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Flora DR, Parsons SK, Liu N, Yu KS, Holmes K, Flores C, Fanale MA, Surinach A, Byrd R, Evens AM. Patient preferences in the treatment of stage III/IV classic Hodgkin lymphoma: Results from the CONNECT cross-sectional survey. Br J Haematol 2024; 204:1262-1270. [PMID: 38323849 DOI: 10.1111/bjh.19307] [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: 10/13/2023] [Revised: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
We explored patient front-line treatment preferences in newly diagnosed stage III/IV classic Hodgkin lymphoma (cHL). The CONNECT patient survey, administered online from 30 December 2020 to 1 March 2021, examined preferences overall and by age at diagnosis in 182 adult patients diagnosed with stage III/IV cHL within the past 10 years in the United States. At diagnosis, patients' median age was 36 years; 66% of patients were younger (aged 16-41 years) and 34% older (aged 42-85 years). When asked about initial treatment goals, 74% of patients ranked cure as their first or second goal (86% younger vs. 52% older patients; p < 0.001). At diagnosis, 72% of patients preferred aggressive treatment, and 85% were willing to accept more short-term risks in exchange for a better-working therapy long term. For long-term risks, younger versus older patients were significantly more concerned about second cancers (p < 0.001) and fertility issues (p = 0.007), whereas older patients were more concerned about lung damage (p = 0.028) and infections (p < 0.001). Most patients (94%) reported having a caregiver at some point, but 99% of these patients retained some control of treatment decisions. Collectively, these survey results highlight patient treatment preferences and differences in treatment goals and long-term side effect concerns based on patient age.
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Affiliation(s)
- Darcy R Flora
- Research Department, Gryt Health, Rochester, New York, USA
| | - Susan K Parsons
- Department of Medicine and Pediatrics, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Nicholas Liu
- Health Economics and Outcomes Research, Pfizer Inc., Bothell, Washington, USA
| | - Kristina S Yu
- Health Economics and Outcomes Research, Pfizer Inc., Bothell, Washington, USA
| | | | | | - Michelle A Fanale
- Health Economics and Outcomes Research, Pfizer Inc., Bothell, Washington, USA
| | | | - Rachel Byrd
- Research Department, Gryt Health, Rochester, New York, USA
| | - Andrew M Evens
- Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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Evens AM, Yu KS, Liu N, Surinach A, Holmes K, Flores C, Fanale MA, Flora DR, Parsons SK. Physician frontline treatment preferences for stage III/IV classic Hodgkin lymphoma: the real-world US CONNECT study. Future Oncol 2024; 20:749-760. [PMID: 37665273 DOI: 10.2217/fon-2023-0358] [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] [Indexed: 09/05/2023] Open
Abstract
Aim: To understand US physicians' frontline (1L) treatment preferences/decision-making for stage III/IV classic Hodgkin lymphoma (cHL). Materials & methods: Medical oncologists and/or hematologists (≥2 years' practice experience) who treat adults with stage III/IV cHL were surveyed online (October-November 2020). Results: Participants (n = 301) most commonly considered trial efficacy/safety data and national guidelines when selecting 1L cHL treatments. Most physicians (91%) rated overall survival (OS) as the most essential attribute when selecting 1L treatment. Variability was seen among regimen selection for hypothetical newly diagnosed patients, with OS cited as the most common reason for regimen selection. Conclusion: While treatment selection varied based on patient characteristics, US physicians consistently cited OS as the top factor considered when selecting a 1L treatment for cHL.
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Affiliation(s)
- Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
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Katsin M, Dormeshkin D, Meleshko A, Migas A, Dubovik S, Konoplya N. CAR-T Cell Therapy for Classical Hodgkin Lymphoma. Hemasphere 2023; 7:e971. [PMID: 38026793 PMCID: PMC10656097 DOI: 10.1097/hs9.0000000000000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Classical Hodgkin lymphoma (cHL) is a malignancy characterized by the presence of Hodgkin and Reed-Sternberg (HRS) cells within a complex tumor microenvironment (TME). Despite advances in conventional therapies, a subset of cHL patients experience relapse or refractory disease, necessitating the exploration of novel treatment strategies. Chimeric antigen receptor T cell (CAR-T cell) therapy has emerged as a promising approach for the management of cHL, harnessing the power of genetically modified T cells to recognize and eliminate tumor cells. In this article, we provide an overview of the pathogenesis of cHL, highlighting the key molecular and cellular mechanisms involved. Additionally, we discuss the rationale for the development of CAR-T cell therapy in cHL, focusing on the identification of suitable targets on HRS cells (such as CD30, CD123, LMP1, and LMP2A), clonotypic lymphoma initiating B cells (CD19, CD20), and cells within the TME (CD123, CD19, CD20) for CAR-T cell design. Furthermore, we explore various strategies employed to enhance the efficacy and safety of CAR-T cell therapies in the treatment of cHL. Finally, we present an overview of the results obtained from clinical trials evaluating the efficacy of CAR-T cell therapies in cHL, highlighting their potential as a promising therapeutic option. Collectively, this article provides a comprehensive review of the current understanding of cHL pathogenesis and the rationale for CAR-T cell therapy development, offering insights into the future directions of this rapidly evolving field.
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Affiliation(s)
- Mikalai Katsin
- Vitebsk Regional Clinical Cancer Centre, Vitebsk, Belarus
| | - Dmitri Dormeshkin
- Institute of Bioorganic Chemistry of the National academy of Sciences of Belarus, Minsk, Belarus
| | - Alexander Meleshko
- Belarusian Research Center for Pediatric Oncology and Hematology, Minsk, Belarus
| | | | - Simon Dubovik
- Institute of Bioorganic Chemistry of the National academy of Sciences of Belarus, Minsk, Belarus
| | - Natalya Konoplya
- N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
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Phillips T, Liu N, Bloudek B, Migliaccio-Walle K, Reynolds J, Burke JM. Estimated impact of ECHELON-1 overall survival on productivity costs in stage III/IV classical Hodgkin lymphoma in the United States. J Manag Care Spec Pharm 2023; 29:1312-1320. [PMID: 37921077 PMCID: PMC10701259 DOI: 10.18553/jmcp.2023.23101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND A 2010 study on the impact of cancer mortality on productivity costs found Hodgkin lymphoma to have the second largest productivity cost lost per death in the United States. The ECHELON-1 trial demonstrated that frontline brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) improves overall survival (OS) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in stage III/IV classical Hodgkin lymphoma (cHL), reducing the risk of death to 41% (hazard ratio = 0.59; 95% CI = 0.40-0.88; P = 0.009). OBJECTIVES To assess the estimated impact of frontline treatment choice on mortality and productivity using an oncology simulation model informed by ECHELON-1 data. METHODS Individual productivity was estimated using the human capital approach and reported via present value lifetime earnings (PVLE) estimates. Deaths avoided and lifeyears saved without and with A+AVD were calculated using a model informed by realworld treatment use, treatment-specific OS, and expert clinicians' opinions. A+AVD use in the base case was 27% (range: 0%-80%). Stage III/IV cHL prevalence over a 10-year period was estimated; downstream lifetime productivity costs were projected without and with A+AVD. RESULTS In 2031, 3,645 patients were estimated to be newly diagnosed with stage III/IV cHL. Over 10 years with 27% A+AVD vs no A+AVD use, estimates predicted 14% fewer deaths (2,290 vs 2,650) and 14% less total PVLE losses ($1.438 vs $1.664 billion). Results from scenario analyses (40%-80% vs no A+AVD use) showed 20% to 32% decreases in PVLE losses ($1.331-$1.137 billion vs $1.664 billion), saving up to $527 million over 10 years. CONCLUSIONS Productivity cost losses due to mortality in stage III/IV cHL are high. Increasing A+AVD use for patients with stage III/IV cHL would reduce productivity cost losses as deaths are avoided, based on ECHELON-1 OS results.
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Affiliation(s)
- Tycel Phillips
- Department of Hematology, City of Hope Medical Center, Duarte, CA
| | | | | | | | | | - John M. Burke
- US Oncology Hematology Research Program, Rocky Mountain Cancer Centers, Aurora, CO
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Yasenchak C, Liu N, Beeks A, Fanale M, Robert N, He D, Yu KS. Real-World Use of Positron Emission Tomography-Computed Tomography and Reported Deauville Scores in Advanced-Stage Classic Hodgkin Lymphoma: A Community Oncology Practice Perspective. JCO Oncol Pract 2023; 19:860-870. [PMID: 37651672 PMCID: PMC10615434 DOI: 10.1200/op.23.00021] [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: 01/12/2023] [Revised: 06/02/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE To evaluate the use of interim positron emission tomography-computed tomography (PET-CT) scans and Deauville 5-point scale (5PS) score reporting for stage III/IV classic Hodgkin lymphoma (cHL) treated frontline (1L) in community oncology settings. METHODS This retrospective, observational study included adults with stage III/IV cHL initiating 1L doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine, or an escalated dosing regimen of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone within the US Oncology Network between January 2017 and October 2019. Data were collected from electronic health records and chart reviews and summarized descriptively. RESULTS A total of 262 patients were included; 48.9% were age 39 years or younger. Most were male (57%), White (59%), had an International Prognostic Score <4 (76%), and received 1L ABVD (74%). Forty-nine percent of patients had stage III and 51% had stage IV cHL. Of 258 patients with ≥1 PET-CT scan, 71% (n = 184) had an interim scan and 64% received ≥1 scan at an off-site location. Of patients treated 1L with ABVD who received a baseline and interim scan, Deauville 5PS scores were not documented for 45% of patients; in 90% of these cases, a standardized uptake value (SUV) was reported. CONCLUSION In community oncology settings, under-reporting of Deauville 5PS scores for interim PET-CT scans was observed. In the absence of Deauville 5PS scores, SUV results were generally provided. These results highlight educational opportunities that exist for PET-adapted ABVD, including consistency in reporting/utilization of Deauville 5PS scores to de-escalate or escalate treatment.
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Affiliation(s)
- Christopher Yasenchak
- Willamette Valley Cancer Institute and Research Center/US Oncology Research, Eugene, OR
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Parsons SK, Yu KS, Liu N, Kumar S, Fanale MA, Holmes K, Flores C, Surinach A, Flora DR, Evens AM. Observations of Oncologists on Treatment Selection With Interim Positron Emission Tomography-Adapted Approaches in Classic Hodgkin Lymphoma: The Real-World CONNECT Study. JCO Oncol Pract 2023:OP2200811. [PMID: 36947720 DOI: 10.1200/op.22.00811] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
PURPOSE We surveyed oncologists who treat classic Hodgkin lymphoma (cHL) as part of the CONNECT study to understand the treatment decision-making process, including the impact of positron emission tomography/computed tomography (PET/CT) imaging. METHODS US physicians self-identifying as oncologists, hematologists, or hematologists/oncologists with ≥2 years of practice experience who treated ≥1 adult with stage III/IV cHL in the frontline setting in the last year were surveyed (October 19-November 16, 2020). Physician demographics, guideline adherence, and PET/CT utilization, interpretation, and access barriers were assessed. RESULTS In total, 301 physicians participated in the survey. Eighty-eight percent of physicians gave somewhat-to-significant consideration to NCCN guidelines. Most physicians (94%; n = 284) reported obtaining a PET/CT scan at diagnosis; of these physicians, 97% reported obtaining an interim PET/CT scan for stage III/IV cHL, with 65% typically obtaining an interim PET/CT scan after cycle 2. The Deauville 5-point scale (5PS) was the primary scoring system used to review PET/CT results by 62% of physicians, with a positive score defined as ≥3 by 44%, ≥4 by 37%, and ≥2 by 12% of physicians. Fifty-five percent of physicians reported difficulty in obtaining PET/CT scans. CONCLUSION Although most physicians considered NCCN guidelines when treating patients with stage III/IV cHL, interim PET/CT scans after cycle 2 were not universally obtained. When PET/CT scans were obtained, Deauville 5PS scores were not always provided, and variability existed on what defined a positive score. These findings suggest that opportunities exist for education and improved PET-adapted treatment approaches.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
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Lacet DFR, Oliveira CC. The role of immunohistochemistry in the assessment of classical Hodgkin lymphoma microenvironment. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2022; 15:412-424. [PMID: 36381421 PMCID: PMC9638837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Classical Hodgkin lymphoma (CHL) has a unique cellular composition, containing a minority of neoplastic cells - Hodgkin and Reed-Sternberg (HRS) cells - in an inflammatory background. Investigations into this microenvironment have been given special importance in scientific hematopathology, playing an important role in elucidating its composition and its relationship to the prognosis of patients. OBJECTIVE To investigate microenvironment tumor markers in CHL, in order to analyze their interactions with clinical-morphological aspects of interest in onco-hematopathology. METHODS This retrospective study analyzed 184 patients with a pathologic diagnosis of CHL. Clinical data were reviewed from medical records. A morphological and immunophenotypic study with CD20, CD30, CD15, PAX-5, CD3, CD4, CD8, CD68, CD34, CD138 and PD-1 were performed. The data were tabulated and p value less than 0.05 was considered significant. RESULTS The time-to-cure was shorter in CD20+ patients, especially in those with more than 25% positivity (P=0.0183). The time-to-cure (P=0.0309) and the death (P=0.016) rates were shorter in PD-1 negative patients. Among patients with the presence of plasma cells in the microenvironment, those with lower numbers tend to be cured earlier (P=0.0374). Higher vascular density is associated with lower frequency of B symptoms (P=0.036) and presence of disease recurrence (P=0.004). CONCLUSIONS The microenvironment is certainly the setting of increasingly robust studies and the findings of this work highlight non-neoplastic B lymphocytes, plasma cells, PD-1 lymphocytes, and vascular density, related to prognosis of CHL patients.
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Affiliation(s)
- Dominique Fonseca Rodrigues Lacet
- Department of Pathology, Botucatu School of Medicine, São Paulo State University (FMB UNESP) and Department of Pathology, Luxemburgo HospitalBelo Horizonte, Brazil
| | - Cristiano Claudino Oliveira
- Department of Pathology, Botucatu School of Medicine, São Paulo State University (FMB UNESP) and Department of Pathology - AC Carmargo Cancer CenterSão Paulo, Brazil
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Macrophage Infiltration Correlates with Genomic Instability in Classic Hodgkin Lymphoma. Biomedicines 2022; 10:biomedicines10030579. [PMID: 35327381 PMCID: PMC8945507 DOI: 10.3390/biomedicines10030579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 12/10/2022] Open
Abstract
Hodgkin lymphoma (HL) is a biologically diverse group of lymphoid tumors, which accounts for 1% of all de novo neoplasms in the world’s population. It is divided into two main groups: the more common classic Hodgkin lymphoma (cHL) and the less common nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). cHL is further divided into four subtypes, which differ in morphology and the contents of tumor microenvironment. Macrophages are one of the components of tumor microenvironment known to contribute to creating an immunosuppressive microenvironment, which inhibits the activity of cells expressing granzyme B against tumor cells, even when tumor cells are infected with Epstein–Barr virus (EBV). Our research aimed to explore the association between the specific contents of tumor microenvironment and the genetic anomalies in tumor cells. The presence and the relative percentage of cytotoxic T lymphocytes and macrophages was detected by immunohistochemical staining of the antigens specific for certain cell populations. Fluorescent in situ hybridization was used to detect anomalies in the genome of tumor cells and in situ hybridization was used to detect the presence of EBV. Our results show an association between the number of CD163+ macrophages and the number of TP53 copies or BCL6 gene translocation. Patients who had a higher number of CD163+ macrophages infiltrating tumor tissue and three or higher number of copies of TP53 showed poorer survival. We conclude that the presence of macrophages may contribute to genetic instability in cHL, which drives the progression of cHL and decreases survival of the patients.
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Mpunga T, Clifford GM, Morgan EA, Milner DA, de Martel C, Munyanshongore C, Muvugabigwi G, Combes JD. Epstein-Barr virus prevalence among subtypes of malignant lymphoma in Rwanda, 2012 to 2018. Int J Cancer 2022; 150:753-760. [PMID: 34626122 DOI: 10.1002/ijc.33840] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/03/2021] [Accepted: 09/16/2021] [Indexed: 12/27/2022]
Abstract
Few data exist on Epstein-Barr virus (EBV) prevalence across the full spectrum of lymphoma subtypes, particularly in sub-Saharan Africa. The objective of our study was to test the presence of EBV in a nationally representative sample of malignant lymphomas diagnosed in the Butaro Cancer Center of Excellence (BCCOE) in Rwanda. Of 102 Hodgkin (HL) and 378 non-Hodgkin lymphomas (NHL) diagnosed in BCCOE between 2012 and 2018, 52 HL and 207 NHL were successfully tested by EBV-encoding RNA in situ hybridization. EBV prevalence was 54% in HL, being detected in all classical HL subtypes: mixed-cellularity (n = 3/8), nodular-sclerosis (n = 7/17) and lymphocyte-rich (n = 2/3). EBV prevalence was 9% in NHL, being 10% among 158 B-cell NHL, 3% among 35 T-cell NHL and the single NK-cell NHL was EBV-positive. Among B-cell NHL, EBV was present in the majority of Burkitt (n = 8/13), and was also rarely detected in follicular (n = 1/4) and acute B-cell lymphoblastic (n = 1/45) lymphomas. Five of the 45 (11%) diffuse large B-cell lymphomas (DLBCLs) were EBV-positive, including three out of five plasmablastic lymphoma (PBL). Of 39 HL and 163 NHL of known human immunodeficiency virus (HIV) status, 2 (5%) and 14 (9%) were HIV-positive, respectively, of which only four were also EBV-positive (2 PBL, 2 HL). In summary, we report rare regional-level data on the association of EBV with classical HL, Burkitt and DLBCLs, and report sporadic detection in other subtypes possibly related to EBV. Such data inform the burden of disease caused by EBV and can help guide application of future advances in EBV-specific prevention and therapeutics.
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Affiliation(s)
- Tharcisse Mpunga
- Butaro Cancer Center of Excellence, Ministry of Health, Butaro, Rwanda
| | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Elizabeth A Morgan
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Danny A Milner
- American Society for Clinical Pathology, Chicago, Illinois, USA
| | - Catherine de Martel
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | | | - Jean-Damien Combes
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
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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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Immune Microenvironment Features and Dynamics in Hodgkin Lymphoma. Cancers (Basel) 2021; 13:cancers13143634. [PMID: 34298847 PMCID: PMC8304929 DOI: 10.3390/cancers13143634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 01/01/2023] Open
Abstract
Simple Summary As happens in all neoplasms, the many reciprocal interactions taking place between neoplastic cells and the other reactive cells impact the course of the disease. Hodgkin Lymphoma is an haematologic malignancy where most of the pathological tissue is indeed composed by reactive cells and few neoplastic cells. Consequently, it represents an interesting subject for the description of the neoplastic and non-neoplastic cells interaction. In this review we report and discuss the more recent findings of microenvironmental studies about this disease. Abstract Classical Hodgkin’s lymphoma (cHL) accounts for 10% of all lymphoma diagnosis. The peculiar feature of the disease is the presence of large multinucleated Reed–Sternberg and mononuclear Hodgkin cells interspersed with a reactive microenvironment (ME). Due to the production of a large number of cytokines, Hodgkin cells (HCs) and Hodgkin Reed–Sternberg cells (HRSCs) attract and favour the expansion of different immune cell populations, modifying their functional status in order to receive prosurvival stimuli and to turn off the antitumour immune response. To this purpose HRSCs shape a biological niche by organizing the spatial distribution of cells in the ME. This review will highlight the contribution of the ME in the pathogenesis and prognosis of cHL and its role as a possible therapeutic target.
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Zahnreich S, Schmidberger H. Childhood Cancer: Occurrence, Treatment and Risk of Second Primary Malignancies. Cancers (Basel) 2021; 13:cancers13112607. [PMID: 34073340 PMCID: PMC8198981 DOI: 10.3390/cancers13112607] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022] Open
Abstract
Cancer represents the leading cause of disease-related death and treatment-associated morbidity in children with an increasing trend in recent decades worldwide. Nevertheless, the 5-year survival of childhood cancer patients has been raised impressively to more than 80% during the past decades, primarily attributed to improved diagnostic technologies and multiagent cytotoxic regimens. This strong benefit of more efficient tumor control and prolonged survival is compromised by an increased risk of adverse and fatal late sequelae. Long-term survivors of pediatric tumors are at the utmost risk for non-carcinogenic late effects such as cardiomyopathies, neurotoxicity, or pneumopathies, as well as the development of secondary primary malignancies as the most detrimental consequence of genotoxic chemo- and radiotherapy. Promising approaches to reducing the risk of adverse late effects in childhood cancer survivors include high precision irradiation techniques like proton radiotherapy or non-genotoxic targeted therapies and immune-based treatments. However, to date, these therapies are rarely used to treat pediatric cancer patients and survival rates, as well as incidences of late effects, have changed little over the past two decades in this population. Here we provide an overview of the epidemiology and etiology of childhood cancers, current developments for their treatment, and therapy-related adverse late health consequences with a special focus on second primary malignancies.
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Derqaoui S, Zouaidia F, Jahid A, Bernoussi Z, Znati K. Primary Hodgkin lymphoma of the ulnar nerve: the first case report with review of the literature. J Surg Case Rep 2021; 2021:rjab185. [PMID: 34040754 PMCID: PMC8136864 DOI: 10.1093/jscr/rjab185] [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] [Received: 04/15/2021] [Accepted: 03/21/2021] [Indexed: 11/12/2022] Open
Abstract
Hodgkin lymphoma is a lymphoid malignancy characterized by minority population of neoplastic cells (Reed-Sternberg cells and its variants) within a reactive inflammatory background. It encompasses two entities: classical HL (∼95% of cases) and nodular lymphocyte predominant HL (∼5% of cases). Primary lymphoma of peripheral nerves (PLPN) represent a very rare condition, since only 19 cases have been reported in the English literature to date, all of which are of a non-HL phenotype. A 20-year-old female presented an intramural mass of the ulnar nerve. Histological analysis revealed a Classical Hodgkin lymphoma. Further investigations failed to reveal nodal or extranodal involvement. PLPN is a very rare entity. There is a need for further understanding of this unusual lymphoma presentation.
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Affiliation(s)
- Sabrine Derqaoui
- Department of Pathology, Ibn Sina Teaching Hospital, Abderrahim Bouabid Avenue, Rabat 12000, Morocco
| | - Fouad Zouaidia
- Department of Pathology, Ibn Sina Teaching Hospital, Abderrahim Bouabid Avenue, Rabat 12000, Morocco
| | - Ahmed Jahid
- Department of Pathology, Ibn Sina Teaching Hospital, Abderrahim Bouabid Avenue, Rabat 12000, Morocco
| | - Zakia Bernoussi
- Department of Pathology, Ibn Sina Teaching Hospital, Abderrahim Bouabid Avenue, Rabat 12000, Morocco
| | - Kaoutar Znati
- Department of Pathology, Ibn Sina Teaching Hospital, Abderrahim Bouabid Avenue, Rabat 12000, Morocco
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Paschold L, Willscher E, Bein J, Vornanen M, Eichenauer DA, Simnica D, Thiele B, Wickenhauser C, Rosenwald A, Bernd HW, Klapper W, Feller AC, Ott G, Fend F, Hartmann S, Binder M. Evolutionary clonal trajectories in nodular lymphocyte predominant Hodgkin lymphoma with high transformation risk. Haematologica 2021; 106:2654-2666. [PMID: 33882641 PMCID: PMC8485677 DOI: 10.3324/haematol.2021.278427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Indexed: 11/09/2022] Open
Abstract
The B cell architecture of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is complex since it is composed of malignant lymphocyte-predominant (LP) cells along with a B cell rich bystander environment. To gain insight into molecular determinants of transformation, we studied B cell evolutionary trajectories in lymphoma tissue from diagnosis to relapse or transformation to non-Hodgkin lymphoma by immunoglobulin heavy chain next-generation sequencing. NLPHL cases that later transformed showed higher age, IgD negativity, absence of the characteristic IGHV3/IGHD3/IGHJ6 LP rearrangement and high repertoire clonality. We constructed phylogenetic trees within the compartment of the malignant clone to investigate clonal evolution. In all relapsing cases, the LP rearrangement was identical at diagnosis and relapse. NLPHL cases with transformation showed more complex trajectories with strong intraclonal diversification. The dominant founder clone in transformations showed clonal evolution, if derived from the same cell of origin, or originated from a different cell of origin. Together, our data point to a significant role of antigenic drive in NLHPL transformations and identify high B cell repertoire clonality with dominant intraclonal LP cell diversification as a hallmark of transformation. Sequencing of the initial paraffin-embedded tissue may therefore be diagnostically applied to identify NLPHL cases with high transformation risk.
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Affiliation(s)
- Lisa Paschold
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Edith Willscher
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Hospital of Frankfurt Main, Theodor-Stern-Kai 7, D-60590 Frankfurt a. Main
| | - Martine Vornanen
- Department of Pathology, Tampere University Hospital and University of Tampere, Tampere 33520
| | - Dennis A Eichenauer
- University of Cologne, First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, and German Hodgkin Study Group, University Hospital Cologne, Cologne
| | - Donjete Simnica
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Benjamin Thiele
- Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Claudia Wickenhauser
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle (Saale)
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg
| | | | - Wolfram Klapper
- Department of Pathology, Division of Hematopathology and Lymph Node Registry, Schleswig-Holstein Medical Center, Campus Kiel, Kiel
| | | | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus and Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart
| | - Falko Fend
- Institute of Pathology, Eberhard Karls University Tübingen, Tübingen
| | - Sylvia Hartmann
- Institute of Pathology, Eberhard Karls University Tübingen, Tübingen, Germany; Reference and Consultation Center for Lymph Node and Lymphoma Pathology, Goethe University, Frankfurt am Main
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale).
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Molecular Pathogenesis of Hodgkin Lymphoma: Past, Present, Future. Int J Mol Sci 2020; 21:ijms21186623. [PMID: 32927751 PMCID: PMC7554683 DOI: 10.3390/ijms21186623] [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: 08/12/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022] Open
Abstract
Our understanding of the tumorigenesis of classical Hodgkin lymphoma (cHL) and the formation of Reed–Sternberg cells (RS-cells) has evolved drastically in the last decades. More recently, a better characterization of the signaling pathways and the cellular interactions at play have paved the way for new targeted therapy in the hopes of improving outcomes. However, important gaps in knowledge remain that may hold the key for significant changes of paradigm in this lymphoma. Here, we discuss the past, present, and future of cHL, and review in detail the more recent discoveries pertaining to genetic instability, anti-apoptotic signaling pathways, the tumoral microenvironment, and host-immune system evasion in cHL.
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M A, Chatterjee S, A P, S M, Davuluri S, Ar AK, T A, M P, Cs P, Sinha M, Chugani A, R VP, Kk A, R S J. Natural Killer cell transcriptome during primary EBV infection and EBV associated Hodgkin Lymphoma in children-A preliminary observation. Immunobiology 2020; 225:151907. [PMID: 32044149 DOI: 10.1016/j.imbio.2020.151907] [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] [Received: 12/13/2019] [Revised: 01/09/2020] [Accepted: 01/25/2020] [Indexed: 01/22/2023]
Abstract
Epstein Barr Viral infection is a common childhood infection in India and is also nearly 100 % etiologically associated with pediatric Hodgkin Lymphoma (HL). The main question in EBV immunobiology has been, why only a small subset of infected individuals develop EBV associated malignancies, while the vast majority carry this virus asymptomatically for life. Natural Killer (NK) cells, with a phenotype of CD56dim CD16+ exhibit potent cytotoxicity towards both virus infected cells and transformed cells and hence have been considered to be crucial in preventing the development of symptomatic EBV infection and lymphoma. In order to get an insight into the various possible molecular aspects of NK cells, in the pathogenesis of both these EBV mediated diseases in children we studied the whole transcriptome of MACS sorted CD56dim CD16 + NK cells from four patients from each of the three groups of children viz. Infectious Mononucleosis (IM), HL and age matched controls by using a massively parallel sequencing approach. NK cells from both IM and HL had down-regulated innate immunity and chemokine signaling genes. While down-regulation of genes responsible for polarization of the secretory apparatus, activated NK cell signaling and MAP kinase signaling were exclusive to NK cells in patients with IM, in NK cells of HL, specifically, genes involved in extracellular matrix (ECM) - receptor interaction, cytokine-cytokine receptor interaction, TNF signaling, Toll-like receptor signaling pathway and cytosolic DNA-sensing pathways were significantly down-regulated. Enrichment analysis showed STAT3 to be the most significant transcription factor (TF) for the down-regulated genes in IM, whereas, GATA1 was found to be the most significant TF for the genes down-regulated in HL. Analysis of protein interaction network identified functionally important protein clusters. Top clusters, comprised of down-regulated genes, involved in signaling and ubiquitin-related processes and pathways. These may perhaps be responsible for the hypo-responsiveness of NK cells in both diseases. These possibly point to different deficiencies in NK cell activation, loss of activating receptor signaling and degranulation in IM, versus loss of cytokine and chemokine signaling in HL, in the two EBV associated pathologies investigated. Various suppressed molecules and pathways were novel, which have not been reported earlier and could therefore be potential targets for immunotherapy of NK cell reactivation in both the diseases in future.
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Affiliation(s)
- Alka M
- Departments of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | | | - Parchure A
- Departments of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Mahantesh S
- Departments of Microbiology, Indira Gandhi Institute of Child Health, Bangalore, India
| | - Sravanthi Davuluri
- Biological Data Analyzers' Association (BdataA), Electronic City, Phase I, Bangalore, India
| | - Arun Kumar Ar
- Departments of Pediatric Oncology, Kidwai Memorial Institute of Oncology, India
| | - Avinash T
- Departments of Pediatric Oncology, Kidwai Memorial Institute of Oncology, India
| | - Padma M
- Departments of Pediatric Oncology, Kidwai Memorial Institute of Oncology, India
| | - Premalata Cs
- Departments of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - Mahua Sinha
- Departments of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | | | | | - Acharya Kk
- Biological Data Analyzers' Association (BdataA), Electronic City, Phase I, Bangalore, India; Institute of Bioinformatics and Applied Biotechnology, Bangalore, India
| | - Jayshree R S
- Departments of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India.
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Ahmed HAS, Raslan WF, Deifalla AHS, Fathallah MD. CD163 is a predictive biomarker for prognosis of classical Hodgkin's lymphoma in Saudi patients. Mol Clin Oncol 2019; 11:67-76. [PMID: 31289681 PMCID: PMC6535641 DOI: 10.3892/mco.2019.1850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 04/05/2019] [Indexed: 01/05/2023] Open
Abstract
Hodgkin's lymphoma (HL) is a hematological malignancy characterized by a minority of neoplastic cells outnumbered by tumor-associated macrophages (TAMs). The overexpression of the CD163 antigen by TAMs is considered to be a significant predictive biomarker for risk stratification. This is likely caused by a genetic single-nucleotide polymorphism (SNP) at the gene promoter. The aim of the present retrospective case-control study was to establish a gene expression profile of a specific biomarker for classical HL (CHL) in order to predict the outcome and survival of CHL patients in Saudi Arabia. The protein expression of CD163 on TAMs was studied using immunohistochemistry (IHC). A prognosis index was calculated for the CD163 protein to assess the risk stratification of CHL. Genotyping of selected SNPs of this antigen was performed for 100 CHL cases and controls. The analysis revealed that the CD163 protein expression level was significantly correlated with disease relapse (DR) and overall survival (OS). In addition, the CD163 index threshold (15.0) was found to be significantly correlated with the relapse rate. Among the studied CD163 SNPs, rs75608120 exhibited a significant correlation with the DR rate of CHL patients, but not with OS. The findings of the present study confirmed that CD163 is a specific marker for TAMs, and its overexpression by TAMs is significantly associated with relapse and reduced survival post-therapy. In addition, a new methodology of indexing CD163 protein expression for HL risk stratification was proposed. Thus, the present study identified a specific predictive molecular and antigenic biomarker for CHL prognosis.
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Affiliation(s)
- Huda Al Sayed Ahmed
- Pathology and Laboratory Services Department, Johns Hopkins Aramco Healthcare, 1709 Dhahran, Saudi Arabia
| | - Wasim Fawzi Raslan
- Pathology and Laboratory Services Department, Johns Hopkins Aramco Healthcare, 10613 Dhahran, Saudi Arabia
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Al Sayed Ahmed H, Raslan WF, Deifalla AHS, Fathallah MD. Overall survival of classical Hodgkins lymphoma in Saudi patients is affected by XPG repair gene polymorphism. Biomed Rep 2018; 10:10-16. [PMID: 30588297 DOI: 10.3892/br.2018.1165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/23/2018] [Indexed: 12/13/2022] Open
Abstract
In Hodgkin's lymphoma (HL), single nucleotide polymorphisms (SNPs) of specific DNA repair genes have been identified to have an important role in the risk of HL. Consequently, they may also serve an important role in HL prognosis and disease outcome. The present study aimed to define an SNP molecular profile, based on DNA repair genes mutations, as predictive biomarkers for the prognostic outcome of patients with Classical HL (CHL) in Saudi Arabia. Genotyping of selected SNPs located in selected DNA repair genes was performed on 100 CHL cases and an equivalent number of healthy controls. No significant associations between CHL disease relapse (DR) or overall survival (OS) and 4 DNA repair genes were observed, with the exception of xeroderma pigmentosum, complementation group G (XPG) repair gene SNP (rs17655), which revealed a statistically significant association with CHL patient survival (P=0.036). Accordingly, these data suggest that the XPG gene may be a useful predictive molecular genetic biomarker for CHL clinical outcome. The present study also provided valuable insights on the contribution of DNA repair genes in Saudi patients with CHL. To the best of our knowledge, we defined for the first time, a specific genetic pattern associated with CHL outcome was defined in the present study in Saudi patients.
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Affiliation(s)
- Huda Al Sayed Ahmed
- Pathology Services Division and Laboratory Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Kingdom of Saudi Arabia
| | - Wasim Fawzi Raslan
- Pathology Services Division and Laboratory Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Kingdom of Saudi Arabia
| | - Abdel Halim Salem Deifalla
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 26671, Kingdom of Bahrain
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An integrated automated multispectral imaging technique that simultaneously detects and quantitates viral RNA and immune cell protein markers in fixed sections from Epstein-Barr virus-related tumours. Ann Diagn Pathol 2018; 37:12-19. [PMID: 30218928 DOI: 10.1016/j.anndiagpath.2018.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIM Epstein-Barr virus (EBV) is an oncovirus that is commonly associated with the development of lymphomas and epithelial carcinomas. In the era of immunotherapy, histological evaluation of EBV-related cancers is currently a multi-sample, multi-technique process requiring separate time-consuming detection of EBV-encoded small RNAs by in situ hybridisation (ISH), and parallel labelling of sections for cancer-associated protein markers. METHODS Using EBV-associated tumours as proof-of-concept for feasibility, here we developed an approach that allows simultaneous detection of EBV RNAs and multiple protein markers such as PD-L1, EBV-LMP, CD8, CD4, CD20, CD30 and CD15on a single tissue section based on our recently reported automated staining protocol. RESULTS We successfully combined multiplex immunofluorescence (mIF) to detect 3 abovementioned protein markers involved in cancer, with ISH, and applied the protocol to f tissue samples from patients diagnosed with EBV-associated pulmonary lymphoepithelioma-like carcinoma (LELC), gastric carcinoma and Hodgkin's Lymphoma. Empowered by the Vectra 3 Automated Quantitative Pathology Imaging System, we demonstrate the utility and potential of this integrated approach to concurrently detect and quantitate viral RNA and protein biomarkers of immune and tumour cells. CONCLUSION This study represents an important step forward in the research and diagnosis of EBV-associated cancers, and could be readily modified to include other proteins and RNA markers to apply to other malignancies. More importantly, the novel automated ISH-mIF protocol that we detailly described here could also be readily reproduced by most of the diagnostic and research lab to future projects that aim to look at both RNA and protein markers.
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20
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Kosari F, Ghaffari F. The Comparison Between Microwave and Autoclave as Antigen Retrieval Methods for Immunohistochemical Detection of CD15 and CD30 in Hodgkin's Lymphoma. IRANIAN JOURNAL OF PATHOLOGY 2018; 13:390-396. [PMID: 30774676 PMCID: PMC6358563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/13/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Hodgkin's lymphoma is a potentially curable hematologic malignancy with difficulty in its diagnosis especially in atypical cases even in expert hands. Today, immunohistochemistry plays a significant role in the diagnosis of it especially applying the anti-CD15 and anti-CD30 antibodies. The negativity of CD15 can be reduced by antigen retrieval for methods. In this study, the effect of autoclave was compared with microwave as heating sources of antigen retrieval in immunohistochemical staining. METHODS Sections prepared from 50 formalin-fixed paraffin-embedded tissue blocks of Classic Hodgkin's lymphomas stained for CD15 and CD30 using autoclave and microwave, were randomly and blindly reviewed by an expert hematopathologist, mostly focusing on Reed-Sternberg cells; the intensities were scored from 0 to +4 and analyzed by SPSS software. RESULTS Fifty eight percent of patients were male. The mean age was 32 years (range: 7 to 77). Nodular sclerosis was the most prevalent subtype. CD15 positivity in microwave treatment was 92% compared to 50% in autoclave. Negative CD30 decreased from 20% in autoclave to 2% in microwave. Intensity of staining in both markers was at least +1 greater in microwave treatment. No background staining was seen in microwave method. CONCLUSION There was bimodal age distribution in Hodgkin's lymphoma patients with the predominant male and Nodular Sclerosis as the most common type. Comparing autoclave and microwave, higher rate of the positivity was detected using microwave treatment, especially in CD15 staining. Improvement in staining intensity was also noticeable in both markers. There was no background or non-specific staining in microwave method. No disturbance of cells or nuclear morphology was also reported.
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Affiliation(s)
- Farid Kosari
- Dept. of Pathology, Tehran University of Medical Sciences, Tehran, Iran,Corresponding information:Farid Kosari, Dept. of Pathology, Tehran University of Medical Sciences, Tehran, Iran E-mail:
| | - Fatemeh Ghaffari
- Pathology Laboratory, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Qu XL, Hei Y, Kang L, Yang XJ, Wang Y, Lu XZ, Xiao LH, Yang G. Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease. PLoS One 2017; 12:e0160175. [PMID: 28510589 PMCID: PMC5433690 DOI: 10.1371/journal.pone.0160175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 07/14/2016] [Indexed: 11/19/2022] Open
Abstract
Lymphoproliferative diseases (LPDs) of the ocular adnexa encompass the majority of orbital diseases and include reactive follicular hyperplasia (RFH), atypical lymphoid hyperplasia (ALH), and mucosa-associated lymphoid tissue lymphoma (MALToma). Lymphoid follicles (LFs) are usually observed during the histological examination of LPDs. Currently, because there is a lack of specific clinical signs and diagnostic immunohistochemical biomarkers, it is difficult for pathologists to distinguish MALToma from ocular RFH and ALH, which makes the clinical management of these conditions difficult. Here, we analyzed the clinical features of patients with ocular adnexal LPDs (n = 125) and investigated the structure of LFs in paraffin-embedded tissue samples using anti-CD23 and anti-IgD immunochemistry. We found that some clinical features including age, sex, and laterality were different among RFH, LFH, and MALToma. Additionally, immunohistochemistry revealed that the expression of IgD and CD23 was higher in RFH patients and decreased in patients with ALH and MALToma. Moreover, LFs in RFH were intact, whereas the structures of most LFs were disrupted in ALH. In MALToma specimens, few intact LFs were observed. In a further investigation, we combined the results for CD23/IgD immunohistochemistry and the structure of LFs to establish a scoring method for the differential diagnosis of LPDs. According to the BIOMED-2 protocol, we further detected IgH gene monoclonal rearrangement in 73 cases (35 RFH, 17 ALH, and 21 MALToma cases). The sensitivity of our scoring method, based on a comparison with the results of IgH gene monoclonal rearrangement detection, was 85.7% (18/21) for MALToma and 35.3% (6/17) for ALH. Our study provides a method that may be useful for the differential diagnosis of RFH, ALH, and MALToma.
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Affiliation(s)
- Xiao-Li Qu
- Ophthalmology Department, Qianfoshan Hospital, Shandong Province, China
| | - Yan Hei
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Li Kang
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Xin-Ji Yang
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Yi Wang
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Xiao-Zhong Lu
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
| | - Li-Hua Xiao
- Institute of Orbital Disease, General Hospital of Chinese People’s Armed Police Forces, Beijing, China
- * E-mail: (LX); (GY)
| | - Guang Yang
- Beijing Institute of Basic Medical Sciences, Beijing, China
- * E-mail: (LX); (GY)
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Lawson JS, Singh S. An unusual complication of extra nodal Hodgkin's lymphoma. ANZ J Surg 2017; 88:E803-E804. [PMID: 28304121 DOI: 10.1111/ans.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/24/2016] [Accepted: 10/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Joshua S Lawson
- Department of General Surgery, Moruya District Hospital, Moruya, New South Wales, Australia
| | - Sanjay Singh
- Mogo Day Surgery, Sydney, New South Wales, Australia
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Kampers J, Orjuela-Grimm M, Schober T, Schulz TF, Stiefel M, Klein C, Körholz D, Mauz-Körholz C, Kreipe H, Beier R, Maecker-Kolhoff B. Classical Hodgkin lymphoma-type PTLD after solid organ transplantation in children: a report on 17 patients treated according to subsequent GPOH-HD treatment schedules. Leuk Lymphoma 2016; 58:633-638. [DOI: 10.1080/10428194.2016.1205742] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Johanna Kampers
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Manuela Orjuela-Grimm
- Pediatric Oncology Hematology & Stem Cell Transplantation, Columbia University Medical Center, New York, NY, USA
| | - Tilmann Schober
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Thomas F. Schulz
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Martina Stiefel
- Center of Pediatrics, University of Halle/Saale, Halle, Germany
| | - Christoph Klein
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dieter Körholz
- Pediatric Hematology and Oncology, Department of Pediatrics, Justus Liebig University of Gießen, Gießen, Germany
| | - Christine Mauz-Körholz
- Pediatric Hematology and Oncology, Department of Pediatrics, Justus Liebig University of Gießen, Gießen, Germany
- Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Hans Kreipe
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Rita Beier
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
- Pediatric Hematology and Oncology, Department for Pediatrics III, University Hospital of Essen, Essen, Germany
| | - Britta Maecker-Kolhoff
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
- Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover, Germany
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David JA, Huang JZ. Diagnostic Utility of Flow Cytometry Analysis of Reactive T Cells in Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Am J Clin Pathol 2016; 145:107-15. [PMID: 26712878 DOI: 10.1093/ajcp/aqv017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study aims to define the diagnostic utility of flow cytometric features of T cells in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). METHODS Cases were retrospectively identified based on diagnosis with NLPHL (n = 30 samples), classic Hodgkin lymphoma (CHL; n = 33), and reactive lymphoid hyperplasia (RLH; n = 43). Pathology slides were reviewed. Flow cytometry list mode data were reanalyzed. RESULTS The mean proportion of CD4 + CD8 + T cells (8.4%) in cases of NLPHL was significantly higher than seen in CHL (1.0%) or RLH (0.6%). Of the T cells, 28.4% were CD57 + in NLPHL, significantly higher (P < .05) than in CHL (3.2%) or RLH (3.2%). Based on receiver operating characteristic curve analysis, when using a cutoff of 3.0% of CD4 + CD8 + T cells, the diagnostic sensitivity for NLPHL is 83.3% with a specificity of 97.4%. The diagnostic sensitivity was 96.7% with a specificity of 98.7% when using a cutoff of 12% for CD57 + T cells. CONCLUSIONS Increased portions of CD57 + T cells and CD4 + CD8 + T cells are highly suggestive of the possibility of NLPHL. In addition, NLPHL diagnosis appears unlikely if neither CD57 + T cells nor CD4 + CD8 + T cells are increased. Future prospective studies including cases of progressive transformation of germinal center and T-cell/histiocyte-rich large B-cell lymphoma will further define the utility of flow cytometry of T cells in NLPHL.
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Affiliation(s)
- James A David
- From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - James Z Huang
- From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI; Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI.
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25
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Seth R, Das RR, Puri K, Singh P. Clinical Profile and Chemotherapy Response in Children with Hodgkin Lymphoma at a Tertiary Care Centre. J Clin Diagn Res 2015; 9:SC25-30. [PMID: 26674594 DOI: 10.7860/jcdr/2015/14876.6845] [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: 05/12/2015] [Accepted: 09/07/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Optimal treatment strategy in children with advance stage Hodgkin Lymphoma (HL) still remains controversial. AIM To evaluate the clinical profile and the efficacy of chemotherapy (CT) as a treatment modality in paediatric HL. MATERIAL AND METHODS Retrospective case record evaluation of paediatric HL cases over 5 years (October 2005 to October 2010) period. RESULTS Thirty five cases (31 boys) with a median age of eight years were studied. 24 cases were <10-year-old, and 23 had late stage disease (stage III to IV). B-symptoms were present in 60%, bulky mediastinal disease in 25.7%, and spleen involvement in 60% cases. None had bone marrow involvement. Most common histological type was nodular sclerosis (28.6%). Most cases received ABVD/COPP or ABVD regimen. Two cases needed BEACOPP due to progressive disease, and 4 needed low-dose involved field radiotherapy (RT). At a mean (SD) extended event-free follow-up of 42.7(±17.1) months, four cases relapsed (one was lost to follow-up, and three were treated with chemotherapy and low-dose involved field RT). None died due to the disease. CONCLUSION Present study found systemic CT alone to be an effective therapy in childhood Hodgkin lymphoma. However, a small sample in present study limits the generalisability of these findings. The findings needs to be replicated in larger population, preferably randomized clinical trials, before any firm conclusion can be made.
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Affiliation(s)
- Rachna Seth
- Additional Professor, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS) , New Delhi, India
| | - Rashmi Ranjan Das
- Assistant Professor, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS) , Bhubaneswar, India
| | - Kirti Puri
- Intern, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS) , New Delhi, India
| | - Prashant Singh
- Intern, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS) , New Delhi, India
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Panico L, Tenneriello V, Ronconi F, Lepore M, Cantore N, Dell’Angelo AC, Ferbo L, Ferrara F. High CD20+ background cells predict a favorable outcome in classical Hodgkin lymphoma and antagonize CD68+ macrophages. Leuk Lymphoma 2014; 56:1636-42. [DOI: 10.3109/10428194.2014.951849] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ma J, Wang Y, Zhao H, Liu S, Li Q, Lin L, Yue Y, Wang X, Zhao Z, Yu Y, Zhang Y. Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:5045-50. [PMID: 25197377 PMCID: PMC4152067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/12/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Most Hodgkin lymphoma (HL) patients present with disease in nodal regions. However, in a small subset, disease develops extranodal sites primarily, such as lung and liver. This study aims to identify the characteristics and outcomes of patients with primary extranodal HL. METHODS A retrospective analysis of patients with HL from 1998 to 2012 was enrolled. We selected 26 HL patients with primary extranodal involvement from 251 previously untreated HL patients. All data analyses were performed with SPSS software version 17.0 and GraphPad Prism 5. RESULTS We identified 26 patients with primary extranodal HL. Results in the series of young patients, male predominated. Pathologically, the major pathologic types were nodular sclerosis classical HL (NSCHL, 46.2%) and mixed cellularity classical HL (MCCHL, 38.5%). Thirteen patients had early stage (I or II stage). The most commonly primarily extranodal sites were the lung and the stomach and intestine, followed by the liver and bones. Fifteen of 26 received chemotherapy alone and 11 received combination therapy. Finally, primary extranodal HLs in our study have a favorable survival. Furthermore, there was no significant association between the international prognostic score (IPS) and survival in patients with extranodal HL. CONCLUSION Our retrospective data in part reflect clinical characteristics of primary extranodal HL in China, and form the basis for further concerning researches.
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Affiliation(s)
- Jing Ma
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yafei Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Haifeng Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Su Liu
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Qian Li
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Li Lin
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yuanfang Yue
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Xiaofang Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Zhigang Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yong Yu
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yizhuo Zhang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
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Provencio M, Sánchez A, Sánchez-Beato M. New drugs and targeted treatments in Hodgkin's lymphoma. Cancer Treat Rev 2013; 40:457-64. [PMID: 24095205 DOI: 10.1016/j.ctrv.2013.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 08/24/2013] [Accepted: 09/04/2013] [Indexed: 12/26/2022]
Abstract
New drugs are being developed in recent years that may change the handling of relapsed and refractory Hodgkin's lymphoma patients. Brentuximab vedotin treatment has already been approved by the FDA; and other drugs are promising, such as histone deacetylase inhibitors, bendamustine, lenalidomide and m-TOR inhibitors.
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Affiliation(s)
- Mariano Provencio
- Medical Oncology Service, Onco-hematology Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro, Hospital Universitario Puerta de Hierro-Majadahonda, Spain.
| | - Antonio Sánchez
- Medical Oncology Service, Onco-hematology Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
| | - Margarita Sánchez-Beato
- Medical Oncology Service, Onco-hematology Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro, Hospital Universitario Puerta de Hierro-Majadahonda, Spain
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[Primary Hodgkin's lymphoma of the colon]. DER PATHOLOGE 2013; 35:191-5. [PMID: 23793289 DOI: 10.1007/s00292-013-1790-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary Hodgkin's lymphoma of the colon is exceedingly rare. We report on the case of a 74-year-old female patient presenting with weight loss and hematochezia. Proctocolonoscopy revealed a bleeding tumor localized in the right colonic flexure. Histological examination of initial mucosal biopsies could not verify malignancy; however, explorative surgery was decided in an interdisciplinary conference setting and right-sided hemicolectomy was performed. Macroscopically, a tumor measuring 5.5 cm in maximum diameter was found. By means of histology and immunohistochemistry the diagnosis of classic Hodgkin's lymphoma was made. Mesenteric lymph nodes were not affected and postoperative staging revealed no systemic spread. Therefore, the tumor fulfilled the criteria of a primary colonic Hodgkin's lymphoma. Diagnosis of primary colonic lymphoma can be difficult as clinical symptoms are typically unspecific and, as shown in this case, even primary biopsy histology can be falsely negative.
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Irshaid F, Tarawneh K, Alshdefat A, Dilmi F, Jaran A, Al-Hadithi R, Al-Khatib A. Loss of P16 Protein Expression and Its Association with Epstein-Barr Virus LMP-1 Expression in Hodgkin's Lymphoma. IRANIAN JOURNAL OF CANCER PREVENTION 2013; 6:78-84. [PMID: 25250115 PMCID: PMC4142916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/23/2013] [Indexed: 11/08/2022]
Abstract
Background Expression of Epstein-Barr virus Latent Member Protein-1 (EBV LMP-1) and loss of P16 protein expression are documented in lymphoma, indicating a relationship between them, but this relationship is not clear and sometimes contradictory. Thus, this study was conducted to examine the relationship between the loss of P16 and EBV LMP-1 expression in Jordanian patients diagnosed with lymphoma. Methods Sections were made from archival formalin-fixed and paraffin-embedded blocks from 55 patients diagnosed with lymphoma. P16 expression and LMP-1 expression were detected by immunohistochemistry using monoclonal antibodies. Results In Hodgkin's Lymphoma (HL), the loss of P16 was higher in LMP-1 positive cases (61%) than LMP-1 negative cases (25%; P = 0.072). Conversely, in Non-Hodgkin's Lymphoma (NHL), none of LMP-1 positive samples showed loss of P16. Furthermore, among LMP-1 HL positive cases, the loss of P16 was more frequent in male (75%) than female (33%). Also, there was a significantly higher proportion of LMP-1 positive cases showing loss of P16 in HL (11:18), compared to those in NHL (0:8, P < 0.001), confirming a difference between HL and NHL, concerning the LMP-1/P16 relationship. Conclusion A trend for an association between loss of P16 and LMP-1 expression was observed in HL but not NHL patients. These findings suggest that there are molecular and clinical differences in the pathogenesis and development of different subtypes of lymphoma.
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Affiliation(s)
- Fawzi Irshaid
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Khaled Tarawneh
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Aisha Alshdefat
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Fatiha Dilmi
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Adnan Jaran
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Raji Al-Hadithi
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
| | - Ahad Al-Khatib
- Dept. of Biological Sciences, Faculty of Science, Al al-Bayt University, Al-Mafraq, Jordan
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Vassilakopoulos TP, Angelopoulou MK. Advanced and Relapsed/Refractory Hodgkin Lymphoma: What Has Been Achieved During the Last 50 Years. Semin Hematol 2013; 50:4-14. [DOI: 10.1053/j.seminhematol.2013.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Banzo J, Ubieto M, Giraldo P, Razola P, Prats E, Tardin L, Santapau A, Parra A, Rambalde E, Velilla J. Resistance to First Line Chemotherapy Treatment in a Patient Diagnosed with Nodular Lymphocyte-predominant Hodgkin Lymphoma Identified by 18F-FDG PET/CT: Diagnostic and Therapeutic Implications. Rev Esp Med Nucl Imagen Mol 2012. [DOI: 10.1016/j.remngl.2011.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cacciatore M, Guarnotta C, Calvaruso M, Sangaletti S, Florena AM, Franco V, Colombo MP, Tripodo C. Microenvironment-centred dynamics in aggressive B-cell lymphomas. Adv Hematol 2012; 2012:138079. [PMID: 22400028 PMCID: PMC3287037 DOI: 10.1155/2012/138079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 10/27/2011] [Indexed: 12/13/2022] Open
Abstract
Aggressive B-cell lymphomas share high proliferative and invasive attitudes and dismal prognosis despite heterogeneous biological features. In the interchained sequence of events leading to cancer progression, neoplastic clone-intrinsic molecular events play a major role. Nevertheless, microenvironment-related cues have progressively come into focus as true determinants for this process. The cancer-associated microenvironment is a complex network of nonneoplastic immune and stromal cells embedded in extracellular components, giving rise to a multifarious crosstalk with neoplastic cells towards the induction of a supportive milieu. The immunological and stromal microenvironments have been classically regarded as essential partners of indolent lymphomas, while considered mainly negligible in the setting of aggressive B-cell lymphomas that, by their nature, are less reliant on external stimuli. By this paper we try to delineate the cardinal microenvironment-centred dynamics exerting an influence over lymphoid clone progression in aggressive B-cell lymphomas.
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Affiliation(s)
- Matilde Cacciatore
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
| | - Carla Guarnotta
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
| | - Marco Calvaruso
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
| | - Sabina Sangaletti
- Dipartimento di Oncologia Sperimentale, Unità di Immunologia Molecolare, IRCCS Fondazione Istituto Nazionale Tumori, 20133 Milano, Italy
| | - Ada Maria Florena
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
| | - Vito Franco
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
| | - Mario Paolo Colombo
- Dipartimento di Oncologia Sperimentale, Unità di Immunologia Molecolare, IRCCS Fondazione Istituto Nazionale Tumori, 20133 Milano, Italy
| | - Claudio Tripodo
- Dipartimento di Scienze per la Promozione della Salute, Sezione di Anatomia Patologica, Università degli Studi di Palermo, 90127 Palermo, Italy
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Downing ME, Dite GS, Ballinger ML. An increased incidence of Hodgkin's lymphoma in patients with adult-onset sarcoma. Clin Sarcoma Res 2012; 2:1. [PMID: 22588051 PMCID: PMC3351710 DOI: 10.1186/2045-3329-2-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 01/09/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sarcomas are rare, often fatal malignancies of connective tissues that can occur in genetic predisposition syndromes or result from carcinogen exposure. Hodgkin's lymphoma (HL) is not known to contribute to any recognised familial cancer syndrome comprising sarcomas, but is known to be associated with a variety of second cancers, including sarcomas. This study describes the prevalence of HL in families affected by sarcoma. METHODS The International Sarcoma Kindred Study (ISKS) is a prospective cohort of 561 families ascertained via a proband with adult-onset sarcoma. Cancer-specific standardised incidence ratios (SIR) for multiple primary malignancies in probands were estimated. Clinical characteristics of individuals reporting both sarcoma and HL were described. Standardised incidence ratios for the occurrence of cancer in ISKS families were also estimated. RESULTS Multiple primary cancers were reported in 16% of probands, significantly higher than in the general population. The risk of HL in probands was increased 15.8-fold (95%CI 7.9-31.6) and increased risks were also seen for breast cancer (SIR 2.9, 95%CI 1.9-4.4) and thyroid cancer (SIR 8.4, 95%CI 4.2-16.8). In 8 probands with both HL and sarcoma, the diagnosis of HL preceded that of sarcoma in 7 cases, and occurred synchronously in one case. Only 3 cases of sarcoma occurred in or close to prior radiotherapy fields. The overall incidence of HL in the ISKS cohort was not significantly increased by comparison with age- and gender-specific population estimates (SIR 1.63, 95%CI 1.05-2.43), suggesting that the association between HL and sarcomas did not extend to other family members. The age of onset of non-sarcoma, non-HL cancers in families affected by both HL and sarcoma was younger than the general population (56.2 y vs 65.6 y, P < 0.0001). CONCLUSIONS The basis for the association between HL and sarcomas may include the carcinogenic effects of therapy combined with excellent survival rates for HL. Common risk factors for both may also exist, including both environmental and heritable factors.
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Affiliation(s)
- Megan E Downing
- Sarcoma Genomics and Genetics Laboratory, Research Division, The Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
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Carbone A, Gloghini A. "Intrafollicular neoplasia" of nodular lymphocyte predominant Hodgkin lymphoma: description of a hypothetic early step of the disease. Hum Pathol 2011; 43:619-28. [PMID: 22209342 DOI: 10.1016/j.humpath.2011.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/05/2011] [Accepted: 09/07/2011] [Indexed: 12/22/2022]
Abstract
The 2008 WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues has addressed the problem of intrafollicular neoplasia/"in situ" lesion for follicular lymphoma. The concept of intrafollicular neoplasia has also been proposed for other lymphomas in which the putative normal counterpart of the tumor cell is located in the germinal center or the mantle zone or the marginal zone of the follicle. However, unlike in situ follicular lymphoma, the precise histologic definition of this early lesion for other lymphomas is still lacking. When applied to nodular lymphocyte predominant Hodgkin lymphoma, another germinal center-derived lymphoma, "intrafollicular neoplasia" may be regarded as a neoplasia at an early stage of development, such as in situ follicular lymphoma. Interestingly, this early lesion can be observed in lymph nodes that otherwise show the most common nodular involvement by nodular lymphocyte predominant Hodgkin lymphoma. The recognition of intrafollicular neoplasia is based on the identification of typical, strongly stained BCL6+, lymphocyte predominant tumor cells located within altered follicles with a recognizable germinal center. Lymphocyte predominant tumor cells, surrounded by rosetting PD1+ T cells, reside in an environment reminiscent of a secondary follicle. Intrafollicular neoplasia in nodular lymphocyte predominant Hodgkin lymphoma is correctly identifiable based on immunohistochemical recognition of the CD23+ meshwork of follicular dendritic cells surrounded by an outer zone containing immunoglobulin D+ B cells. This immunoarchitectural pattern, highlighting the intrafollicular involvement by the neoplasia, is of great utility for diagnosis. An appropriate immunohistochemical characterization for diagnosis should include lymphocyte predominant (BCL6 and CD20) and microenvironmental (CD23, immunoglobulin D, and PD1) cell markers.
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Affiliation(s)
- Antonino Carbone
- Division of Pathology, Centro di Riferimento Oncologico Aviano, Istituto Nazionale Tumori, IRCCS, 33081 Aviano, Italy.
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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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Banzo J, Ubieto MA, Giraldo P, Razola P, Prats E, Tardin L, Santapau A, Parra A, Rambalde EF, Velilla J. [Resistance to first line chemotherapy treatment in a patient diagnosed of nodular lymphocyte-predominant Hodgkin's lymphoma identified by 18F-FDG PET/CT: diagnostic and therapeutic implications]. Rev Esp Med Nucl Imagen Mol 2011; 31:89-92. [PMID: 21620527 DOI: 10.1016/j.remn.2011.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 03/09/2011] [Accepted: 03/28/2011] [Indexed: 12/31/2022]
Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity that accounts for less than 5% of the cases of Hodgkin lymphoma (HL) with morphological, immunophenotypical, genetic and clinical behavior traits different from the classic HL. In a minority of patients, the NLPHL course is complicated by a transformation to a non-Hodgkin diffuse large B-cell lymphoma (NHDLBCL) with prognostic and therapeutic implications. Early metabolic changes observed by (18)F-FDG PET in patients with HL and NHL, after 1-3 cycles of chemotherapy, predict the final response to treatment and progression-free survival. In the case we are presenting herein, whether NLPHL is transformed to NHDLBCL or the two types of lymphoma co-exist in the same patient, the (18)F-FDG PET/CT scan was crucial for the identification of tumor resistance to first line chemotherapy and to guide a second biopsy decision and therefore modify the chemotherapy regimen.
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Affiliation(s)
- J Banzo
- Unidad de Medicina Nuclear, Grupo Hospitalario Quirón La Floresta, Zaragoza, España.
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