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Bende RJ, Donner N, Wormhoudt TA, Beentjes A, Scantlebery A, Grobben M, Tejjani K, Chandler F, Sikkema RS, Langerak AW, Guikema JE, van Noesel CJ. Distinct groups of autoantigens as drivers of ocular adnexal MALT lymphoma pathogenesis. Life Sci Alliance 2024; 7:e202402841. [PMID: 38977312 PMCID: PMC11231493 DOI: 10.26508/lsa.202402841] [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: 05/23/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024] Open
Abstract
Chronic B-cell receptor signals incited by cognate antigens are believed to play a crucial role in the pathogenesis of mucosa-associated lymphoid tissue lymphomas. We have explored the immunoglobulin variable regions (IGHV) expressed by 124 ocular adnexal MALT lymphomas (OAML) and tested the in vitro reactivity of recombinant IgM derived from 23 OAMLs. Six of 124 OAMLs (5%) were found to express a high-affinity stereotyped rheumatoid factor. OAMLs have a biased IGHV4-34 usage, which confers intrinsic super auto-antigen reactivity with poly-N-acetyllactosamine (NAL) epitopes, present on cell surface glycoproteins of erythrocytes and B cells. Twenty-one OAMLs (17%) expressed IGHV4-34-encoded B-cell receptors. Five of the 23 recombinant OAML IgMs expressed IGHV4-34, four of which bound to the linear NAL i epitope expressed on B cells but not to the branched NAL I epitope on erythrocytes. One non-IGHV4-34-encoded OAML IgM was also reactive with B cells. Interestingly, three of the 23 OAML IgMs (13%) specifically reacted with proteins of U1-/U-snRNP complexes, which have been implicated as cognate-antigens in various autoimmune diseases such as systemic lupus erythematosus and mixed connective tissue disease. The findings indicate that local autoimmune reactions are instrumental in the pathogenesis of a substantial fraction of OAMLs.
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MESH Headings
- Humans
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/genetics
- Autoantigens/immunology
- Immunoglobulin M/immunology
- Immunoglobulin M/metabolism
- Eye Neoplasms/immunology
- Eye Neoplasms/genetics
- Female
- Middle Aged
- Receptors, Antigen, B-Cell/metabolism
- Receptors, Antigen, B-Cell/immunology
- Receptors, Antigen, B-Cell/genetics
- B-Lymphocytes/immunology
- B-Lymphocytes/metabolism
- Male
- Aged
- Immunoglobulin Variable Region/genetics
- Immunoglobulin Variable Region/immunology
- Aged, 80 and over
- Epitopes/immunology
- Adult
- Rheumatoid Factor/immunology
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Affiliation(s)
- Richard J Bende
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Lymphoma and Myeloma Center (LYMMCARE), Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam, Netherlands
| | - Naomi Donner
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
| | - Thera Am Wormhoudt
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Lymphoma and Myeloma Center (LYMMCARE), Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam, Netherlands
| | - Anna Beentjes
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
| | - Angelique Scantlebery
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
| | - Marloes Grobben
- Department of Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, Netherlands
| | - Khadija Tejjani
- Department of Medical Microbiology and Infection Prevention, Laboratory of Experimental Virology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, Netherlands
| | - Felicity Chandler
- https://ror.org/018906e22 Department of Viroscience, Erasmus MC, Rotterdam, Netherlands
| | - Reina S Sikkema
- https://ror.org/018906e22 Department of Viroscience, Erasmus MC, Rotterdam, Netherlands
| | - Anton W Langerak
- https://ror.org/018906e22 Department of Immunology, Laboratory Medical Immunology, Erasmus MC, Rotterdam, Netherlands
| | - Jeroen Ej Guikema
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Lymphoma and Myeloma Center (LYMMCARE), Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam, Netherlands
| | - Carel Jm van Noesel
- Department of Pathology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
- Lymphoma and Myeloma Center (LYMMCARE), Amsterdam, Netherlands
- Cancer Center Amsterdam (CCA), Amsterdam, Netherlands
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Walewska R, Eyre TA, Barrington S, Brady J, Fields P, Iyengar S, Joshi A, Menne T, Parry-Jones N, Walter H, Wotherspoon A, Linton K. Guideline for the diagnosis and management of marginal zone lymphomas: A British Society of Haematology Guideline. Br J Haematol 2024; 204:86-107. [PMID: 37957111 DOI: 10.1111/bjh.19064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Renata Walewska
- Cancer Care, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Toby A Eyre
- Department of Haematology, Cancer and Haematology Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sally Barrington
- King's College London and Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, King's Health Partners, Kings College London, London, UK
| | - Jessica Brady
- Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul Fields
- Guy's and St Thomas' Hospital, Kings Health Partners, London, UK
| | - Sunil Iyengar
- Department of Haematology, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Anurag Joshi
- All Wales Lymphoma Panel, Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nilima Parry-Jones
- Department of Haematology, Aneurin Bevan University Health Board, Newport, Wales, UK
| | - Harriet Walter
- The Ernest and Helen Scott Haematological Research Institute, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Andrew Wotherspoon
- Department of Histopathology, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Kim Linton
- Division of Cancer Sciences, The Christie NHS Foundation Trust and The University of Manchester, Manchester, UK
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Magistri M, Happ LE, Ramdial J, Lu X, Stathias V, Kunkalla K, Agarwal N, Jiang X, Schürer SC, Dubovy SR, Chapman JR, Vega F, Dave S, Lossos IS. Correction: The Genetic Landscape of Ocular Adnexa MALT Lymphoma Reveals Frequent Aberrations in NFAT and MEF2B Signaling Pathways. CANCER RESEARCH COMMUNICATIONS 2023; 3:1688. [PMID: 37649813 PMCID: PMC10464847 DOI: 10.1158/2767-9764.crc-23-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
[This corrects the article DOI: 10.1158/2767-9764.CRC-21-0022.][This corrects the article DOI: 10.1158/2767-9764.CRC-21-0022.].
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Raderer M, Kiesewetter B, Du MQ. Clinical relevance of molecular aspects in extranodal marginal zone lymphoma: a critical appraisal. Ther Adv Med Oncol 2023; 15:17588359231183565. [PMID: 37389189 PMCID: PMC10302523 DOI: 10.1177/17588359231183565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/24/2023] [Indexed: 07/01/2023] Open
Abstract
Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is among the more common types of lymphoma accounting for up to 8% of newly diagnosed lymphoma cases. As opposed to other B-cell lymphomas, however, no predominant genetic hallmark has been defined in MALT lymphoma, but different localizations appear to be affected by different, sometimes distinct changes. Nonetheless, a high proportion of these genetic changes reported in MALT lymphomas dysregulate the pathways leading to NF-kB activation. t(11;18)(q21;q21)/BIRC3::MALT1 appears to be MALT lymphoma specific and is found in 24% of gastric and 40% of pulmonary MALT lymphomas. The translocation is associated with more disseminated disease in gastric MALT lymphoma and is found in a large percentage of patients whose lymphoma is unresponsive to antibiotic eradication of Helicobacter pylori. In addition to t(11;18)(q21;q21), nuclear expression of BCL10 or NF-kB appears to be highly associated with lymphoma cell survival independence of H. pylori-mediated stimulations. Antibiotic eradication, however, is the recommended therapy of choice irrespective of genetic findings, and molecular analysis is not required before initiation of therapy. The influence of genetic translocations including t(11;18)(q21;q21) on systemic therapies, however, is less clearly defined. While small series have shown no influence on the outcome for treatment with the anti-CD20 antibody rituximab (R) or treatment with cladribine (2-CdA), conflicting data have been reported for alkylating agents, especially chlorambucil and the combination of R + chlorambucil. None of other genetic changes seen in MALT lymphoma to date has discernible value in routine clinical applications, but recent data suggest that changes in TNFAIP3(A20), KMTD2 and CARD11 might be associated with response to Bruton kinase inhibitors.
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Affiliation(s)
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Austria
| | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
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Alderuccio JP, Lossos IS. Enhancing prognostication and personalizing treatment of extranodal marginal zone lymphoma. Expert Rev Hematol 2023; 16:333-348. [PMID: 37086394 PMCID: PMC10183153 DOI: 10.1080/17474086.2023.2206557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/20/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Extranodal marginal zone lymphoma (EMZL) of mucosa-associated lymphoid tissue is an indolent lymphoma originating from marginal zone B-cells and associated with chronic inflammation. EMZL demonstrates distinct genomic alterations according to the primary extranodal site of disease but commonly affects signaling pathways including NF-ĸB, B-cell receptor, and NOTCH. Treatment with radiation therapy is commonly implemented in localized diseases, and multiple agents are available for patients with advanced-stage diseases in need of therapy. Bendamustine with rituximab is a frontline platform associated with high efficacy. AREAS COVERED Clinical features, diagnosis, genomics, models enabling risk stratification, treatment options, and future directions. EXPERT OPINION The lack of consistent genotyping profile in EMZL precludes the development of tissue and circulatory biomarkers for the diagnosis, risk stratification, and monitoring of minimal residual disease. Furthermore, the biological heterogeneity observed in extranodal sites associated with overall limited genomic data prevents the testing of druggable pathways aiming for a personalized treatment approach. Future clinical trials should focus on EMZL considering the unique clinical characteristics in the eligibility criteria and response assessment to better inform efficacy of novel agents and delineate sequences of therapies.
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Affiliation(s)
| | - Izidore S. Lossos
- Department of Medicine, Division of Hematology
- Department of Molecular and Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Alderuccio JP, Habermann T, Kuker R, Moskowitz CH, Zelenetz AD, Lossos IS. A roadmap for clinical trial design in marginal zone lymphoma. Am J Hematol 2022; 97:1398-1403. [PMID: 36030403 PMCID: PMC9561038 DOI: 10.1002/ajh.26706] [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: 07/04/2022] [Revised: 08/05/2022] [Accepted: 08/23/2022] [Indexed: 01/28/2023]
Abstract
Marginal zone lymphoma (MZL) is commonly underrepresented in clinical trials collectively studying mostly nodal indolent lymphomas.In this manuscript we propose new inclusion and response criteria defined by MZL subtype and disease location for those with extranodal MZL. Progression of disease within 24 months is associated with poor outcomes in MZL and future studies should assess the efficacy of novel agents in this population.
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Affiliation(s)
- Juan Pablo Alderuccio
- Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Russ Kuker
- Division of Nuclear Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Craig H. Moskowitz
- Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew D. Zelenetz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Izidore S. Lossos
- Division of Hematology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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The Biology of Ocular Adnexal Marginal Zone Lymphomas. Cancers (Basel) 2022; 14:cancers14051264. [PMID: 35267569 PMCID: PMC8908984 DOI: 10.3390/cancers14051264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/06/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
This review focuses on the biology of ocular adnexal marginal zone B-cell lymphomas of the mucosa-associated lymphatic tissue (MALT) (OAMZL) subtype. The ocular adnexa includes all structures and tissues within the orbit except for the eye bulb. In the region of the ocular adnexa, MALT lymphomas represent the most common subtype of lymphoma, accounting for around 8% of all non-Hodgkin lymphomas. These lymphomas are often preceded by inflammatory precursor lesions. Either autoantigens or infectious antigens may lead to disease development by functioning as continuous antigenic triggers. This triggering leads to a constitutive activation of the NF-κB signaling pathway. The role of antigenic stimulation in the pathogenesis of OAMZL is supported by the detection of somatic mutations (partially with further intraclonal diversity) in their rearranged immunoglobulin V genes; hence, their derivation from germinal-center-experienced B cells, by a restricted IGHV gene usage, and the validation of autoreactivity of the antibodies in selected cases. In the established lymphomas, NF-κB activity is further enforced by mutations in various genes regulating NF-κB activity (e.g., TNFAIP3, MYD88), as well as recurrent chromosomal translocations affecting NF-κB pathway components in a subset of cases. Further pathogenetic mechanisms include mutations in genes of the NOTCH pathway, and of epigenetic regulators. While gene expression and sequencing studies are available, the role of differential methylation of lymphoma cells, the role of micro-RNAs, and the contribution of the microenvironment remain largely unexplored.
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Affiliation(s)
- Davide Rossi
- From the International Extranodal Lymphoma Study Group, Bellinzona; the Institute of Oncology Research, Bellinzona; the Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona; and the Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano - all in Switzerland
| | - Francesco Bertoni
- From the International Extranodal Lymphoma Study Group, Bellinzona; the Institute of Oncology Research, Bellinzona; the Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona; and the Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano - all in Switzerland
| | - Emanuele Zucca
- From the International Extranodal Lymphoma Study Group, Bellinzona; the Institute of Oncology Research, Bellinzona; the Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona; and the Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano - all in Switzerland
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