Anaplastic Large Cell Lymphoma Presenting as a Pediatric Breast Mass. J Pediatr Hematol Oncol 2023; 45:99-102. [PMID: 36716245 DOI: 10.1097/mph.0000000000002615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare non-Hodgkin T-cell lymphoma characterized by a cluster of differentiation-30 positivity. Subtypes are characterized by positive or negative anaplastic lymphoma kinase (ALK) expression. ALCLs account for about 10% to 15% of all pediatric non-Hodgkin lymphomas and more than 90% of the cases are ALK-positive. We report a rare case of pediatric systemic ALK-negative ALCL with an atypical presentation as a painful breast mass. Despite the general benign features of most pediatric breast masses, it is important to consider malignant systemic diagnoses like the one reported here.
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Affiliation(s)
| | | | | | - Shawn Lyo
- Department of Radiology, SUNY Downstate Health Science University, Brooklyn, NY
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9
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Davies OMT, Astle JM, Harker-Murray PD, Wanat KA, Carlberg VM. A 12-year-old male with localized, pink, tender papules. Pediatr Dermatol 2023; 40:367-368. [PMID: 36989164 DOI: 10.1111/pde.15167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 10/04/2022] [Indexed: 03/30/2023]
Affiliation(s)
- Olivia M T Davies
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - John M Astle
- Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Paul D Harker-Murray
- Department of Pediatrics, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Karolyn A Wanat
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Valerie M Carlberg
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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10
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Lozano-Jaramillo DA, Millan-Arreola E, Esquer-Cota OO, Lozano-Garcia JM, Valenzuela-Espinoza MA. Soft-Tissue Anaplastic Lymphoma Kinase-Positive Anaplastic Large Cell Lymphoma in a Child Unmasked by COVID-19. J Hematol 2023; 12:37-41. [PMID: 36895288 PMCID: PMC9990711 DOI: 10.14740/jh1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/26/2023] [Indexed: 03/11/2023] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is children's most common mature T-cell neoplasm. The majority is positive for anaplastic lymphoma kinase (ALK). Initial presentation as a soft-tissue pelvic mass without nodal involvement is rare and can be easily misdiagnosed. We report a case of a 12-year-old male presenting with pain and movement restriction in the right extremity. Computed tomography (CT) scan revealed a solitary pelvic mass. Initial biopsy examination concluded rhabdomyosarcoma. After developing pediatric multisystemic inflammatory syndrome due to coronavirus disease 2019 (COVID-19), central and peripheral lymph node enlargement appeared. New cervical adenopathy and pelvic mass biopsies were performed. Immunohistochemistry concluded an ALK-positive ALCL with a small-cell pattern. The patient was treated with brentuximab-based chemotherapy and eventually improved. Differential diagnosis of pelvic masses in children and adolescents must include ALCL. An inflammatory trigger may promote the appearance of a typical nodal disease, previously absent. Attention is warranted during histopathological examination to avoid diagnostic errors.
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Affiliation(s)
- Diego Alberto Lozano-Jaramillo
- Centro de Investigacion Valle Bibb Fundacion, Tijuana, Baja California, Mexico.,Centro Oncologico Pediatrico de Baja California, Tijuana, Baja California, Mexico
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11
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Management of Aggressive Non-Hodgkin Lymphomas in the Pediatric, Adolescent, and Young Adult Population: An Adult vs. Pediatric Perspective. Cancers (Basel) 2022; 14:cancers14122912. [PMID: 35740580 PMCID: PMC9221186 DOI: 10.3390/cancers14122912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary This review details the diagnosis and treatment of primary non-Hodgkin lymphoma (NHL) in the pediatric and adolescent population. We also describe treatment modalities such as hematopoietic stem cell transplantation for relapsed or refractory NHL in patients that fail or do not respond to the initial therapy. We then detail the current advancements in treatment for patients that fail initial therapy such as CAR T-cell therapy, the use of immunotherapy that target surface makers on malignant cells and highlight areas where further research is needed. The purpose of our review is to inform the pediatric oncology community in regard to the various types of NHLs and emphasize areas where the science is evolving in the treatment of primary, relapsed or refractory disease. Abstract Non-Hodgkin lymphoma (NHL) is a broad entity which comprises a number of different types of lymphomatous malignancies. In the pediatric and adolescent population, the type and prognosis of NHL varies by age and gender. In comparison to adults, pediatric and adolescent patients generally have better outcomes following treatment for primary NHL. However, relapsed/refractory (R/R) disease is associated with poorer outcomes in many types of NHL such as diffuse large B cell lymphoma and Burkitt lymphoma. Newer therapies have been approved in the use of primary NHL in the pediatric and adolescent population such as Rituximab and other therapies such as chimeric antigen receptor T-cell (CAR T-cell) therapy are under investigation for the treatment of R/R NHL. In this review, we feature the characteristics, diagnosis, and treatments of the most common NHLs in the pediatric and adolescent population and also highlight the differences that exist between pediatric and adult disease. We then detail the areas of treatment advances such as immunotherapy with CAR T-cells, brentuximab vedotin, and blinatumomab as well as cell cycle inhibitors and describe areas where further research is needed. The aim of this review is to juxtapose established research regarding pediatric and adolescent NHL with recent advancements as well as highlight treatment gaps where more investigation is needed.
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12
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Pokorna P, Lakka Klement G, Vasikova A, Kanderova V, Jezova M, Noskova K, Mudry P, Kyr M, Merta T, Bajciova V, Krenova Z, Palova H, Valik D, Zdrazilova Dubska L, Slaby O, Sterba J. Minimal Residual Disease-Guided Intermittent Dosing in Patients With Cancer: Successful Treatment of Chemoresistant Anaplastic Large Cell Lymphoma Using Intermittent Lorlatinib Dosing. JCO Precis Oncol 2022; 6:e2100525. [PMID: 35700412 PMCID: PMC9384955 DOI: 10.1200/po.21.00525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Petra Pokorna
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Giannoula Lakka Klement
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,CSTS Health Care, Toronto, ON, Canada
| | - Alzbeta Vasikova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Veronika Kanderova
- CLIP, Department of Pediatric Hematology/Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marta Jezova
- Department of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Kristyna Noskova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Clinical Pharmacy Section of Hospital Pharmacy, University Hospital Brno, Brno, Czech Republic
| | - Peter Mudry
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Kyr
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Merta
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Viera Bajciova
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdenka Krenova
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Hana Palova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Dalibor Valik
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Zdrazilova Dubska
- Department of Clinical Microbiology and Immunology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ondrej Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jaroslav Sterba
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
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13
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Kreutmair S, Lippert LJ, Klingeberg C, Albers-Leischner C, Yacob S, Shlyakhto V, Mueller T, Mueller-Rudorf A, Yu C, Gorantla SP, Miething C, Duyster J, Illert AL. NIPA (Nuclear Interaction Partner of ALK) Is Crucial for Effective NPM-ALK Mediated Lymphomagenesis. Front Oncol 2022; 12:875117. [PMID: 35646639 PMCID: PMC9137267 DOI: 10.3389/fonc.2022.875117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
The NPM-ALK fusion kinase is expressed in 60% of systemic anaplastic large-cell lymphomas (ALCL). A Nuclear Interaction Partner of ALK (NIPA) was identified as a binding partner of NPM-ALK. To identify the precise role of NIPA for NPM-ALK-driven lymphomagenesis, we investigated various NPM-ALK+ cell lines and mouse models. Nipa deletion in primary mouse embryonic fibroblasts resulted in reduced transformation ability and colony formation upon NPM-ALK expression. Downregulating NIPA in murine NPM-ALK+ Ba/F3 and human ALCL cells decreased their proliferation ability and demonstrated synergistic effects of ALK inhibition and NIPA knockdown. Comprehensive in vivo analyses using short- and long-latency transplantation mouse models with NPM-ALK+ bone marrow (BM) revealed that Nipa deletion inhibited NPM-ALK-induced tumorigenesis with prolonged survival and reduced spleen colonies. To avoid off-target effects, we combined Nipa deletion and NPM-ALK expression exclusively in T cells using a lineage-restricted murine ALCL-like model resembling human disease: control mice died from neoplastic T-cell infiltration, whereas mice transplanted with Lck-CreTG/wtNipaflox/flox NPM-ALK+ BM showed significantly prolonged survival. Immunophenotypic analyses indicated a characteristic ALCL-like phenotype in all recipients but revealed fewer “stem-cell-like” features of Nipa-deficient lymphomas compared to controls. Our results identify NIPA as a crucial player in effective NPM-ALK-driven ALCL-like disease in clinically relevant murine and cell-based models.
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Affiliation(s)
- Stefanie Kreutmair
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany
| | - Lena Johanna Lippert
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Cathrin Klingeberg
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Corinna Albers-Leischner
- Department of Hematology, Oncology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Comprehensive Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Salome Yacob
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Valeria Shlyakhto
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tony Mueller
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department I of Internal Medicine, Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Alina Mueller-Rudorf
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Chuanjiang Yu
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sivahari Prasad Gorantla
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Hematology and Oncology, Medical Center, University of Schleswig-Holstein, Lübeck, Germany
| | - Cornelius Miething
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany
| | - Justus Duyster
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany
| | - Anna Lena Illert
- Department of Internal Medicine I, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Cancer Consortium and German Cancer Research Center, Heidelberg, Germany
- *Correspondence: Anna Lena Illert,
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14
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Wang Y, He J, Xu M, Xue Q, Zhu C, Liu J, Zhang Y, Shi W. Holistic View of ALK TKI Resistance in ALK-Positive Anaplastic Large Cell Lymphoma. Front Oncol 2022; 12:815654. [PMID: 35211406 PMCID: PMC8862178 DOI: 10.3389/fonc.2022.815654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase expressed at early stages of normal development and in various cancers including ALK-positive anaplastic large cell lymphoma (ALK+ ALCL), in which it is the main therapeutic target. ALK tyrosine kinase inhibitors (ALK TKIs) have greatly improved the prognosis of ALK+ALCL patients, but the emergence of drug resistance is inevitable and limits the applicability of these drugs. Although various mechanisms of resistance have been elucidated, the problem persists and there have been relatively few relevant clinical studies. This review describes research progress on ALK+ ALCL including the application and development of new therapies, especially in relation to drug resistance. We also propose potential treatment strategies based on current knowledge to inform the design of future clinical trials.
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Affiliation(s)
- Yuan Wang
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.,Nantong University School of Medicine, Nantong, China
| | - Jing He
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.,Nantong University School of Medicine, Nantong, China
| | - Manyu Xu
- Department of Clinical Biobank, Affiliated Hospital of Nantong University, Nantong, China
| | - Qingfeng Xue
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Cindy Zhu
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Juan Liu
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.,Nantong University School of Medicine, Nantong, China
| | - Yaping Zhang
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong, China
| | - Wenyu Shi
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.,Department of Hematology, Affiliated Hospital of Nantong University, Nantong, China
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15
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Mellacheruvu S, Sayegh MN, Sica RA, Cheng H, Santos-Zabala ML, Gebrael JH, Hermanto U, Rosen NL. Lymphomatous Meningitis From Anaplastic Lymphoma Kinase+ Anaplastic Large T-Cell Lymphoma Treated With Lorlatinib: A Case Report. JCO Precis Oncol 2022; 6:e2100250. [PMID: 35138917 PMCID: PMC8865515 DOI: 10.1200/po.21.00250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Smitha Mellacheruvu
- Department of Hematology and Oncology, St John's Riverside Hospital, Yonkers, NY.,Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Mark N Sayegh
- Department of Hematology and Oncology, St John's Riverside Hospital, Yonkers, NY
| | - R Alejandro Sica
- Division of Hematologic Malignancies, Department of Oncology, Montefiore Medical Center, Bronx, NY
| | - Haiying Cheng
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | | | - Jacob H Gebrael
- Department of Radiology, St John's Riverside Hospital, Yonkers, NY
| | - Ulrich Hermanto
- Department of Radiation Oncology, Montefiore Yonkers Radiation Oncology, Yonkers, NY
| | - Norman L Rosen
- Department of Hematology and Oncology, St John's Riverside Hospital, Yonkers, NY
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16
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Resistance to Targeted Agents Used to Treat Paediatric ALK-Positive ALCL. Cancers (Basel) 2021; 13:cancers13236003. [PMID: 34885113 PMCID: PMC8656581 DOI: 10.3390/cancers13236003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/25/2022] Open
Abstract
Simple Summary In general, the non-Hodgkin lymphoma (NHL), anaplastic large cell lymphoma (ALCL) diagnosed in childhood has a good survival outcome when treated with multi-agent chemotherapy. However, side effects of treatment are common, and outcomes are poorer after relapse, which occurs in up to 30% of cases. New drugs are required that are more effective and have fewer side effects. Targeted therapies are potential solutions to these problems, however, the development of resistance may limit their impact. This review summarises the potential resistance mechanisms to these targeted therapies. Abstract Non-Hodgkin lymphoma (NHL) is the third most common malignancy diagnosed in children. The vast majority of paediatric NHL are either Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), anaplastic large cell lymphoma (ALCL), or lymphoblastic lymphoma (LL). Multi-agent chemotherapy is used to treat all of these types of NHL, and survival is over 90% but the chemotherapy regimens are intensive, and outcomes are generally poor if relapse occurs. Therefore, targeted therapies are of interest as potential solutions to these problems. However, the major problem with all targeted agents is the development of resistance. Mechanisms of resistance are not well understood, but increased knowledge will facilitate optimal management strategies through improving our understanding of when to select each targeted agent, and when a combinatorial approach may be helpful. This review summarises currently available knowledge regarding resistance to targeted therapies used in paediatric anaplastic lymphoma kinase (ALK)-positive ALCL. Specifically, we outline where gaps in knowledge exist, and further investigation is required in order to find a solution to the clinical problem of drug resistance in ALCL.
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17
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The Dual Role of Autophagy in Crizotinib-Treated ALK + ALCL: From the Lymphoma Cells Drug Resistance to Their Demise. Cells 2021; 10:cells10102517. [PMID: 34685497 PMCID: PMC8533885 DOI: 10.3390/cells10102517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 02/06/2023] Open
Abstract
Autophagy has been described as harboring a dual role in cancer development and therapy. Depending on the context, it can exert either pro-survival or pro-death functions. Here, we review what is known about autophagy in crizotinib-treated ALK+ ALCL. We first present our main findings on the role and regulation of autophagy in these cells. Then, we provide literature-driven hypotheses that could explain mechanistically the pro-survival properties of autophagy in crizotinib-treated bulk and stem-like ALK+ ALCL cells. Finally, we discuss how the potentiation of autophagy, which occurs with combined therapies (ALK and BCL2 or ALK and RAF1 co-inhibition), could convert it from a survival mechanism to a pro-death process.
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18
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Merlio JP, Kadin ME. Cytokines, Genetic Lesions and Signaling Pathways in Anaplastic Large Cell Lymphomas. Cancers (Basel) 2021; 13:4256. [PMID: 34503066 PMCID: PMC8428234 DOI: 10.3390/cancers13174256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022] Open
Abstract
ALCL is a tumor of activated T cells and possibly innate lymphoid cells with several subtypes according to clinical presentation and genetic lesions. On one hand, the expression of transcription factors and cytokine receptors triggers signaling pathways. On the other hand, ALCL tumor cells also produce many proteins including chemokines, cytokines and growth factors that affect patient symptoms. Examples are accumulation of granulocytes stimulated by IL-8, IL-17, IL-9 and IL-13; epidermal hyperplasia and psoriasis-like skin lesions due to IL-22; and fever and weight loss in response to IL-6 and IFN-γ. In this review, we focus on the biology of the main ALCL subtypes as the identification of signaling pathways and ALCL-derived cytokines offers opportunities for targeted therapies.
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Affiliation(s)
- Jean-Philippe Merlio
- Tumor Biology and Tumor Bank Laboratory, Centre Hospitalier et Universitaire de Bordeaux, 33600 Pessac, France
- INSERM U1053, University Bordeaux, 33000 Bordeaux, France
| | - Marshall E. Kadin
- Department of Pathology and Laboratory Medicine, Brown University Alpert School of Medicine, Providence, RI 02903, USA
- Department of Dermatology, Boston University, Boston, MA 02215, USA
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19
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Boustani H, Khodadi E, Shahidi M. Autophagy in Hematological Malignancies: Molecular Aspects in Leukemia and Lymphoma. Lab Med 2021; 52:16-23. [PMID: 32634208 DOI: 10.1093/labmed/lmaa027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The organization of the hematopoietic system is dependent on hematopoietic stem cells (HSCs) that are capable of self-renewal and multilineage differentiation to produce different blood cell lines. Autophagy has a central role in energy production and metabolism of the cells during starvation, cellular stress adaption, and removing mechanisms for aged or damaged organelles. The role and importance of autophagy pathways are becoming increasingly recognized in the literature because these pathways can be useful in organizing intracellular circulation, molecular complexes, and organelles to meet the needs of various hematopoietic cells. There is supporting evidence in the literature that autophagy plays an emerging role in the regulation of normal cells and that it also has important features in malignant hematopoiesis. Understanding the molecular details of the autophagy pathway can provide novel methods for more effective treatment of patients with leukemia. Overall, our review will emphasize the role of autophagy and its different aspects in hematological malignant neoplasms.
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Affiliation(s)
- Hassan Boustani
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elahe Khodadi
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Minoo Shahidi
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
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20
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Mason EF, Kovach AE. Update on Pediatric and Young Adult Mature Lymphomas. Clin Lab Med 2021; 41:359-387. [PMID: 34304770 DOI: 10.1016/j.cll.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
After acute leukemia and brain and central nervous system tumors, mature lymphomas represent the third most common cancer in pediatric patients. Non-Hodgkin lymphoma accounts for approximately 60% of lymphoma diagnoses in children, with the remainder representing Hodgkin lymphoma. Among non-Hodgkin lymphomas in pediatric patients, aggressive lymphomas, such as Burkitt lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma, predominate. This article summarizes the epidemiologic, histopathologic, and molecular features of selected mature systemic B-cell and T-cell lymphomas encountered in this age group.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 4603A TVC, Nashville, TN 37232-5310, USA.
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #32, Los Angeles, CA 90027, USA
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21
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Butler E, Ludwig K, Pacenta HL, Klesse LJ, Watt TC, Laetsch TW. Recent progress in the treatment of cancer in children. CA Cancer J Clin 2021; 71:315-332. [PMID: 33793968 DOI: 10.3322/caac.21665] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 12/12/2022] Open
Abstract
Although significant improvements have been made in the outcomes of children with cancer, the pace of improvement has slowed in recent years as the limits of therapy intensification may have been reached for many pediatric cancers. Furthermore, with increasing numbers of pediatric cancer survivors, the long-term side effects of treatment have become increasingly apparent. Therefore, attention has shifted to the use of molecularly targeted agents and immunotherapies to improve the outcomes of children who are not cured by traditional cytotoxic chemotherapies and to decrease exposure to cytotoxic chemotherapy and reduce late effects. This review describes the recent progress in the treatment of children with cancer, focusing in particular on diseases in which targeted and immunotherapeutic agents have made an impact.
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Affiliation(s)
- Erin Butler
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas
| | - Kathleen Ludwig
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas
| | - Holly L Pacenta
- Division of Hematology and Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Laura J Klesse
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas
| | - Tanya C Watt
- Department of Pediatrics and Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas
| | - Theodore W Laetsch
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
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22
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Di Battista P, Lovisa F, Gaffo E, Gallingani I, Damanti CC, Garbin A, Ferrone L, Carraro E, Pillon M, Lo Nigro L, Mura R, Pizzi M, Guzzardo V, Dei Tos AP, Biffi A, Bortoluzzi S, Mussolin L. Low miR-214-5p Expression Correlates With Aggressive Subtypes of Pediatric ALCL With Non-Common Histology. Front Oncol 2021; 11:663221. [PMID: 34113568 PMCID: PMC8185221 DOI: 10.3389/fonc.2021.663221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
The unsatisfactory cure rate of relapsing ALK-positive Anaplastic Large-Cell Lymphoma (ALCL) of childhood calls for the identification of new prognostic markers. Here, the small RNA landscape of pediatric ALK-positive ALCL was defined by RNA sequencing. Overall, 121 miRNAs were significantly dysregulated in ALCL compared to non-neoplastic lymph nodes. The most up-regulated miRNA was miR-21-5p, whereas miR-19a-3p and miR-214-5p were reduced in ALCL. Characterization of miRNA expression in cases that relapsed after first line therapy disclosed a significant association between miR-214-5p down-regulation and aggressive non-common histology. Our results suggest that miR-214-5p level may help to refine the prognostic stratification of pediatric ALK-positive ALCL.
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Affiliation(s)
- Piero Di Battista
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, 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, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Enrico Gaffo
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Ilaria Gallingani
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Carlotta C Damanti
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Anna Garbin
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Lavinia Ferrone
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Elisa Carraro
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy
| | - Marta Pillon
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy
| | - Luca Lo Nigro
- Center of Pediatric Hematology Oncology, Azienda Policlinico G. Rodolico - San Marco, Catania, Italy
| | - Rossella Mura
- Department of Paediatric Haematology-Oncology, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Vincenza Guzzardo
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - Alessandra Biffi
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Stefania Bortoluzzi
- Department of Molecular Medicine, University of Padova, Padova, Italy.,CRIBI Interdepartmental Research Center for Innovative Biotechnologies (CRIBI), University of Padova, Padova, Italy
| | - Lara Mussolin
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Maternal and Child Health Department, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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23
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Mason EF, Hossein-Zadeh Z, Kovach AE. Pediatric hematolymphoid pathology in the gastrointestinal tract. Semin Diagn Pathol 2021; 38:31-37. [PMID: 33863576 DOI: 10.1053/j.semdp.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/25/2021] [Accepted: 03/22/2021] [Indexed: 11/11/2022]
Abstract
Hematolymphoid processes involving the gastrointestinal tract in the pediatric and adolescent young adult (AYA) populations include processes occurring primarily within the gastrointestinal tract as well as systemic diseases with predilection for gastrointestinal involvement. Here, we present a focused review of reactive and neoplastic entities occurring in the pediatric and AYA age groups.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Zarrin Hossein-Zadeh
- Department of Pathology, New York University (NYU) Long Island, Winthrop Hospital, Mineola, NY, United States
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA, United States
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24
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McCarthy P, Harford J, O'Marcaigh A, Malone A, Evans P, Sills A, Storey L, Rooney S, Betts D, O'Sullivan MJ, McDermott M, Bond J, Trinquand A, Smith OP. Ongoing excellent outcomes with reduced toxicities following integration of molecular targeted therapies in pediatric anaplastic large cell lymphoma. Leuk Lymphoma 2021; 62:1995-1999. [PMID: 33685326 DOI: 10.1080/10428194.2021.1894644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Peter McCarthy
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland
| | - John Harford
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Aengus O'Marcaigh
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Andrea Malone
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Pamela Evans
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Aoife Sills
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Lorna Storey
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Sean Rooney
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - David Betts
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Maureen J O'Sullivan
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Michael McDermott
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Jonathan Bond
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland.,National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Amélie Trinquand
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Owen P Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.,Systems Biology Ireland, School of Medicine, University College Dublin, Ireland
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25
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Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1. Blood 2021; 137:3595-3603. [PMID: 33684925 PMCID: PMC8462406 DOI: 10.1182/blood.2020009806] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/24/2021] [Indexed: 11/20/2022] Open
Abstract
The addition of brentuximab vedotin was tolerable and prevented relapses, and EFS compares favorably with conventional chemotherapy. The study confirmed that minimal disseminated disease detection in peripheral blood was prognostic, with a significant impact on EFS.
Approximately 30% of pediatric patients with anaplastic large cell lymphoma (ALCL) relapse. Although brentuximab vedotin has demonstrated excellent activity in ALCL, it has not been used for newly diagnosed patients. Children’s Oncology Group (COG) trial ANHL12P1 determined the toxicity and efficacy of brentuximab vedotin with chemotherapy in children with newly diagnosed nonlocalized anaplastic large cell lymphoma kinase (ALK)+/CD30+ ALCL. From 2013 to 2017, 68 children with ALK+ ALCL were enrolled and received brentuximab vedotin. All patients received 5-day prophase, followed by 6 cycles of chemotherapy. Brentuximab vedotin was given on day 1 of each of the 6 cycles. Of the 67 patients eligible for toxicity evaluation, 66 completed all 6 cycles of chemotherapy, resulting in 399 evaluable cycles. There were no toxic deaths, no case of progressive multifocal leukoencephalopathy syndrome, and no case of grade 3 or 4 neuropathy. The 2-year event-free survival (EFS) was 79.1% (95% confidence interval [CI], 67.2-87.1). The 2-year overall survival (OS) was 97.0% (95% CI, 88.1-99.2). Fourteen patients relapsed. Eleven of 14 (79%) relapses occurred within 10 months of diagnosis; only 1 patient (1.5%) relapsed during therapy. Quantitative reverse transcription polymerase chain reaction for NPM-ALK at baseline (minimal disseminated disease) demonstrated prognostic value for EFS (P = .0004). Overall, the addition of brentuximab vedotin to standard chemotherapy does not add significant toxicity or alter the desired interval between cycles. The addition of brentuximab vedotin prevented relapses during therapy, and the OS and EFS estimates compare favorably with results obtained using conventional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01979536.
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26
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Congras A, Hoareau-Aveilla C, Caillet N, Tosolini M, Villarese P, Cieslak A, Rodriguez L, Asnafi V, Macintyre E, Egger G, Brousset P, Lamant L, Meggetto F. ALK-transformed mature T lymphocytes restore early thymus progenitor features. J Clin Invest 2021; 130:6395-6408. [PMID: 33141118 DOI: 10.1172/jci134990] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 08/11/2020] [Indexed: 12/15/2022] Open
Abstract
Anaplastic large cell lymphoma (ALCL) is a mature T cell neoplasm that often expresses the CD4+ T cell surface marker. It usually harbors the t(2;5) (p23;q35) translocation, leading to the ectopic expression of NPM-ALK, a chimeric tyrosine kinase. We demonstrated that in vitro transduction of normal human CD4+ T lymphocytes with NPM-ALK results in their immortalization and malignant transformation. The tumor cells displayed morphological and immunophenotypical characteristics of primary patient-derived anaplastic large cell lymphomas. Cell growth, proliferation, and survival were strictly dependent on NPM-ALK activity and include activation of the key factors STAT3 and DNMT1 and expression of CD30 (the hallmark of anaplastic large-cell lymphoma). Implantation of NPM-ALK-transformed CD4+ T lymphocytes into immunodeficient mice resulted in the formation of tumors indistinguishable from patients' anaplastic large cell lymphomas. Integration of "Omic" data revealed that NPM-ALK-transformed CD4+ T lymphocytes and primary NPM-ALK+ ALCL biopsies share similarities with early T cell precursors. Of note, these NPM-ALK+ lymphoma cells overexpress stem cell regulators (OCT4, SOX2, and NANOG) and HIF2A, which is known to affect hematopoietic precursor differentiation and NPM-ALK+ cell growth. Altogether, for the first time our findings suggest that NPM-ALK could restore progenitor-like features in mature CD30+ peripheral CD4+ T cells, in keeping with a thymic progenitor-like pattern.
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Affiliation(s)
- Annabelle Congras
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Coralie Hoareau-Aveilla
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Nina Caillet
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France
| | - Marie Tosolini
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Pôle Technologique du CRCT, Plateau Bioinformatique, Toulouse, France
| | - Patrick Villarese
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Agata Cieslak
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Laura Rodriguez
- Etablissement Français du Sang, Nouvelle Aquitaine, INSERM U1035, Université de Bordeaux, Bordeaux, France
| | - Vahid Asnafi
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Elisabeth Macintyre
- Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France
| | - Gerda Egger
- Department of Pathology, Medical University Vienna, Vienna, Austria.,Ludwig Boltzmann Institute Applied Diagnostics, Vienna, Austria
| | - Pierre Brousset
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France
| | - Laurence Lamant
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France.,European Research Initiative on ALK-Related Malignancies, Cambridge, United Kingdom, Vienna, Austria, and Toulouse, France
| | - Fabienne Meggetto
- INSERM, UMR1037 CRCT, F-31000, Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000, Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Equipe Labellisée LIGUE 2017, Toulouse, France.,Hematology and INSERM1151, Institut Necker-Enfants Malades, University Sorbonne Paris Cité at Descartes and Assistance Publique-Hopitaux de Paris, Paris, France.,Institut Carnot Lymphome, Toulouse, France.,Laboratoire d'Excellence Toulouse Cancer and after Cancer (Labex TOUCAN), Toulouse, France.,European Research Initiative on ALK-Related Malignancies, Cambridge, United Kingdom, Vienna, Austria, and Toulouse, France
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27
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Lovisa F, Garbin A, Crotti S, Di Battista P, Gallingani I, Damanti CC, Tosato A, Carraro E, Pillon M, Mafakheri E, Romanato F, Gaffo E, Biffi A, Bortoluzzi S, Agostini M, Mussolin L. Increased Tenascin C, Osteopontin and HSP90 Levels in Plasmatic Small Extracellular Vesicles of Pediatric ALK-Positive Anaplastic Large Cell Lymphoma: New Prognostic Biomarkers? Diagnostics (Basel) 2021; 11:diagnostics11020253. [PMID: 33562105 PMCID: PMC7915848 DOI: 10.3390/diagnostics11020253] [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: 11/24/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022] Open
Abstract
Over the past 15 years, several biological and pathological characteristics proved their significance in pediatric anaplastic lymphoma kinase (ALK)-positive anaplastic large-cell lymphoma (ALCL) prognostic stratification. However, the identification of new non-invasive disease biomarkers, relying on the most important disease mechanisms, is still necessary. In recent years, plasmatic circulating small extracellular vesicles (S-EVs) gathered great importance both as stable biomarker carriers and active players in tumorigenesis. In the present work, we performed a comprehensive study on the proteomic composition of plasmatic S-EVs of pediatric ALCL patients compared to healthy donors (HDs). By using a mass spectrometry-based proteomics approach, we identified 50 proteins significantly overrepresented in S-EVs of ALCL patients. Gene Ontology enrichment analysis disclosed cellular components and molecular functions connected with S-EV origin and vesicular trafficking, whereas cell adhesion, glycosaminoglycan metabolic process, extracellular matrix organization, collagen fibril organization and acute phase response were the most enriched biological processes. Of importance, consistently with the presence of nucleophosmin (NPM)-ALK fusion protein in ALCL cells, a topological enrichment analysis based on Reactome- and Kyoto Encyclopedia of Genes and Genomes (KEGG)-derived networks highlighted a dramatic increase in proteins of the phosphatidylinositol 3-kinase (PI3K)/AKT pathway in ALCL S-EVs, which included heat shock protein 90-kDa isoform alpha 1 (HSP90AA1), osteopontin (SPP1/OPN) and tenascin C (TNC). These results were validated by Western blotting analysis on a panel of ALCL and HD cases. Further research is warranted to better define the role of these S-EV proteins as diagnostic and, possibly, prognostic parameters at diagnosis and for ALCL disease monitoring.
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Affiliation(s)
- Federica Lovisa
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Anna Garbin
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Sara Crotti
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Piero Di Battista
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Ilaria Gallingani
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Carlotta Caterina Damanti
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Anna Tosato
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Elisa Carraro
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padova University Hospital, 35128 Padova, Italy; (E.C.); (M.P.)
| | - Marta Pillon
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padova University Hospital, 35128 Padova, Italy; (E.C.); (M.P.)
| | - Erfan Mafakheri
- Department of Physics and Astronomy, Padova University, 35131 Padova, Italy; (E.M.); (F.R.)
| | - Filippo Romanato
- Department of Physics and Astronomy, Padova University, 35131 Padova, Italy; (E.M.); (F.R.)
- IOM-CNR, S.S. 14 km 163,5, 34149 Trieste, Italy
| | - Enrico Gaffo
- Department of Molecular Medicine, Padova University, 35121 Padova, Italy; (E.G.); (S.B.)
| | - Alessandra Biffi
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
| | - Stefania Bortoluzzi
- Department of Molecular Medicine, Padova University, 35121 Padova, Italy; (E.G.); (S.B.)
- CRIBI Interdepartmental Research Center for Innovative Biotechnologies (CRIBI), Padova University, 35121 Padova, Italy
| | - Marco Agostini
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
- First Surgical Clinic Section, Department of Surgical, Oncological and Gastroenterological Sciences, Padova University, 35128 Padova, Italy
| | - Lara Mussolin
- Maternal and Child Health Department, Padova University, 35128 Padova, Italy; (F.L.); (A.G.); (P.D.B.); (I.G.); (C.C.D.); (A.T.); (A.B.)
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padova, Italy; (S.C.); (M.A.)
- Correspondence:
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28
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O'Brien MM. Defining the Optimal Treatment of First Relapse of Pediatric Relapsed Anaplastic Large-Cell Lymphoma: Clinical Trial Challenges for Rare Diagnoses. J Clin Oncol 2020; 38:3980-3982. [PMID: 33058715 DOI: 10.1200/jco.20.02285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Maureen M O'Brien
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
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29
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Quelen C, Grand D, Sarot E, Brugières L, Sibon D, Pradines A, Laurent C, Brousset P, Lamant L. Minimal Residual Disease Monitoring Using a 3'ALK Universal Probe Assay in ALK-Positive Anaplastic Large-Cell Lymphoma: ddPCR, an Attractive Alternative Method to Real-Time Quantitative PCR. J Mol Diagn 2020; 23:131-139. [PMID: 33246076 DOI: 10.1016/j.jmoldx.2020.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/06/2020] [Accepted: 11/03/2020] [Indexed: 12/20/2022] Open
Abstract
In ALK-positive anaplastic large-cell lymphomas, positive qualitative PCR for NPM1-anaplastic lymphoma kinase (ALK) in peripheral blood and/or bone marrow at diagnosis and during treatment are associated with a higher risk of treatment failure. Real-time quantitative PCR allows identification of very high risk patients. However, this latter technique initially designed for patients with lymphomas carrying the most frequent NPM1-ALK translocation necessitates calibration curves, limiting interlaboratory reproducibility. An ALK universal quantitative PCR based on 3'ALK transcript amplification was designed to allow the detection of all ALK fusion transcripts. The absolute concordance of 3'ALK quantitative PCR results were validated with the routine NPM1-ALK qualitative and quantitative PCR on 46 samples. The universality of ALK fusion transcript detection also was validated on TPM3-, ALO17-, and ATIC-ALK-positive samples, and the EML4-ALK-positive cell line. Digital droplet PCR using the 3'ALK universal probe showed highly concordant results with 3'ALK universal quantitative PCR. A major benefit of digital droplet PCR is a reduced experimental set-up compared with quantitative PCR, without generation of standard curves, leading to a reliable protocol for multilaboratory validation in multicenter clinical trials essential for this rare pathology. Our ALK universal method could be used for the screening of ALK fusion transcripts in liquid biopsy specimens of other ALK-positive tumors, including non-small cell lung carcinomas.
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Affiliation(s)
- Cathy Quelen
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Université Toulouse III-Paul-Sabatier, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - David Grand
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Emeline Sarot
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif
| | - David Sibon
- Department of Hematology, Hopital Necker-Enfants Malades, Paris, France
| | - Anne Pradines
- Medical Laboratory, Claudius Regaud Institute, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Camille Laurent
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - Pierre Brousset
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; Cancer Research Center of Toulouse, INSERM UMR 1037, ERL5294 CNRS, Université Toulouse III-Paul-Sabatier, Toulouse, France.
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30
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Fukano R, Mori T, Sekimizu M, Choi I, Kada A, Saito AM, Asada R, Takeuchi K, Terauchi T, Tateishi U, Horibe K, Nagai H. Alectinib for relapsed or refractory anaplastic lymphoma kinase-positive anaplastic large cell lymphoma: An open-label phase II trial. Cancer Sci 2020; 111:4540-4547. [PMID: 33010107 PMCID: PMC7734006 DOI: 10.1111/cas.14671] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/14/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK) inhibition is expected to be a promising therapeutic strategy for ALK‐positive malignancies. We aimed to examine the efficacy and safety of alectinib, a second‐generation ALK inhibitor, in patients with relapsed or refractory ALK‐positive anaplastic large cell lymphoma (ALCL). This open‐label, phase II trial included patients (aged 6 years or older) with relapsed or refractory ALK‐positive ALCL. Alectinib 300 mg was given orally twice a day (600 mg/d) for 16 cycles, and the duration of each cycle was 21 days. Patients who weighed less than 35 kg were given a reduced dose of alectinib of 150 mg twice a day (300 mg/d). Ten patients were enrolled, and the median age was 19.5 years (range, 6‐70 years). Objective responses were documented in eight of 10 patients (80%; 90% confidence interval, 56.2‐95.9), with six complete responses. The 1‐year progression‐free survival, event‐free survival, and overall survival rates were 58.3%, 70.0%, and 70.0%, respectively. The median duration of therapy was 340 days. No unexpected adverse events occurred. The most common grade 3 and higher adverse event was a decrease in neutrophil count in two patients. Alectinib showed favorable clinical activity and was well tolerated in patients with ALK‐positive ALCL who had progressed on standard chemotherapy. Based on the results of the current study, the Ministry of Health, Labour and Welfare of Japan approved alectinib for the treatment of recurrent or refractory ALK‐positive ALCL in February 2020.
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Affiliation(s)
- Reiji Fukano
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine Hospital, Kanagawa, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Akiko Kada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Akiko Moriya Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ryuta Asada
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Kengo Takeuchi
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hirokazu Nagai
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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31
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Sorrentino D, Frentzel J, Mitou G, Blasco RB, Torossian A, Hoareau-Aveilla C, Pighi C, Farcé M, Meggetto F, Manenti S, Espinos E, Chiarle R, Giuriato S. High Levels of miR-7-5p Potentiate Crizotinib-Induced Cytokilling and Autophagic Flux by Targeting RAF1 in NPM-ALK Positive Lymphoma Cells. Cancers (Basel) 2020; 12:cancers12102951. [PMID: 33066037 PMCID: PMC7650725 DOI: 10.3390/cancers12102951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Anaplastic lymphoma kinase positive anaplastic large cell lymphomas are a pediatric disease, which still needs treatment improvement. Crizotinib was the first ALK-targeted inhibitor used in clinics, but relapses are now known to occur. Current research efforts indicate that combined therapies could represent a superior strategy to eradicate malignant cells and prevent tumor recurrence. Autophagy is a self-digestion cellular process, known to be induced upon diverse cancer therapies. Our present work demonstrates that the potentiation of the crizotinib-induced autophagy flux, through the serine/threonine kinase RAF1 downregulation, drives ALK+ ALCL cells to death. These results should encourage further investigations on the therapeutic modulation of autophagy in this particular cancer settings and other ALK-related malignancies. Abstract Anaplastic lymphoma kinase positive anaplastic large cell lymphomas (ALK+ ALCL) are an aggressive pediatric disease. The therapeutic options comprise chemotherapy, which is efficient in approximately 70% of patients, and targeted therapies, such as crizotinib (an ALK tyrosine kinase inhibitor (TKI)), used in refractory/relapsed cases. Research efforts have also converged toward the development of combined therapies to improve treatment. In this context, we studied whether autophagy could be modulated to improve crizotinib therapy. Autophagy is a vesicular recycling pathway, known to be associated with either cell survival or cell death depending on the cancer and therapy. We previously demonstrated that crizotinib induced cytoprotective autophagy in ALK+ lymphoma cells and that its further intensification was associated with cell death. In line with these results, we show here that combined ALK and Rapidly Accelerated Fibrosarcoma 1 (RAF1) inhibition, using pharmacological (vemurafenib) or molecular (small interfering RNA targeting RAF1 (siRAF1) or microRNA-7-5p (miR-7-5p) mimics) strategies, also triggered autophagy and potentiated the toxicity of TKI. Mechanistically, we found that this combined therapy resulted in the decrease of the inhibitory phosphorylation on Unc-51-like kinase-1 (ULK1) (a key protein in autophagy initiation), which may account for the enforced autophagy and cytokilling effect. Altogether, our results support the development of ALK and RAF1 combined inhibition as a new therapeutic approach in ALK+ ALCL.
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Affiliation(s)
- Domenico Sorrentino
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- Department of Pathology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.B.B.); (C.P.); (R.C.)
- Ligue Nationale Contre le Cancer, équipe labellisée 2016, F-31037 Toulouse, France
- European Research Initiative on ALK-related malignancies (ERIA), Cambridge CB2 0QQ, UK
| | - Julie Frentzel
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- Merck Serono S.A., Department of Biotechnology Process Sciences, Route de Fenil 25, Z.I. B, 1804 Corsier-sur-Vevey, Switzerland
| | - Géraldine Mitou
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
| | - Rafael B. Blasco
- Department of Pathology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.B.B.); (C.P.); (R.C.)
| | - Avédis Torossian
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
| | - Coralie Hoareau-Aveilla
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
| | - Chiara Pighi
- Department of Pathology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.B.B.); (C.P.); (R.C.)
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy
| | - Manon Farcé
- Pôle Technologique du CRCT—Plateau de Cytométrie et Tri cellulaire—INSERM U1037, F-31037 Toulouse, France;
| | - Fabienne Meggetto
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- European Research Initiative on ALK-related malignancies (ERIA), Cambridge CB2 0QQ, UK
| | - Stéphane Manenti
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- Ligue Nationale Contre le Cancer, équipe labellisée 2016, F-31037 Toulouse, France
| | - Estelle Espinos
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- European Research Initiative on ALK-related malignancies (ERIA), Cambridge CB2 0QQ, UK
| | - Roberto Chiarle
- Department of Pathology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.B.B.); (C.P.); (R.C.)
- European Research Initiative on ALK-related malignancies (ERIA), Cambridge CB2 0QQ, UK
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy
| | - Sylvie Giuriato
- Cancer Research Center of Toulouse, INSERM U1037—Université Toulouse III-Paul Sabatier—CNRS ERL5294, F-31037 Toulouse, France; (D.S.); (J.F.); (G.M.); (A.T.); (C.H.-A.); (F.M.); (S.M.); (E.E.)
- Department of Pathology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.B.B.); (C.P.); (R.C.)
- Ligue Nationale Contre le Cancer, équipe labellisée 2016, F-31037 Toulouse, France
- European Research Initiative on ALK-related malignancies (ERIA), Cambridge CB2 0QQ, UK
- TRANSAUTOPHAGY: European Network for Multidisciplinary Research and Translation of Autophagy Knowledge, COST Action CA15138, 08193 Barcelona, Spain
- Correspondence: ; Tel.: +33-(5)-82-74-16-35
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Mussolin L, Le Deley MC, Carraro E, Damm-Welk C, Attarbaschi A, Williams D, Burke A, Horibe K, Nakazawa A, Wrobel G, Mann G, Csóka M, Uyttebroeck A, Fernández-Delgado Cerdá R, Beishuizen A, Mellgren K, Burkhardt B, Klapper W, Turner SD, d’Amore ES, Lamant L, Reiter A, Woessmann W, Brugières L, Pillon M. Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma: Long Term Results of the International ALCL99 Trial. Cancers (Basel) 2020; 12:cancers12102747. [PMID: 32987765 PMCID: PMC7598675 DOI: 10.3390/cancers12102747] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/14/2022] Open
Abstract
With the aim of describing the long-term follow-up and to define the prognostic role of the clinical/pathological/molecular characteristics at diagnosis for childhood, adolescent and young adults affected by anaplastic large cell lymphoma (ALCL), we analyzed 420 patients aged up to 22 years homogeneously treated within the international ALCL99 trial. The 10-year progression free survival (PFS) was 70% and overall survival was 90%, rare late relapses occurred but no secondary malignancies were reported. Among clinical/pathological characteristics, only patients presenting a small cell/lymphohistiocytic (SC/LH) pattern were independently associated with risk of failure (hazard ratio = 2.49). Analysis of minimal disseminated disease (MDD), available for 162 patients, showed that both SC/LH pattern (hazard ratio = 2.4) and MDD positivity (hazard ratio = 2.15) were significantly associated with risk of failure in multivariate analysis. Considering MDD and SC/LH results, patients were separated into three biological/pathological (bp) risk groups: a high-risk group (bpHR) including MDD-positive patients with SC/LH pattern; a low-risk group (bpLR) including MDD-negative patients without SC/LH pattern; and an intermediate-risk group (bpIR) including remaining patients. The 10-year PFS was 40%, 75% and 86% for bpHR, bpIR and bpLR, respectively (p < 0.0001). These results should be considered in the design of future ALCL trials to tailor individual treatments.
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Affiliation(s)
- Lara Mussolin
- Maternal and Child Health Department, Padua University, 35128 Padua, Italy;
- Istituto di Ricerca Pediatrica Città della Speranza, 35127 Padua, Italy
- Correspondence: ; Tel.: +39-049-8215565; Fax: +39-049-9640150
| | | | - Elisa Carraro
- Maternal and Child Health Department, Padua University, 35128 Padua, Italy;
| | - Christine Damm-Welk
- University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany; (C.D.-W.); (W.W.)
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria; (A.A.); (G.M.)
| | - Denise Williams
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; (D.W.); (A.B.)
| | - Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; (D.W.); (A.B.)
| | - Keizo Horibe
- Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan;
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children’s Medical Center, Saitama 330-8777, Japan;
| | - Grazyna Wrobel
- Department of Bone Marrow Transplantation, Children Oncology and Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Georg Mann
- Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria; (A.A.); (G.M.)
| | - Monika Csóka
- 2nd Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary;
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, 3000 Leuven, Belgium;
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
| | - Karin Mellgren
- Department of Pediatric Haematology and Oncology, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden;
| | - Birgit Burkhardt
- Department of Pediatric Hematology and Oncology, University Hospital Muenster, D-48149 Muenster, Germany;
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology, University Hospital Schleswig Holstein, D-24105 Kiel, Germany;
| | - Suzanne D. Turner
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK;
- Central European Institute of Technology (CEITEC), Masaryk University, 60200 Brno, Czech Republic
| | | | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, France—Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France;
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus Liebig-University Giessen, 35390 Giessen, Germany;
| | - Wilhelm Woessmann
- University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany; (C.D.-W.); (W.W.)
| | - Laurence Brugières
- Department of Pediatrics and Adolescents Oncology, Gustave Roussy, 94800 Villejuif, France;
| | - Marta Pillon
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, 35128 Padua, Italy;
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Y RNA: An Overview of Their Role as Potential Biomarkers and Molecular Targets in Human Cancers. Cancers (Basel) 2020; 12:cancers12051238. [PMID: 32423154 PMCID: PMC7281143 DOI: 10.3390/cancers12051238] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022] Open
Abstract
Y RNA are a class of small non-coding RNA that are largely conserved. Although their discovery was almost 40 years ago, their function is still under investigation. This is evident in cancer biology, where their role was first studied just a dozen years ago. Since then, only a few contributions were published, mostly scattered across different tumor types and, in some cases, also suffering from methodological limitations. Nonetheless, these sparse data may be used to make some estimations and suggest routes to better understand the role of Y RNA in cancer formation and characterization. Here we summarize the current knowledge about Y RNA in multiple types of cancer, also including a paragraph about tumors that might be included in this list in the future, if more evidence becomes available. The picture arising indicates that Y RNA might be useful in tumor characterization, also relying on non-invasive methods, such as the analysis of the content of extracellular vesicles (EV) that are retrieved from blood plasma and other bodily fluids. Due to the established role of Y RNA in DNA replication, it is possible to hypothesize their therapeutic targeting to inhibit cell proliferation in oncological patients.
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Singh A, De Silva P, Chamberlain J, Deshpande A. Anaplastic large cell lymphoma mimicking a psoas abscess. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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35
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Fitzal F, Turner SD, Kenner L. Is breast implant-associated anaplastic large cell lymphoma a hazard of breast implant surgery? Open Biol 2020; 9:190006. [PMID: 30939983 PMCID: PMC6501645 DOI: 10.1098/rsob.190006] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) may occur after reconstructive or aesthetic breast surgery. Worldwide, approximately 1.7 million breast implant surgeries are performed each year. To date, over 500 cases of BIA-ALCL have been reported around the world, with 16 women having died. This review highlights the most important facts surrounding BIA-ALCL. There is no consensus regarding the true incidence rate of BIA-ALCL as it varies between countries, is probably significantly under-reported and is difficult to estimate due to the true number of breast prostheses used largely being unknown. BIA-ALCL develops in the breast mostly as a seroma surrounding the implant, but contained within the fibrous capsule, or more rarely as a solid mass that can become invasive infiltrating the chest wall and muscle, in some instances spreading to adjacent lymph nodes, in these cases having a far worse prognosis. The causation of BIA-ALCL remains to be established, but it has been proposed that chronic infection and/or implant toxins may be involved. What is clear is that complete capsulectomy is required for treatment of BIA-ALCL, which for early-stage disease leads to cure, whereas chemotherapy is needed for advanced-stage disease, whereby improved results have been reported with the use of brentuximab. A worldwide database for BIA-ALCL and implants should be supported by local governments.
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Affiliation(s)
- Florian Fitzal
- 1 Department of Surgery and Comprehensive Cancer Center, Medical University Vienna , Vienna , Austria
| | - Suzanne D Turner
- 2 Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge , Cambridge CB20QQ , UK.,6 Department for Experimental and Laboratory Animal Pathology, Clinical Institute of Pathology, Medical University of Vienna , 1090 Vienna , Austria
| | - Lukas Kenner
- 3 Ludwig Boltzmann Institute for Cancer Research , 1090 Vienna , Austria.,4 Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna , 1210 Vienna , Austria.,5 Division of Experimental Pathology, Medical University of Vienna , 1090 Vienna , Austria.,6 Department for Experimental and Laboratory Animal Pathology, Clinical Institute of Pathology, Medical University of Vienna , 1090 Vienna , Austria.,7 The European Research Initiative for ALK-related Malignancies (ERIA) , Cambridge , UK
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Abstract
Pediatric T-cell hematologic malignancies are a diverse group of rare cancers. The most common pediatric T-cell malignancies include T-cell acute lymphoblastic leukemia (T-ALL) and anaplastic large cell lymphoma (ALCL). Although the overall survival rates have improved markedly in recent years, children with relapsed T-ALL and ALCL have very low rates of cure and few salvage therapies exist. Current treatment regimens rely on toxic chemotherapies with significant short- and long-term morbidity. Immunotherapies, including antibodies and adoptive cellular therapies, have revolutionized the treatment of B-cell malignancies in pediatrics. The adaptation of these therapies to T-cell malignancies has been slower because of challenges implicit in the design and implementation of immunotherapies for T-cell malignancies, including the potential risks of fratricide, immunosuppression, and graft versus host disease (GVHD). We present a review of current challenges in the development of immunotherapies for T-cell hematologic malignancies, potential solutions and therapies under investigation. We include a particular focus on T-ALL and ALCL. Immunotherapies offer promising strategies to improve outcomes in children with T-cell malignancies, particularly in the setting of relapse. Optimizing efficacy, mitigating toxicity, and safely integrating with conventional therapies are key considerations as immunotherapies are translated into the clinic.
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Affiliation(s)
- Caroline Diorio
- Division of Oncology, Department of Pediatrics, Center for Childhood Cancer Research, Children's Hospital of Philadelphia and Pereleman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David T Teachey
- Division of Oncology, Department of Pediatrics, Center for Childhood Cancer Research, Children's Hospital of Philadelphia and Pereleman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Lovisa F, Di Battista P, Gaffo E, Damanti CC, Garbin A, Gallingani I, Carraro E, Pillon M, Biffi A, Bortoluzzi S, Mussolin L. RNY4 in Circulating Exosomes of Patients With Pediatric Anaplastic Large Cell Lymphoma: An Active Player? Front Oncol 2020; 10:238. [PMID: 32175280 PMCID: PMC7056873 DOI: 10.3389/fonc.2020.00238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/12/2020] [Indexed: 12/20/2022] Open
Abstract
Emerging evidence indicates that extracellular vesicles, particularly exosomes, play a role in several biological processes and actively contribute to cancer development and progression, by carrying and delivering proteins, transcripts and small RNAs (sRNAs). There is high interest in studying exosomes of cancer patients both to develop non-invasive liquid biopsy tests for risk stratification and to elucidate their possible involvement in disease mechanisms. We profiled by RNA-seq the sRNA content of circulating exosomes of 20 pediatric patients with Anaplastic Large Cell Lymphoma (ALCL) and five healthy controls. Our analysis disclosed that non-miRNA derived sRNAs constitute the prominent fraction of sRNA loaded in exosomes and identified 180 sRNAs significantly more abundant in exosomes of ALCL patients compared to controls. YRNA fragments, accounting for most of exosomal content and being significantly increased in ALCL patients, were prioritized for further investigation by qRT-PCR. Quantification of RNY4 fragments and full-length sequences disclosed that the latter are massively loaded into exosomes of ALCL patients with more advanced and aggressive disease. These results are discussed in light of recent findings on the role of RNY4 in the modulation of tumor microenvironment.
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Affiliation(s)
- Federica Lovisa
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Piero Di Battista
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Enrico Gaffo
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Carlotta C Damanti
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Anna Garbin
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Ilaria Gallingani
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Elisa Carraro
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Marta Pillon
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Alessandra Biffi
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's 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, United States
| | - Stefania Bortoluzzi
- Department of Molecular Medicine, University of Padova, Padova, Italy.,CRIBI Interdepartmental Research Center for Innovative Biotechnologies (CRIBI), University of Padova, Padova, Italy
| | - Lara Mussolin
- Clinic of Pediatric Onco-Hematology, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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Prognostic Factors and Treatment Outcome of Pediatric Anaplastic Large Cell Lymphoma Treated at the Children Cancer Hospital Egypt. J Pediatr Hematol Oncol 2019; 41:e427-e431. [PMID: 31343479 DOI: 10.1097/mph.0000000000001553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the current study is to report the epidemiologic data, response rate, treatment outcome, and overall survival of anaplastic large cell lymphoma (ALCL) patients during the 8-year period. PATIENTS AND METHODS A retrospective study included all patients with newly diagnosed ALCL from July 2007 till December 2015. RESULTS A total of 48 patients were enrolled. The majority (66.7%) were male individuals. Twenty-one patients (43.7%) were low stage I or II, whereas 27 (56.2%) had advanced stage III or IV. Two patients (4.2%) died during induction chemotherapy. Disease status at last follow-up showed 35 patients (72.9%) in complete remission, 5 (10.5%) relapse, and 5 disease progression. The median time to relapse was 17.2 months. Four patients (8.4%) were salvaged by high-dose chemotherapy ifosphamide, carboplatine, etoposide followed by autologous hematopoietic stem cell transplantation, whereas 5 (10.5%) died out of disease progression. The 5-year overall survival and event-free survival were 81.2% and 68.6%, respectively. Median FU period was 58.7 month. Multivariate analysis included age, sex, stage, and response to chemotherapy and showed no statistical significance. CONCLUSION Treatment of ALCL according to the Children's Oncology Group ANHL 0131 protocol is well tolerated. The relapsing patient could be salvaged by high-dose chemotherapy and autologous hematopoietic stem cell transplantation.
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Penberthy K, Mendoza J, Mendoza M, Harrison G, Lancaster L, Belyea B, Zeichner SL. Abdominal Pain and Intermittent Fevers in a 16-Year-Old Girl. Pediatrics 2019; 144:e20190093. [PMID: 31375532 PMCID: PMC6855813 DOI: 10.1542/peds.2019-0093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2019] [Indexed: 01/19/2023] Open
Abstract
A 16-year-old girl presented to the emergency department with intermittent fevers and worsening abdominal pain of 5 weeks duration. She had a history of travel to a less developed country and exposure to possible infectious diseases. Abdominal imaging and blood tests revealed diffuse mesenteric lymphadenopathy, elevated transaminases, and elevation of inflammatory markers. Gastroesophageal and colon endoscopies revealed gastric ulcers, and the patient was discharged with a presumptive diagnosis of systemic juvenile idiopathic arthritis given the lymphadenopathy seen on imaging, serositis, sacroiliac joint stiffness noted on physical examination, and pain relief with celecoxib. She presented again 4 days later with worsening abdominal tenderness, elevated transaminases, and new-onset abdominal distention. Tissue biopsy yielded the diagnosis and directed appropriate treatment.
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MESH Headings
- Abdominal Pain/etiology
- Adolescent
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Arthritis, Juvenile/diagnosis
- Biomarkers/blood
- Biopsy
- Diagnosis, Differential
- Emergency Service, Hospital
- Endoscopy, Gastrointestinal
- Enterobiasis/diagnosis
- Female
- Fever/etiology
- Humans
- Inflammation/diagnosis
- Lymphadenopathy/diagnosis
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/diagnostic imaging
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, Large-Cell, Anaplastic/pathology
- Positron Emission Tomography Computed Tomography
- Stomach Ulcer/chemically induced
- Stomach Ulcer/diagnosis
- Tomography, X-Ray Computed
- Transaminases/blood
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Affiliation(s)
- Kristen Penberthy
- Microbiology, Immunology, and Cancer Biology, School of Medicine, University of Virginia, Charlottesville, Virginia
| | | | | | | | | | | | - Steven L Zeichner
- Pediatric Infectious Diseases, Department of Pediatrics and Departments of
- Microbiology, Immunology, and Cancer Biology, School of Medicine, University of Virginia, Charlottesville, Virginia
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Wang X, Wu J, Zhang M. Advances in the treatment and prognosis of anaplastic lymphoma kinase negative anaplastic large cell lymphoma. ACTA ACUST UNITED AC 2019; 24:440-445. [PMID: 31072226 DOI: 10.1080/16078454.2019.1613290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anaplastic lymphoma kinase negative anaplastic large cell lymphoma (ALK- ALCL) is a definite entity in the WHO 2016 Classification that represents 2-3% of non-Hodgkin lymphoma (NHL) and 12% of T-cell NHL cases. ALK- ALCL lacks ALK protein expression, but expresses CD30 and has morphologic features similar to ALK positive anaplastic large cell lymphoma (ALK+ ALCL). Some studies indicate that ALK- ALCL and ALK+ ALCL possess different molecular and genetic characteristics. Besides, ALK- ALCL is worse than ALK+ ALCL in terms of treatment outcome, prognosis, and long-term survival. This review is aimed at summarizing information about ALK- ALCL, especially with respect to the treatment and prognosis.
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Affiliation(s)
- Xiaoli Wang
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
| | - Jingjing Wu
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
| | - Mingzhi Zhang
- a Department of Oncology , Lymphoma Diagnosis and Treatment Centre of Henan Province, The First Affiliated Hospital of Zhengzhou University , Zhengzhou , People's Republic of China
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41
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Cairo MS, Beishuizen A. Childhood, adolescent and young adult non-Hodgkin lymphoma: current perspectives. Br J Haematol 2019; 185:1021-1042. [PMID: 30729513 PMCID: PMC6897376 DOI: 10.1111/bjh.15764] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The 6th International Symposium on Childhood, Adolescent and Young Adult (CAYA) Non-Hodgkin Lymphoma (NHL) was held in Rotterdam, Netherlands, 26-29 September, 2018. This summary manuscript is a perspective on the presentations from the plenary scientific sessions, including wellness and survivorship, B-cell NHL, AYA lymphoma, translational NHL biology, lymphoma immunology, bone marrow transplantation and cell therapy, T/Natural Killer cell lymphoma, anaplastic large cell lymphoma, lymphoblastic lymphoma, novel lymphoma therapeutics and Hodgkin lymphoma. The symposium was attended by over 260 registrants from 42 different countries and included young, middle and senior investigators. Finally, the Angelo Rosolen, MD, Memorial Lecture was delivered by Alfred Reiter, MD.
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Affiliation(s)
- Mitchell S. Cairo
- Departments of Pediatrics, Medicine, Pathology, Microbiology& Immunology, and Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA
| | - Auke Beishuizen
- Division of Paediatric Haemato-Oncology, Princess Maxima Centre for Paediatric Oncology, Utrecht
- Department of Paediatric Oncology/Haematology, Erasmus MC - Sophia Children’s Hospital, Rotterdam, The Netherlands
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42
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Non-Coding RNA Networks in ALK-Positive Anaplastic-Large Cell Lymphoma. Int J Mol Sci 2019; 20:ijms20092150. [PMID: 31052302 PMCID: PMC6539248 DOI: 10.3390/ijms20092150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/18/2022] Open
Abstract
Non-coding RNAs (ncRNAs) are essential regulators of gene expression. In recent years, it has become more and more evident that the different classes of ncRNAs, such as micro RNAs, long non-coding RNAs and circular RNAs are organized in tightly controlled networks. It has been suggested that deregulation of these networks can lead to disease. Several studies show a contribution of these so-called competing-endogenous RNA networks in various cancer entities. In this review, we highlight the involvement of ncRNA networks in anaplastic-large cell lymphoma (ALCL), a T-cell neoplasia. A majority of ALCL cases harbor the molecular hallmark of this disease, a fusion of the anaplastic lymphoma kinase (ALK) gene with the nucleophosmin (NPM, NPM1) gene leading to a permanently active kinase that promotes the malignant phenotype. We have focused especially on ncRNAs that are regulated by the NPM-ALK fusion gene and illustrate how their deregulation contributes to the pathogenesis of ALCL. Lastly, we summarize the findings and point out potential therapeutic implications.
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43
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Umapathy G, Mendoza-Garcia P, Hallberg B, Palmer RH. Targeting anaplastic lymphoma kinase in neuroblastoma. APMIS 2019; 127:288-302. [PMID: 30803032 PMCID: PMC6850425 DOI: 10.1111/apm.12940] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/18/2019] [Indexed: 12/15/2022]
Abstract
Over the last decade, anaplastic lymphoma kinase (ALK), a receptor tyrosine kinase (RTK), has been identified as a fusion partner in a diverse variety of translocation events resulting in oncogenic signaling in many different cancer types. In tumors where the full‐length ALK RTK itself is mutated, such as neuroblastoma, the picture regarding the role of ALK as an oncogenic driver is less clear. Neuroblastoma is a complex and heterogeneous tumor that arises from the neural crest derived peripheral nervous system. Although high‐risk neuroblastoma is rare, it often relapses and becomes refractory to treatment. Thus, neuroblastoma accounts for 10–15% of all childhood cancer deaths. Since most cases are in children under the age of 2, understanding the role and regulation of ALK during neural crest development is an important goal in addressing neuroblastoma tumorigenesis. An impressive array of tyrosine kinase inhibitors (TKIs) that act to inhibit ALK have been FDA approved for use in ALK‐driven cancers. ALK TKIs bind differently within the ATP‐binding pocket of the ALK kinase domain and have been associated with different resistance mutations within ALK itself that arise in response to therapeutic use, particularly in ALK‐fusion positive non‐small cell lung cancer (NSCLC). This patient population has highlighted the importance of considering the relevant ALK TKI to be used for a given ALK mutant variant. In this review, we discuss ALK in neuroblastoma, as well as the use of ALK TKIs and other strategies to inhibit tumor growth. Current efforts combining novel approaches and increasing our understanding of the oncogenic role of ALK in neuroblastoma are aimed at improving the efficacy of ALK TKIs as precision medicine options in the clinic.
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Affiliation(s)
- Ganesh Umapathy
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Patricia Mendoza-Garcia
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bengt Hallberg
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ruth H Palmer
- Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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44
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Wang R, Li L, Duan A, Li Y, Liu X, Miao Q, Gong J, Zhen Y. Crizotinib enhances anti-CD30-LDM induced antitumor efficacy in NPM-ALK positive anaplastic large cell lymphoma. Cancer Lett 2019; 448:84-93. [PMID: 30742941 DOI: 10.1016/j.canlet.2019.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/28/2019] [Accepted: 02/01/2019] [Indexed: 12/21/2022]
Abstract
Combining antibody-drug conjugates (ADCs) with targeted small-molecule inhibitors can enhance antitumor effects beyond those attainable with monotherapy. In this study, we investigated the therapeutic combination of a CD30-targeting ADC (anti-CD30-lidamycin [LDM]) with a small-molecule inhibitor (crizotinib) of nucleophosmin-anaplastic lymphoma kinase NPM-ALK in CD30+/ALK+ anaplastic large cell lymphoma (ALCL). In vitro, anti-CD30-LDM showed strong synergistic antiproliferative activity when combined with crizotinib. Furthermore, treatment with anti-CD30-LDM plus crizotinib resulted in a stronger induction of cell apoptosis than monotherapy with either treatment. Western blot analysis revealed that ERK1/2 phosphorylation was increased in response to anti-CD30-LDM-induced DNA damage. Interestingly, the addition of crizotinib inhibited the expression of phosphorylated ERK1/2 and further augmented anti-CD30-LDM-mediated apoptosis, providing a potential synergistic mechanism for DNA-damaging agents combined with NPM-ALK inhibitors. In Karpas299 and SU-DHL-1 xenograft models, anti-CD30-LDM plus crizotinib was more effective in inhibiting tumor growth than either treatment alone. This research demonstrated for the first time that the combination of anti-CD30-LDM and crizotinib exhibits a synergistic inhibitory effect in tumor cells. These results provide scientific support for future clinical evaluations of anti-CD30-LDM, or other DNA-damaging agents, combined with NPM-ALK inhibitors.
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Affiliation(s)
- Rong Wang
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Department of Blood Transfusion, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Liang Li
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Aijun Duan
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yi Li
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiujun Liu
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qingfang Miao
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jianhua Gong
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yongsu Zhen
- NHC Key Laboratory of Biotechnology of Antibiotics, Department of Oncology, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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45
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Turner SD. The Cellular Origins of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Implications for Immunogenesis. Aesthet Surg J 2019; 39:S21-S27. [PMID: 30715172 DOI: 10.1093/asj/sjy229] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The exact cellular origins of most malignancies are unknown, largely because of the complex nature of malignancies, and because the potential vast number of pathways towards transformation are difficult to discern from established growths. This is compounded by the fact that cancer cells have evolved rather than being the consequence of a design process, with most data collected from (sometimes epidemiological) studies of large numbers of related malignancies. In the case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), the relative rarity of this disease, coupled with limited insight into its biological basis, have hampered progress. The known facts that are holding up as our knowledge increases with rising incidences are that most cases have been reported in the context of textured breast implants, although not all women with these implants develop BIA-ALCL, and cure for early-stage disease (accounting for the majority of patients) can be achieved via complete capsulectomy and implant removal. However, some theories can be gleaned from the limited biological studies conducted to date whereby a T-helper cell derivation is implicated, with its specific and apparent subset of origin dependent on, and shaped by, a number of factors, including the inflammatory microenvironment (the presence of other inflammatory cell types), the driving antigen (bacterial and/or synthetic), the acquisition of driving oncogenic events, and the inherent genetics/health status of the patient.
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Affiliation(s)
- Suzanne Dawn Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
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46
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Therapeutic Modulation of Autophagy in Leukaemia and Lymphoma. Cells 2019; 8:cells8020103. [PMID: 30704144 PMCID: PMC6406467 DOI: 10.3390/cells8020103] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/26/2019] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
Haematopoiesis is a tightly orchestrated process where a pool of hematopoietic stem and progenitor cells (HSPCs) with high self-renewal potential can give rise to both lymphoid and myeloid lineages. The HSPCs pool is reduced with ageing resulting in few HSPC clones maintaining haematopoiesis thereby reducing blood cell diversity, a phenomenon called clonal haematopoiesis. Clonal expansion of HSPCs carrying specific genetic mutations leads to increased risk for haematological malignancies. Therefore, it comes as no surprise that hematopoietic tumours develop in higher frequency in elderly people. Unfortunately, elderly patients with leukaemia or lymphoma still have an unsatisfactory prognosis compared to younger ones highlighting the need to develop more efficient therapies for this group of patients. Growing evidence indicates that macroautophagy (hereafter referred to as autophagy) is essential for health and longevity. This review is focusing on the role of autophagy in normal haematopoiesis as well as in leukaemia and lymphoma development. Attenuated autophagy may support early hematopoietic neoplasia whereas activation of autophagy in later stages of tumour development and in response to a variety of therapies rather triggers a pro-tumoral response. Novel insights into the role of autophagy in haematopoiesis will be discussed in light of designing new autophagy modulating therapies in hematopoietic cancers.
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47
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Barth MJ, Minard-Colin V. Novel targeted therapeutic agents for the treatment of childhood, adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2019; 185:1111-1124. [PMID: 30701541 DOI: 10.1111/bjh.15783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023]
Abstract
Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of malignancies. Most NHLs in children, adolescent and young adult patients are aggressive lymphomas that are generally treated with multi-agent chemotherapy or immunochemotherapy regimens. While overall survival is high, the treatment can lead to a high rate of acute and long-term toxicity. However, in the rarer instance of relapsed or refractory disease, outcomes are dismal. Novel therapeutic approaches to the treatment of both T-cell and B-cell NHLs are critical to improve outcomes while also minimising the associated toxicity of current treatment regimes. Potential therapeutic approaches in development include humoral and cellular immunotherapies, small molecule inhibitors of relevant signalling pathways and epigenetic modifying agents. In this review, we will highlight the current state of development of agents of interest with a focus on agents relevant to childhood, adolescent and young adult NHL.
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Affiliation(s)
- Matthew J Barth
- Department of Pediatric Hematology/Oncology, University at Buffalo, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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48
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Torossian A, Broin N, Frentzel J, Daugrois C, Gandarillas S, Saati TA, Lamant L, Brousset P, Giuriato S, Espinos E. Blockade of crizotinib-induced BCL2 elevation in ALK-positive anaplastic large cell lymphoma triggers autophagy associated with cell death. Haematologica 2019; 104:1428-1439. [PMID: 30679328 PMCID: PMC6601090 DOI: 10.3324/haematol.2017.181966] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/22/2019] [Indexed: 12/11/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphomas are tumors that carry translocations involving the ALK gene at the 2p23 locus, leading to the expression of ALK tyrosine kinase fusion oncoproteins. Amongst hematologic malignancies, these lymphomas are particular in that they express very low levels of B-cell lymphoma 2 (BCL2), a recognized inhibitor of apoptosis and autophagy, two processes that share complex interconnections. We have previously shown that treatment of ALK-positive anaplastic large cell lymphoma cells with the ALK tyrosine kinase inhibitor crizotinib induces autophagy as a pro-survival response. Here, we observed that crizotinib-mediated inactivation of ALK caused an increase in BCL2 levels that restrained the cytotoxic effects of the drug. BCL2 downregulation in combination with crizotinib treatment potentiated loss of cell viability through both an increase in autophagic flux and cell death, including apoptosis. More importantly, our data revealed that the blockade of autophagic flux completely reversed impaired cell viability, which demonstrates that excessive autophagy is associated with cell death. We propose that the downregulation of BCL2 protein, which plays a central role in the autophagic and apoptotic machinery, combined with crizotinib treatment may represent a promising therapeutic alternative to current ALK-positive anaplastic large cell lymphoma treatments.
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Affiliation(s)
- Avedis Torossian
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France
| | - Nicolas Broin
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France
| | - Julie Frentzel
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France
| | - Camille Daugrois
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Laboratoire d'Excellence Toulouse-Cancer-TOUCAN, F-31024 Toulouse, France
| | | | - Talal Al Saati
- Inserm/UPS, US006/CREFRE, Service d'Histopathologie, F-31000 Toulouse, France
| | - Laurence Lamant
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Laboratoire d'Excellence Toulouse-Cancer-TOUCAN, F-31024 Toulouse, France.,Département de Pathologie, IUCT, F-31000 Toulouse, France.,European Research Initiative on ALK-related Malignancies (ERIA), Cambridge, UK
| | - Pierre Brousset
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France.,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Laboratoire d'Excellence Toulouse-Cancer-TOUCAN, F-31024 Toulouse, France.,Département de Pathologie, IUCT, F-31000 Toulouse, France.,European Research Initiative on ALK-related Malignancies (ERIA), Cambridge, UK
| | - Sylvie Giuriato
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France .,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,European Research Initiative on ALK-related Malignancies (ERIA), Cambridge, UK.,Transautophagy: European network for multidisciplinary research and translation of autophagy knowledge, COST Action CA15138, Brussel, Belgium
| | - Estelle Espinos
- Inserm, UMR1037 CRCT, F-31000 Toulouse, France .,Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France.,CNRS, ERL5294 UMR1037 CRCT, F-31000, Toulouse, France.,Laboratoire d'Excellence Toulouse-Cancer-TOUCAN, F-31024 Toulouse, France.,European Research Initiative on ALK-related Malignancies (ERIA), Cambridge, UK
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49
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Chen SH, Chen JS, Jou ST, Wu KH, Hung IJ, Sheen JM, Lu MY, Chen BW, Jaing TH, Wang SC, Lin MT, Chang TK, Liu HC, Yang CP. Outcome and prognosis of anaplastic large cell lymphoma in children: a report from the Taiwan Pediatric Oncology Group. Leuk Lymphoma 2019; 60:1942-1949. [DOI: 10.1080/10428194.2018.1562182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shih-Hsiang Chen
- Division of Pediatric Hematology/Oncology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Jiann-Shiuh Chen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shiann-Tarng Jou
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kang-Hsi Wu
- Division of Pediatric Hematology-Oncology, Children's Hospital China Medical University, Taichung, Taiwan
| | - Iou-Jih Hung
- Division of Pediatric Hematology/Oncology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Jiunn-Ming Sheen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Yao Lu
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bow-Wen Chen
- Division of Pediatric Hematology and Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Tang-Her Jaing
- Division of Pediatric Hematology/Oncology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Shih-Chung Wang
- Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Tsan Lin
- Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan
| | - Te-Kau Chang
- Department of Pediatrics, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Hsi-Che Liu
- Department of Pediatrics, Mackay Memorial Hospital, Mackay Medical College, Taipei, Taiwan
| | - Chao-Ping Yang
- Division of Pediatric Hematology/Oncology, Chang Gung Memorial Hospital, Chang Gung University School of Medicine, Taoyuan, Taiwan
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50
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Hudson S, Wang D, Middleton F, Nevaldine BH, Naous R, Hutchison RE. Crizotinib induces apoptosis and gene expression changes in ALK+ anaplastic large cell lymphoma cell lines; brentuximab synergizes and doxorubicin antagonizes. Pediatr Blood Cancer 2018; 65:e27094. [PMID: 29697184 DOI: 10.1002/pbc.27094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) shows 60-70% event free survival with standard treatments. Targeted therapies are being tested for increased benefit and/or reduced toxicity, but interactions with standard agents are not well known. METHODS We exposed four ALCL cell lines to two targeted agents, crizotinib and brentuximab vedotin, and to two standard agents, doxorubicin and vinblastine. For each agent and combination, we measured apoptosis and expression of approximately 300 previously annotated genes of interest using targeted RNA-sequencing. An aurora kinase inhibitor, alisertib, was similarly tested for gene expression effects. RESULTS Only crizotinib, alone or in combination, showed significant effects (adjusted P < 0.05) on expression and apoptosis. One hundred and nine of 277 gene expressions showed crizotinib-associated differential expression, mostly downregulation, 62 associated with apoptosis, and 28 associated with both crizotinib and apoptosis. Doxorubicin was antagonistic with crizotinib on gene expression and apoptosis. Brentuximab was synergistic with crizotinib in apoptosis, and not antagonistic in gene expression. Vinblastine also appeared synergistic with crizotinib but did not achieve statistical significance. Alisertib did not show significant expression changes. CONCLUSIONS Our data suggest that crizotinib induces apoptosis through orderly changes in cell signaling associated with ALK inhibition. Expression effects of crizotinib and associated apoptosis are antagonized by doxorubicin, but apoptosis is synergized by brentuximab vedotin and possibly vinblastine. These findings suggest that concurrent use of crizotinib and doxorubicin may be counterproductive, while the pairing of crizotinib with brentuximab (or vinblastine) may increase efficacy. Alisertib did not induce expression changes at cytotoxic dosage.
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Affiliation(s)
- Sandra Hudson
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Frank Middleton
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Barbara H Nevaldine
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Rana Naous
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
| | - Robert E Hutchison
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
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