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Huang H, Mu Y, Li S. The biological function of Serpinb9 and Serpinb9-based therapy. Front Immunol 2024; 15:1422113. [PMID: 38966643 PMCID: PMC11222584 DOI: 10.3389/fimmu.2024.1422113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
Recent breakthroughs in discovering novel immune signaling pathways have revolutionized different disease treatments. SERPINB9 (Sb9), also known as Proteinase Inhibitor 9 (PI-9), is a well-known endogenous inhibitor of Granzyme B (GzmB). GzmB is a potent cytotoxic molecule secreted by cytotoxic T lymphocytes and natural killer cells, which plays a crucial role in inducing apoptosis in target cells during immune responses. Sb9 acts as a protective mechanism against the potentially harmful effects of GzmB within the cells of the immune system itself. On the other hand, overexpression of Sb9 is an important mechanism of immune evasion in diseases like cancers and viral infections. The intricate functions of Sb9 in different cell types represent a fine-tuned regulatory mechanism for preventing immunopathology, protection against autoimmune diseases, and the regulation of cell death, all of which are essential for maintaining health and responding effectively to disease challenges. Dysregulation of the Sb9 will disrupt human normal physiological condition, potentially leading to a range of diseases, including cancers, inflammatory conditions, viral infections or other pathological disorders. Deepening our understanding of the role of Sb9 will aid in the discovery of innovative and effective treatments for various medical conditions. Therefore, the objective of this review is to consolidate current knowledge regarding the biological role of Sb9. It aims to offer insights into its discovery, structure, functions, distribution, its association with various diseases, and the potential of nanoparticle-based therapies targeting Sb9.
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Affiliation(s)
- Haozhe Huang
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yiqing Mu
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, United States
| | - Song Li
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, United States
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, United States
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Montalvo MJ, Bandey IN, Rezvan A, Wu KL, Saeedi A, Kulkarni R, Li Y, An X, Sefat KMSR, Varadarajan N. Decoding the mechanisms of chimeric antigen receptor (CAR) T cell-mediated killing of tumors: insights from granzyme and Fas inhibition. Cell Death Dis 2024; 15:109. [PMID: 38307835 PMCID: PMC10837176 DOI: 10.1038/s41419-024-06461-8] [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: 09/04/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/04/2024]
Abstract
Chimeric antigen receptor (CAR) T cell show promise in cancer treatments, but their mechanism of action is not well understood. Decoding the mechanisms used by individual T cells can help improve the efficacy of T cells while also identifying mechanisms of T cell failure leading to tumor escape. Here, we used a suite of assays including dynamic single-cell imaging of cell-cell interactions, dynamic imaging of fluorescent reporters to directly track cytotoxin activity in tumor cells, and scRNA-seq on patient infusion products to investigate the cytotoxic mechanisms used by individual CAR T cells in killing tumor cells. We show that surprisingly, overexpression of the Granzyme B (GZMB) inhibitor, protease inhibitor-9 (PI9), does not alter the cytotoxicity mediated by CD19-specific CAR T cells against either the leukemic cell line, NALM6; or the ovarian cancer cell line, SkOV3-CD19. We designed and validated reporters to directly assay T cell delivered GZMB activity in tumor cells and confirmed that while PI9 overexpression inhibits GZMB activity at the molecular level, this is not sufficient to impact the kinetics or magnitude of killing mediated by the CAR T cells. Altering cytotoxicity mediated by CAR T cells required combined inhibition of multiple pathways that are tumor cell specific: (a) B-cell lines like NALM6, Raji and Daudi were sensitive to combined GZMB and granzyme A (GZMA) inhibition; whereas (b) solid tumor targets like SkOV3-CD19 and A375-CD19 (melanoma) were sensitive to combined GZMB and Fas ligand inhibition. We realized the translational relevance of these findings by examining the scRNA-seq profiles of Tisa-cel and Axi-cel infusion products and show a significant correlation between GZMB and GZMA expression at the single-cell level in a T cell subset-dependent manner. Our findings highlight the importance of the redundancy in killing mechanisms of CAR T cells and how this redundancy is important for efficacious T cells.
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Affiliation(s)
- Melisa J Montalvo
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Irfan N Bandey
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Ali Rezvan
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Kwan-Ling Wu
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Arash Saeedi
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Rohan Kulkarni
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Yongshuai Li
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Xingyue An
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - K M Samiur Rahman Sefat
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Navin Varadarajan
- William A. Brookshire Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA.
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Kimman T, Slomp A, Martens A, Grabherr S, Li S, van Diest E, Meeldijk J, Kuball J, Minnema MC, Eldering E, Bovenschen N, Sebestyén Z, Peperzak V. Serpin B9 controls tumor cell killing by CAR T cells. J Immunother Cancer 2023; 11:jitc-2022-006364. [PMID: 36931661 PMCID: PMC10030924 DOI: 10.1136/jitc-2022-006364] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Initial clinical responses with gene engineered chimeric antigen receptor (CAR) T cells in cancer patients are highly encouraging; however, primary resistance and also relapse may prevent durable remission in a substantial part of the patients. One of the underlying causes is the resistance mechanisms in cancer cells that limit effective killing by CAR T cells. CAR T cells exert their cytotoxic function through secretion of granzymes and perforin. Inhibition of granzyme B (GrB) can underlie resistance to T cell-mediated killing, and it has been shown that serine proteinase inhibitor serpin B9 can effectively inhibit GrB. We aimed to determine whether expression of serpin B9 by cancer cells can lead to resistance toward CAR T cells. METHODS Serpin B9 gene and protein expression were examined by R2 or DepMap database mining and by western blot or flow cytometric analysis, respectively. Coculture killing experiments were performed with melanoma cell line MeWo, diffuse large B cell lymphoma (DLBCL) cell line OCI-Ly7 or primary chronic lymphocytic leukemia (CLL) cells as target cells and natural killer cell line YT-Indy, CD20 CAR T cells or CD19 CAR T cells as effector cells and analyzed by flow cytometry. RESULTS Serpin B9 protein expression was previously shown to be associated with clinical outcome in melanoma patients and in line with these observations we demonstrate that enforced serpin B9 expression in melanoma cells reduces sensitivity to GrB-mediated killing. Next, we examined serpin B9 expression in a wide array of primary tumor tissues and human cell lines to find that serpin B9 is uniformly expressed in B-cell lymphomas and most prominently in DLBCL and CLL. Subsequently, using small interfering RNA, we silenced serpin B9 expression in DLBCL cells, which increased their sensitivity to CD20 CAR T cell-mediated killing. In addition, we showed that co-ulture of primary CLL cells with CD20 CAR T cells results in selection of serpin B9-high CLL cells, suggesting these cells resist CAR T-cell killing. CONCLUSIONS Overall, the data indicate that serpin B9 is a resistance mediator for CAR T cell-mediated tumor cell killing that should be inhibited or bypassed to improve CAR T-cell responses.
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Affiliation(s)
- Thomas Kimman
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
| | - Anne Slomp
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
| | - Anne Martens
- Department of Experimental Immunology, Amsterdam University Medical Centres, Duivendrecht, Netherlands
| | - Sarah Grabherr
- Institute of Immunobiology, Medical Research Center, Kantonsspital St Gallen, Sankt Gallen, Switzerland
| | - Shuang Li
- Department of Pathology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Eline van Diest
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
| | - Jan Meeldijk
- Center for Translational Immunology and Department of Pathology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Jurgen Kuball
- Center for Translational Immunology and Department of Hematology, University Medical Centre Utrecht, Utrecht, Netherlands
- Utrecht University, Utrecht, Netherlands
| | - Monique C Minnema
- Utrecht University, Utrecht, Netherlands
- Department of Hematology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Eric Eldering
- Department of Experimental Immunology, Amsterdam University Medical Centres, Duivendrecht, Netherlands
- University of Amsterdam, Amsterdam, Netherlands
| | - Niels Bovenschen
- Center for Translational Immunology and Department of Pathology, University Medical Centre Utrecht, Utrecht, Netherlands
- Utrecht University, Utrecht, Netherlands
| | - Zsolt Sebestyén
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
- Utrecht University, Utrecht, Netherlands
| | - Victor Peperzak
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Utrecht, Netherlands
- Utrecht University, Utrecht, Netherlands
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Kumar C, Jain G, Gupta A, Pramanik R, Chopra A. Extra-nasal NK-T Cell Lymphoma: A rare case with a rarer presentation. Cytopathology 2022; 33:518-521. [PMID: 34995382 DOI: 10.1111/cyt.13095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chandan Kumar
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Jain
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Anshul Gupta
- Medical Oncology Department, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Raja Pramanik
- Medical Oncology Department, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Laboratory Oncology unit, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
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Wang WJ, Wang J, Ouyang C, Chen C, Xu XF, Ye XQ. Overview of serpin B9 and its roles in cancer (Review). Oncol Rep 2021; 46:190. [PMID: 34278491 DOI: 10.3892/or.2021.8141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022] Open
Abstract
Serine proteinase inhibitor B9 (serpin B9) is a member of the serine protease inhibitor superfamily, which is widely found in animals, plants and microorganisms. Serpin B9 has been reported to protect cells from the immune‑killing effect of granzyme B (GrB) released by lymphocytes. In recent years, an increasing number of studies have indicated that serpin B9 is involved in tumour apoptosis, immune evasion, tumorigenesis, progression, metastasis, drug resistance and even in maintaining the stemness of cancer stem cells (CSCs). Moreover, according to clinical studies, serpin B9 has been demonstrated to be significantly associated with the development of precancerous lesions, a poor prognosis and ineffective therapies, suggesting that serpin B9 may be a potential target for cancer treatment and an indicator of cancer diagnosis; thus, it has begun to attract increased attention from scholars. The present review concisely described the structure and biological functions of the serpin superfamily and serpin B9. In addition, related research on serpins in cancer is discussed in order to provide a comprehensive understanding of the role of serpin B9 in cancer, as well as its clinical significance for cancer diagnosis and prognosis.
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Affiliation(s)
- Wen-Jun Wang
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jiao Wang
- Department of Respiratory Diseases, Jiujiang First People's Hospital, Jiujiang, Jiangxi 332000, P.R. China
| | - Chao Ouyang
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Chong Chen
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xiao-Feng Xu
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xiao-Qun Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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CD1d expression and invariant natural killer T-cell numbers are reduced in patients with upper gastrointestinal cancers and are further impaired by commonly used chemotherapies. Cancer Immunol Immunother 2020; 69:969-982. [DOI: 10.1007/s00262-020-02514-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 02/02/2020] [Indexed: 12/24/2022]
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IL-13 Contributes to Drug Resistance of NK/T-Cell Lymphoma Cells by Regulating ABCC4. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2606834. [PMID: 30643796 PMCID: PMC6311311 DOI: 10.1155/2018/2606834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/08/2018] [Accepted: 12/02/2018] [Indexed: 12/18/2022]
Abstract
Background Extranodal natural killer/T (NK/T) cell lymphoma, nasal type (ENKTL), represents a rare subtype of T-cell lymphomas with aggressive clinical behavior and is relatively resistant to chemotherapy. However, there is relatively poor understanding of molecular pathogenesis of multidrug resistance in ENKTL. Here, we aimed to explore the biological roles and potential mechanism of IL-13 and ABCC4 in multidrug resistance of NK/T-cell lymphoma. Methods ELISA analysis was used to determine the level of serum IL-13 and immunohistochemical analysis was applied to detect the ABCC4 expression level in patients with human NK/T-cell lymphoma. Western blot assay was employed to measure the expression of ABCC4 in cells. Lenti-sh-ABCC4 viruses were constructed to knock down ABCC4 in YTS cells. CCK-8 assay and flow cytometric analysis were performed to detect the effects of IL-13 and ABCC4 on cell proliferation and apoptosis. CCK-8 assay was conducted to detect the effect of IL-13 and ABCC4 on cell sensitivity to adriamycin (ADM) in YTS cells. Results Levels of serum IL-13 and ABCC4 expression were observed to be upregulated in patients with human NK/T-cell lymphoma. Moreover, ABCC4 protein expression was also increased in NK/T-cell lymphoma YTS cells compared to the normal NK cells. Interestingly, IL-13 promoted ABCC4 expression in YTS cells. IL-13 promoted proliferation and suppressed apoptosis of YTS cells and reversed the effects of ABCC4 knockdown on promotive proliferation and inhibitory apoptosis. In addition, IL-13 enhanced YTS cell chemotherapy resistance to ADM by promoting ABCC4 expression. Conclusion Our findings concluded that IL-13 inhibited chemotherapy sensitivity of NK/T-cell lymphoma cells by regulating ABCC4, disrupting which may effectively improve the therapy protocols against resistant NK/T-cell lymphoma.
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Yamaguchi M, Oguchi M, Suzuki R. Extranodal NK/T-cell lymphoma: Updates in biology and management strategies. Best Pract Res Clin Haematol 2018; 31:315-321. [PMID: 30213402 DOI: 10.1016/j.beha.2018.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/15/2018] [Accepted: 07/02/2018] [Indexed: 12/21/2022]
Abstract
Extranodal NK/T-cell lymphoma, nasal type (ENKL), is a rare lymphoma subtype of peripheral T/NK-cell lymphoma that is very common in East Asia and Latin America. Two-thirds of patients have localized disease in the nasal cavity or adjacent sites. Large retrospective studies have revealed the clinicopathologic features of ENKL patients, identified risk factors for short survival time, and developed prognostic models. Next-generation sequencing studies have provided a comprehensive list of recurrent mutations in ENKL. Since the early 2000s, disease-specific therapeutic approaches have been developed, and the standard of care for ENKL has markedly changed. Non-anthracycline-containing chemotherapy with or without radiotherapy is the current standard approach for ENKL treatment. Emerging therapies, including the use of immune checkpoint inhibitors, are being investigated.
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Affiliation(s)
- Motoko Yamaguchi
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan.
| | - Masahiko Oguchi
- Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ritsuro Suzuki
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
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Liu X, Huang E, Wang Y, He Y, Luo H, Zhong M, Qiu D, Li C, Yang H, He G, Zhou J, Jin F. Dosimetric comparison of helical tomotherapy, VMAT, fixed-field IMRT and 3D-conformal radiotherapy for stage I-II nasal natural killer T-cell lymphoma. Radiat Oncol 2017; 12:76. [PMID: 28449713 PMCID: PMC5408431 DOI: 10.1186/s13014-017-0812-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 04/25/2017] [Indexed: 01/15/2023] Open
Abstract
Background The aim of this study was to compare radiotherapy plans for Stage I-II nasal natural killer/T-cell lymphoma (NNKTL) using helical tomotherapy (HT), volumetric-modulated arc therapy (VMAT), Fixed-Field intensity-modulated radiotherapy (IMRT), and three-dimensional conformal radiotherapy (3D-CRT). Methods Eight patents with Stage I-II NNKTL treated with IMRT were re-planned for HT, VMAT (two full arcs), and 3D-CRT. The quality of target coverage, the exposure of normal tissue and the efficiency of radiation delivery were analyzed. Results HT showed significant improvement over IMRT in terms of D98%, cold spot volume and homogeneity index (HI) of planning target volume (PTV). VMAT provided best dose uniformity (p = 0.000) to PTV, while HT had best dose homogeneity among the four radiotherapy techniques (p = 0.000) to PTV. VMAT obviously reduced treatment time (p = 0.010; 0.000) compared to HT and IMRT. Mean dose of left and right optic nerve was significantly reduced by IMRT compared to HT (19.86%, p = 0.000; 21.40%, p = 0.002) and VMAT (8.97%, p = 0.002; 9.35%, p = 0.001), and maximum dose of left lens of VMAT increased over the HT (36.25%, p = 0.043) and IMRT (40.65%, p = 0.001). Conclusion The unexpected results show that both HT and VMAT can achieve higher conformal treatment plans while getting worse organs at risk (OARs) sparing than IMRT for patients with Stage I-II NNKTL. VMAT requires the shortest delivery time, and IMRT delivers the lowest dose to most OARs. The results could provide guidance for selecting proper radiation technologies for different cases.
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Affiliation(s)
- Xianfeng Liu
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Erliang Huang
- Department of Medical Equipment Guangzhou Women and Children's Medical Center, Guangzhou, 510623, People's Republic of China
| | - Ying Wang
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Yanan He
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Huanli Luo
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Mingsong Zhong
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Da Qiu
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Chao Li
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Han Yang
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Guanglei He
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China
| | - Juan Zhou
- Forensic Identification Center, College of Criminal Investigation, Southwest University of Political Science and Law, Chongqing, People's Republic of China
| | - Fu Jin
- Department of Radiation Oncology, Chongqing Cancer Institute & Hospital & Cancer Center, Shapingba District, Chongqing, 400030, China.
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Yamaguchi M, Suzuki R, Oguchi M, Asano N, Amaki J, Akiba T, Maeda T, Itasaka S, Kubota N, Saito Y, Kobayashi Y, Itami J, Ueda K, Miyazaki K, Ii N, Tomita N, Sekiguchi N, Takizawa J, Saito B, Murayama T, Ando T, Wada H, Hyo R, Ejima Y, Hasegawa M, Katayama N. Treatments and Outcomes of Patients With Extranodal Natural Killer/T-Cell Lymphoma Diagnosed Between 2000 and 2013: A Cooperative Study in Japan. J Clin Oncol 2017; 35:32-39. [DOI: 10.1200/jco.2016.68.1619] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To elucidate the management and outcomes of patients with extranodal natural killer/T-cell lymphoma, nasal type (ENKL), who were diagnosed between 2000 and 2013 in Japan. Patients and Methods Data from 358 patients with ENKL diagnosed between 2000 and 2013 from 31 institutes were retrospectively analyzed. Results Patients’ median age was 58 years, and 257 (72%) had localized disease. The most common first-line treatment was radiotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin (RT-DeVIC) (66%) for localized ENKL and L-asparaginase–containing chemotherapy (30%) for advanced ENKL. With a median follow-up of 5.8 years, overall survival (OS) rates at 5 years for localized and advanced ENKL were 68% and 24%, respectively. The prognostic index of natural killer lymphoma was validated in our study, although only 4% of patients with localized ENKL were classified as high risk. With a median follow-up of 5.6 years, OS and progression-free survival at 5 years in the 150 patients who received RT-DeVIC in clinical practice were 72% (95% CI, 63% to 78%) and 61% (95% CI, 52% to 69%), respectively. Toxicities of RT-DeVIC were comparable to those in a previous trial. Multivariate analysis in patients with localized ENKL who received RT-DeVIC identified elevated soluble interleukin-2 receptor as an independent predictive factor for worse OS and progression-free survival (adjusted hazard ratios, 2.28 and 2.46; 95% CI, 1.24 to 4.23 and 1.42 to 4.28; P = .008 and .0014, respectively). Conclusion Favorable OS in response to new treatments was demonstrated in a large number of patients. Improved treatment approaches are needed for localized ENKL exhibiting elevated pretreatment soluble interleukin-2 receptor.
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Affiliation(s)
- Motoko Yamaguchi
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Ritsuro Suzuki
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Masahiko Oguchi
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Naoko Asano
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Jun Amaki
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Takeshi Akiba
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Takeshi Maeda
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Satoshi Itasaka
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Nobuko Kubota
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Yoshihiro Saito
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Yukio Kobayashi
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Jun Itami
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Kyoko Ueda
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Kana Miyazaki
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Noriko Ii
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Naoto Tomita
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Nodoka Sekiguchi
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Jun Takizawa
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Bungo Saito
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Tohru Murayama
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Toshihiko Ando
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Hideho Wada
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Rie Hyo
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Yasuo Ejima
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Masatoshi Hasegawa
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
| | - Naoyuki Katayama
- Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of
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11
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Wang H, Li P, Zhang X, Xia Z, Lu Y, Huang H. Histological vascular invasion is a novel prognostic indicator in extranodal natural killer/T-cell lymphoma, nasal type. Oncol Lett 2016; 12:825-836. [PMID: 27446357 PMCID: PMC4950690 DOI: 10.3892/ol.2016.4691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/15/2016] [Indexed: 01/01/2023] Open
Abstract
Extranodal natural killer (NK)/T-cell lymphoma, (ENKTL), nasal type, is an aggressive lymphoma with no validated prognostic parameters, to date. In the present study, vascular invasion by this tumor was retrospectively analyzed in 214 patients with untreated ENKTL to evaluate its association with clinical features, treatment response and prognosis. Histological vascular invasion by the tumor was confirmed in 32.7% of patients with ENKTL. The presence of vascular invasion significantly correlated with poor performance status, B symptoms, extranodal involved sites, advanced stage, elevated serum lactate dehydrogenase, D-dimer and cluster of differentiation 68+ tumor-associated macrophages. Upon treatment termination, the complete remission (CR) rate and overall response rate were significantly lower for the vascular invasion group compared with the non-vascular invasion group. Furthermore, vascular invasion resulted in significantly reduced 5-year progression-free survival (PFS; 21.8 vs. 60.1%) and overall survival (OS; 36.8 vs. 77.0%) rates. Using the multivariate Cox regression model, vascular invasion, stage III/IV and CR after chemotherapy were independent prognostic factors for OS and PFS. Thus, histological vascular invasion by the tumor affected the response to treatment, and was also an independent prognostic factor for OS and PFS in ENKTL, nasal type, suggesting a role for vascular invasion in disease progression.
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Affiliation(s)
- Hua Wang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Pengfei Li
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Xinke Zhang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Pathology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Zhongjun Xia
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Yue Lu
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Huiqiang Huang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China; Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
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12
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van Kempen PMW, Noorlag R, Swartz JE, Bovenschen N, Braunius WW, Vermeulen JF, Van Cann EM, Grolman W, Willems SM. Oropharyngeal squamous cell carcinomas differentially express granzyme inhibitors. Cancer Immunol Immunother 2016; 65:575-85. [PMID: 26993499 PMCID: PMC4840222 DOI: 10.1007/s00262-016-1819-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 02/26/2016] [Indexed: 01/10/2023]
Abstract
Objectives Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs) have an improved prognosis compared to HPV-negative OPSCCs. Several theories have been proposed to explain this relatively good prognosis. One hypothesis is a difference in immune response. In this study, we compared tumor-infiltrating CD3+, CD4+, CD8+ T-cells, and granzyme inhibitors (SERPINB1, SERPINB4, and SERPINB9) between HPV-positive and HPV-negative tumors and the relation with survival. Methods Protein expression of tumor-infiltrating lymphocytes (TILs) (CD3, CD4, and CD8) and granzyme inhibitors was analyzed in 262 OPSCCs by immunohistochemistry (IHC). Most patients (67 %) received primary radiotherapy with or without chemotherapy. Cox regression analysis was carried out to compare overall survival (OS) of patients with low and high TIL infiltration and expression of granzyme inhibitors. Results HPV-positive OPSCCs were significantly more heavily infiltrated by TILs (p < 0.001) compared to HPV-negative OPSCCs. A high level of CD3+ TILs was correlated with a favorable outcome in the total cohort and in HPV-positive OPSCCs, while it reached no significance in HPV-negative OPSCCs. There was expression of all three granzyme inhibitors in OPSCCs. No differences in expression were found between HPV-positive and HPV-negative OPSCCs. Within the group of HPV-positive tumors, a high expression of SERPINB1 was associated with a significantly worse overall survival. Conclusion HPV-positive OPSCCs with a low count of CD3+ TILs or high expression of SERPINB1 have a worse OS, comparable with HPV-negative OPSCCs. This suggests that the immune system plays an important role in the carcinogenesis of the virally induced oropharynx tumors.
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Affiliation(s)
- Pauline M W van Kempen
- Department of Otorhinolaryngology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Rob Noorlag
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Justin E Swartz
- Department of Otorhinolaryngology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Niels Bovenschen
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Weibel W Braunius
- Department of Otorhinolaryngology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Department of Head and Neck Surgical Oncology, Cancer Center University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jeroen F Vermeulen
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Ellen M Van Cann
- Department of Head and Neck Surgical Oncology, Cancer Center University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Laboratory of Translational Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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13
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Huang Y, Xie J, Ding Y, Zhou X. Extranodal Natural Killer/T-Cell Lymphoma in Children and Adolescents: A Report of 17 Cases in China. Am J Clin Pathol 2016; 145:46-54. [PMID: 26712870 DOI: 10.1093/ajcp/aqv010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To investigate the clinicopathologic features of extranodal natural killer/T-cell lymphoma (ENKTL) not preceded by another Epstein-Barr virus (EBV)-related disorder in children and adolescents. METHODS A series of 17 cases of ENKTL not preceded by another EBV-related disorder in children and adolescents in one institution from China was retrospectively analyzed. RESULTS The patients had a median age of 13 years (range, 2-17 years), and the male to female ratio was 3.25:1. All the patients were of Chinese origin and without a history of another EBV-related disorder. The upper aerodigestive tract was involved in 14 (82.4%) cases, of which the sinonasal region was involved in 10 (58.8%) cases. Twelve (70.6%) patients had stage I/II disease. Morphologically, coagulative necrosis and angiocentric/angiodestructive growth pattern were observed in 94.1% (16/17) and 88.2% (15/17) of all cases, respectively. Thirteen (76.5%) cases were mainly composed of medium-sized cells. All cases expressed cytoplasmic CD3 and at least one marker for cytotoxic granules. CD56 expression was seen in 16 (94.1%) of 17 cases. Each case harbored EBV. CONCLUSIONS ENKTL not preceded by another EBV-related disorder in children and adolescents is occasionally observed in China. It tends to have a male predominance. The upper aerodigestive tract, especially the sinonasal region, is the most commonly involved site. The morphologic features and immunophenotype in children and adolescents are similar to that occurring in adults.
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Affiliation(s)
- Yuhua Huang
- From the Department of Pathology, Beijing Friendship Hospital, Capital Medical University Beijing, China; Department of Pathology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Jianlan Xie
- From the Department of Pathology, Beijing Friendship Hospital, Capital Medical University Beijing, China
| | - Yi Ding
- From the Department of Pathology, Beijing Friendship Hospital, Capital Medical University Beijing, China; Department of Pathology, the First Affiliated Hospital of Xiamen University, China
| | - Xiaoge Zhou
- From the Department of Pathology, Beijing Friendship Hospital, Capital Medical University Beijing, China;
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14
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Wang L, Wang Z, Xia ZJ, Lu Y, Huang HQ, Zhang YJ. CD56-negative extranodal NK/T cell lymphoma should be regarded as a distinct subtype with poor prognosis. Tumour Biol 2015; 36:7717-23. [PMID: 25935537 DOI: 10.1007/s13277-015-3485-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/21/2015] [Indexed: 01/20/2023] Open
Abstract
Previous results about the clinical and prognostic significance concerning CD56 expression status in extranodal NK/T cell lymphoma (ENKTL) are controversial due to a small sample size and the heterogeneity nature of this disease. The complete data of 288 patients with early-stage upper aerodigestive tract ENKTL were retrospectively reviewed. One hundred eighty-three patients (63.5 %) had stage I disease, and the primary tumor site of 204 patients (70.8 %) was in the nasal cavity. Sixty patients (20.8 %) were categorized to CD56-negative ENKTL group. The complete remission rate in CD56-positive ENKTL group was 80.6 %, significantly higher than that in CD56-negative ENKTL group (60.8 %, P = 0.005). At a median follow-up time of 69 months, the 5-year and 10-year progression-free survival (PFS) rate were 52 and 41 %, respectively, and the 5-year and 10-year overall survival (OS) rate were 69 % and 68 %, respectively. Patients with primary tumor site located in the nasal cavity or CD56-positive expression had significantly superior PFS and OS (P < 0.05). In multivariate Cox regression model that included age, Ann Arbor stage, lactate dehydrogenase (LDH) level, primary tumor site, chemotherapy regimens, and CD56 expression status, all these six factors remained to be independent prognostic factors for PFS, and the first five factors were independent prognostic factors for OS, while CD56 expression status had a trend to be independently correlated with OS (P = 0.084). In a subgroup analysis according to primary tumor site location, CD56 expression status significantly correlated with survival outcomes in patients with primary nasal cavity involvement (P < 0.05). In conclusion, in this large cohort of patients with early-stage ENKTL, we found that CD56-negative ENKTL had significantly inferior survival outcomes, indicating CD56-negative ENKTL should be regarded as a distinct phenotype, and optimal treatment strategies need to be evaluated further for this entity.
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Affiliation(s)
- Liang Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.,Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Zhao Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Zhong-Jun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.,Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Yue Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.,Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Hui-Qiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Yu-Jing Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China. .,Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China.
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15
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Park S, Ko YH. Epstein-Barr virus-associated T/natural killer-cell lymphoproliferative disorders. J Dermatol 2015; 41:29-39. [PMID: 24438142 DOI: 10.1111/1346-8138.12322] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/19/2013] [Indexed: 12/22/2022]
Abstract
Primary infection with Epstein-Barr virus (EBV) is usually asymptomatic and, in a normal host, EBV remains latent in B cells after primary infection for the remainder of life. Uncommonly, EBV can infect T or natural killer (NK) cells in a person with a defect in innate immunity, and EBV infection can cause unique systemic lymphoproliferative diseases (LPD) of childhood. Primary infection in young children can be complicated by hemophagocytic lymphohistiocytosis or fulminant systemic T-cell LPD of childhood. Uncommonly, patients can develop chronic active EBV (CAEBV) disease-type T/NK LPD, which includes CAEBV infection of the systemic form, hydroa vacciniforme-like T-cell LPD, and mosquito-bite hypersensitivity. The clinical course of CAEBV disease-type T/NK LPD can be smoldering, persistent or progressive, depending on the balance between viral factors and host immunity. Aggressive NK-cell leukemia, hydroa vacciniforme-like T-cell lymphoma, or uncommonly extranodal NK/T-cell lymphoma can develop in children and young adults with CAEBV disease-type T/NK-cell LPD. Extranodal T/NK-cell lymphoma is a disease of adults, and its incidence begins to increase in the third decade and comprises the major subtype of T/NK LPD throughout life. Aggressive NK-cell leukemia and nodal T/NK-cell lymphoma of the elderly are fulminant diseases, and immune senescence may be an important pathogenetic factor. This review describes the current progress in identifying different types of EBV-associated T/NK-cell LPD and includes a brief presentation of data from Korea.
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Affiliation(s)
- Sanghui Park
- Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea
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16
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Perna SK, Huye LE, Savoldo B. Management of patients with non-Hodgkin's lymphoma: focus on adoptive T-cell therapy. Immunotargets Ther 2015; 4:55-63. [PMID: 27471712 PMCID: PMC4918257 DOI: 10.2147/itt.s31389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Non-Hodgkin’s lymphoma (NHL) represents a heterogeneous group of malignancies with high diversity in terms of biology, clinical responses, and prognosis. Standard therapy regimens produce a 5-year relative survival rate of only 69%, with the critical need to increase the treatment-success rate of this patient population presenting at diagnosis with a median age of 66 years and many comorbidities. The evidence that an impaired immune system favors the development of NHL has opened the stage for new therapeutics, and specifically for the adoptive transfer of ex vivo-expanded antigen-specific T-cells. In this review, we discuss how T-cells specific for viral-associated antigens, nonviral-associated antigens expressed by the tumor, T-cells redirected through the expression of chimeric antigen receptors, and transgenic T-cell receptors against tumor cells have been developed and used in clinical trials for the treatment of patients with NHLs.
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Affiliation(s)
- Serena Kimi Perna
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Leslie E Huye
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Barbara Savoldo
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston Methodist Hospital, Houston, TX, USA; Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
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Zhao Z, Liao Y, Li J, Wu J, Zhang Y, Feng G, Tan B, Reng S, Zhang Z, Feng X, Wang J, Du X. Association between higher expression of YB-1 and poor prognosis in early-stage extranodal nasal-type natural killer/T-cell lymphoma. Biomark Med 2014; 8:581-8. [PMID: 24796623 DOI: 10.2217/bmm.14.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Aim: A recent study shows that YB-1-related biomarkers affect the prognosis of patients with natural killer/T-cell lymphoma (NKTCL). The aim of this study was to determine whether there is an association between YB-1 expression and the prognosis of patients with early-stage extranodal nasal-type NKTCL. Materials & methods: To clarify the roles of YB-1 in early-stage extranodal nasal-type NKTCL, we used immunohistochemical studies to examine YB-1 expression in 36 early-stage extranodal nasal-type NKTCL specimens. Results: Subsequently, YB-1 expression was correlated with clinicopathologic parameters. Higher expression of YB-1 was associated with an increased potential for relapse, poor disease-free survival and reduced overall survival. Discussion: Higher expression of YB-1 could be an independent risk factor for poor prognosis in patients with early-stage extranodal nasal-type NKTCL. Understanding the biology of YB-1-mediated pathways may lead to novel therapeutic strategies for early-stage extranodal nasal-type NKTCL.
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Affiliation(s)
- Zhenhua Zhao
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
| | - Yao Liao
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
- The Second Internal Department, The Affiliated Tumor Hospital of Guangzhou Medical College, Guangzhou, People’s Republic of China
| | - Jie Li
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
- Department of Oncology, Attached Hospital to North Sichuan Medical College, Sichuan, People’s Republic of China
| | - Jingbo Wu
- Department of Oncology, Affiliated Hospital of Luzhou Medical College, Sichuan, People’s Republic of China
| | - Yu Zhang
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
| | - Gang Feng
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
| | - Bangxian Tan
- Department of Oncology, Attached Hospital to North Sichuan Medical College, Sichuan, People’s Republic of China
| | - Surong Reng
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
| | - Zhikui Zhang
- Guangzhou Kingmed Center For Clinical Laboratory, Guangzhou, People’s Republic of China
| | - Xioaodong Feng
- Guangzhou Kingmed Center For Clinical Laboratory, Guangzhou, People’s Republic of China
| | - Jin Wang
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
| | - Xiaobo Du
- Department of Oncology, Mian Yang Central Hospital, Sichuan, People’s Republic of China
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Fang H, Jin J, Wang WH, Wang SL, Zhou LQ, Li YX. Prognostic factors and treatment outcomes for patients with stage II extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract. Leuk Lymphoma 2014; 55:1832-7. [DOI: 10.3109/10428194.2013.852668] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Liu QF, Wang WH, Wang SL, Liu YP, Huang WT, Lu N, Zhou LQ, Ouyang H, Jin J, Li YX. Immunophenotypic and clinical differences between the nasal and extranasal subtypes of upper aerodigestive tract natural killer/T-cell lymphoma. Int J Radiat Oncol Biol Phys 2014; 88:806-13. [PMID: 24495590 DOI: 10.1016/j.ijrobp.2013.12.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/01/2013] [Accepted: 12/04/2013] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate, in a large cohort of patients, the immunophenotypic and clinical differences of nasal and extranasal extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract (UADT-NKTCL) and examine the relevance of the immunophenotype on the clinical behavior, prognosis, and treatment. METHODS AND MATERIALS A total of 231 patients with UADT-NKTCL were recruited. One hundred eighty-one patients had primary location in the nasal cavity (nasal UADT-NKTCL), and 50 patients had primary extranasal UADT-NKTCL. RESULTS Patients with extranasal UADT-NKTCL had more adverse clinical features, including advanced-stage disease, regional lymph node involvement, B symptoms, and poor performance status, than patients with nasal UADT-NKTCL. In addition, CD56 and granzyme B were less frequently expressed in extranasal UADT-NKTCL. The 5-year overall survival rate was 74.1% for the entire group and 76.0% for early-stage disease. The 5-year overall survival rate for extranasal UADT-NKTCL was similar or superior to that of nasal UADT-NKTCL for all disease stages (76.9% vs 73.4%, P=.465), stage I disease (75.9% vs 79.2%, P=.786), and stage II disease (83.3% vs 50.3%, P=.018). CD56 expression and a Ki-67 proliferation rate ≥ 50% predicted poorer survival for extranasal UADT-NKTCL but not for nasal UADT-NKTCL. CONCLUSIONS Patients with nasal and extranasal UADT-NKTCL have significantly different clinical features, immunophenotypes, and prognosis. Extranasal UADT-NKTCL should be considered as a distinct subgroup apart from the most commonly diagnosed prototype of nasal UADT-NKTCL.
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Affiliation(s)
- Qing-Feng Liu
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Wei-Hu Wang
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Shu-Lian Wang
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Yue-Ping Liu
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Wen-Ting Huang
- Department of Pathology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Ning Lu
- Department of Pathology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Li-Qiang Zhou
- Department of Medical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Han Ouyang
- Department of Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jing Jin
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Ye-Xiong Li
- Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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Abstract
PURPOSE OF REVIEW Extranodal natural killer (NK)/T-cell lymphoma, nasal-type is a highly aggressive disease more frequent in Asia than in Western countries. There is no consensus treatment. The outcome depends on disease stage. Localized NK/T-cell lymphomas often respond to radiotherapy. In contrast, patients who have extensive disease or who relapse after radiotherapy have a very poor prognosis. Overall, long-term survival in these lymphomas tends to be inferior to that for other aggressive lymphomas. This review focuses on the new management modalities in light of advances in risk stratification, patient monitoring and treatment strategies. RECENT FINDINGS Many parameters have been reported to correlate with prognosis and new staging systems have been elaborated. Detecting Epstein-Barr virus (EBV) in the bone marrow is important for staging and measuring EBV DNA in the serum improved monitoring response to therapy. Radiation modalities have been precised and new strategies combining radiation and chemotherapy have been proposed for patients with localized disease. The particular efficacy of L-asparaginase in this disease has been confirmed and L-asparaginase-based regimens have been studied in prospective trials for patients with refractory, relapsing or disseminated disease with good results. Laboratory studies may point the way toward new therapeutic approaches. SUMMARY Early-stage disease is treated by involved-field radiotherapy with adjuvant chemotherapy. L-Asparaginase-containing regimens are the mainstay of treatment for advanced or disseminated disease. The role of targeted therapies, autologous and allogeneic haematopoietic stem cell transplantation is yet to be clearly defined.
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JAK3 deregulation by activating mutations confers invasive growth advantage in extranodal nasal-type natural killer cell lymphoma. Leukemia 2013; 28:338-48. [PMID: 23689514 DOI: 10.1038/leu.2013.157] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/13/2013] [Accepted: 05/16/2013] [Indexed: 12/27/2022]
Abstract
Extranodal, nasal-type natural killer (NK)/T-cell lymphoma (NKCL) is an aggressive malignancy with poor prognosis in which, usually, signal transducer and activator of transcription 3 (STAT3) is constitutively activated and oncogenic. Here, we demonstrate that STAT3 activation mostly results from constitutive Janus kinase (JAK)3 phosphorylation on tyrosine 980, as observed in three of the four tested NKCL cell lines and in 20 of the 23 NKCL tumor samples under study. In one of the cell lines and in 4 of 19 (21%) NKCL primary tumor samples, constitutive JAK3 activation was related to an acquired mutation (A573V or V722I) in the JAK3 pseudokinase domain. We then show that constitutive activation of the JAK3/STAT3 pathway has a major role in NKCL cell growth and survival and in the invasive phenotype. Indeed, NKCL cell growth was slowed down in vitro by targeting JAK3 with chemical inhibitors or small-interfering RNAs. In a human NKCL xenograft mouse model, tumor growth was significantly delayed by the JAK3 inhibitor CP-690550. Altogether, the constitutive activation of JAK3, which can result from JAK3-activating mutations, is a frequent feature of NKCL that deserves to be tested as a therapeutic target.
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SerpinB1 is critical for neutrophil survival through cell-autonomous inhibition of cathepsin G. Blood 2013; 121:3900-7, S1-6. [PMID: 23532733 DOI: 10.1182/blood-2012-09-455022] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Bone marrow (BM) holds a large reserve of polymorphonuclear neutrophils (PMNs) that are rapidly mobilized to the circulation and tissues in response to danger signals. SerpinB1 is a potent inhibitor of neutrophil serine proteases neutrophil elastase (NE) and cathepsin G (CG). SerpinB1 deficiency (sB1(-/-)) results in a severe reduction of the BM PMN reserve and failure to clear bacterial infection. Using BM chimera, we found that serpinB1 deficiency in BM cells was necessary and sufficient to reproduce the BM neutropenia of sB1(-/-) mice. Moreover, we showed that genetic deletion of CG, but not NE, fully rescued the BM neutropenia in sB1(-/-) mice. In mixed BM chimera and in vitro survival studies, we showed that CG modulates sB1(-/-) PMN survival through a cell-intrinsic pathway. In addition, membrane permeabilization by lysosomotropic agent l-leucyl-l-leucine methyl ester that allows cytosolic release of granule contents was sufficient to induce rapid PMN death through a CG-dependent pathway. CG-mediated PMN cytotoxicity was only partly blocked by caspase inhibition, suggesting that CG cleaves a distinct set of targets during apoptosis. In conclusion, we have unveiled a new cytotoxic function for the serine protease CG and showed that serpinB1 is critical for maintaining PMN survival by antagonizing intracellular CG activity.
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Huang Y, de Leval L, Gaulard P. Molecular underpinning of extranodal NK/T-cell lymphoma. Best Pract Res Clin Haematol 2013; 26:57-74. [DOI: 10.1016/j.beha.2013.04.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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24
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Improving the Therapeutic Potential of Human Granzyme B for Targeted Cancer Therapy. Antibodies (Basel) 2013. [DOI: 10.3390/antib2010019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Extranodal NK/T-cell lymphoma, nasal type: a report of 73 cases at MD Anderson Cancer Center. Am J Surg Pathol 2013; 37:14-23. [PMID: 23232851 DOI: 10.1097/pas.0b013e31826731b5] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Extranodal NK/T-cell lymphoma, nasal type (ENKTL) is uncommon in the United States. We report 73 patients with ENKTL, including 49 men and 24 women (median age, 46 y). Sixty-three patients had nasal/upper aerodigestive tract disease; 10 had extranasal disease involving skin, small intestine, epiglottis, testis, adrenal glands, kidney, and breast. Complete staging data were available for 68 patients: 44 stage I/II and 24 stage IV. Fifteen of 69 (22%) had lymphadenopathy and 10/63 had bone marrow involvement. Histologically, 67/73 (92%) showed necrosis, and 48/70 (69%) had an angiocentric/angiodestructive growth pattern. The neoplastic cells showed a wide spectrum: medium sized (n=34), mixed small and large (n=21), large (n=13), and small (n=5). In situ hybridization for Epstein-Barr virus-encoded small RNA was positive in every case. Immunohistochemical studies showed expression of cytotoxic markers (100%), T-bet (96%), CD2 (96%), CD3 (93%), CD56 (90%), and ETS-1 (64%). Ki-67 was ≥60% in 46% cases. Therapy was known for 64 patients; 14 received only chemotherapy, 8 radiation alone, and 42 received combined radiation and chemotherapy. Median survival was 4.2 years, and 5-year overall survival was 46% (median follow-up, 3.8 y). Extranasal disease, high International Prognostic Index score, and high proliferation rate correlated with poorer prognosis. We conclude that ENKTL cases in the United States are similar to those reported in Asia and other countries. Absence of the angiocentric/angiodestructive pattern and presence of lymphadenopathy, features underemphasized in the literature, occurred in appreciable subsets of patients. The International Prognostic Index score, anatomic site of disease, and proliferation rate had prognostic value in this patient cohort.
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Increased proteinase inhibitor-9 (PI-9) and reduced granzyme B in lung cancer: Mechanism for immune evasion? Lung Cancer 2012; 77:38-45. [DOI: 10.1016/j.lungcan.2012.01.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 12/20/2011] [Accepted: 01/30/2012] [Indexed: 11/19/2022]
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Chauchet A, Michallet AS, Berger F, Bedgedjian I, Deconinck E, Sebban C, Antal D, Orfeuvre H, Corront B, Petrella T, Hacini M, Bouteloup M, Salles G, Coiffier B. Complete remission after first-line radio-chemotherapy as predictor of survival in extranodal NK/T cell lymphoma. J Hematol Oncol 2012; 5:27. [PMID: 22682004 PMCID: PMC3416641 DOI: 10.1186/1756-8722-5-27] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 06/08/2012] [Indexed: 01/06/2023] Open
Abstract
Background Extranodal nasal-type NK/T-cell lymphoma is a rare and severe disease. Considering the rarity of this lymphoma in Europe, we conducted a multicentric retrospective study on nasal-type NK/T cell lymphoma to determine the optimal induction strategy and identify prognostic factors. Methods Thirty-six adult patients with nasal-type NK/T-cell lymphoma were recruited and assessed. In total, 80 % of patients were classified as having upper aerodigestive tract NK/T-cell lymphoma (UNKTL) and 20 % extra-upper aerodigestive tract NK/T-cell lymphoma (EUNKTL). Results For advanced-stage disease, chemotherapy alone (CT) was the primary treatment (84 % vs. 10 % for combined CT + radiation therapy (RT), respectively), while for early-stage disease, 50 % of patients received the combination of CT + RT and 50 % CT alone. Five-year overall survival (OS) and progression-free survival (PFS) rates were 39 % and 33 %. Complete remission (CR) rates were significantly higher when using CT + RT (90 %) versus CT alone (33 %) (p < 0.0001). For early-stage disease, CR rates were 37 % for CT alone versus 100 % for CT + RT. Quality of response was significantly associated with survival, with 5-year OS being 80 % for CR patients versus 0 % for progressive disease patients (p < 0.01). Conclusion Early RT concomitantly or sequentially with CT led to improved patient outcomes, with quality of initial response being the most important prognosticator for 5-year OS.
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Affiliation(s)
- Adrien Chauchet
- Department of Hematology, Centre Hospitalier universitaire Lyon Sud, Pierre Benite, France
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Li YX, Wang H, Jin J, Wang WH, Liu QF, Song YW, Wang ZY, Qi SN, Wang SL, Liu YP, Liu XF, Yu ZH. Radiotherapy Alone With Curative Intent in Patients With Stage I Extranodal Nasal-Type NK/T-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2012; 82:1809-15. [DOI: 10.1016/j.ijrobp.2010.10.040] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/16/2010] [Accepted: 10/21/2010] [Indexed: 10/18/2022]
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Qi SN, Li YX, Wang WH, Jin J, Wang SL, Liu YP, Song YW, Fang H, Ren H, Lu NN, Liu QF, Wu RY, Zhang XM, Liu XF, Yu ZH. The extent of cutaneous lesions predicts outcome in extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract with secondary cutaneous involvement. Leuk Lymphoma 2011; 53:855-61. [PMID: 22035375 DOI: 10.3109/10428194.2011.634040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study determined the clinical characteristics and prognosis for patients with extranodal nasal-type natural killer/T-cell lymphoma (NKTCL) with secondary cutaneous involvement. Twenty-eight patients with NKTCL of the upper aerodigestive tract with secondary cutaneous involvement were reviewed. The median overall survival (OS) was 21.5 months from the first diagnosis, and 12.3 months from the presentation of a cutaneous lesion. The 5-year OS rate was 43.1% (median, 28 months) for patients with localized cutaneous disease compared with 0% (median, 3.6 months) for generalized cutaneous disease (p = 0.017). The 2-year OS rates were 67.5% for patients who achieved a complete response (CR) compared with 19.4% (median, 5.2 months) for patients who did not (p = 0.003). Patients with NKTCL with secondary cutaneous dissemination overall have a poor prognosis, but a relatively favorable prognosis was identified for the small subgroup of patients who had localized cutaneous lesions and achieved a CR.
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Affiliation(s)
- Shu-Nan Qi
- Department of Radiation Oncology, Chinese Academy of Medical Sciences, Beijing , People's Republic of China
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Phase 2 trial of “Sandwich”L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer 2011; 118:3294-301. [DOI: 10.1002/cncr.26629] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Revised: 08/08/2011] [Accepted: 09/14/2011] [Indexed: 11/07/2022]
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Paik JH, Jang JY, Jeon YK, Kim WY, Kim TM, Heo DS, Kim CW. MicroRNA-146a downregulates NFκB activity via targeting TRAF6 and functions as a tumor suppressor having strong prognostic implications in NK/T cell lymphoma. Clin Cancer Res 2011; 17:4761-71. [PMID: 21610143 DOI: 10.1158/1078-0432.ccr-11-0494] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE We investigated prognostic implications of microRNAs in extranodal NK/T cell lymphoma (NKTL). EXPERIMENTAL DESIGN We measured miRNA expression in NKTL tissues and cell lines, using real-time PCR, and analyzed its role in NKTL, using cell lines. RESULTS Multivariate analysis showed low miR-146a expression (P < 0.001; HR = 13.110), primary non-upper aerodigestive tract lesion (non-UAT; P = 0.008; HR = 5.376) and high International Prognostic Index (IPI; ≥3; P = 0.013; HR = 3.584) to be independent poor prognostic factors. miR-146a expression could subdivide UAT-NKTL into 2 prognostic groups, resulting in the following prognostic groups: (i) UAT(Low-146a), (ii) UAT(High-146a), and (iii) non-UAT. Compared with UAT(High-146a), UAT(Low-146a) showed distinctively poor prognosis (P < 0.001; HR = 15.620), similar to the non-UAT group. In vitro, miR-146a overexpression in NKTL cell lines, SNK6 and YT, inhibited nuclear factor κB (NFκB) activity, suppressed cell proliferation, induced apoptosis, and enhanced chemosensitivity. TNF receptor-associated factor 6, a target of miR-146a and a known NFκB activator, was downregulated by miR-146a in SNK6 and YT cells. Promoter methylation of miR-146a gene was observed in SNK6 and YT cells, as well as in NKTL tissues with low miR-146a expression, and miR-146a expression was induced by the conversion of methylation status with a demethylating agent in SNK6 and YT cells. CONCLUSIONS These results suggest that miR-146a might function as a potent tumor suppressor in NKTL and be useful for patient assessment and therapeutic targeting.
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Affiliation(s)
- Jin Ho Paik
- Department of Pathology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Li YX, Wang H, Feng XL, Liu QF, Wang WH, Lv N, Jin J, Wang SL, Liu YP, Fang H, Song YW, Liu XF, Zhou LQ, Wang ZY, Yu ZH. Immunophenotypic characteristics and clinical relevance of CD56+ and CD56- extranodal nasal-type natural killer/T-cell lymphoma. Leuk Lymphoma 2011; 52:417-24. [PMID: 21323521 DOI: 10.3109/10428194.2010.543718] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study aimed to determine whether the phenotypic characteristics of the two subtypes of CD56+ and CD56- lymphoma have relevance for their clinical behavior and prognosis. The immunophenotypes of all patients were confirmed using standard criteria for CD20, CD3ε, CD56, cytotoxic molecules (T-cell intracellular antigen-1 [TIA-1] and granzyme B), and Ki-67, and in situ hybridization for Epstein-Barr virus (EBV)-encoded RNA (EBER). CD56 was expressed in 90 of 118 (76.3%) patients. The majority (83.3%) of patients with nasal natural killer/T-cell lymphoma (NKTCL) presented with CD56+ lymphoma, whereas patients with NKTCL of the extranasal upper aerodigestive tract were more likely to have CD56- lymphoma (53.6%, p < 0.000). A lower percentage of expression of granzyme B and Ki-67 (>50%) was found in patients with CD56- lymphoma compared with those with CD56+ lymphoma (p <0.05). The clinical characteristics and prognosis were comparable between patients with CD56+ and CD56- lymphomas. The corresponding overall survival and progression-free survival rates were 74.1% and 56.7%, respectively, for patients with CD56+ lymphoma compared with 81.6% and 60.5% for those with CD56- lymphoma (p > 0.05). There was no clinical or prognostic significance in determining the two subtypes of CD56+ and CD56- NKTCL based on their immunophenotypic profiles, which has clinical implications for pathological diagnosis and insight into disease behavior.
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Affiliation(s)
- Ye-Xiong Li
- Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
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Li YX, Liu QF, Wang WH, Jin J, Song YW, Wang SL, Liu YP, Liu XF, Zhou LQ, Yu ZH. Failure patterns and clinical implications in early stage nasal natural killer/T-cell lymphoma treated with primary radiotherapy. Cancer 2011; 117:5203-11. [PMID: 21523771 DOI: 10.1002/cncr.26167] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 02/17/2011] [Accepted: 03/03/2011] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study aimed to evaluate the failure patterns and clinical implications in patients with early stage nasal natural killer (NK)/T-cell lymphoma treated with primary radiotherapy. METHODS Two-hundred fourteen patients were included. There were 182 cases of stage I and 32 cases of stage II disease. Patients received radiotherapy alone (n = 96) or radiotherapy and chemotherapy (n = 118). The median dose was 50 grays, and most patients received doxorubicin-based chemotherapy. RESULTS The 5-year overall survival (OS) and progression-free survival rates for all patients were 72% and 65%, respectively. Sixty-three patients experienced treatment failure. The 5-year cumulative incidences of locoregional, systemic, and overall failures were 12.0%, 25.5%, and 32.9%, respectively. Stage and paranasal extension were significant predictors for systemic failure. The 5-year cumulative incidence of systemic failure was 22.6% for stage I disease versus 42.7% for stage II disease (P < .001), and 16.9% for limited disease versus 30.4% for paranasal extension (P < .001), respectively. Adding chemotherapy to extended involved-field radiotherapy did not significantly decrease the systemic failure rate nor improve survival. The cumulative incidence of systemic failure and OS rate at 5 years were 24.1% and 74.4% for combined modality therapy compared with 28.5% (P = 0.758) and 69.8% (P = 0.529) for radiotherapy alone. A very low incidence of cervical lymph node or central nervous system relapse was observed. CONCLUSIONS Patients with early stage nasal NK/T-cell lymphoma have excellent locoregional control and favorable prognosis with radiotherapy, but patients with stage II disease or paranasal extension are at high risk of systemic failure, emphasizing the importance of integration of optimal radiotherapy with innovative systemic therapy.
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Affiliation(s)
- Ye-Xiong Li
- Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China.
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Extranodal NK/T-cell lymphoma: toward the identification of clinical molecular targets. J Biomed Biotechnol 2011; 2011:790871. [PMID: 21541194 PMCID: PMC3085502 DOI: 10.1155/2011/790871] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 02/24/2011] [Indexed: 02/08/2023] Open
Abstract
Extranodal natural killer (NK)/T-cell lymphoma of nasal type (NKTCL) is a malignant disorder of cytotoxic lymphocytes of NK or more rarely T cells associated with clonal Epstein-Barr virus infection. Extranodal NKTCL is rare in Western countries, but in Asia and Central and South America it can account for up to 10% of non-Hodgkin's lymphomas. It is an aggressive neoplasm with very poor prognosis. Although the pathogenesis of extranodal NKTCL remains poorly understood, some insights have been gained in the recent years, especially from genome-wide studies. Based on our own experience and knowledge of the literature, we here review some of the genomic and functional pathway alterations observed in NKTCL that could provide a rationale for the development of innovative therapeutic strategies.
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Dearden CE, Johnson R, Pettengell R, Devereux S, Cwynarski K, Whittaker S, McMillan A. Guidelines for the management of mature T-cell and NK-cell neoplasms (excluding cutaneous T-cell lymphoma). Br J Haematol 2011; 153:451-85. [PMID: 21480860 DOI: 10.1111/j.1365-2141.2011.08651.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The peripheral T-cell neoplasms are a biologically and clinically heterogeneous group of rare disorders that result from clonal proliferation of mature post-thymic lymphocytes. Natural killer (NK) cell neoplasms are included in this group. The World Health Organization classification of haemopoietic malignancies has divided this group of disorders into those with predominantly leukaemic (disseminated), nodal, extra-nodal or cutaneous presentation. They usually affect adults and are more commonly reported in males than in females. The median age at diagnosis is 61 years with a range of 17-90 years. Although some subtypes may follow a relatively benign protracted course most have an aggressive clinical behaviour and poor prognosis. Excluding anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL), which has a good outcome, 5-year survival for other nodal and extranodal T-cell lymphomas is about 30%. Most patients present with unfavourable international prognostic index scores (>3) and poor performance status. The rarity of these diseases and the lack of randomized trials mean that there is no consensus about optimal therapy for T- and NK-cell neoplasms and recommendations in this guideline are therefore based on small case series, phase II trials and expert opinion.
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Liao KA, Tsay YG, Huang LC, Huang HY, Li CF, Wu TF. Search for the Tumor-Associated Proteins of Oral Squamous Cell Carcinoma Collected in Taiwan using Proteomics Strategy. J Proteome Res 2011; 10:2347-58. [DOI: 10.1021/pr101146w] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kuo-An Liao
- Department of Oral and Maxillofacial Surgery, Chi-Mei Medical Center, Tainan, 710, Taiwan
| | - Yeou-Guang Tsay
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, 112, Taiwan
| | - Li-Chien Huang
- Department of Biotechnology, Southern Taiwan University, Tainan,710, Taiwan
| | - Hsuan-Ying Huang
- Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, 833, Taiwan
| | - Chien-Feng Li
- Department of Pathology, Chi-Mei Medical Center, Tainan, 710, Taiwan
- Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung, 804, Taiwan
| | - Ting-Feng Wu
- Department of Biotechnology, Southern Taiwan University, Tainan,710, Taiwan
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Ng SB, Selvarajan V, Huang G, Zhou J, Feldman AL, Law M, Kwong YL, Shimizu N, Kagami Y, Aozasa K, Salto-Tellez M, Chng WJ. Activated oncogenic pathways and therapeutic targets in extranodal nasal-type NK/T cell lymphoma revealed by gene expression profiling. J Pathol 2011; 223:496-510. [DOI: 10.1002/path.2823] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 11/03/2010] [Accepted: 11/04/2010] [Indexed: 11/10/2022]
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Yang H, Wu M, Yin W, Sun W, Zhang G. Diagnosis and treatment of a patient with primary gastric extranodal natural killer/T-cell lymphoma, nasal type. Leuk Lymphoma 2010; 51:2137-40. [PMID: 20858103 DOI: 10.3109/10428194.2010.512964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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39
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Les lymphomes, une pathologie en augmentation. ACTUALITES PHARMACEUTIQUES 2010. [DOI: 10.1016/s0515-3700(10)70752-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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40
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Wang ZY, Li YX, Wang H, Wang WH, Jin J, Liu YP, Song YW, Wang SL, Liu XF, Yu ZH. Unfavorable prognosis of elderly patients with early-stage extranodal nasal-type NK/T-cell lymphoma. Ann Oncol 2010; 22:390-6. [PMID: 20616195 DOI: 10.1093/annonc/mdq347] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Extranodal nasal-type NK (natural killer)/T-cell lymphoma in elderly patients is rare, and its prognosis is unclear. This study aims to investigate the clinical characteristics and prognosis of this lymphoma. PATIENTS AND METHODS We analyzed 24 patients (age, >60 years old) with early-stage extranodal nasal-type NK/T-cell lymphoma. Among these patients, 23 received radiotherapy alone (n = 15) or radiotherapy and chemotherapy (n = 8) and 1 received chemotherapy alone. RESULTS Elderly patients with early-stage extranodal nasal-type NK/T-cell lymphoma were characterized by male predominance, good performance, large proportion of localized disease, more comorbidities, low-risk international prognostic index, and unfavorable prognosis. The 5-year cancer-specific survival (CSS), overall survival (OS), and progression-free survival (PFS) rates for all patients were 54.3%, 42.0%, and 40.2%, respectively. The 5-year CSS, OS, and PFS rates were 43.5%, 36.6%, and 34.1% in patients who received radiotherapy alone, and 50%, 50%, and 50% in patients who received radiotherapy and chemotherapy, respectively (P = 0.852 for CSS, P = 0.801 for OS, and P = 0.694 for PFS). Four patients died of treatment-related mortality. CONCLUSION Elderly patients with early-stage extranodal nasal-type NK/T-cell lymphoma exhibit poor prognosis and need special attention because of high treatment-related mortality.
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Affiliation(s)
- Z Y Wang
- Department of Radiation Oncology, Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
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41
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Watanabe T, Kinoshita T, Itoh K, Yoshimura K, Ogura M, Kagami Y, Yamaguchi M, Kurosawa M, Tsukasaki K, Kasai M, Tobinai K, Kaba H, Mukai K, Nakamura S, Ohshima K, Hotta T, Shimoyama M. Pretreatment total serum protein is a significant prognostic factor for the outcome of patients with peripheral T/natural killer-cell lymphomas. Leuk Lymphoma 2010; 51:813-21. [DOI: 10.3109/10428191003721359] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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42
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Kim TM, Heo DS. Extranodal NK / T-cell lymphoma, nasal type: new staging system and treatment strategies. Cancer Sci 2009; 100:2242-8. [PMID: 19758393 PMCID: PMC11159079 DOI: 10.1111/j.1349-7006.2009.01319.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Extranodal NK/T-cell lymphoma (NTCL) is characterized by clinical heterogeneity based on clinical prognostic factors and survival outcome. NTCL subsets are classified as upper aerodigestive tract (UAT) NTCL or non-UAT NTCL; non-UAT has pathologic similarity to UAT-NTCL but is a clinically distinct subtype. Due to the clinical heterogeneity of NTCL, optimal treatment modalities and prognostic factors have been difficult to determine. Ann Arbor staging for lymphomas and the International Prognostic Index (IPI) have been used to predict prognosis for UAT-NTCL; however, local tumor invasiveness (bony invasion or perforation or invasion of the overlying skin) is the most significant factor for poor outcomes in localized UAT-NTCL. Thus, a new staging system is proposed: limited disease (stage I/II UAT-NTCL without local tumor invasiveness) and extensive disease (stage I/II with local invasiveness or stage III/IV disease of UAT NTCL, and non-UAT NTCL) based on treatment outcomes. NTCL is resistant to anthracycline-based chemotherapy, whereas non-anthracycline combination chemotherapy (such as ifosfamide, methotrexate, etoposide, and prednisolone) has an activity against NTCL as either a front-line or as a second-line treatment. The effectiveness of radiotherapy is evident in limited disease, but questionable in extensive disease.
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Affiliation(s)
- Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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43
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Gene expression profiling identifies emerging oncogenic pathways operating in extranodal NK/T-cell lymphoma, nasal type. Blood 2009; 115:1226-37. [PMID: 19965620 DOI: 10.1182/blood-2009-05-221275] [Citation(s) in RCA: 233] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Biopsies and cell lines of natural killer/T-cell lymphoma, nasal type (NKTCL) were subject to combined gene expression profiling and array-based comparative genomic hybridization analyses. Compared with peripheral T-cell lymphoma, not otherwise specified, NKTCL had greater transcript levels for NK-cell and cytotoxic molecules, especially granzyme H. Compared with normal NKcells, tumors were closer to activated than resting cells and overexpressed several genes related to vascular biology, Epstein-Barr Virus-induced genes, and PDGFRA. Notably, platelet-derived growth factor receptor alpha and its phosphorylated form were confirmed at the protein level, and in vitro the MEC04 NKTCL cell line was sensitive to imatinib. Deregulation of the AKT, Janus kinase-signal transducers and activators of transcription, and nuclear factor-kappaB pathways was corroborated by nuclear expression of phosphorylated AKT, signal transducers and activators of transcription 3, and RelA in NKTCL, and several deregulated genes in these pathways mapped to regions of recurrent copy number aberrations (AKT3 [1q44], IL6R [1q21.3], CCL2 [17q12], TNFRSF21 [6p12.3]). Several features of NKTCL uncovered by this analysis suggest perturbation of angiogenic pathways. Integrative analysis also evidenced deregulation of the tumor suppressor HACE1 in the frequently deleted 6q21 region. This study highlights emerging oncogenic pathways in NKTCL and identifies novel diagnostic and therapeutic targets.
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Primary radiotherapy showed favorable outcome in treating extranodal nasal-type NK/T-cell lymphoma in children and adolescents. Blood 2009; 114:4771-6. [PMID: 19812381 DOI: 10.1182/blood-2009-07-235853] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Abstract
Extranodal nasal-type natural killer (NK)/T-cell lymphoma is rarely observed in children and adolescents. We aim to investigate the clinical features, prognosis, and treatment outcomes in these patients. Thirty-seven patients were reviewed. There were 19, 14, 2, and 2 patients with stage I, stage II, stage III, and stage IV diseases, respectively. Among the patients with stage I and II disease, 19 patients received initial radiotherapy with or without chemotherapy, and 14 patients received chemotherapy followed by radiotherapy. The 4 patients with stage III and IV disease received primary chemotherapy and radiation of the primary tumor. Children and adolescents with extranodal nasal-type NK/T-cell lymphoma usually presented with early-stage disease, high frequency of B symptoms, good performance, low-risk age-adjusted international prognostic index, and chemoresistance. The complete response rate after initial radiotherapy was 73.7%, which was significantly higher than the response rate after initial chemotherapy (16.7%; P = .002). The 5-year overall survival (OS) and progression-free survival (PFS) rates for all the patients were 77.0% and 68.5%, respectively. The corresponding OS and PFS rates for patients with stage I and II disease were 77.6% and 72.3%, respectively. Children and adolescents with early-stage extranodal nasal-type NK/T-cell lymphoma treated with primary radiotherapy had a favorable prognosis.
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Abstract
Although proteolysis mediated by granzymes has an important role in the immune response to infection or tumours, unrestrained granzyme activity may damage normal cells. In this review, we discuss the role of serpins within the immune system, as specific regulators of granzymes. The well-characterised human granzyme B-SERPINB9 interaction highlights the cytoprotective function that serpins have in safeguarding lymphocytes from granzymes that may leak from granules. We also discuss some of the pitfalls inherent in using rodent models of granzyme-serpin interactions and the ways in which our understanding of serpins can help resolve some of the current, contentious issues in granzyme biology.
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Affiliation(s)
- D Kaiserman
- Department of Biochemistry and Molecular Biology, Monash University, Building 77, Wellington Road, Clayton, Victoria 3800, Australia.
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Chihara D, Oki Y, Ine S, Yamamoto K, Kato H, Taji H, Kagami Y, Yatabe Y, Nakamura S, Morishima Y. Analysis of prognostic factors in peripheral T-cell lymphoma: prognostic value of serum albumin and mediastinal lymphadenopathy. Leuk Lymphoma 2009; 50:1999-2004. [DOI: 10.3109/10428190903318311] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | | | - Shouji Ine
- Department of Hematology and Cell Therapy
| | | | | | | | | | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shigeo Nakamura
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
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47
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Kim W, Jeon Y, Kim T, Kim J, Kim Y, Lee SH, Kim DW, Heo D, Kim CW. Increased quantity of tumor-infiltrating FOXP3-positive regulatory T cells is an independent predictor for improved clinical outcome in extranodal NK/T-cell lymphoma. Ann Oncol 2009; 20:1688-96. [DOI: 10.1093/annonc/mdp056] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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STAT3 transcription factor is constitutively activated and is oncogenic in nasal-type NK/T-cell lymphoma. Leukemia 2009; 23:1667-78. [PMID: 19421230 DOI: 10.1038/leu.2009.91] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nasal-type natural killer (NK) cell lymphoma is an infrequent aggressive malignant disease with very poor prognosis. We aimed to explore the possible role of the transcription factor STAT3 in the pathophysiology of this malignancy, as it was involved in oncogenesis and chemoresistance. For this, we established and characterized a continuous interleukin 2-dependent NK cell line (MEC04) from a patient with a fatal nasal-type NK-cell lymphoma. Cells harbored poor cytotoxic activity against K562 cells, and spontaneously secreted interferon-gamma, interleukin-10 and vascular-endothelium growth factor in vitro. STAT3 was phosphorylated in Y705 dimerization residue in MEC04 cells and restricted to the nucleus. Y705 STAT3 phosphorylation involved JAK2, as exposure of cells to AG490 inhibitor inhibited Y705 STAT3 phosphorylation. By using recombinant transducible TAT-STAT3-beta (beta isoform), TAT-STAT3Y705F (a STAT3 protein mutated on Y705 residue, which prevents STAT3 dimerization) and peptides inhibiting specifically STAT3 dimerization, we inhibited STAT3 phosphorylation and cell growth, with cell death induction. Finally, STAT3 was phosphorylated in Y705 residue in the nuclei of lymphoma cells in eight/nine patients with nasal-type NK/T-cell lymphoma and in YT, another NK cell line. Our results suggest that STAT3 protein has a major role in the oncogenic process of nasal-type NK-cell lymphomas, and may represent a promising therapeutical target.
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Li YX, Liu QF, Fang H, Qi SN, Wang H, Wang WH, Song YW, Lu J, Jin J, Wang SL, Liu YP, Lu N, Liu XF, Yu ZH. Variable Clinical Presentations of Nasal and Waldeyer Ring Natural Killer/T-Cell Lymphoma. Clin Cancer Res 2009; 15:2905-12. [DOI: 10.1158/1078-0432.ccr-08-2914] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yasuda H, Sugimoto K, Imai H, Isobe Y, Sasaki M, Kojima Y, Nakamura S, Oshimi K. Expression levels of apoptosis-related proteins and Ki-67 in nasal NK / T-cell lymphoma. Eur J Haematol 2008; 82:39-45. [PMID: 18778369 DOI: 10.1111/j.1600-0609.2008.01152.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Nasal natural killer (NK)/T-cell lymphoma is characterized by chemo-resistance, angiodestruction, and aggressive tumor progression. Few studies exist on molecular characteristics of this disease entity. METHODS Expression levels of major apoptosis-related proteins Bcl-2, Bcl-x, Mcl-1, Bax, and a proliferative marker Ki-67 were analyzed in 11 nasal NK/T-cell lymphoma cases by immunohistochemical methods. Nine cases were of NK-cell lineage and two cases were of T-cell lineage. For comparison, 12 follicular lymphoma (FL) cases and 16 diffuse large B-cell lymphoma (DLBCL) cases were also studied. RESULTS AND CONCLUSIONS Bax expression was low in all nasal NK-cell lymphoma cases, which constitute the major population of nasal NK/T-cell lymphoma. Bax expression in nasal NK-cell lymphoma was similar to FL and significantly lower compared with DLBCL. Bcl-2 expression was significantly lower in nasal NK/T-cell lymphoma compared with that of FL and DLBCL. Bcl-x expression was high in all three lymphomas. Two distinct Mcl-1 expression groups existed for nasal NK/T-cell lymphoma (6.2 +/- 5.2% and 59.1 +/- 12.3%, 95% CI). Ki-67 expression was high in nasal NK/T-cell lymphoma, and worse prognostic groups tended to express higher levels of Ki-67. The results suggest a combination of impaired apoptosis and aggressive proliferation in nasal NK/T-cell lymphoma, and may provide explanations for its poor prognosis.
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Affiliation(s)
- Hajime Yasuda
- Division of Hematology, Department of Medicine, Juntendo University School of Medicine, Tokyo
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