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Kim M, Ahn SY, Ahn JS, Song GY, Jung SH, Lee JJ, Kim HJ, Lee JH, Shin MG, Song SY, Yang DH. Diagnostic Accuracy and Prognostic Relevance of Immunoglobulin Heavy Chain Rearrangement and 18F-FDG-PET/CT Compared With Unilateral Bone Marrow Trephination for Detecting Bone Marrow Involvement in Patients With Diffuse Large B-Cell Lymphoma. J Korean Med Sci 2022; 37:e2. [PMID: 34981678 PMCID: PMC8723897 DOI: 10.3346/jkms.2022.37.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/05/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In diffuse large B-cell lymphoma (DLBCL), bone marrow involvement (BMI) has an important clinical implication as a component of staging and International Prognostic Index. This study aimed to determine whether molecular analysis of immunoglobulin heavy chain (IgH) genes and positron emission tomography-computed tomography (PET/CT) could overcome the limitation of defining morphologic BMI by trephination biopsy and could increase the diagnostic accuracy or prognostic prediction. METHODS A total of 94 de novo patients with DLBCL underwent PET/CT, polymerase chain reaction (PCR) test for detection of IgH gene rearrangement, and unilateral bone marrow (BM) trephination at diagnosis. RESULTS A total of 9 patients (9.6%) were confirmed to present morphologic BMI (mBMI) based on trephination biopsy. On the other hand, 21 patients (22.3%) were confirmed to have IgH clonality (IgH BMI), while 16 (17.0%) were classified with BMI based on the assessment of PET/CT (PET BMI). Each IgH rearrangement PCR and PET/CT showed the high negative predictive value of detecting the BMI. However, the combined assessment of IgH rearrangement and PET/CT could increase the diagnostic accuracy and specificity with 87.2% and 97.0%, respectively. The survival outcome of patients with double positive PET BMI and IgH BMI was significantly worse than that with either single positive PET BMI or IgH BMI, and even less than patients with neither PET BMI nor IgH BMI (3-year PFS: 50.0% vs. 75.4% vs. 97.9%, P = 0.007, 3-year OS: 50.0% vs. 75.6% vs. 80.1%, P = 0.035, respectively). CONCLUSION This study suggests that the combined evaluation of PET/CT and IgH rearrangement could give additional information for predicting therapeutic outcomes in patients with negative morphologic BMI as an important part of the prognosis.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biopsy/methods
- Bone Marrow Examination
- Bone Marrow Neoplasms/diagnostic imaging
- Bone Marrow Neoplasms/genetics
- Bone Marrow Neoplasms/immunology
- Bone Marrow Neoplasms/pathology
- Female
- Fluorodeoxyglucose F18
- Gene Rearrangement, B-Lymphocyte, Light Chain
- Humans
- Immunoglobulin Heavy Chains
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Positron Emission Tomography Computed Tomography/methods
- Prognosis
- Prospective Studies
- Radiopharmaceuticals
- Young Adult
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Affiliation(s)
- Mihee Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Seo-Yeon Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jae-Sook Ahn
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ga-Young Song
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Sung-Hoon Jung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Je-Jung Lee
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hyeoung-Joon Kim
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jun Hyung Lee
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Myung-Geun Shin
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Sang Yun Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Deok-Hwan Yang
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
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Papageorgiou SG, Thomopoulos TP, Katagas I, Bouchla A, Pappa V. Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications. Ther Adv Hematol 2021; 12:20406207211013987. [PMID: 34104369 PMCID: PMC8150462 DOI: 10.1177/20406207211013987] [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: 11/08/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) represents a group of tumors characterized by substantial heterogeneity in terms of their pathological and biological features, a causal factor of their varied clinical outcome. This variation has persisted despite the implementation of rituximab in treatment regimens over the last 20 years. In this context, prognostic biomarkers are of great importance in order to identify high-risk patients that might benefit from treatment intensification or the introduction of novel therapeutic agents. Herein, we review current knowledge on specific immunohistochemical or genetic biomarkers that might be useful in clinical practice. Gene-expression profiling is a tool of special consideration in this effort, as it has enriched our understanding of DLBCL biology and has allowed for the classification of DLBCL by cell-of-origin as well as by more elaborate molecular signatures based on distinct gene-expression profiles. These subgroups might outperform individual biomarkers in terms of prognostication; however, their use in clinical practice is still limited. Moreover, the underappreciated role of the tumor microenvironment in DLBCL prognosis is discussed in terms of prognostic gene-expression signatures, as well as in terms of individual biomarkers of prognostic significance. Finally, the efficacy of novel therapeutic agents for the treatment of DLBCL patients are discussed and an evidence-based therapeutic approach by specific genetic subgroup is suggested.
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Affiliation(s)
- Sotirios G. Papageorgiou
- Second Department of Internal Medicine and Research Unit, University General Hospital ‘Attikon’, 1 Rimini Street, Haidari, Athens 12462, Greece
| | - Thomas P. Thomopoulos
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, ‘Attikon’, Haidari, Athens, Greece
| | - Ioannis Katagas
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, ‘Attikon’, Haidari, Athens, Greece
| | - Anthi Bouchla
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, ‘Attikon’, Haidari, Athens, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine and Research Unit, Hematology Unit, University General Hospital, ‘Attikon’, Haidari, Athens, Greece
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3
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Interplay between HGAL and Grb2 proteins regulates B-cell receptor signaling. Blood Adv 2020; 3:2286-2297. [PMID: 31362927 DOI: 10.1182/bloodadvances.2018016162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 05/30/2019] [Indexed: 01/30/2023] Open
Abstract
Human germinal center (GC)-associated lymphoma (HGAL) is an adaptor protein expressed in GC B cells. HGAL regulates cell motility and B-cell receptor (BCR) signaling, processes that are central for the successful completion of the GC reaction. Herein, we demonstrate phosphorylation of HGAL by Syk and Lyn kinases at tyrosines Y80, Y86, Y106Y107, Y128, and Y148. The HGAL YEN motif (amino acids 107-109) is similar to the phosphopeptide motif pYXN used as a binding site to the growth factor receptor-bound protein 2 (Grb2). We demonstrate by biochemical and molecular methodologies that HGAL directly interacts with Grb2. Concordantly, microscopy studies demonstrate HGAL-Grb2 colocalization in the membrane central supramolecular activation clusters (cSMAC) following BCR activation. Mutation of the HGAL putative binding site to Grb2 abrogates the interaction between these proteins. Further, this HGAL mutant localizes exclusively in the peripheral SMAC and decreases the rate and intensity of BCR accumulation in the cSMAC. Furthermore, we demonstrate that Grb2, HGAL, and Syk interact in the same complex, but Grb2 does not modulate the effects of HGAL on Syk kinase activity. Overall, the interplay between the HGAL and Grb2 regulates the magnitude of BCR signaling and synapse formation.
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Guo F, Luo Y, Jiang X, Lu X, Roberti D, Lossos C, Kunkalla K, Magistri M, Rui L, Verdun R, Vega F, Moy VT, Lossos IS. Recent BCR stimulation induces a negative autoregulatory loop via FBXO10 mediated degradation of HGAL. Leukemia 2019; 34:553-566. [PMID: 31570756 DOI: 10.1038/s41375-019-0579-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/11/2019] [Accepted: 09/17/2019] [Indexed: 02/08/2023]
Abstract
Regulating B-cell receptor (BCR) signaling after antigenic stimulation is essential to properly control immune responses. Currently known mechanisms of inhibiting BCR signaling are via co-receptor stimulation and downstream immunoreceptor tyrosine-based inhibition motif (ITIM) phosphorylation. Herein we demonstrate that BCR stimulation induces rapid and reversible palmitoylation of the SCF-FBXO10 ubiquitin E3 ligase. This results in FBXO10 relocation to the cell membrane, where it targets the human germinal center-associated lymphoma (HGAL) protein for ubiquitylation and degradation, leading to decreases in both BCR-induced calcium influx and phosphorylation of proximal BCR effectors. Importantly, FBXO10 recognition and degradation of HGAL is phosphorylation independent and instead relies on a single evolutionarily conserved HGAL amino acid residue (H91) and FBXO10 relocalization to the cytoplasmic membrane. Together our findings demonstrate the first evidence of negative BCR signaling regulation from direct BCR stimulation and define the temporospatial functions of the FBXO10-HGAL axis. FBXO10 is infrequently mutated in DLBCL but some of these mutations deregulate BCR signaling. These observations may have important implications on lymphomagenesis and other immune processes.
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Affiliation(s)
- Fengjie Guo
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yuan Luo
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xiaoyu Jiang
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - XiaoQing Lu
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Domenico Roberti
- Department of Pathology, Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Chen Lossos
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kranthi Kunkalla
- Department of Pathology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Marco Magistri
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lixin Rui
- Department of Medicine and Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ramiro Verdun
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Francisco Vega
- Department of Pathology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Vincent T Moy
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA. .,Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL, USA.
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Menguy S, Beylot‐Barry M, Parrens M, Ledard A, Frison E, Comoz F, Battistella M, Szablewski V, Balme B, Croue A, Franck F, Ortonne N, Tournier E, Lamant L, Carlotti A, De Muret A, Le Gall F, Lorton M, Merlio J, Vergier B. Primary cutaneous large B‐cell lymphomas: relevance of the 2017 World Health Organization classification: clinicopathological and molecular analyses of 64 cases. Histopathology 2019; 74:1067-1080. [DOI: 10.1111/his.13832] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/31/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Sarah Menguy
- Pathology Department University Hospital of Bordeaux Hôpital Haut‐Lévêque Bordeaux France
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
| | - Marie Beylot‐Barry
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
- Dermatology Department University Hospital of Bordeaux Hôpital Saint‐André Bordeaux France
| | - Marie Parrens
- Pathology Department University Hospital of Bordeaux Hôpital Haut‐Lévêque Bordeaux France
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
| | - Anne‐Pham Ledard
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
- Dermatology Department University Hospital of Bordeaux Hôpital Saint‐André Bordeaux France
| | - Eric Frison
- ISPED University Hospital of Bordeaux and University of Bordeaux Bordeaux France
| | - François Comoz
- Pathology Department University Hospital of Caen Hôpital Clémenceau Caen France
| | - Maxime Battistella
- Pathology Department University Hospital of Paris Hôpital Saint‐Louis APHP Paris France
| | - Vanessa Szablewski
- Pathology Department University Hospital of Montpellier Hôpital Gui‐de‐Chauliac Montpellier France
| | - Brigitte Balme
- Pathology Department University Hospital of Lyon‐Sud Lyon France
| | - Anne Croue
- Pathology Department University Hospital of Angers Angers France
| | - Frédéric Franck
- Pathology Department University Hospital of Clermont‐Ferrand Hôpital Estaing Clermont‐Ferrand France
| | - Nicolas Ortonne
- Pathology Department University Hospital of Paris Hôpital Henri‐Mondor APHP Créteil France
| | - Emilie Tournier
- Pathology Department Institut Universitaire du Cancer Toulouse Oncopôle Toulouse France
| | - Laurence Lamant
- Pathology Department Institut Universitaire du Cancer Toulouse Oncopôle Toulouse France
| | - Agnès Carlotti
- Pathology Department University Hospital of Paris Hôpital Cochin APHP Paris France
| | - Anne De Muret
- Pathology Department University Hospital of Tours Hôpital Trousseau Tours France
| | - François Le Gall
- Pathology Department University Hospital of Rennes Hôpital Pontchaillou Rennes France
| | | | - Jean‐Philippe Merlio
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
- Tumour Biology and Tumour Bank Department University Hospital of Bordeaux Hôpital Haut‐Lévêque Bordeaux France
| | - Béatrice Vergier
- Pathology Department University Hospital of Bordeaux Hôpital Haut‐Lévêque Bordeaux France
- INSERM U1053 Team 3 Oncogenesis of Cutaneous Lymphomas University of Bordeaux Bordeaux France
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B-cell Function Gene Mutations in Diffuse Large B-cell Lymphoma: A Retrospective Cohort Study. EBioMedicine 2017; 16:106-114. [PMID: 28153771 PMCID: PMC5474506 DOI: 10.1016/j.ebiom.2017.01.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 01/20/2017] [Indexed: 12/22/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous subtype of non-Hodgkin lymphoma. In addition to clinical and immunophenotypic characteristics, recurrent gene mutations have recently been identified in patients with DLBCL using next-generation sequencing technologies. The aim of this study is to investigate the clinical relevance of B-cell function gene mutations in DLBCL. Clinical analysis was performed on 680 Chinese DLBCL patients (146 non-CR and 534 CR cases) treated with six cycles of 21-day R-CHOP (Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), alone or followed by two additional doses of rituximab consolidation on patients' own intention. Somatic mutations of B-cell function genes were further screened on 275 (71 non-CR and 204 CR) cases with available tumor samples by targeted sequencing, including genes involved in B-cell receptors (BCRs) pathway (CARD11, LYN, CD79A, and CD79B), Toll-like receptors (TLRs) pathway (MYD88), and tumor necrotic factor receptor (TNFR) pathway (TRAF2 and TNFAIP3). B-cell function gene mutations occurred in 44.0% (121/275) of DLBCL patients. The TLRs and TNFR related gene mutations were more frequently observed in non-CR patients (p = 0.019 and p = 0.032, respectively). BCRs related gene mutations, as well as revised IPI (R-IPI) and double BCL-2/MYC expression, were independently related to short progression-free survival in DLBCL after CR. The adverse prognostic effect of BCRs related gene mutations could be overcome by two additional doses of rituximab consolidation. These results highlight the molecular heterogeneity of DLBCL and identify a significant role of B-cell function gene mutations on lymphoma progression and response to rituximab in DLBCL. Next-generation sequencing technologies permit rapid screening of gene mutations. TLRs and TNFR related gene mutations indicate poor response to R-CHOP in DLBCL. BCRs related gene mutations could be overcome by prolonged rituximab consolidation.
We performed a retrospective study and assessed B-cell function gene mutations in a large cohort of Chinese patients with diffuse large B-cell lymphoma (DLBCL). Patients not achieving complete remission show significant increased TLRs (MYD88) and TNFR related gene mutations (TRAF2, TNFAIP3). Patients with BCRs related gene mutations (CARD11, LYN, CD79A, CD79B) display improved progression-free survival from additional two doses of rituximab, along with those of low-risk revised International Prognostic Index or negative for double BCL-2/MYC expression. Our study highlights the molecular heterogeneity of DLBCL and provides clinical significance of B-cell function gene mutations in guiding risk stratification treatment in DLBCL.
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New developments in the pathology of malignant lymphoma: a review of the literature published from June-August 2016. J Hematop 2016; 9:129-134. [PMID: 27766120 PMCID: PMC5047927 DOI: 10.1007/s12308-016-0284-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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