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Moser O, Ngoya M, Galimard JE, Dalissier A, Dalle JH, Kalwak K, Wössmann W, Burkhardt B, Bierings M, Gonzalez-Vicent M, López Corral L, Mellgren K, Attarbaschi A, Bourhis JH, Carlson K, Corbacioglu S, Drabko K, Sundin M, Toporski J, Cario G, Kontny U. Hematopoietic stem cell transplantation for pediatric patients with non-anaplastic peripheral T-cell lymphoma. An EBMT pediatric diseases working party study. Bone Marrow Transplant 2024; 59:604-614. [PMID: 38331982 DOI: 10.1038/s41409-024-02226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
Peripheral T-cell lymphomas (PTCL) other than anaplastic large-cell lymphoma are rare in children, and the role of hematopoietic stem cell transplantation (HSCT) has not been clarified yet. In a retrospective analysis of registry-data of the European Society for Blood and Marrow Transplantation we analyzed 55 patients aged < 18 years who received allogeneic (N = 46) or autologous (N = 9) HSCT for PTCL. Median age at HSCT was 13.9 years; 33 patients (60%) were in first remission, and 6 (19%) in progression at HSCT. Conditioning was myeloablative in 87% of the allogeneic HSCTs and in 27 (58.7%) based on total body irradiation. After allogeneic HSCT the 5-year overall- and progression-free survival was 58.9% (95% CI 42.7-71.9) and 52.6% (95% CI 36.8-66.1), respectively. 5-year relapse incidence was 27.6% (95% CI 15.1-41.6), the non-relapse mortality rate was 19.8% (95% CI 9.7-32.6). Five of the six patients with progression at HSCT died. Seven of nine patients after autologous HSCT were alive and disease-free at last follow-up. Our data suggest a role of allogeneic HSCT in consolidation-treatment of patients with high-risk disease, who reach at least partial remission after primary- or relapse-therapy, whereas patients with therapy-refractory or progressive disease prior to transplantation do not profit from HSCT.
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Affiliation(s)
- Olga Moser
- University Hospital RWTH Aachen, Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Aachen, Germany.
| | - Maud Ngoya
- EBMT Paris Office, Hôpital Saint Antoine, Paris, France
| | | | | | - Jean Hugues Dalle
- Hôpital Robert Debre Pediatric Hematology and Immunology Department, GHU APHP Nord Université Paris Cité, Paris, France
| | - Krzysztof Kalwak
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Wilhelm Wössmann
- University Medical Center Hamburg Eppendorf, Pediatric Hematology and Oncology, Hamburg, Germany
| | - Birgit Burkhardt
- Pediatric Hematology, Oncology and BMT, University Hospital Münster, Münster, Germany
| | - Marc Bierings
- Princess Maxima Center/ University Hospital for Children (WKZ), Utrecht, The Netherlands
| | | | - Lucía López Corral
- Hematology Department. Hospital Universitario de Salamanca (Spain), IBSAL, CIBERONC. Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Karin Mellgren
- Sahlgrenska University Hospital, Department of Pediatric Oncology, Göteborg, Sweden
| | - Andishe Attarbaschi
- St. Anna Children's Hospital. Department of Pediatric Hematology and Oncology, Medical University of Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | | | - Kristina Carlson
- University Children's Hospital Dept. of Women's & Children's Health, Uppsala, Sweden
| | - Selim Corbacioglu
- University Hospital Regensburg, Paediatric Haematology, Oncology and Stem Cell Transplantation, Regensburg, Germany
| | - Katarzyna Drabko
- Medical University of Lublin, Dept. Pediatric Hematology, Oncology, and Transplantology, Lublin, Poland
| | - Mikael Sundin
- Karolinska University Hospital Children's Hospital, Paediatric Haematology, Stockholm, Sweden
| | - Jacek Toporski
- Karolinska University Hospital Children's Hospital, Paediatric Haematology, Stockholm, Sweden
| | - Gunnar Cario
- University Medical Center Schleswig-Holstein Kiel, División of Stem Cell Transplantation and Immunotherapy, Kiel, Germany
| | - Udo Kontny
- University Hospital RWTH Aachen, Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Aachen, Germany
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2
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Shen CQ, He GQ, Wan Z, Lin C, Yang X, Lu XX, Zhu YP, Gao J, Guo X. "Sandwich" protocol based on modified SMILE regimen for children with newly extranodal NK/T cell lymphoma, nasal type: a single-arm, single-center clinical study. Ann Hematol 2023; 102:3143-3152. [PMID: 37486391 PMCID: PMC10567983 DOI: 10.1007/s00277-023-05375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
Extranodal NK/T-cell lymphoma, nasal type (ENKTL), which is a rare form of mature T/NK cell lymphoma in children, currently lacks a standardized first-line treatment approach. However, a treatment protocol known as the "sandwich" regimen has been used in children newly diagnosed with ENKTL. This protocol combines the administration of methotrexate, ifosfamide, etoposide, pegaspargase, and dexamethasone (referred to as SMILE) with the addition of radiotherapy (RT). From September 2017 to December 2020, a total of five patients were included in the study, consisting of three males and two females. The median age of onset was 10.6 years (range, 9.8 to 14.0 years). Among the patients, four had nasal/nasopharyngeal disease at stage II, while one patient had extra nasal disease involving the skin at stage IV. The median EBV-DNA level in plasma was 1.68 × 103 copies/ml (range, 0.44 to 21.1 × 103copies/ml). All the patients had good overall response after 2 cycles of chemotherapy and radiotherapy, including 4 of the patients who had a complete response and 1 of the patients with partial remission. The patient with stage IV received allogeneic hematopoietic stem cell transplantation after the EBV-DNA level was elevated again during treatment. One patient in the low-risk group experienced grade 4 oral mucositis, while no other severe complications or treatment-related deaths were observed. The median follow-up period was 22 months (range, 5 to 57 months). All five patients successfully completed their treatment, with four patients achieving event-free survival, and one patient was lost to follow-up. The median OS time and EFS time was 33 months (range: 18-57 months) and 20 months (range: 5-47 months), respectively. The sandwich protocol has demonstrated a high response rate, good tolerance to chemotherapy, and no treatment-related fatalities. However, further confirmation is necessary through additional clinical studies involving larger sample sizes. Clinical trial registration number: Due to modified SMILE regimens with sandwiched radiotherapy yielded promising outcomes in children ENKTL, we have carried out a phase II multicenter clinical trial (ChiCTR220005954) for children ENKTL in China to further verify the efficacy and safety.
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Affiliation(s)
- Cheng-Qi Shen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Guo-Qian He
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Zhi Wan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Chao Lin
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Xue Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Xiao-Xi Lu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, 610041, China
| | - Yi-Ping Zhu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Ju Gao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China.
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, 610041, China.
| | - Xia Guo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Section 3, South Renmin Road, Chengdu, 610041, China.
- NHC Key Laboratory of Chronobiology, Sichuan University, Chengdu, 610041, China.
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3
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Delehaye F, Deparis M, Buchbinder N, Bodet D, Minard V, Jean-Jacques B, Marie-Laure Q, Gaulard P, Sako N, Robe C, Bardet H, Damaj G, Rouger J. Successful allogeneic hematopoietic stem cell transplantation in a child with angioimmunoblastic T-cell lymphoma: A case report. Pediatr Blood Cancer 2023; 70:e30497. [PMID: 37335263 DOI: 10.1002/pbc.30497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Affiliation(s)
- Fanny Delehaye
- Department of Pediatric Oncology and Hematology, University Hospital of Caen, Normandy, Caen, France
- University of Caen, Normandy, Caen, France
| | - Marianna Deparis
- Department of Pediatric Oncology and Hematology, University Hospital of Caen, Normandy, Caen, France
| | - Nimrod Buchbinder
- Department of Pediatric Oncology and Hematology, University Hospital of Rouen, Normandy, Rouen, France
| | - Damien Bodet
- Department of Pediatric Oncology and Hematology, University Hospital of Caen, Normandy, Caen, France
| | - Véronique Minard
- Department of Pediatric Oncology, Gustave Roussy Institute, VilleJuif, France
| | | | | | - Philippe Gaulard
- Department of Pathology, Hôpital Henri Mondor APHP, Créteil, France
| | - Nouhoum Sako
- Department of Pathology, Hôpital Henri Mondor APHP, Créteil, France
| | - Cyrielle Robe
- Department of Pathology, Hôpital Henri Mondor APHP, Créteil, France
| | - Hippolyte Bardet
- Department of Hematology, University Hospital of Caen, Caen, France
| | - Gandhi Damaj
- Department of Hematology, University Hospital of Caen, Caen, France
| | - Jérémie Rouger
- Department of Pediatric Oncology and Hematology, University Hospital of Caen, Normandy, Caen, France
- University of Caen, Normandy, Caen, France
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4
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Lim MS, Foley M, Mussolin L, Siebert R, Turner S. Biopathology of childhood, adolescent and young adult non-Hodgkin lymphoma. Best Pract Res Clin Haematol 2023; 36:101447. [PMID: 36907637 DOI: 10.1016/j.beha.2023.101447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Mature non-Hodgkin lymphomas (NHL) in the childhood, adolescent and young adult (CAYA) population are rare and exhibit unique clinical, immunophenotypic and genetic characteristics. Application of large-scale unbiased genomic and proteomic technologies such as gene expression profiling and next generation sequencing (NGS) have led to enhanced understanding of the genetic basis for many lymphomas in adults. However, studies to investigate the pathogenetic events in CAYA population are relatively sparse. Enhanced understanding of the pathobiologic mechanisms involved in non-Hodgkin lymphomas in this unique population will allow for improved recognition of these rare lymphomas. Elucidation of the pathobiologic differences between CAYA and adult lymphomas will also lead to the design of more rational and much needed, less toxic therapies for this population. In this review, we summarize recent insights gained from the proceedings of the recent 7th International CAYA NHL Symposium held in New York City, New York October 20-23, 2022.
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Affiliation(s)
- Megan S Lim
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center,417 East 68th New York City, NY, USA.
| | - Michelle Foley
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Howard 14, New York City, NY, USA New York City, NY, USA.
| | - Lara Mussolin
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, University Hospital of Padova, via Giustiniani 3, 35128 Padova, Italy.
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University & Ulm University Medical Center, Albert-Einstein-Allee 11, D-89081 Ulm, Germany.
| | - Suzanne Turner
- Department of Pathology, University of Cambridge, Lab Block Level 3, Box 231, Addenbrookes Hospital, Hills Road, Cambridge CB20QQ, UK; CEITEC, Masaryk University, Brno, Czech Republic.
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5
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Xavier AC, Suzuki R, Attarbaschi A. Diagnosis and management of rare paediatric Non-Hodgkin lymphoma. Best Pract Res Clin Haematol 2023; 36:101440. [PMID: 36907633 DOI: 10.1016/j.beha.2023.101440] [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: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/16/2023]
Abstract
Mature B-cell lymphomas, (B- or T-cell) lymphoblastic lymphomas (LBL), and anaplastic large cell lymphoma (ALCL) correspond to about 90% of all non-Hodgkin lymphoma (NHL) cases occurring in children and adolescents. The remaining 10% encompass a complex group of entities characterized by low/very low incidences, paucity of knowledge in terms of underlying biology in comparison to their adult counterparts, and consequent lack of standardization of care, information on clinical therapeutic efficacy and long-term survival. At the Seventh International Symposium on Childhood, Adolescent and Young Adult NHL, organized on October 20-23, 2022, in New York City, New York, US, we had the opportunity to discuss clinical, pathogenetic, diagnostic, and treatment aspects of certain subtypes of rare B- or T-cell NHL and they will be the topic of this review.
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Affiliation(s)
- Ana C Xavier
- Division of Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, 1600 7(th) Avenue South, Lowder 512 Birmingham, AL, 35233, USA.
| | - Ritsuro Suzuki
- Department of Hematology and Oncology, Shimane University, 89-1 En-ya Cho, Izumo, 693-8501, Japan.
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Kinderspitalgasse 6, 1090, Vienna, Austria; St. Anna Children's Cancer Research Institute, Zimmermannplatz 10, 1090, Vienna, Austria.
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6
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First-Time Diagnosis and Ultrasound Features of Extranodal Lymphoma in Children. JOURNAL OF ONCOLOGY 2022; 2022:4229112. [PMID: 35602294 PMCID: PMC9119746 DOI: 10.1155/2022/4229112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 11/18/2022]
Abstract
Objective.To assess the diagnostic value of ultrasound for extranodal lymphoma in children. Methods. In this retrospective study, the first diagnostic clinical manifestation, ultrasound sonograms, and puncture pathology of 40 cases of pediatric lymphoma treated in Xi’an Children’s Hospital from August 2018 to March 2020 were analyzed. Results. The first diagnostic clinical manifestation varied from jaundice to gastrointestinal, motor, neurological, respiratory, circulatory skin, and soft tissue multisystem disorders. The intranodal ultrasound results showed abnormally enlarged lymph nodes with extranodal involvement of the liver, pancreas, spleen, kidney, ovaries, and mediastinum as hypoechoic masses with multiple plasma cavity effusions, and color Doppler flow imaging (CDFI) results showed abundant blood flow signals in the lesions. The pathological diagnosis by ultrasound-guided puncture was Hodgkin lymphoma, non-Hodgkin lymphoma, and multiple subtypes. Conclusion. Routine ultrasound can provide an imaging basis for early identification and differential diagnosis of lymphoma, and ultrasound-guided puncture biopsy is simple, minimally invasive, and histopathological-based.
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7
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Wedekind MF, Saraf A, Willen F, Audino AN. Durable Response in Relapsed Adolescent Peripheral T-cell Lymphoma: A Case Report and Review of the Literature. J Pediatr Hematol Oncol 2022; 44:e278-e281. [PMID: 33769385 DOI: 10.1097/mph.0000000000002147] [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: 11/25/2020] [Accepted: 02/12/2021] [Indexed: 11/27/2022]
Abstract
Peripheral T-cell lymphoma (PTCL) is an aggressive tumor, rarely seen in pediatrics or adolescent and young adults (AYAs) so there is no upfront or relapsed standard of care. The authors describe a 16-year-old with PTCL, treated with chemotherapy and autologous stem cell transplant. Upon relapse, he received ifosfamide, carboplatin, etoposide, and radiation with durable remission of 4 years. Data in pediatric/AYA PCTL continue to lack an understanding of the biology and microenvironment, the differences to adult patients, and a lack of adequate therapy. Targeted therapy may improve outcomes for children and AYAs with refractory or relapsed PTCL.
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Affiliation(s)
- Mary Frances Wedekind
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Amanda Saraf
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Indiana University, Riley Hospital for Children, Indianapolis, IN
| | - Faye Willen
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, The Ohio State University, Nationwide Children's Hospital, Columbus, OH
| | - Anthony N Audino
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, The Ohio State University, Nationwide Children's Hospital, Columbus, OH
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Ohki K, Kiyokawa N, Watanabe S, Iwafuchi H, Nakazawa A, Ishiwata K, Ogata-Kawata H, Nakabayashi K, Okamura K, Tanaka F, Fukano R, Hata K, Mori T, Moriya Saito A, Hayashi Y, Taga T, Sekimizu M, Kobayashi R. Characteristics of genetic alterations of peripheral T-cell lymphoma in childhood including identification of novel fusion genes: the Japan Children's Cancer Group (JCCG). Br J Haematol 2021; 194:718-729. [PMID: 34258755 DOI: 10.1111/bjh.17639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022]
Abstract
Peripheral T-cell lymphoma (PTCL) is a group of heterogeneous non-Hodgkin lymphomas showing a mature T-cell or natural killer cell phenotype, but its molecular abnormalities in paediatric patients remain unclear. By employing next-generation sequencing and multiplex ligation-dependent probe amplification of tumour samples from 26 patients, we identified somatic alterations in paediatric PTCL including Epstein-Barr virus (EBV)-negative (EBV- ) and EBV-positive (EBV+ ) patients. As recurrent mutational targets for PTCL, we identified several previously unreported genes, including TNS1, ZFHX3, LRP2, NCOA2 and HOXA1, as well as genes previously reported in adult patients, e.g. TET2, CDKN2A, STAT3 and TP53. However, for other reported mutations, VAV1-related abnormalities were absent and mutations of NRAS, GATA3 and JAK3 showed a low frequency in our cohort. Concerning the association of EBV infection, two novel fusion genes: STAG2-AFF2 and ITPR2-FSTL4, and deletion and alteration of CDKN2A/2B, LMO1 and HOXA1 were identified in EBV- PTCL, but not in EBV+ PTCL. Conversely, alterations of PCDHGA4, ADAR, CUL9 and TP53 were identified only in EBV+ PTCL. Our observations suggest a clear difference in the molecular mechanism of onset between paediatric and adult PTCL and a difference in the characteristics of genetic alterations between EBV- and EBV+ paediatric PTCL.
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Affiliation(s)
- Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Satoru Watanabe
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hideto Iwafuchi
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pathology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Astuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Keisuke Ishiwata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiroko Ogata-Kawata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kohji Okamura
- Department of Systems BioMedicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Fumiko Tanaka
- Department of Pediatrics, Saiseikai Yokohamashi Nanbu Hospital, Kanagawa, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Akiko Moriya Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yasuhide Hayashi
- Institute of Physiology and Medicine, Jobu University, Takasaki, Japan
| | - Takashi Taga
- Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ryoji Kobayashi
- Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Hokkaido, Japan
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9
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Lu T, Shi L, Shi G, Cai Y, Hu S, Liu J, Ren S, Zhou X, Wang X. Derivation and validation of a lipid-covered prognostic model for mature T-cell lymphomas. Cancer Cell Int 2021; 21:348. [PMID: 34225710 PMCID: PMC8256497 DOI: 10.1186/s12935-021-02042-3] [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: 02/06/2021] [Accepted: 06/24/2021] [Indexed: 12/18/2022] Open
Abstract
Background Mature T-cell lymphomas (MTCLs), a group of diseases with high aggressiveness and vulnerable prognosis, lack for the accurate prognostic stratification systems at present. Novel prognostic markers and models are urgently demanded. Aberrant lipid metabolism is closely related to the tumor progression but its prognostic significance in MTCLs remains unexplored. This study aims to investigate the relationship between dysregulated lipid metabolism and survival prognosis of MTCLs and establish a novel and well-performed prognostic scoring system for MTCL patients. Methods A total of 173 treatment-naive patients were enrolled in this study. Univariate and multivariate Cox regression analysis were performed to assess the prognostic significance of serum lipid profiles and screen out independent prognostic factors, which constituted a novel prognostic model for MTCLs. The performance of the novel model was assessed in the training and validation cohort, respectively, by examining its calibration, discrimination and clinical utility. Results Among the 173 included patients, 115 patients (01/2006–12/2016) constituted the training cohort and 58 patients (01/2017–06/2020) formed the validation cohort. Univariate analysis revealed declined total cholesterol (TC, P = 0.000), high-density lipoprotein cholesterol (HDL-C, P = 0.000) and increased triglycerides (TG, P = 0.000) correlated to inferior survival outcomes. Multivariate analysis revealed extranodal involved sites ≥ 2 (hazard ratio [HR]: 2.439; P = 0.036), β2-MG ≥ 3 mg/L (HR: 4.165; P = 0.003) and TC < 3.58 mmol/L (HR: 3.338; P = 0.000) were independent predictors. Subsequently, a novel prognostic model, EnBC score, was constructed with these three factors. Harrell’s C-index of the model in the training and validation cohort was 0.840 (95% CI 0.810–0.870) and 0.882 (95% CI 0.822–0.942), respectively, with well-fitted calibration curves. The model divided patients into four risk groups with distinct OS [median OS: not available (NA) vs. NA vs. 14.0 vs. 4.0 months, P < 0.0001] and PFS (median PFS: 84.0 vs. 19.0 vs. 8.0 vs. 1.5 months, P < 0.0001). Time-dependent receiver operating characteristic curve and decision curve analysis further revealed that EnBC score provided higher diagnostic capacity and clinical benefit, compared with International Prognostic Index (IPI). Conclusion Firstly, abnormal serum lipid metabolism was demonstrated significantly related to the survival of MTCL patients. Furthermore, a lipid-covered prognostic scoring system was established and performed well in stratifying patients with MTCLs. Supplementary Information The online version contains supplementary material available at 10.1186/s12935-021-02042-3.
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Affiliation(s)
- Tiange Lu
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Lei Shi
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Guanggang Shi
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Yiqing Cai
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Shunfeng Hu
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Jiarui Liu
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Shuai Ren
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China.,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.,School of Medicine, Shandong University, Jinan, 250012, Shandong, China
| | - Xiangxiang Zhou
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China. .,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China. .,School of Medicine, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Provincial Engineering Research Center of Lymphoma, Jinan, 250021, Shandong, China. .,Branch of National Clinical Research Center for Hematologic Diseases, Jinan, 250021, Shandong, China. .,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 251006, China.
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China. .,Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China. .,School of Medicine, Shandong University, Jinan, 250012, Shandong, China. .,Shandong Provincial Engineering Research Center of Lymphoma, Jinan, 250021, Shandong, China. .,Branch of National Clinical Research Center for Hematologic Diseases, Jinan, 250021, Shandong, China. .,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, 251006, China.
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