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Rask Kragh Jørgensen R, Bergström F, Eloranta S, Tang Severinsen M, Bjøro Smeland K, Fosså A, Haaber Christensen J, Hutchings M, Bo Dahl-Sørensen R, Kamper P, Glimelius I, E Smedby K, K Parsons S, Mae Rodday A, J Maurer M, M Evens A, C El-Galaly T, Hjort Jakobsen L. Machine Learning-Based Survival Prediction Models for Progression-Free and Overall Survival in Advanced-Stage Hodgkin Lymphoma. JCO Clin Cancer Inform 2024; 8:e2300255. [PMID: 38608215 PMCID: PMC11161240 DOI: 10.1200/cci.23.00255] [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: 12/07/2023] [Revised: 02/02/2024] [Accepted: 02/21/2024] [Indexed: 04/14/2024] Open
Abstract
PURPOSE Patients diagnosed with advanced-stage Hodgkin lymphoma (aHL) have historically been risk-stratified using the International Prognostic Score (IPS). This study investigated if a machine learning (ML) approach could outperform existing models when it comes to predicting overall survival (OS) and progression-free survival (PFS). PATIENTS AND METHODS This study used patient data from the Danish National Lymphoma Register for model development (development cohort). The ML model was developed using stacking, which combines several predictive survival models (Cox proportional hazard, flexible parametric model, IPS, principal component, penalized regression) into a single model, and was compared with two versions of IPS (IPS-3 and IPS-7) and the newly developed aHL international prognostic index (A-HIPI). Internal model validation was performed using nested cross-validation, and external validation was performed using patient data from the Swedish Lymphoma Register and Cancer Registry of Norway (validation cohort). RESULTS In total, 707 and 760 patients with aHL were included in the development and validation cohorts, respectively. Examining model performance for OS in the development cohort, the concordance index (C-index) for the ML model, IPS-7, IPS-3, and A-HIPI was found to be 0.789, 0.608, 0.650, and 0.768, respectively. The corresponding estimates in the validation cohort were 0.749, 0.700, 0.663, and 0.741. For PFS, the ML model achieved the highest C-index in both cohorts (0.665 in the development cohort and 0.691 in the validation cohort). The time-varying AUCs for both the ML model and the A-HIPI were consistently higher in both cohorts compared with the IPS models within the first 5 years after diagnosis. CONCLUSION The new prognostic model for aHL on the basis of ML techniques demonstrated a substantial improvement compared with the IPS models, but yielded a limited improvement in predictive performance compared with the A-HIPI.
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Affiliation(s)
- Rasmus Rask Kragh Jørgensen
- Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Fanny Bergström
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Eloranta
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Tang Severinsen
- Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Alexander Fosså
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Martin Hutchings
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Kamper
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Ingrid Glimelius
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Immunology, Genetics and Pathology, Cancer Precision Medicine, Uppsala University, Uppsala, Sweden
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Susan K Parsons
- Department of Medicine, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA
| | - Angie Mae Rodday
- Department of Medicine, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA
| | - Matthew J Maurer
- Department of Qualitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Andrew M Evens
- Division of Blood Disorders, Rutgers Cancer Institute New Jersey, New Brunswick, NJ
| | - Tarec C El-Galaly
- Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lasse Hjort Jakobsen
- Department of Hematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Mathematical Sciences, Aalborg University, Aalborg, Denmark
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Wu H, Zhang Z, Zhang Y, Zhao Z, Zhu H, Yue C. Extracellular vesicle: A magic lamp to treat skin aging, refractory wound, and pigmented dermatosis? Front Bioeng Biotechnol 2022; 10:1043320. [PMID: 36420445 PMCID: PMC9676268 DOI: 10.3389/fbioe.2022.1043320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/24/2022] [Indexed: 09/19/2023] Open
Abstract
Exposure of the skin to an external stimulus may lead to a series of irreversible dysfunctions, such as skin aging, refractory wounds, and pigmented dermatosis. Nowadays, many cutaneous treatments have failed to strike a balance between cosmetic needs and medical recovery. Extracellular vesicles (EVs) are one of the most promising therapeutic tools. EVs are cell-derived nanoparticles that can carry a variety of cargoes, such as nucleic acids, lipids, and proteins. They also have the ability to communicate with neighboring or distant cells. A growing body of evidence suggests that EVs play a significant role in skin repair. We summarize the current findings of EV therapy in skin aging, refractory wound, and pigmented dermatosis and also describe the novel engineering strategies for optimizing EV function and therapeutic outcomes.
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Affiliation(s)
- Haiyan Wu
- Key Laboratory of Microbial Drugs Innovation and Transformation of Yan’an, School of Basic Medicine, Yan’an University, Yan’an, China
- Institute for Regenerative Medicine & Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenchun Zhang
- Key Laboratory of Microbial Drugs Innovation and Transformation of Yan’an, School of Basic Medicine, Yan’an University, Yan’an, China
- Institute for Regenerative Medicine & Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuemeng Zhang
- Key Laboratory of Microbial Drugs Innovation and Transformation of Yan’an, School of Basic Medicine, Yan’an University, Yan’an, China
| | - Zhenlin Zhao
- Shenzhen Ruipuxun Academy for Stem Cell & Regenerative Medicine, Shenzhen, China
| | - Hongming Zhu
- Institute for Regenerative Medicine & Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Shenzhen Ruipuxun Academy for Stem Cell & Regenerative Medicine, Shenzhen, China
| | - Changwu Yue
- Key Laboratory of Microbial Drugs Innovation and Transformation of Yan’an, School of Basic Medicine, Yan’an University, Yan’an, China
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Rinaldi C, Corrigan DK, Dennany L, Jarrett RF, Lake A, Baker MJ. Development of an Electrochemical CCL17/TARC Biosensor toward Rapid Triage and Monitoring of Classic Hodgkin Lymphoma. ACS Sens 2021; 6:3262-3272. [PMID: 34478275 DOI: 10.1021/acssensors.1c00972] [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: 12/12/2022]
Abstract
A point-of-care blood test for the detection of an emerging biomarker, CCL17/TARC, could prove transformative for the clinical management of classic Hodgkin lymphoma (cHL). Primary care diagnosis is challenging due to nonspecific clinical presentation and lack of a diagnostic test, leading to significant diagnostic delays. Treatment monitoring encounters false-positive and negative results, leading to avoidable chemotherapy toxicity, or undertreatment, impacting patient morbidity and mortality. Here, we present an amperometric CCL17/TARC immunosensor, based on the utilization of a thiolated heterobifunctional cross-linker and sandwich antibody assay, to facilitate novel primary care triage and chemotherapy monitoring strategies for cHL. The immunosensor shows excellent analytical performance for clinical testing; linearity (R2 = 0.986), detection limit (194 pg/mL), and lower and upper limits of quantitation (387-50 000 pg/mL). The biosensor differentiated all 42 newly diagnosed cHL patients from healthy volunteers, based on serum CCL17/TARC concentration, using blood samples collected prior to treatment intervention. The immunosensor also discriminated between paired blood samples of all seven cHL patients, respectively, collected prior to treatment and during chemotherapy, attributed to the decrease in serum CCL17/TARC concentration following chemotherapy response. Overall, we have shown, for the first time, the potential of an electrochemical CCL17/TARC biosensor for primary care triage and chemotherapy monitoring for cHL, which would have positive clinical and psychosocial implications for patients, while streamlining current healthcare pathways.
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Affiliation(s)
- Christopher Rinaldi
- WestCHEM, Department of Pure and Applied Chemistry, Technology and Innovation Centre, University of Strathclyde, 99 George Street, Glasgow G1 1RD, U.K
| | - Damion K. Corrigan
- Department of Biomedical Engineering, University of Strathclyde, 40 George Street, Glasgow G1 1QE, U.K
| | - Lynn Dennany
- WestCHEM, Department of Pure and Applied Chemistry, Technology and Innovation Centre, University of Strathclyde, 99 George Street, Glasgow G1 1RD, U.K
| | - Ruth F. Jarrett
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, Bearsden, Glasgow G61 1QH, U.K
| | - Annette Lake
- MRC-University of Glasgow Centre for Virus Research, 464 Bearsden Road, Bearsden, Glasgow G61 1QH, U.K
| | - Matthew J. Baker
- DXCOVER Ltd., University of Strathclyde, Technology and Innovation Centre, 99 George Street, Glasgow G1 1RD, U.K
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Martins DP, Correa-Netto NF, Melo N, Loggetto SR, de Liberal MMC. Overview of lymphoma diagnosis in Brazilian public health system patients: Open data analysis for health care planning. Hematol Transfus Cell Ther 2020; 44:40-48. [PMID: 33288492 PMCID: PMC8885380 DOI: 10.1016/j.htct.2020.08.017] [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: 02/17/2020] [Revised: 07/24/2020] [Accepted: 08/21/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Knowing the information regarding the panorama of lymphoma diagnosis in patients treated in the Brazilian Public Unified Health System from the last 10 years is a challenge for Strategic Health Planning. Objective To characterize the Brazilian population with lymphoma treated in the Brazilian Public Unified Health System between 2008 and 2017 regarding staging, sex, residence site and mortality. Material and methods A descriptive, retrospective, and longitudinal trial with secondary data from DataSUS (SIA/SUS and SIM/SUS) obtained from patients with ICD-10 C81−85. Results There were 70,850 lymphoma cases between 2008 and 2017, of which 55% were male, the median age was 51 years, and 27% had Hodgkin Lymphoma. Most patients (56%) were treated outside the residence city. São Paulo State accounted for 25% of patients. Treatment initiation took more than 60 days in 27% of cases. A total of 45,601 deaths were due to lymphoma (12% Hodgkin Lymphoma and 88% Non-Hodgkin Lymphoma), with a median age 63 years, and were mainly males (55%). Staging data were inadequate in 23% of patients, and analysis was performed only on the valid records. Advanced disease was diagnosed in 58% of patients (60% male; 57% female) and was more common in Non-Hodgkin Lymphoma (62%) versus Hodgkin Lymphoma (49%). Discussion Late diagnosis interferes with mortality rates. Health promotion and cancer prevention campaigns, especially targeting the male public, and training for early diagnosis and early treatment are needed. Conclusion Effective measures for early diagnosis and treatment are urgently needed for lymphoma control.
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Affiliation(s)
| | | | - Nina Melo
- Associação Brasileira de Linfoma e Leucemia (Abrale), São Paulo, SP, Brazil
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Policiano C, Subirá J, Aguilar A, Monzó S, Iniesta I, Rubio Rubio JM. Impact of ABVD chemotherapy on ovarian reserve after fertility preservation in reproductive-aged women with Hodgkin lymphoma. J Assist Reprod Genet 2020; 37:1755-1761. [PMID: 32488563 DOI: 10.1007/s10815-020-01844-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Abstract
RESEARCH QUESTION How is ovarian reserve affected by chemotherapy in patients with Hodgkin lymphoma (HL) who undergo fertility preservation (FP)? METHODS A retrospective study was conducted by reviewing medical records of 105 HL patients referred to the FP unit before starting adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. Ovarian reserve was evaluated before chemotherapy and at the last follow-up using anti-Müllerian hormone (AMH) and antral follicle count (AFC) measurements. The decrease in AMH was compared with that expected from normograms. AMH was compared between patients who underwent cryopreservation of ovarian tissue and those who underwent cryopreservation of mature oocytes. RESULTS After ABVD, 15% of patients required hematopoietic stem cell transplantation. At a median follow-up of 33 months, the median decrease in AMH was 0.88 ng/mL, which was significantly greater than that of the general population of this age group (p < 0.001). Of the 82 women who only had ABVD, 38 underwent FP by cryopreservation of mature oocytes and 44 underwent cryopreservation of the ovarian cortex. There was no significant difference in AMH or AFC at the last follow-up between FP techniques. CONCLUSION Although ABVD is considered to be of low gonadotoxic risk, the decrease in AMH was greater than expected for patients' age, and 15% of patients needed more aggressive therapy during follow-up. Type of FP was not associated with decline in ovarian reserve. Reproductive-aged women with HL should have the opportunity for FP counseling before starting treatment.
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Affiliation(s)
- Catarina Policiano
- Department of Obstetrics and Gynecology, CHLN-Hospital Universitário de Santa Maria, Lisbon, Portugal
| | - Jessica Subirá
- Accredited Group on Reproductive Medicine, Institute of Health Investigation La Fe, University Hospital La Fe, Valencia, Spain.
- IVI-Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain.
| | - Alejandra Aguilar
- Accredited Group on Reproductive Medicine, Institute of Health Investigation La Fe, University Hospital La Fe, Valencia, Spain
| | - Susana Monzó
- Accredited Group on Reproductive Medicine, Institute of Health Investigation La Fe, University Hospital La Fe, Valencia, Spain
| | - Ignacio Iniesta
- Accredited Group on Reproductive Medicine, Institute of Health Investigation La Fe, University Hospital La Fe, Valencia, Spain
| | - Jose María Rubio Rubio
- Accredited Group on Reproductive Medicine, Institute of Health Investigation La Fe, University Hospital La Fe, Valencia, Spain
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Sollini M, Kirienko M, Cavinato L, Ricci F, Biroli M, Ieva F, Calderoni L, Tabacchi E, Nanni C, Zinzani PL, Fanti S, Guidetti A, Alessi A, Corradini P, Seregni E, Carlo-Stella C, Chiti A. Methodological framework for radiomics applications in Hodgkin's lymphoma. Eur J Hybrid Imaging 2020; 4:9. [PMID: 34191173 PMCID: PMC8218114 DOI: 10.1186/s41824-020-00078-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND According to published data, radiomics features differ between lesions of refractory/relapsing HL patients from those of long-term responders. However, several methodological aspects have not been elucidated yet. PURPOSE The study aimed at setting up a methodological framework in radiomics applications in Hodgkin's lymphoma (HL), especially at (a) developing a novel feature selection approach, (b) evaluating radiomic intra-patient lesions' similarity, and (c) classifying relapsing refractory (R/R) vs non-(R/R) patients. METHODS We retrospectively included 85 patients (male:female = 52:33; median age 35 years, range 19-74). LIFEx (www.lifexsoft.org) was used for [18F]FDG-PET/CT segmentation and feature extraction. Features were a-priori selected if they were highly correlated or uncorrelated to the volume. Principal component analysis-transformed features were used to build the fingerprints that were tested to assess lesions' similarity, using the silhouette. For intra-patient similarity analysis, we used patients having multiple lesions only. To classify patients as non-R/R and R/R, the fingerprint considering one single lesion (fingerprint_One) and all lesions (fingerprint_All) was tested using Random Undersampling Boosting of Tree Ensemble (RUBTE). RESULTS HL fingerprints included up to 15 features. Intra-patient lesion similarity analysis resulted in mean/median silhouette values below 0.5 (low similarity especially in the non-R/R group). In the test set, the fingerprint_One classification accuracy was 62% (78% sensitivity and 53% specificity); the classification by RUBTE using fingerprint_All resulted in 82% accuracy (70% sensitivity and 88% specificity). CONCLUSIONS Lesion similarity analysis was developed, and it allowed to demonstrate that HL lesions were not homogeneous within patients in terms of radiomics signature. Therefore, a random target lesion selection should not be adopted for radiomics applications. Moreover, the classifier to predict R/R vs non-R/R performed the best when all the lesions were used.
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Affiliation(s)
- Martina Sollini
- Humanitas University, Via Rita Levi Montalcini 4, MI 20090 Pieve Emanuele, Italy
- Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano, MI Italy
| | - Margarita Kirienko
- Humanitas University, Via Rita Levi Montalcini 4, MI 20090 Pieve Emanuele, Italy
| | - Lara Cavinato
- Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano, MI Italy
- MOX–Modelling and Scientific Computing lab., Department of Mathematics, Politecnico di Milano, Milano, Italy
| | - Francesca Ricci
- Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano, MI Italy
| | - Matteo Biroli
- Humanitas University, Via Rita Levi Montalcini 4, MI 20090 Pieve Emanuele, Italy
| | - Francesca Ieva
- MOX–Modelling and Scientific Computing lab., Department of Mathematics, Politecnico di Milano, Milano, Italy
- CADS–Center for Analysis, Decision, and Society, Human Technopole, Milano, Italy
| | | | | | | | - Pier Luigi Zinzani
- Institute of Hematology “Seràgnoli”, University of Bologna, Bologna, Italy
| | - Stefano Fanti
- Nuclear Medicine, AOU S.Orsola-Malpighi, Bologna, Italy
| | - Anna Guidetti
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- University of Milan, Milan, Italy
| | | | - Paolo Corradini
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- University of Milan, Milan, Italy
| | - Ettore Seregni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carmelo Carlo-Stella
- Humanitas University, Via Rita Levi Montalcini 4, MI 20090 Pieve Emanuele, Italy
- Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano, MI Italy
| | - Arturo Chiti
- Humanitas University, Via Rita Levi Montalcini 4, MI 20090 Pieve Emanuele, Italy
- Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano, MI Italy
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Al‐Shaya HM, Li H, Beg OU, Hamama AA, Witiak SM, Kaseloo P, Siddiqui RA. Phytochemical profile and antioxidation activity of annona fruit and its effect on lymphoma cell proliferation. Food Sci Nutr 2020; 8:58-68. [PMID: 31993132 PMCID: PMC6977502 DOI: 10.1002/fsn3.1228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/26/2019] [Accepted: 08/31/2019] [Indexed: 12/24/2022] Open
Abstract
Cancers of the lymphatic system are broadly classified into Hodgkin and non-Hodgkin types. Although lymphomas can be effectively treated with chemotherapy, this approach is associated with the risk of adverse side effects. High intake of certain vegetables and fruits is associated with a reduced risk of cancer development. We hypothesized that Annona fruit, which is rich in fibers and phytochemicals that are known to possess anticancer properties, can be effective in inhibiting lymphoma growth. The Annona fruit's fractions were extracted with water, methanol, or chloroform and then assayed for total phenolic, flavonoids, and tannins content; antioxidation activities; and inhibition of in vitro cell proliferation using the Ramos-1 lymphoma cells. The methanol fractions contained the highest phenolics, flavonoids, and tannins content, and antioxidation activity. However, the methanol extracts of skin, pulp, and seeds had a moderate whereas the chloroform extracts of pulp and seeds had strong effects on Ramos-1 cell proliferation. Our findings suggest that Annona fruits may be effective in the prevention or treatment of lymphoma.
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Affiliation(s)
- Huda Mohammed Al‐Shaya
- Food Chemistry and Nutrition Science Research LaboratoryVirginia State UniversityPetersburgVirginia
- Department of BiologyCollege of Natural and Health SciencesVirginia State UniversityPetersburgVirginia
- Princess Nourah Bint Abdulrahman UniversityRiyadhSaudi Arabia
| | - Haiwen Li
- Food Chemistry and Nutrition Science Research LaboratoryVirginia State UniversityPetersburgVirginia
| | - Obaid U. Beg
- Food Chemistry and Nutrition Science Research LaboratoryVirginia State UniversityPetersburgVirginia
| | - Anwar A. Hamama
- Common Research LaboratoryAgricultural Research StationCollege of AgricultureVirginia State UniversityPetersburgVirginia
| | - Sarah Melissa Witiak
- Department of BiologyCollege of Natural and Health SciencesVirginia State UniversityPetersburgVirginia
| | - Paul Kaseloo
- Department of BiologyCollege of Natural and Health SciencesVirginia State UniversityPetersburgVirginia
| | - Rafat A. Siddiqui
- Food Chemistry and Nutrition Science Research LaboratoryVirginia State UniversityPetersburgVirginia
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Kasinathan G, Kori AN, Hassan N. Abdominal Lymphocyte-Depleted Hodgkin Lymphoma: A Rare Presentation. Int J Gen Med 2019; 12:405-409. [PMID: 31807052 PMCID: PMC6842749 DOI: 10.2147/ijgm.s232254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/14/2019] [Indexed: 11/23/2022] Open
Abstract
Background Hodgkin lymphoma (HL) is a type of lymphoma that arises from the B lymphocytes. The four main subtypes of HL are the nodular sclerosing, mixed cellularity, lymphocyte rich and the lymphocyte depleted. Nodular sclerosis subtype accounts for majority of all classical HL, whereas lymphocytic depletion type accounts for less than 1%. The main objective of reporting this case is to share with the medical fraternity a rare presentation of abdominal lymphocyte-depleted classical Hodgkin lymphoma. A 47-year-old gentleman of Malay ethnicity with no known pre-morbidities, presented to the haematology unit with a 2-month history of night fever, loss of weight, malaise, anorexia and abdominal swelling. Abdominal examination revealed a periumbilical and lower epigastric swelling measuring 6x6 cms. The swelling was non-tender, firm in consistency and smooth on palpation. The Contrast Enhanced Computed Tomography (CECT) imaging revealed an enlarged mesenteric mass measuring 5.8x6.9x5.7 cm and multiple enlarged aorta-caval lymph nodes. The mesenteric tumour histology and immunohistochemistry were consistent with lymphocyte depleted HL. He completed six cycles of intravenous ABVD polychemotherapy consisting of doxorubicin (Adriamycin) 25mg/m2, Bleomycin 10mg/m2, Vinblastine 6mg/m2 and Dacarbazine 375mg/m2. The Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET /CT) imaging post 2 cycles and 6 cycles of ABVD polychemotherapy showed complete metabolic response to chemotherapy. Conclusion Lymphocyte-depleted classical Hodgkin lymphoma (LDcHL) is a rare entity and is mostly diagnosed at a later stage rendering it a disease with poor prognostic outcomes. Early detection and prompt institution of therapy is crucial in the management of this disease.
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Affiliation(s)
- Ganesh Kasinathan
- Haematology Unit, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia
| | - Ahlam Naila Kori
- Haematology Unit, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia
| | - Nurhidayah Hassan
- Histopathology Unit, Department of Pathology, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia
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Ma L, Varma S, Niranjan-Azadi A. Hodgkin lymphoma presenting as alcohol-induced back pain. BMJ Case Rep 2019; 12:e228440. [PMID: 31780609 PMCID: PMC6887434 DOI: 10.1136/bcr-2018-228440] [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] [Accepted: 11/02/2019] [Indexed: 11/04/2022] Open
Abstract
A 32-year-old Chinese man without significant medical history presented with a 2-month history of worsening lumbosacral back pain radiating to the groin and left lower extremity. He also described a shooting pain in the sciatic nerve distribution that began with and was exacerbated by alcohol consumption, a rare but known symptom of Hodgkin lymphoma (HL). On exam, an anterior chest wall mass was noted. Radiographic evaluation of an anterior mediastinal mass showed osseous erosion into the manubrium. MRI of the lumbar spine showed diffuse osseous disease of the lower thoracic and lumbar spine with extension into the right sacroiliac joint and S2 neural foramen without vertebral body collapse or stenosis. Tissue biopsy revealed nodular sclerosis HL, stage IVB IPS2. The patient was primary refractory to ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) therapy. Salvage ICE (ifosfamide, carboplatin, etoposide) chemotherapy was used and then followed by non-myeloablative haploidentical bone marrow transplant was performed on 5 March 2019.
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Affiliation(s)
- Lucy Ma
- Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine, Bethesda, Maryland, USA
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Mikkilineni L, Whitaker-Menezes D, Domingo-Vidal M, Sprandio J, Avena P, Cotzia P, Dulau-Florea A, Gong J, Uppal G, Zhan T, Leiby B, Lin Z, Pro B, Sotgia F, Lisanti MP, Martinez-Outschoorn U. Hodgkin lymphoma: A complex metabolic ecosystem with glycolytic reprogramming of the tumor microenvironment. Semin Oncol 2017; 44:218-225. [PMID: 29248133 PMCID: PMC5737784 DOI: 10.1053/j.seminoncol.2017.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Twenty percent of patients with classical Hodgkin Lymphoma (cHL) have aggressive disease defined as relapsed or refractory disease to initial therapy. At present we cannot identify these patients pre-treatment. The microenvironment is very important in cHL because non-cancer cells constitute the majority of the cells in these tumors. Non-cancer intra-tumoral cells, such as tumor-associated macrophages (TAMs) have been shown to promote tumor growth in cHL via crosstalk with the cancer cells. Metabolic heterogeneity is defined as high mitochondrial metabolism in some tumor cells and glycolysis in others. We hypothesized that there are metabolic differences between cancer cells and non-cancer tumor cells, such as TAMs and tumor-infiltrating lymphocytes in cHL and that greater metabolic differences between cancer cells and TAMs are associated with poor outcomes. METHODS A case-control study was conducted with 22 tissue samples of cHL at diagnosis from a single institution. The case samples were from 11 patients with aggressive cHL who had relapsed after standard treatment with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) or were refractory to this treatment. The control samples were from 11 patients with cHL who achieved a remission and never relapsed after ABVD. Reactive non-cancerous lymph nodes from four subjects served as additional controls. Samples were stained by immunohistochemistry for three metabolic markers: translocase of the outer mitochondrial membrane 20 (TOMM20), monocarboxylate transporter 1 (MCT1), and monocarboxylate transporter 4 (MCT4). TOMM20 is a marker of mitochondrial oxidative phosphorylation (OXPHOS) metabolism. Monocarboxylate transporter 1 (MCT1) is the main importer of lactate into cells and is a marker of OXPHOS. Monocarboxylate transporter 4 (MCT4) is the main lactate exporter out of cells and is a marker of glycolysis. The immunoreactivity for TOMM20, MCT1, and MCT4 was scored based on staining intensity and percentage of positive cells, as follows: 0 for no detectable staining in > 50% of cells; 1+ for faint to moderate staining in > 50% of cells, and 2+ for high or strong staining in > 50% of cells. RESULTS TOMM20, MCT1, and MCT4 expression was significantly different in Hodgkin and Reed Sternberg (HRS) cells, which are the cancerous cells in cHL compared with TAMs and tumor-associated lymphocytes. HRS have high expression of TOMM20 and MCT1, while TAMs have absent expression of TOMM20 and MCT1 in all but two cases. Tumor-infiltrating lymphocytes have low TOMM20 expression and absent MCT1 expression. Conversely, high MCT4 expression was found in TAMs, but absent in HRS cells in all but one case. Tumor-infiltrating lymphocytes had absent MCT4 expression. Reactive lymph nodes in contrast to cHL tumors had low TOMM20, MCT1, and MCT4 expression in lymphocytes and macrophages. High TOMM20 and MCT1 expression in cancer cells with high MCT4 expression in TAMs is a signature of high metabolic heterogeneity between cancer cells and the tumor microenvironment. A high metabolic heterogeneity signature was associated with relapsed or refractory cHL with a hazard ratio of 5.87 (1.16-29.71; two-sided P < .05) compared with the low metabolic heterogeneity signature. CONCLUSION Aggressive cHL exhibits features of metabolic heterogeneity with high mitochondrial metabolism in cancer cells and high glycolysis in TAMs, which is not seen in reactive lymph nodes. Future studies will need to confirm the value of these markers as prognostic and predictive biomarkers in clinical practice. Treatment intensity may be tailored in the future to the metabolic profile of the tumor microenvironment and drugs that target metabolic heterogeneity may be valuable in this disease.
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Affiliation(s)
- Lekha Mikkilineni
- Department of Medical Oncology, National Cancer Institute, Bethesda, MD
| | | | | | - John Sprandio
- Department of Medical Oncology, Chester County Memorial Hospital, West Chester, PA
| | - Paola Avena
- Department of Pharmacy and Health and Nutritional Sciences, University of Calabria, Calabria, Italy
| | - Paolo Cotzia
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Jerald Gong
- Department of Pathology, Thomas Jefferson University, Philadelphia, PA
| | - Guldeep Uppal
- Department of Pathology, Thomas Jefferson University, Philadelphia, PA
| | - Tingting Zhan
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Benjamin Leiby
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Zhao Lin
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Barbara Pro
- Division of Medical Oncology, Northwestern University, Evanston, IL
| | - Federica Sotgia
- School of Environment and Life Sciences, University of Salford, Salford, UK
| | - Michael P Lisanti
- School of Environment and Life Sciences, University of Salford, Salford, UK
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Expression of TIA1 and PAX5 in Classical Hodgkin Lymphoma at Initial Diagnosis May Predict Clinical Outcome. Appl Immunohistochem Mol Morphol 2017; 24:383-91. [PMID: 26067141 DOI: 10.1097/pai.0000000000000200] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although the expression of T-cell antigens and proteins associated with tumor-infiltrating T-lymphocytes (TILs), regulatory T cells (T-regs), and B-cell development have been evaluated in classical Hodgkin lymphoma (cHL), few studies correlate these proteins' expression patterns with clinical outcome. The purpose of this study was to evaluate proteins expressed in the Reed-Sternberg cells (RSCs) and TILs of cHLs at initial diagnosis to determine their prognostic significance. The expression of 12 proteins in RSCs and TILs from 88 diagnostic cHL biopsies was quantitated and correlated to overall survival (OS) and progression-free survival (PFS). CD2, CD3, CD4, CD5, CD7, CD25, PD1, TIA1, MUM1, and ZAP70 expression in RSCs did not correlate with OS or PFS, nor did programmed death 1 (PD1) expression in TILs. High numbers of TIA1-positive TILs (≥50%) correlated with OS (P=0.027), but not PFS (P=0.993) in univariate analysis. Expression of CD2, CD3, CD4, CD5, and/or TIA1 (6%) in RSCs was associated with lymphocyte-rich/mixed-cellularity subtype (P=0.032). High International Prognostic Score (IPS; P=0.036), and high stage (P=0.046) were independent predictors of worse PFS in univariate analysis. Low IPS (P=0.003) and nodular sclerosing subtype (P=0.022) were associated with better OS in univariate analysis. Only the IPS predicted OS in multivariate (P=0.009) analysis. High TIA1+ TILs correlated with worse clinical outcomes for cHLs, as did PAX5-RSCs (P=0.024), although only 2/74 cases were shown to be negative for this marker, suggesting that the tumor microenvironment and a transcription factor crucial for B-cell development are critical biological determinants of the disease course.
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Parodi S, Manneschi C, Verda D, Ferrari E, Muselli M. Logic Learning Machine and standard supervised methods for Hodgkin's lymphoma prognosis using gene expression data and clinical variables. Health Informatics J 2016; 24:54-65. [PMID: 27354395 DOI: 10.1177/1460458216655188] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study evaluates the performance of a set of machine learning techniques in predicting the prognosis of Hodgkin's lymphoma using clinical factors and gene expression data. Analysed samples from 130 Hodgkin's lymphoma patients included a small set of clinical variables and more than 54,000 gene features. Machine learning classifiers included three black-box algorithms ( k-nearest neighbour, Artificial Neural Network, and Support Vector Machine) and two methods based on intelligible rules (Decision Tree and the innovative Logic Learning Machine method). Support Vector Machine clearly outperformed any of the other methods. Among the two rule-based algorithms, Logic Learning Machine performed better and identified a set of simple intelligible rules based on a combination of clinical variables and gene expressions. Decision Tree identified a non-coding gene ( XIST) involved in the early phases of X chromosome inactivation that was overexpressed in females and in non-relapsed patients. XIST expression might be responsible for the better prognosis of female Hodgkin's lymphoma patients.
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Affiliation(s)
- Stefano Parodi
- National Research Council of Italy, Italy.,Rulex Inc, USA
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13
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Singh R, Sheikh S, Pallagatti S, Aggarwal A, Gupta D, Handa R, Goyal G, Kumar R. Lymphocyte Depleted Hodgkin's Lymphoma Presented with Haemolytic Anemia: A Case Report and Literature Review. J Maxillofac Oral Surg 2015; 14:317-22. [PMID: 25861191 DOI: 10.1007/s12663-013-0528-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 04/13/2013] [Indexed: 12/27/2022] Open
Abstract
Hodgkin's lymphoma accounts for ten per cent of all lymphomas. Lymphomas represent the third most frequent neoplasia on a worldwide scale and constitute 3 % of malignant tumors. In the United States, there are about 8,000 new cases every year. This case report describes a case of lymphocyte-depletion Hodgkin's lymphoma (LDHL) manifested by anemia. LDHL is the least common of the types of Hodgkin's disease, comprising less than 1 % of all cases of this cancer. A 19-year-old Indian male presented with complaint of huge asymptomatic swelling in the right lateral part of neck since 8 months. All the lymph nodes of the right side submandibular, submental, cervical and axillary lymph nodes were rubbery in consistency, tender and were palpable. The CBC revealed hemoglobin of 7.4 gm/dL and ESR count was highly raised up to 125 mm/first hour. Direct Coomb's test detected multiple antibodies IgG type, which was consistent with the diagnosis of Haemolytic anemia. Ultrasonography of the neck showed enlarged discrete lymph nodes on the right side of the neck. For further evaluation patient was subject for ultrasonography of the abdomen which revealed there was of enlargement of both spleen and liver. Lymph node FNAC revealed classic LDHL. Anemia and swelling resolved after completion of chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) after 6 cycles. The literature review and our case report discuss the optimal management of this Hodgkin's lymphoma. To our knowledge, this is the first case of LDHL with Haemolytic Anemia treated with only ABVD regime.
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Affiliation(s)
- Ravinder Singh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Soheyl Sheikh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Shambulingappa Pallagatti
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Amit Aggarwal
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Deepak Gupta
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Roopika Handa
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Gaurav Goyal
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
| | - Raman Kumar
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, 133203 Haryana India
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Wu Y, Cai B, Feng W, Yang B, Huang Z, Zuo C, Wang L. Double positive CD4+CD8+ T cells: key suppressive role in the production of autoantibodies in systemic lupus erythematosus. Indian J Med Res 2014; 140:513-9. [PMID: 25488445 PMCID: PMC4277137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND & OBJECTIVES The presence of CD4+CD8+ (double positive) T cells (DPT) in the target organs of several autoimmune diseases has been reported. The aim of this study was to investigate the pathogenic role of DPT in systemic lupus erythematosus (SLE). METHODS A total of 175 SLE cases and 125 matched healthy controls were investigated for CD3+, CD4+, CD8+ lymphocytes and DPT by flow cytometry. Serum samples from SLE patients and controls were tested for antinuclear antibody (ANA), anti-double strain deoxyribonucleic acid (anti-dsDNA), anti-U1 ribonucleoprotein (anti-U1 RNP), anti-sjogren syndrome A (anti-SSA), anti-ribosomal P protein (anti-rib-P), anti-Smith (anti-Sm), anti-Sjogren syndrome B (anti-SSB), complement 3 (C3) and complement 4 (C4). RESULTS The DPT median and 5-95 per cent range of SLE cases and healthy controls were 0.50 [0.10-2.60] and 0.80 [0.20-2.74] respectively (P<0.001). SLE patients were divided into a ≥1:1000 subgroup and a <1:1000 subgroup according to the ANA titre. The DPT of the former subgroup was significantly lower than that of the latter (P=0.032). The DPT medians of positive subgroups with anti-dsDNA (P<0.001), anti-U1RNP (P=0.018), anti-SSA (P=0.021) or anti-rib-P (P=0.039) were also significantly lower than the negative subgroups. Likewise, DPT was significantly lower in SLE subgroups with low concentration of C3 or C4 than those with high concentration (P<0.006). INTERPRETATION & CONCLUSIONS Our findings show that the DPT cells may play a key suppressive role in the production of autoantibodies in SLE. Direct evidence that DPT regulates the pathogenesis of SLE needs to be investigated in future work.
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Affiliation(s)
- Yongkang Wu
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Bei Cai
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Weihua Feng
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Bin Yang
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Zhuochun Huang
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Chuan Zuo
- Department of Rheumatology, West China Hospital affiliated Sichuan University, Chengdu, PR China
| | - Lanlan Wang
- Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, Chengdu, PR China,Reprint requests: Dr Lanlan Wang, Department of Laboratory Medicine, West China Hospital affiliated Sichuan University, 37 Guoxue Xiang, Chengdu, 610041, Sichuan, PR China e-mail:
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Abstract
Although most patients with Hodgkin lymphoma (HL) are cured with primary therapy, patients with primary refractory disease or relapse after initial treatment have poor outcomes and represent an unmet medical need. Recent advances in unraveling the biology of HL have yielded a plethora of novel targeted therapies. This review provides an overview of the data behind the hype generated by these advances and addresses the question of whether or not clinically these targeted therapies offer hope for patients with HL.
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Affiliation(s)
- Catherine Diefenbach
- Assistant Professor of Medicine, New York University School of Medicine, Department of Medicine
| | - Ranjana Advani
- Professor of Medicine, Stanford University Medical Center, Medicine/Oncology
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Brentuximab vedotin: a review of its use in patients with hodgkin lymphoma and systemic anaplastic large cell lymphoma following previous treatment failure. Drugs 2013; 73:371-81. [PMID: 23494187 DOI: 10.1007/s40265-013-0031-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Brentuximab vedotin (ADCETRIS(®)) is an antibody-drug conjugate that is specifically targeted against CD30-positive cancer cells such as those in Hodgkin lymphoma or systemic anaplastic large cell lymphoma (ALCL). Intravenous brentuximab vedotin was associated with an overall objective response rate (primary endpoint) of 75 % in 102 patients with Hodgkin lymphoma who had relapsed after high-dose chemotherapy and autologous haematopoietic stem cell transplantation, in a noncomparative, multicentre, phase II trial. In 58 patients with relapsed systemic ALCL after at least one prior treatment, intravenous brentuximab vedotin was associated with an overall objective response rate (primary endpoint) of 86 % in a noncomparative, multicentre, phase II trial. Tumour reductions were observed in 94 % of patients with Hodgkin lymphoma and 97 % of patients with systemic ALCL, and most tumours decreased in size by >65 % and >85 %, respectively. The estimated 12-month survival rates were 89 % and 52 %, respectively. Brentuximab vedotin was generally well tolerated in these trials. The most common adverse event was peripheral neuropathy; approximately one-half of patients with this adverse event experienced complete resolution.
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18
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Circulating microRNAs: a novel class of potential biomarkers for diagnosing and prognosing central nervous system diseases. Cell Mol Neurobiol 2013; 33:601-13. [PMID: 23633081 DOI: 10.1007/s10571-013-9940-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/13/2013] [Indexed: 10/26/2022]
Abstract
As a class of important endogenous small noncoding RNAs that regulate gene expression at the posttranscriptional level, microRNAs (miRNAs) play a critical role in many physiological and pathological processes. It is believed that miRNAs contribute to the development, differentiation, and synaptic plasticity of the neurons, and their dysregulation has been linked to a series of diseases. MiRNAs exist in the tissues and as circulating miRNAs in several body fluids, including plasma or serum, cerebrospinal fluid, urine, and saliva. There are significant differences between the circulating miRNA expression profiles of healthy individuals and those of patients. Consequently, circulating miRNAs are likely to become a novel class of noninvasive and sensitive biomarkers. Although little is known about the origin and functions of circulating miRNAs at present, their roles in the clinical diagnosis and prognosis of diseases make them attractive markers, particularly for tumors and cardiovascular diseases. Until now, however, there have been limited data regarding the roles of circulating miRNAs in central nervous system (CNS) diseases. This review focuses on the characteristics of circulating miRNAs and their values as potential biomarkers in CNS diseases, particularly in Alzheimer's disease, Huntington's disease, multiple sclerosis, schizophrenia, and bipolar disorder.
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Hodgkin's lymphoma in a patient with cystic fibrosis: a clinical challenge. Ann Hematol 2012; 92:571-2. [DOI: 10.1007/s00277-012-1613-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 10/21/2012] [Indexed: 10/27/2022]
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21
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Circulating microRNAs involved in multiple sclerosis. Mol Biol Rep 2012; 39:6219-25. [PMID: 22231906 DOI: 10.1007/s11033-011-1441-7] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 12/26/2011] [Indexed: 12/18/2022]
Abstract
Multiple sclerosis (MS) is an immune-mediated, demyelinating and neurodegenerative disease of the central nervous system. After traumatic brain injury, it is the leading cause of neurology disability in young adults. Considerable advances have been made in identifying genes involved in MS but the genetic and phenotypic complexity associated with this disease significantly hinders any progress. A novel class of small RNA molecules, microRNAs (miRNAs) has acquired much attention because they regulate the expression of up to 30% of protein-coding genes and may play a pivotal role in the development of many, if not all, complex diseases. Seven published studies investigated miRNAs from peripheral blood mononuclear cells, CD4+, CD8+ T cell, B lymphocytes, peripheral blood leukocytes, whole blood and brain astrocytes with MS risk. The absence of MS studies investigating plasma miRNA prompted the current investigation of identifying a circulating miRNA signature in MS. We conducted a microarray analysis of over 900 known miRNA transcripts from plasma samples collected from four MS individuals and four sex-aged and ethnicity matched healthy controls. We identified six plasma miRNA (miR-614, miR-572, miR-648, miR-1826, miR-422a and miR-22) that were significantly up-regulated and one plasma miRNA (miR-1979) that was significantly down-regulated in MS individuals. Both miR-422a and miR-22 have previously been implicated in MS. The present study is the first to show a circulating miRNA signature involved in MS that could serve as a potential prognostic and diagnostic biomarker for MS.
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Colpo A, Hochberg E, Chen YB. Current status of autologous stem cell transplantation in relapsed and refractory Hodgkin's lymphoma. Oncologist 2011; 17:80-90. [PMID: 22210089 PMCID: PMC3267827 DOI: 10.1634/theoncologist.2011-0177] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 10/13/2011] [Indexed: 12/27/2022] Open
Abstract
Despite the relatively high long-term disease-free survival (DFS) rate for patients with Hodgkin lymphoma (HL) with modern combination chemotherapy or combined modality regimens, ∼20% of patients die from progressive or relapsed disease. The standard treatment for relapsed and primary refractory HL is salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT), which has shown a 5-year progression-free survival rate of ∼50%-60%. Recent developments in a number of diagnostic and therapeutic modalities have begun to improve these results. Functional imaging, refinement of clinical prognostic factors, and development of novel biomarkers have improved the predictive algorithms, allowing better patient selection and timing for ASCT. In addition, these algorithms have begun to identify a group of patients who are candidates for more aggressive treatment beyond standard ASCT. Novel salvage regimens may potentially improve the rate of complete remission prior to ASCT, and the use of maintenance therapy after ASCT has become a subject of current investigation. We present a summary of developments in each of these areas.
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Affiliation(s)
- Anna Colpo
- Department of Clinical and Experimental Medicine, Hematology and Clinical Immunology Branch, University of Padua School of Medicine, Padua, Italy
| | - Ephraim Hochberg
- Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yi-Bin Chen
- Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Varnum SM, Webb-Robertson BJM, Hessol NA, Smith RD, Zangar RC. Plasma biomarkers for detecting Hodgkin's lymphoma in HIV patients. PLoS One 2011; 6:e29263. [PMID: 22195036 PMCID: PMC3240653 DOI: 10.1371/journal.pone.0029263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 11/23/2011] [Indexed: 12/17/2022] Open
Abstract
The lifespan of people with human immunodeficiency virus (HIV) infection has increased as a result of effective antiretroviral therapy, and the incidences of the AIDS-defining cancers, non-Hodgkin's lymphoma and Kaposi sarcoma, have declined. Even so, HIV-infected individuals are now at greater risk of other cancers, including Hodgkin's lymphoma (HL). To identify candidate biomarkers for the early detection of HL, we undertook an accurate mass and elution time tag proteomics analysis of individual plasma samples from either HIV-infected patients without HL (controls; n = 14) and from HIV-infected patient samples with HL (n = 22). This analysis identified 60 proteins that were statistically (p<0.05) altered and at least 1.5-fold different between the two groups. At least three of these proteins have previously been reported to be altered in the blood of HL patients that were not known to be HIV positive, suggesting that these markers may be broadly useful for detecting HL. Ingenuity Pathway Analysis software identified "inflammatory response" and "cancer" as the top two biological functions associated with these proteins. Overall, this study validated three plasma proteins as candidate biomarkers for detecting HL, and identified 57 novel candidate biomarkers that remain to be validated. The relationship of these novel candidate biomarkers with cancer and inflammation suggests that they are truly associated with HL and therefore may be useful for the early detection of this cancer in susceptible populations.
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Affiliation(s)
- Susan M Varnum
- Department of Cell Biology and Biochemistry, Pacific Northwest National Laboratory, Richland, Washington, United States of America
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Oki Y, Copeland A, Younes A. Clinical development of panobinostat in classical Hodgkin's lymphoma. Expert Rev Hematol 2011; 4:245-52. [PMID: 21668391 DOI: 10.1586/ehm.11.24] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Deacetylase (DAC) inhibitors are promising new anticancer drugs that have complex mechanisms of action, including induction of cell-cycle arrest and apoptosis, inhibition of angiogenesis and induction of a favorable anti-tumor immune response. Panobinostat, a potent inhibitor of DAC 1-11 enzymatic activity, has demonstrated a significant in vitro antiproliferative activity against classical Hodgkin's lymphoma (cHL) cell lines in addition to a promising clinical activity in early Phase I studies in patients with relapsed cHL. In a recently completed large Phase II study in patients with relapsed cHL, panobinostat reduced tumor measurements in 74% of patients, including 23% partial and 4% complete remissions. In this article, we review the status of panobinostat drug development and compare its activity to those of other DAC inhibitors in patients with relapsed cHL. Future investigations should focus on designing rational combination regimens and identifying predictive markers that will assist in selecting patients who are likely to benefit from this novel therapy.
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Affiliation(s)
- Yasuhiro Oki
- Department of Lymphoma/Myeloma, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA
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Yassaee F, Hosseini S. Pelvic lymphoma: An unusual presentation. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2011; 16:1382-5. [PMID: 22973336 PMCID: PMC3430032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 09/25/2011] [Indexed: 11/10/2022]
Abstract
Pelvic lymphoma is not a common condition and aggressive recurrence of chronic lymphocytic leukemia (CLL) as a cause is rarely reported. We report a case of lymphoma of left adnexa in a postmenopausal woman, with a three week history of abdominal and left flank pain. Past medical history was consistent with diagnosis of CLL. She had received chemotherapy. Due to abdominal and flank pain and abdominopelvic mass, exploratory laparotomy was done with the impression of ovarian malignancy. A large uterus with adnexal mass and a large tumoral bladder was seen. Biopsy was done from adnexal mass which was compatible with lymphoma. The abdomen was closed and the patient was referred for chemotherapy. Lymphoma usually does not involve the pelvic organs. After laparotomy, her condition deteriorated and she expired.
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Affiliation(s)
- Fakhrolmolouk Yassaee
- Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedighe Hosseini
- Resident, Department of Obstetrics and Gynecology, Shaheed Beheshti Medical Sciences University, Tehran, Iran
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Hurtado-Cordovi JM, Verma V, Gotlieb V, Frieri M. Lymphocyte Rich Hodgkin's Lymphoma Presented with Warm Hemolytic Anemia: A Case Report and Literature Review. Case Rep Hematol 2011; 2011:385408. [PMID: 22937306 PMCID: PMC3420746 DOI: 10.1155/2011/385408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Accepted: 07/13/2011] [Indexed: 01/20/2023] Open
Abstract
Hodgkin's lymphoma accounts for ten percent of all lymphomas. In the United States, there are about 8000 new cases every year. This paper describes a case of lymphocyte-rich Hodgkin's lymphoma (LRHL) manifested by autoimmune hemolytic anemia (AIHA). A 27-year-old Israeli male presented with dizziness associated with one month of low-grade fevers and night sweats; he also complained of persistent cough, pruritus, and ten-pound weight lost during this time. The CBC revealed hemoglobin of 5.9 gm/dL, and direct Coomb's test detected multiple nonspecific antibodies consistent with the diagnosis of AIHA. Chest, abdomen, and pelvic CT scan showed mediastinal lymphadenopathy and splenomegaly. Lymph node biopsy revealed classic LRHL. AIHA resolved after completion of the first cycle of chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD); after six cycles, he went into complete remission. Although infrequent, AIHA can be responsible for the presenting symptoms of HL.
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Affiliation(s)
- Jorge M Hurtado-Cordovi
- Divisions of Hematology and Oncology and Allergy and Immunology, Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA
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Derenzini E, Younes A. Predicting treatment outcome in classical Hodgkin lymphoma: genomic advances. Genome Med 2011; 3:26. [PMID: 21542892 PMCID: PMC3129642 DOI: 10.1186/gm240] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Classical Hodgkin lymphoma is considered a highly curable disease; however, 20% of patients cannot be cured with standard first-line chemotherapy and have a dismal outcome. Current clinical parameters do not allow accurate risk stratification, and personalized therapies are lacking. In fact, Hodgkin lymphoma (HL) is often over- or undertreated because of this lack of accurate risk stratification. In recent years, the early detection of chemoresistance by fluorodeoxyglucose positron emission tomography has become the most important prognostic tool in the management of HL. However, to date, no prognostic scores or molecular markers are available for the early identification of patients at very high risk of failure of induction therapy. In the last decade, many important advances have been made in understanding the biology of HL. In particular, the development of new molecular profiling technologies, such as SNP arrays, comparative genomic hybridization, and gene-expression profiling, have allowed the identification of new prognostic factors that may be useful for risk stratification and predicting response to chemotherapy. In this review, we focus on the prognostic tools and biomarkers that are available for newly diagnosed HL, and we highlight recent advances in the genomic characterization of classical HL and potential targets for therapy.
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Affiliation(s)
- Enrico Derenzini
- Institute of Haematology and Medical Oncology L & A Seràgnoli, University of Bologna, Bologna, 40138 Italy
| | - Anas Younes
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, Texas, USA
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