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Cerchietti L. Genetic mechanisms underlying tumor microenvironment composition and function in diffuse large B-cell lymphoma. Blood 2024; 143:1101-1111. [PMID: 38211334 PMCID: PMC10972714 DOI: 10.1182/blood.2023021002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/18/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
ABSTRACT Cells in the tumor microenvironment (TME) of diffuse large B-cell lymphoma (DLBCL) show enormous diversity and plasticity, with functions that can range from tumor inhibitory to tumor supportive. The patient's age, immune status, and DLBCL treatments are factors that contribute to the shaping of this TME, but evidence suggests that genetic factors, arising principally in lymphoma cells themselves, are among the most important. Here, we review the current understanding of the role of these genetic drivers of DLBCL in establishing and modulating the lymphoma microenvironment. A better comprehension of the relationship between lymphoma genetic factors and TME biology should lead to better therapeutic interventions, especially immunotherapies.
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Affiliation(s)
- Leandro Cerchietti
- Hematology and Oncology Division, Medicine Department, New York-Presbyterian Hospital, Meyer Cancer Center, Weill Cornell Medicine, Cornell University, New York, NY
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2
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Fibi-Smetana S, Inglis C, Schuster D, Eberle N, Granados-Soler JL, Liu W, Krohn S, Junghanss C, Nolte I, Taher L, Murua Escobar H. The TiHoCL panel for canine lymphoma: a feasibility study integrating functional genomics and network biology approaches for comparative oncology targeted NGS panel design. Front Vet Sci 2023; 10:1301536. [PMID: 38144469 PMCID: PMC10748409 DOI: 10.3389/fvets.2023.1301536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Targeted next-generation sequencing (NGS) enables the identification of genomic variants in cancer patients with high sensitivity at relatively low costs, and has thus opened the era to personalized human oncology. Veterinary medicine tends to adopt new technologies at a slower pace compared to human medicine due to lower funding, nonetheless it embraces technological advancements over time. Hence, it is reasonable to assume that targeted NGS will be incorporated into routine veterinary practice in the foreseeable future. Many animal diseases have well-researched human counterparts and hence, insights gained from the latter might, in principle, be harnessed to elucidate the former. Here, we present the TiHoCL targeted NGS panel as a proof of concept, exemplifying how functional genomics and network approaches can be effectively used to leverage the wealth of information available for human diseases in the development of targeted sequencing panels for veterinary medicine. Specifically, the TiHoCL targeted NGS panel is a molecular tool for characterizing and stratifying canine lymphoma (CL) patients designed based on human non-Hodgkin lymphoma (NHL) research outputs. While various single nucleotide polymorphisms (SNPs) have been associated with high risk of developing NHL, poor prognosis and resistance to treatment in NHL patients, little is known about the genetics of CL. Thus, the ~100 SNPs featured in the TiHoCL targeted NGS panel were selected using functional genomics and network approaches following a literature and database search that shielded ~500 SNPs associated with, in nearly all cases, human hematologic malignancies. The TiHoCL targeted NGS panel underwent technical validation and preliminary functional assessment by sequencing DNA samples isolated from blood of 29 lymphoma dogs using an Ion Torrent™ PGM System achieving good sequencing run metrics. Our design framework holds new possibilities for the design of similar molecular tools applied to other diseases for which limited knowledge is available and will improve drug target discovery and patient care.
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Affiliation(s)
- Silvia Fibi-Smetana
- Institute of Biomedical Informatics, Graz University of Technology, Graz, Austria
| | - Camila Inglis
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Daniela Schuster
- Division of Bioinformatics, Department of Biology, Friedrich-Alexander-University, Erlangen, Germany
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Nina Eberle
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany
| | - José Luis Granados-Soler
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany
- UQVETS Small Animal Hospital, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Wen Liu
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Saskia Krohn
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Christian Junghanss
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Ingo Nolte
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany
| | - Leila Taher
- Institute of Biomedical Informatics, Graz University of Technology, Graz, Austria
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
- Division of Bioinformatics, Department of Biology, Friedrich-Alexander-University, Erlangen, Germany
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock University Medical Center, University of Rostock, Rostock, Germany
| | - Hugo Murua Escobar
- Clinic for Hematology, Oncology and Palliative Care, Rostock University Medical Center, University of Rostock, Rostock, Germany
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3
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Chen X, Liu L, Chen M, Xiang J, Wan Y, Li X, Jiang J, Hou J. A Five-Gene Risk Score Model for Predicting the Prognosis of Multiple Myeloma Patients Based on Gene Expression Profiles. Front Genet 2021; 12:785330. [PMID: 34917133 PMCID: PMC8669596 DOI: 10.3389/fgene.2021.785330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Multiple myeloma is a heterogeneous plasma cell malignancy that remains incurable because of the tendency of relapse for most patients. Survival outcomes may vary widely due to patient and disease variables; therefore, it is necessary to establish a more accurate prognostic model to improve prognostic precision and guide clinical therapy. Here, we developed a risk score model based on myeloma gene expression profiles from three independent datasets: GSE6477, GSE13591, and GSE24080. In this model, highly survival-associated five genes, including EPAS1, ERC2, PRC1, CSGALNACT1, and CCND1, are selected by using the least absolute shrinkage and selection operator (Lasso) regression and univariate and multivariate Cox regression analyses. At last, we analyzed three validation datasets (including GSE2658, GSE136337, and MMRF datasets) to examine the prognostic efficacy of this model by dividing patients into high-risk and low-risk groups based on the median risk score. The results indicated that the survival of patients in low-risk group was greatly prolonged compared with their counterparts in the high-risk group. Therefore, the five-gene risk score model could increase the accuracy of risk stratification and provide effective prediction for the prognosis of patients and instruction for individualized clinical treatment.
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Affiliation(s)
- Xiaotong Chen
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lintao Liu
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengping Chen
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Xiang
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yike Wan
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinxing Jiang
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Hou
- Department of Hematology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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4
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Construction and validation of a risk scoring model for diffuse large B-cell lymphoma based on ferroptosis-related genes and its association with immune infiltration. Transl Oncol 2021; 16:101314. [PMID: 34920339 PMCID: PMC8683649 DOI: 10.1016/j.tranon.2021.101314] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022] Open
Abstract
Categorization of DLBCL into four clusters based on survival- and ferroptosis-related factors. Establishment of an efficient risk scoring model is established for patients with DLBCL. Ferroptosis-based risk scoring model reveals immune infiltration correlation in DLBCL.
Backgrounds The prognostic significance of ferroptosis-related genes is well known. However, survival- and ferroptosis-related genes are not currently considered in risk scoring models for diffuse large B-cell lymphoma (DLBCL). Materials and methods Ferroptosis regulators and markers were downloaded from the FerrDb database. The transcriptome profiling data were collected from the cancer genome atlas (TCGA). Transcriptome data and corresponding clinical information of DLBCL were downloaded from the gene expression omnibus (GEO). The validation data were downloaded using the UCSC Xena browser. ConsensusClusterPlus was used to categorize DLBCL samples according to gene expression profiles. The survival function was plotted with the Kaplan-Meier plots. The nomogram was built using multivariate logistic regression analysis and the Cox proportional hazards regression model. Results Based on the GSE11318 dataset of 203 samples and 267 ferroptosis-related gene expression profiles, we identified four clusters. A total of 19 survival-related genes were found associated with ferroptosis. The prognostic risk scoring model was constructed based on the regression coefficients. The obtained area under the receiver operating characteristic curve (AUC) values were 0.769, 0.801, and 0.791 for 1-, 3-, and 5-year survival, respectively. DLBCL samples with cluster 2 or cancer stage IV have shorter survival. Correlations between the immune infiltration and risk scores of the 12 immune cells were demonstrated. The response of DLBCL to doxorubicin was effectively validated by the risk scoring model. Conclusions In this study, a ferroptosis-based risk scoring model for patients with DLBCL was constructed and validated in an independent dataset. This risk score model has a better efficacy in predicting survival compared to clinical characteristics.
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Zhong C, Cozen W, Bolanos R, Song J, Wang SS. The role of HLA variation in lymphoma aetiology and survival. J Intern Med 2019; 286:154-180. [PMID: 31155783 DOI: 10.1111/joim.12911] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Epidemiologic and laboratory evidence has consistently supported a strong inflammatory and immune component for lymphoma aetiology. These studies have consistently implicated variation in the immune gene, human leucocyte antigen (HLA), to be associated with lymphoma risk. In this review, we summarize the historical and recent evidence of HLA in both lymphoma aetiology and survival. The recent momentum in uncovering HLA associations has been propelled by the conduct of genome-wide association studies (GWAS), which has permitted the evaluation of imputed HLA alleles in much larger sample sizes than historically feasible with allelotyping studies. Based on the culmination of smaller HLA typing studies and larger GWAS, we now recognize several HLA associations with Hodgkin (HL) and non-Hodgkin lymphomas (NHLs) and their subtypes. Although other genetic variants have also been implicated with lymphoma risk, it is notable that HLA associations have been reported in every NHL and HL subtype evaluated to date. Both HLA class I and class II alleles have been linked with NHL and HL risk. It is notable that the associations identified are largely specific to each lymphoma subtype. However, pleiotropic HLA associations have also been observed. For example, rs10484561, which is in linkage disequilibrium with HLA-DRB1*01:01˜DQA1*01:01˜DQB1*05:01, has been implicated in increased FL and DLBCL risk. Opposing HLA associations across subtypes have also been reported, such as for HLA-A*01:01 which is associated with increased risk of EBV-positive cHL but decreased risk of EBV-negative cHL and chronic lymphocytic leukaemia/small cell lymphoma. Due to extensive linkage disequilibrium and allele/haplotypic variation across race/ethnicities, identification of causal alleles/haplotypes remains challenging. Follow-up functional studies are needed to identify the specific immunological pathways responsible in the multifactorial aetiology of HL and NHL. Correlative studies linking HLA alleles with known molecular subtypes and HLA expression in the tumours are also needed. Finally, additional association studies investigating HLA diversity and lymphoma survival are also required to replicate initial associations reported to date.
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Affiliation(s)
- C Zhong
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute and Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - W Cozen
- Genetic Epidemiology Center, Department of Preventive Medicine, Keck School of Medicine of USC, USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - R Bolanos
- Genetic Epidemiology Center, Department of Preventive Medicine, Keck School of Medicine of USC, USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - J Song
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - S S Wang
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute and Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
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Zhao S, Fang S, Liu Y, Li X, Liao S, Chen J, Liu J, Zhao L, Li H, Zhou W, Shen W, Dong X, Xiang R, Wang L, Zhao Y. The long non-coding RNA NONHSAG026900 predicts prognosis as a favorable biomarker in patients with diffuse large B-cell lymphoma. Oncotarget 2018; 8:34374-34386. [PMID: 28423735 PMCID: PMC5470975 DOI: 10.18632/oncotarget.16163] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/24/2017] [Indexed: 12/11/2022] Open
Abstract
Long non-coding RNAs are known to be involved in cancer progression, but their biological functions and prognostic values are still largely unexplored in diffuse large B-cell lymphoma. In this study, long non-coding RNAs expression was characterized in 1,403 samples including normal and diffuse large B-cell lymphoma by repurposing 7 microarray datasets. Compared with any stage of normal B cells, NONHSAG026900 expression was significantly decreased in tumor samples. And in germinal center B-cell subtype, the significantly higher expression of NONHSAG026900 indicated it was a favorable prognosis biomarker. Then the prognostic power of NONHSAG026900 was validated with another independent dataset and NONHSAG026900 improved the predictive power of International Prognostic Index as an independent factor. Moreover, functional prediction and validation demonstrated that NONHSAG026900 could inhibit cell cycle activity to restrain tumor proliferation. These findings identified NONHSAG026900 as a novel prognostic biomarker and offered a new therapeutic target for diffuse large B-cell lymphoma patients.
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Affiliation(s)
- Shuangtao Zhao
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Shuangsang Fang
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Yanhua Liu
- The School of Medicine, Nankai University, Tianjin, China.,The Collaborative Innovation Center for Biotherapy, Nankai University, Tianjin, China.,The Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, China
| | - Xixi Li
- The School of Medicine, Nankai University, Tianjin, China.,Department of Pathology, Nankai University, Tianjin, China
| | - Shengyou Liao
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Jinwen Chen
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Jingjia Liu
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Lianhe Zhao
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Hui Li
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Wei Zhou
- The School of Medicine, Nankai University, Tianjin, China.,The Collaborative Innovation Center for Biotherapy, Nankai University, Tianjin, China.,The Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, China
| | - Wenzhi Shen
- The School of Medicine, Nankai University, Tianjin, China.,The Collaborative Innovation Center for Biotherapy, Nankai University, Tianjin, China.,The Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, China
| | - Xiaoli Dong
- The School of Medicine, Nankai University, Tianjin, China.,The Collaborative Innovation Center for Biotherapy, Nankai University, Tianjin, China.,The Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, China
| | - Rong Xiang
- The School of Medicine, Nankai University, Tianjin, China.,The Collaborative Innovation Center for Biotherapy, Nankai University, Tianjin, China.,The Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, China
| | - Luhua Wang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Zhao
- The Key Laboratory of Intelligent Information Processing, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
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7
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How gene polymorphisms can influence clinical response and toxicity following R-CHOP therapy in patients with diffuse large B cell lymphoma. Blood Rev 2017; 31:235-249. [DOI: 10.1016/j.blre.2017.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 12/07/2016] [Accepted: 02/03/2017] [Indexed: 12/20/2022]
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8
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Lee HJ, Kim TH, Kang SW, Kim YH, Kim SK, Chung JH, Kim YG, Moon JY, Lee SH, Ihm CG, Lee TW, Jeong KH. Association Interleukin-4 and Interleukin-4 Receptor Gene Polymorphism and Acute Rejection and Graft Dysfunction After Kidney Transplantation. Transplant Proc 2017; 48:813-9. [PMID: 27234743 DOI: 10.1016/j.transproceed.2015.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 11/25/2015] [Accepted: 12/30/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cytokine genotypes have previously been studied in patients undergoing solid organ transplantation; certain polymorphisms have been implicated in the development of acute rejection (AR) and graft dysfunction (GD). Allograft outcomes determined, in part, by alloimmune responses is mainly mediated by T-cell responses, activated and driven by cytokines. Interleukin-4 (IL-4) is one such cytokine, which exerts its biological effects through binding to the IL-4 receptor (IL-4R) complex on target cells. In the present study, we investigated whether polymorphisms of the IL-4 and/or IL-4R gene were associated with susceptibility to acute AR and GD after kidney transplantation. METHODS We analyzed 2 single nucleotide polymorphism (SNPs) of IL-4 (rs2243250 and rs2070874) and 3 SNPs of IL-4R (rs1801275, rs2107356, and rs1805010) in 344 kidney transplant recipients. These patients included 62 of whom had developed AR and 215 of whom had GD in 1 year after kidney transplantation. RESULTS The AR group included 62 patients (45 men and 17 women). There was a statistically significant difference in the male-to-female ratio and the use of tacrolimus in the AR group. The GD group included 215 patients. Patients who developed GD were more likely to be older and have an underlying cause of end-stage renal disease that was unknown compared with patients who did not have GD, the cause of which was typically known. Among the SNPs examined, 1 of the SNPs in the IL-4R gene (ie, rs1801275) showed a statistical association with AR (co-dominant model, P = .061; dominant model, P = .019; and log-addictive model, P = .029). In addition, 1 of the IL-4R SNPs (ie, rs2107356) was statistically associated with GD (dominant model, P = .034). No significant difference in the IL-4 genotype was observed between the AR/GD and non-AR/non-GD subjects. CONCLUSIONS One IL-4R gene polymorphism (rs1801275) was associated with AR. In addition, a separate IL-4R SNP (rs2107356) was statistically associated with GD after kidney transplantation.
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Affiliation(s)
- H J Lee
- Department of Nephrology, Seoul Red Cross Hospital, Seoul, Republic of Korea
| | - T H Kim
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - S W Kang
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - Y H Kim
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - S K Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J-H Chung
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Y G Kim
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J Y Moon
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S H Lee
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - C G Ihm
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - T W Lee
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - K H Jeong
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Polymorphisms in cytokine genes as prognostic markers in diffuse large B cell lymphoma patients treated with (R)-CHOP. Ann Hematol 2016; 96:227-235. [DOI: 10.1007/s00277-016-2857-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 10/11/2016] [Indexed: 11/25/2022]
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10
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Zhao S, Bai N, Cui J, Xiang R, Li N. Prediction of survival of diffuse large B-cell lymphoma patients via the expression of three inflammatory genes. Cancer Med 2016; 5:1950-61. [PMID: 27394196 PMCID: PMC4971923 DOI: 10.1002/cam4.714] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/06/2016] [Accepted: 03/03/2016] [Indexed: 01/06/2023] Open
Abstract
Currently, several gene-expression signatures that were used to predict survival of diffuse large B-cell lymphoma (DLBCL) patients, showed a restriction on the practical work for lack of convenient operation. In this study, we screened inflammatory genes whose expression correlated with survival of DLBCL and established a predictive model including IL6, IL1A and CSF3 through multivariate Cox regression based on the expression of these three genes. We validated the model at protein level in our clinical serum cohort composed of 101 patients of DLBCL and 50 healthy controls and 534 DLBCL patients at mRNA level from three independent Gene Expression Omnibus (GEO) data sets. We found our model to be independent of the International Prognostic Index (IPI), moreover, it can augment the predictive power of IPI. In summary, our three-gene model is sufficient to predict survival of DLBCL patients via measuring the concentration of three inflammatory cytokines in peripheral blood.
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Affiliation(s)
- Shuangtao Zhao
- School of Medicine, 94 Weijin Road, Tianjin, 300071, China.,Collaborative Innovation Center for Biotherapy, Nankai University, 94 Weijin Road, Tianjin, 300071, China
| | - Nan Bai
- School of Medicine, 94 Weijin Road, Tianjin, 300071, China.,Prenatal Diagnosis Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Jianlin Cui
- School of Medicine, 94 Weijin Road, Tianjin, 300071, China.,Collaborative Innovation Center for Biotherapy, Nankai University, 94 Weijin Road, Tianjin, 300071, China.,Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, 300071, China
| | - Rong Xiang
- School of Medicine, 94 Weijin Road, Tianjin, 300071, China.,Collaborative Innovation Center for Biotherapy, Nankai University, 94 Weijin Road, Tianjin, 300071, China.,Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, 300071, China
| | - Na Li
- School of Medicine, 94 Weijin Road, Tianjin, 300071, China.,Collaborative Innovation Center for Biotherapy, Nankai University, 94 Weijin Road, Tianjin, 300071, China.,Tianjin Key Laboratory of Tumor Microenvironment and Neurovascular Regulation, Tianjin, 300071, China
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11
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Gao S, Zhu G, Lin Y, Fan X, Qian P, Zhu J, Yu Y. Tumor necrosis factor-308 polymorphism with the risk and prognosis of non-Hodgkin lymphomas: a meta-analysis study. Onco Targets Ther 2016; 9:1657-70. [PMID: 27051301 PMCID: PMC4807942 DOI: 10.2147/ott.s97873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Tumor necrosis factor-308 (TNF-308) was implied to be associated with the development of non-Hodgkin lymphoma (NHL). The aim of this meta-analysis study was to investigate the association of TNF-308A polymorphism with the susceptibility to, and prognosis of, NHL. Methods PubMed, Web of Science, Elsevier, HighWire, Scopus, and Google Scholar were searched up to May 2015. The association of TNF-308 polymorphism with the risk of NHL and prognosis was assessed by odds ratio and hazard ratio, respectively. Results Overall, TNF-308G>A polymorphism increased the risk of NHL, B-cell lymphomas (BCL), and T-cell lymphomas and decreased the risk of follicular lymphomas. In stratified analysis, increased risk of BCL and diffuse large B-cell lymphomas (DLBCL) were observed in Caucasians and population-based studies, whereas decreased risk of NHL, BCL, and DLBCL were detected in Asians and hospital-based studies. Furthermore, pooled results of 1,192 patients with NHL from five studies suggested that TNF-308A was correlated with shorter progression-free survival and overall survival in patients with NHL, BCL, and DLBCL. Conclusion Current evidence indicated that TNF-308A polymorphism was significantly associated with the risk and prognosis of NHL. Future studies should further confirm these associations in other NHL subtypes and ethnicities.
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Affiliation(s)
- Sicheng Gao
- Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Guoqing Zhu
- Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, People's Republic of China
| | - Yan Lin
- Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xingliang Fan
- Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Pingan Qian
- Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Junfeng Zhu
- Department of Hepatology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Yongchun Yu
- Central Laboratory, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
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12
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Maurer MJ, Jais JP, Ghesquières H, Witzig TE, Hong F, Haioun C, Thompson CA, Thieblemont C, Micallef IN, Porrata LF, Ribrag V, Nowakowski GS, Casasnovas O, Bologna S, Morschhauser F, Morrison VA, Peterson BA, Macon WR, Copie-Bergman C, Feldman AL, Syrbu SI, Kurtin PJ, Gascoyne RD, Li H, Allmer C, Kahl BS, Ansell SM, Slager SL, Link BK, Salles G, Habermann TM, Tilly H, Cerhan JR. Personalized risk prediction for event-free survival at 24 months in patients with diffuse large B-cell lymphoma. Am J Hematol 2016; 91:179-84. [PMID: 26492520 DOI: 10.1002/ajh.24223] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 10/14/2015] [Accepted: 10/19/2015] [Indexed: 12/17/2022]
Abstract
We recently defined event-free survival at 24 months (EFS24) as a clinically relevant outcome for patients with DLBCL. Patients who fail EFS24 have very poor overall survival, while those who achieve EFS24 have a subsequent overall survival equivalent to that of the age- and sex-matched general population. Here, we develop and validate a clinical risk calculator (IPI24) for EFS24. Model building was performed on a discovery dataset of 1,348 patients with DLBCL and treated with anthracycline-based immunochemotherapy. A multivariable model containing age, Ann Arbor stage, normalized serum LDH, ALC, ECOG performance status, bulky disease, and sex was identified. The model was then applied to an independent validation dataset of 1,177 DLBCL patients. The IPI24 score estimates the probability of failing to achieve the EFS24 endpoint for an individual patient. The IPI24 model showed superior discriminatory ability (c-statistic = 0.671) in the validation dataset compared to the IPI (c-statistic = 0.649) or the NCCN-IPI (c-statistic = 0.657). After recalibration of the model on the combined dataset, the median predicted probability of failing to achieve EFS24 was 36% (range, 12-88%), and the IPI24 showed an EFS24 gradient in all IPI groups. The IPI24 also identified a significant percentage of patients with high risk disease, with over 20% of patients having a 50% or higher risk of failing to achieve EFS24. The IPI24 provides an individual patient level probability of achieving the clinically relevant EFS24 endpoint. It can be used via electronic apps.
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Affiliation(s)
- Matthew J. Maurer
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | - Jean-Philippe Jais
- Department of Biostatistics; Necker Hospital, INSERM UMRS 872, AP-HP; Paris France
| | - Hervé Ghesquières
- Department of Medical Oncology; Centre Léon Bérard; Lyon France
- Centre National De La Recherche Scientifique (CNRS), Unite Mixte De Recherche (UMR); Université Claude Bernard; Lyon France
| | | | - Fangxin Hong
- Department of Biostatistics & Computational Biology; Harvard T.H. Chan; Boston Massachusetts
| | - Corinne Haioun
- Lymphoid Malignancies Unit, Henri Mondor Hospital; Université Paris-Est; Créteil France
| | | | | | | | | | - Vincent Ribrag
- Department of Medical Oncology; Institut Gustave Roussy; Villejuif France
| | | | | | - Serge Bologna
- Department of Hematology; Centre Hospitalier Nancy-Brabois; Vandoeuvre France
| | - Franck Morschhauser
- Department of Hematology; Centre Hospitalier Régional Universitaire De Lille; Lille France
| | - Vicki A. Morrison
- Department of Medicine; University of Minnesota; Minneapolis Minnesota
- Veterans Affairs Medical Center; Minneapolis Minnesota
| | - Bruce A. Peterson
- Department of Medicine; University of Minnesota; Minneapolis Minnesota
| | - William R. Macon
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
| | | | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
| | - Sergei I. Syrbu
- Department of Pathology; University of Iowa College of Medicine; Iowa City Iowa
| | - Paul J. Kurtin
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
| | - Randy D. Gascoyne
- Centre for Lymphoid Cancers; British Columbia Cancer Agency; Vancouver British Columbia Canada
| | - Hailun Li
- Department of Biostatistics & Computational Biology; Harvard T.H. Chan; Boston Massachusetts
| | - Cristine Allmer
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | - Brad S. Kahl
- Department of Medicine; Washington University, St. Louis; Missouri
| | | | - Susan L. Slager
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | - Brian K. Link
- Department of Pathology; University of Iowa College of Medicine; Iowa City Iowa
| | - Gilles Salles
- Centre National De La Recherche Scientifique (CNRS), Unite Mixte De Recherche (UMR); Université Claude Bernard; Lyon France
- Department of Hematology; Hospices Civils De Lyon; Pierre Benite France
| | | | - Hervé Tilly
- Department of Hematology; INSERM U918, IRIB, Centre Henri Becquerel; Rouen France
| | - James R. Cerhan
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
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13
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Shinozuka K, Tang H, Jones RB, Li D, Nieto Y. Impact of Polymorphic Variations of Gemcitabine Metabolism, DNA Damage Repair, and Drug-Resistance Genes on the Effect of High-Dose Chemotherapy for Relapsed or Refractory Lymphoid Malignancies. Biol Blood Marrow Transplant 2015; 22:843-9. [PMID: 26743341 DOI: 10.1016/j.bbmt.2015.12.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022]
Abstract
The goal of this study was to determine whether single nucleotide polymorphisms (SNPs) in genes involved in gemcitabine metabolism, DNA damage repair, multidrug resistance, and alkylator detoxification influence the clinical outcome of patients with refractory/relapsed lymphoid malignancies receiving high-dose gemcitabine/busulfan/melphalan (Gem/Bu/Mel) with autologous stem cell support. We evaluated 21 germline SNPs of the gemcitabine metabolism genes CDA, deoxycytidine kinase, and hCNT3; DNA damage repair genes RECQL, X-ray repair complementing 1, RAD54L, ATM, ATR, MLH1, MSH2, MSH3, TREX1, EXO1, and TP73; and multidrug-resistance genes MRP2 and MRP5; as well as glutathione-S-transferase GSTP1 in 153 patients with relapsed or refractory lymphoma or myeloma receiving Gem/Bu/Mel. We studied the association of genotypes with overall survival (OS), progression-free survival (PFS), and nonhematological grade 3 or 4 toxicity. CDA C111T and TREX1 Ex14-460C>T genotypes had a significant effect on OS (P = .007 and P = .005, respectively), and CDA C111T, ATR C340T, and EXO1 P757L genotypes were significant predictors for severe toxicity (P = .037, P = .024, and P = .025, respectively) in multivariable models that adjusted for clinical variables. The multi-SNP risk score analysis identified the combined genotypes of TREX1 Ex14-460 TT and hCNT3 Ex5 +25A>G AA as significant predictors for OS and the combination of MRP2 Ex10 + 40GG/GA and MLH1 IVS12-169 TT as significant predictor for PFS. Polymorphic variants of certain genes involved in gemcitabine metabolism and DNA damage repair pathways may be potential biomarkers for clinical outcome in patients with refractory/relapsed lymphoid tumors receiving Gem/Bu/Mel.
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Affiliation(s)
- Keiji Shinozuka
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hongwei Tang
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roy B Jones
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas.
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14
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Zang T, Broszczak DA, Broadbent JA, Cuttle L, Lu H, Parker TJ. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. Expert Rev Proteomics 2015; 13:35-53. [PMID: 26581649 DOI: 10.1586/14789450.2016.1122528] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity.
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Affiliation(s)
- Tuo Zang
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Daniel A Broszczak
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - James A Broadbent
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Leila Cuttle
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,d Centre for Children's Burns and Trauma Research , Queensland University of Technology, Institute of Health and Biomedical Innovation at the Centre for Children's Health Research , South Brisbane , Australia
| | - Haitao Lu
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
| | - Tony J Parker
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
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15
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Zhang Y, Xia ZG, Zhu JH, Chen MB, Wang TM, Shen WX, He J. Association of Interleukin-10 -3575T>A and -1082A>G polymorphisms with non-Hodgkin lymphoma susceptibility: a comprehensive review and meta-analysis. Mol Genet Genomics 2015; 290:2063-73. [PMID: 25977148 DOI: 10.1007/s00438-015-1058-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/23/2015] [Indexed: 02/07/2023]
Abstract
A number of studies have investigated the associations between IL-10 polymorphisms and non-Hodgkin lymphoma (NHL) susceptibility; however, the conclusions were still contradictory. To acquire a more precise estimation of the association, we performed the current meta-analysis. We systematically searched publications from EMBASE and MEDLINE, and calculated pooled odds ratios (ORs) and 95 % confidence intervals (CIs) using either fixed-effects or random-effects model. Genotype-based IL-10 mRNA expression analysis was performed using online public database of 270 individuals with three different ethnicities. A total of 10,703 cases and 11,823 controls from 10 studies were included for the -3575T>A polymorphism, 10,226 cases and 12,215 controls from 17 studies for the -1082A>G polymorphism. Pooled results indicated that IL-10 -3575T>A was associated with increased risk of diffuse large B cell lymphoma (DLBCL) and follicular lymphoma (FL), especially for Caucasians and hospital-based population. There was no association between IL-10 -1082A>G and NHL risk. However, subgroup analysis showed that IL-10 -1082GG might confer increased susceptibility to FL. In summary, this meta-analysis indicated that -3575T>A polymorphism was associated with altered NHL susceptibility for Caucasians and hospital-based population, especially for DLBCL and FL subtypes. The -1082A>G polymorphism may contribute to increased FL risk. Further large-scale population studies among different ethnicities are needed to validate these results.
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Affiliation(s)
- Yan Zhang
- Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, 215300, Jiangsu, China
| | - Zu-Guang Xia
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jin-Hong Zhu
- Molecular Epidemiology Laboratory and Laboratory Medicine, Harbin Medical University Cancer Hospital, Harbin, 150040, Heilongjiang, China
| | - Min-Bin Chen
- Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, 215300, Jiangsu, China
| | - Tong-Min Wang
- State Key Laboratory of Oncology in South China, Department of Experimental Research, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong, China
| | - Wen-Xiang Shen
- Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, 215300, Jiangsu, China.
| | - Jing He
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
- State Key Laboratory of Oncology in South China, Department of Experimental Research, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, Guangdong, China.
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16
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Ghesquieres H, Slager SL, Jardin F, Veron AS, Asmann YW, Maurer MJ, Fest T, Habermann TM, Bene MC, Novak AJ, Mareschal S, Haioun C, Lamy T, Ansell SM, Tilly H, Witzig TE, Weiner GJ, Feldman AL, Dogan A, Cunningham JM, Olswold CL, Molina TJ, Link BK, Milpied N, Cox DG, Salles GA, Cerhan JR. Genome-Wide Association Study of Event-Free Survival in Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy. J Clin Oncol 2015; 33:3930-7. [PMID: 26460308 DOI: 10.1200/jco.2014.60.2573] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE We performed a multistage genome-wide association study to identify inherited genetic variants that predict outcome in diffuse large B-cell lymphoma patients treated with immunochemotherapy. METHODS We conducted a meta-analysis of two genome-wide association study data sets, one from the LNH2003B trial (N = 540), a prospective clinical trial from the Lymphoma Study Association, and the other from the Molecular Epidemiology Resource study (N = 312), a prospective observational study from the University of Iowa-Mayo Clinic Lymphoma Specialized Program of Research Excellence. Top single nucleotide polymorphisms were then genotyped in independent cohorts of patients from the Specialized Program of Research Excellence (N = 391) and the Groupe Ouest-Est des Leucémies Aiguës et Maladies du Sang (GOELAMS) -075 randomized trial (N = 294). We calculated the hazard ratios (HRs) and 95% CIs for event-free survival (EFS) and overall survival (OS) using a log-additive genetic model with adjustment for age, sex, and age-adjusted International Prognostic Index. RESULTS In a meta-analysis of the four studies, the top loci for EFS were marked by rs7712513 at 5q23.2 (near SNX2 and SNCAIP; HR, 1.39; 95% CI, 1.23 to 1.57; P = 2.08 × 10(-7)), and rs7765004 at 6q21 (near MARCKS and HDAC2; HR, 1.38; 95% CI, 1.22 to 1.57; P = 7.09 × 10(-7)), although they did not reach conventional genome-wide significance (P = 5 × 10(-8)). Both rs7712513 (HR, 1.49; 95% CI, 1.29 to 1.72; P = 3.53 × 10(-8)) and rs7765004 (HR, 1.47; 95% CI, 1.27 to 1.71; P = 5.36 × 10(-7)) were also associated with OS. In exploratory analyses, a two-single nucleotide polymorphism risk score was highly predictive of EFS (P = 1.78 × 10(-12)) and was independent of treatment, IPI, and cell-of-origin classification. CONCLUSION Our study provides encouraging evidence for associations between loci at 5q23.2 and 6q21 with EFS and OS in patients with diffuse large B-cell lymphoma treated with immunochemotherapy, suggesting novel biology and the potential contribution of host genetics to the prognosis of this aggressive malignancy.
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Affiliation(s)
- Hervé Ghesquieres
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Susan L Slager
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Fabrice Jardin
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Amelie S Veron
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Yan W Asmann
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Matthew J Maurer
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Thierry Fest
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Thomas M Habermann
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Marie C Bene
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Anne J Novak
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Sylvain Mareschal
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Corinne Haioun
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Thierry Lamy
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Stephen M Ansell
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Herve Tilly
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Thomas E Witzig
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - George J Weiner
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Andrew L Feldman
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Ahmet Dogan
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Julie M Cunningham
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Curtis L Olswold
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Thierry Jo Molina
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Brian K Link
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Noel Milpied
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - David G Cox
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - Gilles A Salles
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA
| | - James R Cerhan
- Hervé Ghesquieres, Universite Claude Bernard Lyon 1, Centre Leon Berard; Amelie S. Veron and David G. Cox, L'Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Cancer Research Center of Lyon, Centre Leon Berard, Lyon; Hervé Ghesquieres and Gilles A. Salles, Faculté de Médecine Lyon-Sud; Gilles A. Salles, Universite Claude Bernard Lyon 1, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite; Fabrice Jardin, Sylvain Mareschal, and Herve Tilly, INSERM U918, Centre Henri Becquerel, Rouen; Thierry Fest, INSERM U917, Université de Rennes 1, Hopital Pontchaillou; Thierry Lamy, Université de Rennes 1, Hopital Pontchaillou, Rennes; Marie C. Bene, Centre Hospitalier Universitaire Nantes, Nantes; Corinne Haioun, Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP) and University Paris Est, Créteil; Thierry Jo Molina, Universite Paris Descartes, AP-HP, Hôpital Necker, Paris; Noel Milpied, University Hospital and University of Bordeaux, Bordeaux, France; Hervé Ghesquieres, Susan L. Slager, Matthew J. Maurer, Thomas M. Habermann, Anne J. Novak, Stephen M. Ansell, Thomas E. Witzig, Andrew L. Feldman, Ahmet Dogan, Julie M. Cunningham, Curtis L. Olswold, and James R. Cerhan, Mayo Clinic, Rochester, MN; Yan W. Asmann, Mayo Clinic, Jacksonville, FL; and George J. Weiner and Brian K. Link, University of Iowa, Iowa City, IA.
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17
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Nielsen KR, Steffensen R, Bendtsen MD, Rodrigo-Domingo M, Baech J, Haunstrup TM, Bergkvist KS, Schmitz A, Boedker JS, Johansen P, Dybkaeær K, Boeøgsted M, Johnsen HE. Inherited Inflammatory Response Genes Are Associated with B-Cell Non-Hodgkin's Lymphoma Risk and Survival. PLoS One 2015; 10:e0139329. [PMID: 26448050 PMCID: PMC4598167 DOI: 10.1371/journal.pone.0139329] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/11/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Malignant B-cell clones are affected by both acquired genetic alterations and by inherited genetic variations changing the inflammatory tumour microenvironment. METHODS We investigated 50 inflammatory response gene polymorphisms in 355 B-cell non-Hodgkin's lymphoma (B-NHL) samples encompassing 216 diffuse large B cell lymphoma (DLBCL) and 139 follicular lymphoma (FL) and 307 controls. The effect of single genes and haplotypes were investigated and gene-expression analysis was applied for selected genes. Since interaction between risk genes can have a large impact on phenotype, two-way gene-gene interaction analysis was included. RESULTS We found inherited SNPs in genes critical for inflammatory pathways; TLR9, IL4, TAP2, IL2RA, FCGR2A, TNFA, IL10RB, GALNT12, IL12A and IL1B were significantly associated with disease risk and SELE, IL1RN, TNFA, TAP2, MBL2, IL5, CX3CR1, CHI3L1 and IL12A were, associated with overall survival (OS) in specific diagnostic entities of B-NHL. We discovered noteworthy interactions between DLBCL risk alleles on IL10 and IL4RA and FL risk alleles on IL4RA and IL4. In relation to OS, a highly significant interaction was observed in DLBCL for IL4RA (rs1805010) * IL10 (rs1800890) (HR = 0.11 (0.02-0.50)). Finally, we explored the expression of risk genes from the gene-gene interaction analysis in normal B-cell subtypes showing a different expression of IL4RA, IL10, IL10RB genes supporting a pathogenetic effect of these interactions in the germinal center. CONCLUSIONS The present findings support the importance of inflammatory genes in B-cell lymphomas. We found association between polymorphic sites in inflammatory response genes and risk as well as outcome in B-NHL and suggest an effect of gene-gene interactions during the stepwise oncogenesis.
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MESH Headings
- Aged
- Alleles
- Female
- Genotype
- Haplotypes
- Humans
- Interleukin-10/genetics
- Interleukin-10/metabolism
- Interleukin-10 Receptor beta Subunit/genetics
- Interleukin-10 Receptor beta Subunit/metabolism
- Interleukin-4/genetics
- Interleukin-4/metabolism
- Interleukin-4 Receptor alpha Subunit/genetics
- Interleukin-4 Receptor alpha Subunit/metabolism
- Linkage Disequilibrium
- Lymphoma, Follicular/etiology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/mortality
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Odds Ratio
- Polymorphism, Single Nucleotide
- Proportional Hazards Models
- Risk
- Survival Analysis
- Transcriptome
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Affiliation(s)
- Kaspar René Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Rudi Steffensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - John Baech
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Thure Mors Haunstrup
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Alexander Schmitz
- Department of Haematology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Preben Johansen
- Department of Haematopathology, Aalborg University Hospital, Aalborg, Denmark
| | - Karen Dybkaeær
- Department of Haematology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Boeøgsted
- Department of Haematology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Hans Erik Johnsen
- Department of Haematology, Aalborg University Hospital, Aalborg, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- * E-mail:
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18
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Nielsen KR, Steffensen R, Haunstrup TM, Bødker JS, Dybkær K, Baech J, Bøgsted M, Johnsen HE. Inherited variation in immune response genes in follicular lymphoma and diffuse large B-cell lymphoma. Leuk Lymphoma 2015; 56:3257-66. [PMID: 26044172 DOI: 10.3109/10428194.2015.1058936] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) both depend on immune-mediated survival and proliferation signals from the tumor microenvironment. Inherited genetic variation influences this complex interaction. A total of 89 studies investigating immune-response genes in DLBCL and FL were critically reviewed. Relatively consistent association exists for variation in the tumor necrosis factor alpha (TNFA) and interleukin-10 loci and DLBCL risk; for DLBCL outcome association with the TNFA locus exists. Variations at chromosome 6p31-32 were associated with FL risk. Importantly, individual risk alleles have been shown to interact with each other. We suggest that the pathogenetic impact of polymorphic genes should include gene-gene interaction analysis and should be validated in preclinical model systems of normal B lymphopoiesis and B-cell malignancies. In the future, large cohort studies of interactions and genome-wide association studies are needed to extend the present findings and explore new risk alleles to be studied in preclinical models.
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Affiliation(s)
| | - Rudi Steffensen
- a Department of Clinical Immunology , Aalborg University Hospital , Denmark
| | | | | | - Karen Dybkær
- b Department of Haematology , Aalborg University Hospital.,c Clinical Cancer Research Center, Aalborg University Hospital , Denmark and Department of Clinical Medicine , Aalborg University , Denmark
| | - John Baech
- a Department of Clinical Immunology , Aalborg University Hospital , Denmark
| | - Martin Bøgsted
- b Department of Haematology , Aalborg University Hospital.,c Clinical Cancer Research Center, Aalborg University Hospital , Denmark and Department of Clinical Medicine , Aalborg University , Denmark
| | - Hans Erik Johnsen
- b Department of Haematology , Aalborg University Hospital.,c Clinical Cancer Research Center, Aalborg University Hospital , Denmark and Department of Clinical Medicine , Aalborg University , Denmark
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Zhang Y, Zhai W, Zhao M, Li D, Chai X, Cao X, Meng J, Chen J, Xiao X, Li Q, Mu J, Shen J, Meng A. Effects of iron overload on the bone marrow microenvironment in mice. PLoS One 2015; 10:e0120219. [PMID: 25774923 PMCID: PMC4361683 DOI: 10.1371/journal.pone.0120219] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/20/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Using a mouse model, Iron Overload (IO) induced bone marrow microenvironment injury was investigated, focusing on the involvement of reactive oxygen species (ROS). METHODS Mice were intraperitoneally injected with iron dextran (12.5, 25, or 50 mg) every three days for two, four, and six week durations. Deferasirox(DFX)125 mg/ml and N-acetyl-L-cysteine (NAC) 40 mM were co-administered. Then, bone marrow derived mesenchymal stem cells (BM-MSCs) were isolated and assessed for proliferation and differentiation ability, as well as related gene changes. Immunohistochemical analysis assessed the expression of haematopoietic chemokines. Supporting functions of BM-MSCs were studied by co-culture system. RESULTS In IO condition (25 mg/ml for 4 weeks), BM-MSCs exhibited proliferation deficiencies and unbalanced osteogenic/adipogenic differentiation. The IO BM-MSCs showed a longer double time (2.07±0.14 days) than control (1.03±0.07 days) (P<0.05). The immunohistochemical analysis demonstrated that chemokine stromal cell-derived factor-1, stem cell factor -1, and vascular endothelial growth factor-1 expression were decreased. The co-cultured system demonstrated that bone marrow mononuclear cells (BMMNCs) co-cultured with IO BM-MSCs had decreased colony forming unit (CFU) count (p<0.01), which indicates IO could lead to decreased hematopoietic supporting functions of BM-MSCs. This effect was associated with elevated phosphatidylinositol 3 kinase (PI3K) and reduced of Forkhead box protein O3 (FOXO3) mRNA expression, which could induce the generation of ROS. Results also demonstrated that NAC or DFX treatment could partially attenuate cell injury and inhibit signaling pathway striggered by IO. CONCLUSION These results demonstrated that IO can impair the bone marrow microenvironment, including the quantity and quality of BM-MSCs.
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Affiliation(s)
- Yuchen Zhang
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Wenjing Zhai
- Department of Stem Cells Transplantation, Blood Disease Hospital of Chinese Academy of Medical Sciences, Tianjin, China
| | - Mingfeng Zhao
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
- * E-mail:
| | - Deguan Li
- Key Lab of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Academy of Medical Science and Peking Union Medical College, Tianjin, China
| | - Xiao Chai
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Xiaoli Cao
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Juanxia Meng
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Jie Chen
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Xia Xiao
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Qing Li
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Juan Mu
- Department of Hematology, Tianjin First Central Hospital, Tianjin, China
| | - Jichun Shen
- Department of Hematology, Affiliated Hospital of Logistics University of People’s Armed Police Force, Tianjin, China
| | - Aimin Meng
- Key Lab of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Academy of Medical Science and Peking Union Medical College, Tianjin, China
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20
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Zhang T, Xie S, Zhu JH, Li QW, He J, Zeng AP. Association of IL10 -819C>T and -592C>A Polymorphisms with Non-Hodgkin Lymphoma Susceptibility: Evidence from Published Studies. J Cancer 2015; 6:709-16. [PMID: 26185532 PMCID: PMC4504106 DOI: 10.7150/jca.11745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 05/04/2015] [Indexed: 02/07/2023] Open
Abstract
Numerous studies have investigated the association of IL10 -819C>T and -592C>A polymorphisms with non-Hodgkin lymphoma (NHL) susceptibility, and yet reported conflicting results. With this in mind, we performed the current meta-analysis with an aim to verify actual causative variants underlying lymphomagenesis. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the associations. Moreover, to explore the biological function of these polymorphisms, we also performed genotype-based mRNA expression analysis using online database derived from 270 subjects within three ethnicities. The final analysis included 11 studies with a total of 5859 NHL cases and 6893 controls for the IL10 -819C>T polymorphism, and 11 studies with 6277 cases and 7350 controls for the IL10 -592C>A polymorphism. No significant association was observed for these two polymorphisms in either the overall analysis or the stratification analyses by ethnicity and source of controls. Nevertheless, stratification analyses demonstrated a significant decreased risk associated with the IL10 -819C>T polymorphism (homozygous: OR=0.81, 95% CI=0.66-0.99, and recessive model: OR=0.80, 95%CI=0.65-0.98) and IL10 -592C>A polymorphism (homozygous: OR=0.80, 95% CI=0.66-0.99, and recessive model: OR=0.80, 95%CI=0.66-0.97) among patients with diffuse large B-cell lymphoma (DLBCL). Despite some limitations, this meta-analysis indicates that polymorphisms in IL10 gene may contribute to DLBCL susceptibility.
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Affiliation(s)
- Ting Zhang
- 1. Department of Clinical Medicine Center, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling 317500, Zhejiang, China
| | - Shang Xie
- 4. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jin-Hong Zhu
- 5. Molecular Epidemiology Laboratory and Laboratory Medicine, Harbin Medical University Cancer Hospital, Harbin 150040, Heilongjiang, China
| | - Qi-Wen Li
- 3. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Experimental Research, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, China
| | - Jing He
- 2. Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China
- 3. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Experimental Research, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, China
- ✉ Corresponding authors: Jing He, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China & Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Experimental Research, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, Guangdong, China. Tel./Fax: (+86-20) 87342410, E-mail: ; or Ai-Ping Zeng, Department of Clinical Medicine Center, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, 190 South Taiping Road, Wenling 317500, Zhejiang, China. Tel: (+86- 0576) 86206186, Fax: (+86-0576) 86206288, E-mail:
| | - Ai-Ping Zeng
- 1. Department of Clinical Medicine Center, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling 317500, Zhejiang, China
- ✉ Corresponding authors: Jing He, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China & Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Experimental Research, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510060, Guangdong, China. Tel./Fax: (+86-20) 87342410, E-mail: ; or Ai-Ping Zeng, Department of Clinical Medicine Center, The First People's Hospital of Wenling, The Affiliated Wenling Hospital of Wenzhou Medical University, 190 South Taiping Road, Wenling 317500, Zhejiang, China. Tel: (+86- 0576) 86206186, Fax: (+86-0576) 86206288, E-mail:
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21
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He YQ, Zhu JH, Huang SY, Cui Z, He J, Jia WH. The association between the polymorphisms of TNF-α and non-Hodgkin lymphoma: a meta-analysis. Tumour Biol 2014; 35:12509-17. [PMID: 25204673 DOI: 10.1007/s13277-014-2569-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 08/28/2014] [Indexed: 02/07/2023] Open
Abstract
Many genetic variations in the promoter region of tumor necrosis factor alpha (TNF-α) may confer host susceptibility to cancer by influencing TNF-α expression. Nevertheless, the results remain inconclusive. The current meta-analysis was performed to investigate the association between three common TNF-α promoter polymorphisms and the risk of non-Hodgkin lymphoma (NHL). A literature search was conducted mainly from PubMed for all eligible studies. The pooled odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were used to assess the association of TNF-α polymorphisms with the risk of NHL. TNF-α -308 A allele showed a statistically significant increased risk for NHL under the homozygous (AA vs. GG, OR = 1.51, 95 % CI = 1.26-1.80) and recessive (OR = 1.47, 95 % CI = 1.23-1.75) models, respectively. The stratified analyses showed an increased risk of NHL with the presence of TNF-α -308 A allele among Africans and Caucasians, but a decreased risk among Asians. No association was observed between -238 G/A polymorphism and NHL risk either in the overall analysis or in the stratified analysis. Similarly, pooled analysis did not reveal an altered risk of NHL with -857 C/T polymorphism. Nonetheless, a statistically significant association was observed among Asians when stratified by ethnicity. Among the three genetic variations of interest, TNF-α -308 G/A polymorphism was significantly associated with the risk of NHL; neither -238 G/A nor -857 C/T polymorphism was shown to alter the overall NHL risk; however, stratified analysis by ethnicity observed a statistically significant association between -857 C/T polymorphism and the risk of NHL among Asians.
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Affiliation(s)
- Yong-Qiao He
- State Key Laboratory of Oncology in South China, Department of Experimental Research, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China
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22
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Abstract
B cell lymphomas are cancers that arise from cells that depend on numerous highly orchestrated interactions with immune and stromal cells in the course of normal development. Despite the recent focus on dissecting the genetic aberrations within cancer cells, it has been increasingly recognized that tumour cells retain a range of dependence on interactions with the non-malignant cells and stromal elements that constitute the tumour microenvironment. A fundamental understanding of these interactions gives insight into the pathogenesis of most B cell lymphomas and, moreover, identifies novel therapeutic opportunities for targeting oncogenic pathways, both now and in the future.
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Affiliation(s)
- David W Scott
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver V5Z 1L3, Canada
| | - Randy D Gascoyne
- 1] Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver V5Z 1L3, Canada. [2] Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver V6T 2B5, Canada
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23
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The associations between immunity-related genes and breast cancer prognosis in Korean women. PLoS One 2014; 9:e103593. [PMID: 25075970 PMCID: PMC4116221 DOI: 10.1371/journal.pone.0103593] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/02/2014] [Indexed: 12/15/2022] Open
Abstract
We investigated the role of common genetic variation in immune-related genes on breast cancer disease-free survival (DFS) in Korean women. 107 breast cancer patients of the Seoul Breast Cancer Study (SEBCS) were selected for this study. A total of 2,432 tag single nucleotide polymorphisms (SNPs) in 283 immune-related genes were genotyped with the GoldenGate Oligonucleotide pool assay (OPA). A multivariate Cox-proportional hazard model and polygenic risk score model were used to estimate the effects of SNPs on breast cancer prognosis. Harrell’s C index was calculated to estimate the predictive accuracy of polygenic risk score model. Subsequently, an extended gene set enrichment analysis (GSEA-SNP) was conducted to approximate the biological pathway. In addition, to confirm our results with current evidence, previous studies were systematically reviewed. Sixty-two SNPs were statistically significant at p-value less than 0.05. The most significant SNPs were rs1952438 in SOCS4 gene (hazard ratio (HR) = 11.99, 95% CI = 3.62–39.72, P = 4.84E-05), rs2289278 in TSLP gene (HR = 4.25, 95% CI = 2.10–8.62, P = 5.99E-05) and rs2074724 in HGF gene (HR = 4.63, 95% CI = 2.18–9.87, P = 7.04E-05). In the polygenic risk score model, the HR of women in the 3rd tertile was 6.78 (95% CI = 1.48–31.06) compared to patients in the 1st tertile of polygenic risk score. Harrell’s C index was 0.813 with total patients and 0.924 in 4-fold cross validation. In the pathway analysis, 18 pathways were significantly associated with breast cancer prognosis (P<0.1). The IL-6R, IL-8, IL-10RB, IL-12A, and IL-12B was associated with the prognosis of cancer in data of both our study and a previous study. Therefore, our results suggest that genetic polymorphisms in immune-related genes have relevance to breast cancer prognosis among Korean women.
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24
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Gustafson HL, Yao S, Goldman BH, Lee K, Spier CM, LeBlanc ML, Rimsza LM, Cerhan JR, Habermann TM, Link BK, Maurer MJ, Slager SL, Persky DO, Miller TP, Fisher RI, Ambrosone CB, Briehl MM. Genetic polymorphisms in oxidative stress-related genes are associated with outcomes following treatment for aggressive B-cell non-Hodgkin lymphoma. Am J Hematol 2014; 89:639-45. [PMID: 24633940 DOI: 10.1002/ajh.23709] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/17/2014] [Accepted: 03/11/2014] [Indexed: 11/10/2022]
Abstract
Variable survival outcomes are seen following treatment for aggressive non-Hodgkin lymphoma (NHL). This study examined whether outcomes for aggressive B-cell NHL are associated with single nucleotide polymorphisms (SNPs) in oxidative stress-related genes, which can alter drug metabolism and immune responses. Genotypes for 53 SNPs in 29 genes were determined for 337 patients given anthracycline-based therapies. Their associations with progression-free survival (PFS) and overall survival (OS) were estimated by Cox proportional hazard regression; associations with hematologic toxicity were estimated by logistic regression. To validate the findings, the top three SNPs were tested in an independent cohort of 572 DLBCL patients. The top SNPs associated with PFS in the discovery cohort were the rare homozygotes for MPO rs2243828 (hazard ratio [HR] = 1.87, 95% confidence interval [CI] = 1.14-3.06, P = 0.013), AKR1C3 rs10508293 (HR = 2.09, 95% CI = 1.28-3.41, P = 0.0032) and NCF4 rs1883112 (HR = 0.66, 95% CI = 0.43-1.02, P = 0.06). The association of the NCF4 SNP with PFS was replicated in the validation dataset (HR = 0.66, 95% CI = 0.44-1.01, P = 0.05) and the meta-analysis was significant (HR = 0.66, 95% CI = 0.49-0.89, P < 0.01). The association of the MPO SNP was attenuated in the validation dataset, while the meta-analysis remained significant (HR = 1.64, 95% CI = 1.12-2.41). These two SNPs showed similar trends with OS in the meta-analysis (for NCF4, HR = 0.72, 95% CI = 0.51-1.02, P = 0.07 and for MPO, HR = 2.06, 95% CI = 1.36-3.12, P < 0.01). In addition, patients with the rare homozygote of the NCF4 SNP had an increased risk of hematologic toxicity. We concluded that genetic variations in NCF4 may contribute to treatment outcomes for patients with aggressive NHL.
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Affiliation(s)
- Heather L. Gustafson
- Cancer Biology Graduate Interdisciplinary Program; University of Arizona; Tucson Arizona
| | - Song Yao
- Department of Cancer Prevention and Control; Roswell Park Cancer Institute; Buffalo New York
| | - Bryan H. Goldman
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Center; Seattle Washington
| | - Kristy Lee
- Cancer Biology Graduate Interdisciplinary Program; University of Arizona; Tucson Arizona
| | | | - Michael L. LeBlanc
- Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Center; Seattle Washington
| | - Lisa M. Rimsza
- Department of Pathology; University of Arizona; Tucson Arizona
| | - James R. Cerhan
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | | | - Brian K. Link
- Department of Internal Medicine; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Matthew J. Maurer
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | - Susan L. Slager
- Department of Health Sciences Research; Mayo Clinic; Rochester Minnesota
| | | | | | | | - Christine B. Ambrosone
- Department of Cancer Prevention and Control; Roswell Park Cancer Institute; Buffalo New York
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Yang B, Liu C, Diao L, Wang C, Guo Z. A polymorphism at the microRNA binding site in the 3' untranslated region of C14orf101 is associated with non-Hodgkin lymphoma overall survival. Cancer Genet 2014; 207:141-6. [PMID: 24831772 DOI: 10.1016/j.cancergen.2014.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 03/13/2014] [Accepted: 03/17/2014] [Indexed: 12/22/2022]
Abstract
MicroRNAs (miRNAs) can bind to the 3' untranslated regions (UTRs) of messenger RNAs, where they interfere with translation and thereby regulate cell differentiation, apoptosis, and tumorigenesis. Genetic polymorphisms in the 3' UTRs targeted by miRNAs alter the strength of miRNA binding in a manner that affects the behavior of individual miRNAs. In this study, four miRNA binding-site single nucleotide polymorphisms (SNPs) located in the 3' UTR of RYR3 (rs1044129), C14orf101 (rs4901706), KIAA0423 (rs1053667), and GOLGA7 (rs11337) were genotyped in non-Hodgkin lymphoma (NHL) patients to assess their relationships with cancer risk and overall survival. rs4901706, located in the 3' UTR of C14orf101, was shown to be independently related to overall survival in NHL patients by multivariate analysis (relative risk, 1.770; 95% CI, 1.046-2.996; P = 0.033). The prognostic value of this SNP on tumor overall survival was supported in diffuse large B-cell lymphoma patients with a P value of 0.095 and validated in T-cell lymphoma patients with a P value of 0.037.
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Affiliation(s)
- Bo Yang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chao Liu
- Hebei Key Lab of Laboratory Animal Science, Hebei Medical University, Shijiazhuang, China
| | - Lanping Diao
- Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Cuiju Wang
- Department of Gynaecology Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhanjun Guo
- Department of Gastroenterology and Hepatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
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26
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Chen JJ, Lin WJ, Chen HC. Pharmacogenomic biomarkers for personalized medicine. Pharmacogenomics 2014; 14:969-80. [PMID: 23746190 DOI: 10.2217/pgs.13.75] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pharmacogenomics examines how the benefits and adverse effects of a drug vary among patients in a target population by analyzing genomic profiles of individual patients. Personalized medicine prescribes specific therapeutics that best suit an individual patient. Much current research focuses on developing genomic biomarkers to identify patients, to identify which patients would benefit from a treatment, have an adverse response, or no response at all, prior to treatment according to relevant differences in risk factors, disease types and/or responses to therapy. This review describes the use of the two personalized medicine biomarkers, prognostic and predictive, to classify patients into subgroups for treatment recommendation.
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Affiliation(s)
- James J Chen
- Division of Bioinformatics & Biostatistics, National Center for Toxicological Research, US FDA, 3900 NCTR Road, HFT-20, Jefferson, AR 72079, USA.
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27
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Ghesquières H, Maurer MJ, Casasnovas O, Ansell SM, Larrabee BR, Lech-Maranda E, Novak AJ, Borrel AL, Slager SL, Brice P, Allmer C, Brion A, Ziesmer SC, Morschhauser F, Habermann TM, Gaillard I, Link BK, Stamatoullas A, Fermé C, Dogan A, Macon WR, Audouin J, Cerhan JR, Salles G. Cytokine gene polymorphisms and progression-free survival in classical Hodgkin lymphoma by EBV status: results from two independent cohorts. Cytokine 2013; 64:523-31. [PMID: 24008079 DOI: 10.1016/j.cyto.2013.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/18/2013] [Accepted: 08/06/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cytokines are important immune mediators of classical Hodgkin lymphoma (CHL) pathogenesis, and circulating levels at diagnosis may help predict prognosis. Germline single nucleotide polymorphisms (SNPs) in immune genes have been correlated with cytokine production and function. METHODS We investigated whether selected germline SNPs in IL10 (rs1800890, rs1800896, rs1800871, rs1800872), TNFA (rs1800629), IL6 (rs1800795), ILRN (rs419598), INFG (rs2430561) and CCL17 (rs223828) were associated with circulating levels of related cytokines at diagnosis and progression-free survival (PFS) in CHL. Patients were from France (GELA, N=464; median age=32years) and the United States (Iowa/Mayo Specialized Program Of Research Excellence [SPORE], N=239; median age=38years); 22% of 346 CHL cases with EBV tumor status were positive. RESULTS There was no association with any of the SNPs with cytokine levels. Overall, there was no association of any of the SNPs with PFS. In exploratory analyses by EBV status, TNFA rs1800629 (HRAA/AG=2.41; 95%CI, 1.17-4.94) was associated with PFS in EBV-negative GELA patients, with similar trends in the SPORE patients (HRAA/AG=1.63; 95%CI, 0.61-4.40). In a meta-analysis of the two studies, TNFA (HRAA/AG=2.11; 95%CI, 1.18-3.77; P=0.01) was statistically significant, and further adjustment for the international prognostic system did not alter this result. CONCLUSIONS This study showed that germline variation in TNFA was associated with CHL prognosis for EBV-negative patients, which will require confirmation. These results support broader studies on the differential impact of genetic variation in immune genes on EBV-positive vs. EBV-negative CHL pathogenesis.
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Affiliation(s)
- Hervé Ghesquières
- Onco-Hematology, Centre Léon Bérard, UMR CNRS 5239, Université Lyon 1, Lyon, France; Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
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28
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Choi H, Jung C, Sohn SK, Kim S, Kim HJ, Kim YK, Kim T, Zhang Z, Shin ES, Lee JE, Moon JH, Kim SH, Kim KH, Mun YC, Kim H, Park J, Kim J, Kim DDH. Genome-wide genotype-based risk model for survival in acute myeloid leukaemia patients with normal karyotype. Br J Haematol 2013; 163:62-71. [DOI: 10.1111/bjh.12492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Hangseok Choi
- Department of Long-Term Care Claims Review; National Health Insurance Corporation; Seoul; Korea
| | - Chulwon Jung
- Division of Haematology/Oncology; Department of Medicine; Samsung Medical Centre; Sungkyunkwan University School of Medicine; Seoul; Korea
| | - Sang Kyun Sohn
- Department of Haematology/Oncology; Kyungpook National University Hospital; Kyungpook National University; Daegu; Korea
| | - Seonwoo Kim
- Biostatistical team; Samsung Medical Centre; Samsung Biomedical Research Institute; Seoul; Korea
| | - Hyeoung-Joon Kim
- Department of Haematology/Oncology; Chonnam National University Hwasun Hospital; Chonnam National University; Hwasun; Korea
| | - Yeo-Kyeoung Kim
- Department of Haematology/Oncology; Chonnam National University Hwasun Hospital; Chonnam National University; Hwasun; Korea
| | - TaeHyung Kim
- Department of Bioinformatics; Donnelley Center; University of Toronto; Toronto; ON; Canada
| | - Zhaolei Zhang
- Department of Bioinformatics; Donnelley Center; University of Toronto; Toronto; ON; Canada
| | | | | | - Joon Ho Moon
- Department of Haematology/Oncology; Kyungpook National University Hospital; Kyungpook National University; Daegu; Korea
| | - Sung Hyun Kim
- Department of Haematology/Oncology; DongA University Medical Centre; DongA University; Busan; Korea
| | - Kyoung Ha Kim
- Department of Haematology/Oncology; Soonchunhyang University Seoul Hospital; Seoul; Korea
| | - Yeung-Chul Mun
- Department of Haematology/Oncology; Ewha Womans University School of Medicine; Seoul; Korea
| | - Hawk Kim
- Division of Hematology and Hematological Malignancies; Ulsan University Hospital; University of Ulsan College of Medicine; Ulsan; Korea
| | - Jinny Park
- Department of Haematology/Oncology; Gachon University Gil Hospital; Incheon; Korea
| | - Jhingook Kim
- Samsung Medical Centre; Samsung Cancer Research Institute; Seoul; Korea
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Yri OE, Ekstrøm PO, Hilden V, Gaudernack G, Liestøl K, Smeland EB, Holte H. Influence of polymorphisms in genes encoding immunoregulatory proteins and metabolizing enzymes on susceptibility and outcome in patients with diffuse large B-cell lymphoma treated with rituximab. Leuk Lymphoma 2013; 54:2205-14. [DOI: 10.3109/10428194.2013.774392] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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30
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Tarabar O, Cikota-Aleksić B, Tukić L, Milanović N, Aleksić A, Magić Z. Association of interleukin-10, tumor necrosis factor-α and transforming growth factor-β gene polymorphisms with the outcome of diffuse large B-cell lymphomas. Int J Clin Oncol 2013; 19:186-92. [DOI: 10.1007/s10147-013-0531-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 01/25/2013] [Indexed: 10/27/2022]
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Genetic association of interleukin-10 promoter polymorphisms and susceptibility to diffuse large B-cell lymphoma: a meta-analysis. Gene 2013; 519:288-94. [PMID: 23485354 DOI: 10.1016/j.gene.2013.01.066] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 11/20/2022]
Abstract
Published data on the association between interleukin-10 (IL-10) gene polymorphisms and diffuse large B-cell lymphoma (DLBCL) risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed, focusing on four major IL-10 gene variants in the promoter region: -3575T/A, -1082A/G, -819C/T and -592C/A. We applied the false discovery rate (FDR) method to adjust for multiple testing. A significant association between IL-10 -3575T/A polymorphism and the risk of DLBCL was observed in the pooled 10 case-control studies (A vs. T: OR=1.16, 95% CI=1.08-1.25, P<0.0001; AA+TA vs. TT: OR=1.20, 95% CI=1.08-1.33, P=0.0009; AA vs. TA+TT: OR=1.25, 95% CI=1.09-1.44, P=0.001). The results indicated that carriers of -1082G allele (-1082GG/GA genotypes) had a nearly 30% increased risk of DLBCL, as compared with carriers of -1082AA genotype (GG+GA vs. AA: OR=1.30, 95% CI=1.08-1.57, P=0.005). When P-values were not adjusted for multiple testing, the risk was significantly decreased among people with -592AA genotype (AA vs. AC+CC: OR=0.63, 95% CI=0.43-0.94, P=0.02), while carriers with -819TT genotype also modestly weakened the DLBCL susceptibility at a marginal level of significance (TT vs. CT+CC: OR=0.59, 95% CI=0.35-0.99, P=0.05). However, these associations were not significant after correction for multiple testing. This meta-analysis suggests that IL-10 -3575A allele confers a greater risk to DLBCL susceptibility, while -1082A/G polymorphism also has significant association with DLBCL risk. These results may help to further clarify the malignancy-risk gene signature of DLBCL, and thus have prognostic and predictive value especially for early-stage DLBCL.
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Chen HC, Chen JJ. Assessment of reproducibility of cancer survival risk predictions across medical centers. BMC Med Res Methodol 2013; 13:25. [PMID: 23425000 PMCID: PMC3598915 DOI: 10.1186/1471-2288-13-25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/13/2013] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Two most important considerations in evaluation of survival prediction models are 1) predictability - ability to predict survival risks accurately and 2) reproducibility - ability to generalize to predict samples generated from different studies. We present approaches for assessment of reproducibility of survival risk score predictions across medical centers. METHODS Reproducibility was evaluated in terms of consistency and transferability. Consistency is the agreement of risk scores predicted between two centers. Transferability from one center to another center is the agreement of the risk scores of the second center predicted by each of the two centers. The transferability can be: 1) model transferability - whether a predictive model developed from one center can be applied to predict the samples generated from other centers and 2) signature transferability - whether signature markers of a predictive model developed from one center can be applied to predict the samples from other centers. We considered eight prediction models, including two clinical models, two gene expression models, and their combinations. Predictive performance of the eight models was evaluated by several common measures. Correlation coefficients between predicted risk scores of different centers were computed to assess reproducibility - consistency and transferability. RESULTS Two public datasets, the lung cancer data generated from four medical centers and colon cancer data generated from two medical centers, were analyzed. The risk score estimates for lung cancer patients predicted by three of four centers agree reasonably well. In general, a good prediction model showed better cross-center consistency and transferability. The risk scores for the colon cancer patients from one (Moffitt) medical center that were predicted by the clinical models developed from the another (Vanderbilt) medical center were shown to have excellent model transferability and signature transferability. CONCLUSIONS This study illustrates an analytical approach to assessing reproducibility of predictive models and signatures. Based on the analyses of the two cancer datasets, we conclude that the models with clinical variables appear to perform reasonable well with high degree of consistency and transferability. There should have more investigations on the reproducibility of prediction models including gene expression data across studies.
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Affiliation(s)
- Hung-Chia Chen
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR 72079, USA
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Cicek MS, Maurer MJ, Goode EL. Survival prediction based on inherited gene variation analysis. Methods Mol Biol 2013; 1049:53-64. [PMID: 23913208 DOI: 10.1007/978-1-62703-547-7_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
There is a significant variation of outcome among ovarian cases. Clinical features such as age, stage, comorbidities, or degree of debulking are known prognostic factors for the disease. However, additional variation remains unexplained, some of which may be due to inherited factors. Here, we describe identification of survival-associated inherited variants in ovarian cancer that can enhance our current prognostic capabilities.
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Affiliation(s)
- Mine S Cicek
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
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Lech-Maranda E, Mlynarski W, Grzybowska-Izydorczyk O, Borowiec M, Pastorczak A, Cebula-Obrzut B, Klimkiewicz-Wojciechowska G, Wcislo M, Majewski M, Kotkowska A, Robak T, Warzocha K. Polymorphisms of TNF and IL-10 genes and clinical outcome of patients with chronic lymphocytic leukemia. Genes Chromosomes Cancer 2012; 52:287-96. [PMID: 23225254 DOI: 10.1002/gcc.22028] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 10/08/2012] [Indexed: 01/14/2023] Open
Abstract
Genetic variations in tumor necrosis factor (TNF) and interleukin-10 (IL-10) were reported to influence susceptibility to and outcome of patients with non-Hodgkin lymphoma. Therefore, we investigated whether single nucleotide polymorphisms in TNF and IL-10 may play a role in the clinical course of patients with chronic lymphocytic leukemia (CLL). TNF-308G>A, IL-10-3575T>A, and IL-10-1082A>G seem to be functionally relevant, were genotyped in 292 previously untreated patients with CLL. The control group consisted of 192 randomly selected blood donors. The patients carrying TNF-308GG and IL-10-1082AA genotypes presented a higher 3-year treatment-free survival (56.6 vs. 40.6%, P = 0.05) as well as a 10-year overall survival (OS) rates (92.3 vs. 57.6%, P = 0.005) than those with other TNF-308 and IL-10-1082 genotype combinations. Multivariate analysis demonstrated the Rai stage (P = 0.0002), IGHV mutation status (P = 0.01), TNF-308G>A (P = 0.03), and TNF/IL-10 polymorphism-based risk groups (P = 0.05) to be independent factors predicting OS. When the mutated IGHV patients were analyzed, the homozygotes TNF-308GG and IL-10-1082AA presented a higher 10-year OS rate than those carrying other TNF-308 and IL-10-1082 genotypes (100 vs. 67.7%, P = 0.01). In the unmutated IGHV patients, only the TNF-308G>A polymorphism influenced OS. The genetic variations in TNF and IL-10 genes work as independent predictors of survival and may play a role in the clinical course of CLL. It suggests inherited ability of the host to shift the balance between the Th1 and Th2 response, which in turn might contribute to the pathogenesis and prognosis of B-cell malignancies.
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Affiliation(s)
- Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.
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Lenalidomide in diffuse large B-cell lymphoma. Adv Hematol 2012; 2012:861060. [PMID: 23251161 PMCID: PMC3508519 DOI: 10.1155/2012/861060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 08/22/2012] [Indexed: 01/05/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin's lymphoma (NHL) in adults. Even if the natural history of DLBCL has been improved with the advent of immunochemotherapy, the survival results obtained with current treatment options clearly indicate that new agents or novel approaches are needed. Lenalidomide (Revlimid, Celgene Corporation, Summit, NJ, USA), an analogue of thalidomide, is an immunomodulatory drug with pleiotropic mechanisms of action potentially adding to immunochemotherapy. We present here the biological rational for the use of lenalidomide in DLBCL in light of recent advances in the pathophysiology of the disease and the therapeutic results of the most recent trials published in literature or reported in meetings in relapsed/refractory situations as well as in first-line treatment.
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36
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Chen HC, Kodell RL, Cheng KF, Chen JJ. Assessment of performance of survival prediction models for cancer prognosis. BMC Med Res Methodol 2012; 12:102. [PMID: 22824262 PMCID: PMC3410808 DOI: 10.1186/1471-2288-12-102] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 07/23/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cancer survival studies are commonly analyzed using survival-time prediction models for cancer prognosis. A number of different performance metrics are used to ascertain the concordance between the predicted risk score of each patient and the actual survival time, but these metrics can sometimes conflict. Alternatively, patients are sometimes divided into two classes according to a survival-time threshold, and binary classifiers are applied to predict each patient's class. Although this approach has several drawbacks, it does provide natural performance metrics such as positive and negative predictive values to enable unambiguous assessments. METHODS We compare the survival-time prediction and survival-time threshold approaches to analyzing cancer survival studies. We review and compare common performance metrics for the two approaches. We present new randomization tests and cross-validation methods to enable unambiguous statistical inferences for several performance metrics used with the survival-time prediction approach. We consider five survival prediction models consisting of one clinical model, two gene expression models, and two models from combinations of clinical and gene expression models. RESULTS A public breast cancer dataset was used to compare several performance metrics using five prediction models. 1) For some prediction models, the hazard ratio from fitting a Cox proportional hazards model was significant, but the two-group comparison was insignificant, and vice versa. 2) The randomization test and cross-validation were generally consistent with the p-values obtained from the standard performance metrics. 3) Binary classifiers highly depended on how the risk groups were defined; a slight change of the survival threshold for assignment of classes led to very different prediction results. CONCLUSIONS 1) Different performance metrics for evaluation of a survival prediction model may give different conclusions in its discriminatory ability. 2) Evaluation using a high-risk versus low-risk group comparison depends on the selected risk-score threshold; a plot of p-values from all possible thresholds can show the sensitivity of the threshold selection. 3) A randomization test of the significance of Somers' rank correlation can be used for further evaluation of performance of a prediction model. 4) The cross-validated power of survival prediction models decreases as the training and test sets become less balanced.
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Affiliation(s)
- Hung-Chia Chen
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, US. Food and Drug Administration, Jefferson, AR 72079, USA
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37
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Cerhan JR, Natkunam Y, Morton LM, Maurer MJ, Asmann Y, Habermann TM, Vasef MA, Cozen W, Lynch CF, Allmer C, Slager SL, Lossos IS, Chanock SJ, Rothman N, Hartge P, Dogan A, Wang SS. LIM domain only 2 protein expression, LMO2 germline genetic variation, and overall survival in diffuse large B-cell lymphoma in the pre-rituximab era. Leuk Lymphoma 2012; 53:1105-12. [PMID: 22066713 PMCID: PMC3575512 DOI: 10.3109/10428194.2011.638717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Both LMO2 (LIM domain only 2) mRNA and protein expression in diffuse large B-cell lymphoma (DLBCL) have been associated with superior survival. However, a role for germline genetic variation in LMO2 has not been previously reported. Immunohistochemistry (IHC) for LMO2 was conducted on tumor tissue from diagnostic biopsies, and 20 tag single nucleotide polymorphisms (SNPs) from LMO2 were genotyped from germline DNA. LMO2 IHC positivity was associated with superior survival (hazard ratio [HR] = 0.55; 95% confidence interval [CI] 0.31-0.97). Four LMO2 SNPs (rs10836127, rs941940, rs750781, rs1885524) were associated with survival after adjusting for LMO2 IHC and clinical factors (p < 0.05), and one of these SNPs (rs941940) was also associated with IHC positivity (p = 0.02). Compared to a model with clinical factors only (c-statistic = 0.676), adding the four SNPs (c-statistic = 0.751) or LMO2 IHC (c-statistic = 0.691) increased the predictive ability of the model, while inclusion of all three factors (c-statistic = 0.754) did not meaningfully add predictive ability above a model with clinical factors and the four SNPs. In conclusion, germline genetic variation in LMO2 was associated with DLBCL prognosis and provided slightly stronger predictive ability relative to LMO2 IHC status.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Adult
- Aged
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Genetic Variation/physiology
- Germ-Line Mutation/physiology
- Humans
- Immunohistochemistry
- LIM Domain Proteins/genetics
- LIM Domain Proteins/metabolism
- Linkage Disequilibrium
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Prognosis
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Rituximab
- Survival Analysis
- Young Adult
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Porrata LF, Ristow K, Habermann TM, Ozsan N, Dogan A, Macon W, Colgan JP, Witzig TE, Inwards DJ, Ansell SM, Micallef IN, Johnston PB, Nowakowski GS, Thompson C, Markovic SN. Absolute monocyte/lymphocyte count prognostic score is independent of immunohistochemically determined cell of origin in predicting survival in diffuse large B-cell lymphoma. Leuk Lymphoma 2012; 53:2159-65. [PMID: 22551474 DOI: 10.3109/10428194.2012.690605] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The absolute monocyte/lymphocyte count prognostic score (AMC/ALC score) has not been directly compared with the cell of origin (COO) to predict overall survival (OS) and progression-free survival (PFS) in diffuse large B-cell lymphoma (DLBCL). Thus, we retrospectively examined a new cohort of 99 patients with DLBCL treated from 2008 to 2010, (1) to validate whether AMC/ALC score affects survival, (2) to investigate whether AMC/ALC score is independent of COO to predict survival and (3) to assess whether AMC/ALC score can further stratify clinical outcomes by COO. By univariate analysis, the AMC/ALC score was a predictor for OS and PFS. On multivariate analysis performed including the COO and the International Prognostic Index, AMC/ALC score remained an independent predictor for OS and PFS. The AMC/ALC score was able to further stratify DLBCL clinical outcomes by COO. The AMC/ALC score was independent of COO and added to its ability to identify patients with high-risk disease.
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Affiliation(s)
- Luis F Porrata
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
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Heemann C, Kreuz M, Stoller I, Schoof N, von Bonin F, Ziepert M, Löffler M, Jung W, Pfreundschuh M, Trümper L, Kube D. Circulating levels of TNF receptor II are prognostic for patients with peripheral T-cell non-Hodgkin lymphoma. Clin Cancer Res 2012; 18:3637-47. [PMID: 22573350 DOI: 10.1158/1078-0432.ccr-11-3299] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Peripheral T-cell non-Hodgkin lymphomas (T-NHL) represent a small but heterogeneous and clinically aggressive subset of NHLs with a poor outcome. Cytokines or their receptors might be associated with the clinical outcome of these lymphomas. Therefore, we tested whether gene variations and serum levels of soluble TNF receptor (TNFR)I (sTNFRI), sTNFRII, interleukin (IL)-10, or sIL-4R are predictive for treatment response in T-NHLs. EXPERIMENTAL DESIGN Peripheral blood DNA from 117 patients with T-NHL treated in prospective clinical trials was subjected to genotyping analysis. Whenever possible, pretreatment sera were obtained, and circulating levels of sTNFRI, sTNFRII, IL-10, and sIL-4R were determined with a specific capture enzyme-linked immunoassay. RESULTS Patients characterized by TNFRI-609GG (rs4149570) showed a trend toward better event free survival [EFS; univariate: P = 0.041; multivariate: HR, 1.76; confidence interval (CI), 0.99-3.14 with P = 0.056]. A protective role of IL-10-1087A, -824T, and -597A reported in another study was not confirmed in our cohort. Patients with circulating levels of soluble TNFRII ≥2.16 ng/mL had a 2.07-fold increased relative risk for shorter overall survival (OS; univariate: P = 0.0034; multivariate: HR, 2.07; CI, 0.92-4.70 with P = 0.081) and a 2.49-fold higher risk for shorter EFS (univariate: P = 0.00068; multivariate: HR, 2.49; CI, 1.22-5.08 with P = 0.012). Elevations of circulating levels of sTNFRI, IL-10, and sIL-4R are frequent, but the clinical response in these patients is not significantly different. CONCLUSIONS Our findings suggest a critical role for TNF-TNFR signaling for the clinical outcome of patients with peripheral T-NHLs.
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Affiliation(s)
- Christina Heemann
- Department of Hematology and Oncology, Medical Center of the Georg-August-University Göttingen, Germany.
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Lu Y, Abdou AM, Cerhan JR, Morton LM, Severson RK, Davis S, Cozen W, Rothman N, Bernstein L, Chanock S, Hartge P, Wang SS. Human leukocyte antigen class I and II alleles and overall survival in diffuse large B-cell lymphoma and follicular lymphoma. ScientificWorldJournal 2011; 11:2062-70. [PMID: 22125456 PMCID: PMC3217596 DOI: 10.1100/2011/373876] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 10/03/2011] [Indexed: 11/17/2022] Open
Abstract
Genetic variation in the 6p21 chromosomal region, including human leukocyte antigen (HLA) genes and tumor necrosis factor (TNF), has been linked to both etiology and clinical outcomes of lymphomas. We estimated the effects of HLA class I (A, B, and C), class II DRB1 alleles, and the ancestral haplotype (AH) 8.1 (HLAA*01-B*08-DRB1*03-TNF-308A) on overall survival (OS) among patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) in a population-based study of non-Hodgkin lymphoma. During a median followup of 89 months, 31% (52 of 166) DLBCL and 28% (46 of 165) FL patients died. Using multivariate Cox regression models, we observed statistically significant associations between genetic variants and survival: HLA-Cw*07:01 was associated with poorer OS among DLBCL patients (Hazard ratio [HR] = 1.76, 95% confidence interval [CI] = 1.01-3.05); HLA-A*01:01 was associated with poorer OS (HR = 2.23, 95% CI = 1.24-4.01), and HLA-DRB1*13 (HR = 0.12, 95% CI = 0.02-0.90) and HLA-B Bw4 (HR = 0.36, 95% CI = 0.20-0.63) with better OS among FL patients. These results support a role for HLA in the prognosis of DLBCL and FL and represent a promising class of prognostic factors that warrants further evaluation.
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MESH Headings
- Alleles
- Chromosomes, Human, Pair 6
- Female
- Genes, MHC Class I
- Genes, MHC Class II
- Humans
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Multivariate Analysis
- Survival Rate
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Affiliation(s)
- Yani Lu
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Amr M. Abdou
- Department of Microbiology and Immunology, National Research Center, Cairo, Egypt
| | | | - Lindsay M. Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA
| | - Richard K. Severson
- Department of Family Medicine and Public Health Sciences, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48202, USA
| | - Scott Davis
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA 98109-4433, USA
| | - Wendy Cozen
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Stephen Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD 20852, USA
| | - Sophia S. Wang
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
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Giachelia M, Voso MT, Tisi MC, Martini M, Bozzoli V, Massini G, D'Aló F, Larocca LM, Leone G, Hohaus S. Interleukin-6 plasma levels are modulated by a polymorphism in the NF-κB1 gene and are associated with outcome following rituximab-combined chemotherapy in diffuse large B-cell non-Hodgkin lymphoma. Leuk Lymphoma 2011; 53:411-6. [PMID: 21902578 DOI: 10.3109/10428194.2011.621566] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Peripheral blood cytokines are known prognostic parameters in diffuse large B-cell lymphoma (DLBCL) treated with chemotherapy, but their role after the introduction of rituximab is unknown. Seven polymorphisms in the promoter regions of IL-6, IL-10 and NF-κB1 genes were assessed in 167 patients with DLBCL and 99 controls and correlated with interleukin-6 (IL-6) and IL-10 plasma levels. Outcome was analyzed in 137 patients treated with rituximab-based chemotherapy. The NF-κB1 - 94ATTG deletion was associated with increased IL-6 and IL-10 in DLBCL. High IL-6 concentration correlated with unfavorable prognostic factors included in the international prognostic index (IPI) and predicted for inferior progression-free (p = 0.007) and overall survival (p = 0.02). IL-6 levels remained a significant outcome predictor also including IPI as a covariate (p = 0.006 for progression-free survival). Our data suggest that the NF-κB1 genetic background influences IL-6 production in DLBCL, and that high IL-6 concentration is an independent prognostic factor also in the "rituximab era."
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42
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Morton LM, Cerhan JR, Hartge P, Vasef MA, Neppalli VT, Natkunam Y, Dogan A, Dave BJ, Jain S, Levy R, Lossos IS, Cozen W, Davis S, Schenk MJ, Maurer MJ, Lynch CF, Rothman N, Chatterjee N, Yu K, Staudt LM, Weisenburger DD, Wang SS. Immunostaining to identify molecular subtypes of diffuse large B-cell lymphoma in a population-based epidemiologic study in the pre-rituximab era. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2011; 2:245-252. [PMID: 21915363 PMCID: PMC3166152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 06/26/2011] [Indexed: 05/31/2023]
Abstract
Gene expression profiling studies have distinguished diffuse large B-cell lymphomas (DLBCLs) by cell of origin, with distinct pathogenetic mechanisms and prognosis. We attempted to identify DLBCL molecular subtypes in an epidemiologic study of 214 DLBCL patients diagnosed during 1998-2000 with archival tissues to investigate etiology. Immunohistochemical staining for CD10, BCL6, LMO2, MUM1/IRF4, and BCL2 and fluorescence in situ hybridization for t(14;18) were conducted, with ≥93% blinded duplicate agreement. CD10, LMO2, and BCL2 expression was similar to previous reports (32%, 44%, and 44% of DLBCLs, respectively), but BCL6 and MUM1/IRF4 expression was lower than expected (29% and 5%, respectively). We classified 112/214 (52%) cases as germinal center B-cell-like DLBCL (GCB-DLBCL; Hans et al., Blood 2004; CD10+ or CD10-/BCL6+/MUM1-), with no difference in prognosis compared with non-GCB-DLBCL (Cox regression, P=0.48). Comparing other GCB correlates, LMO2 expression and t(14;18) were more common but not exclusive to GCB-DLBCL as defined in our study, whereas BCL2 expression did not differ between DLBCL molecular subtypes. We could not confidently identify patients with GCB-DLBCL using these immunohistochemistry-based markers on archival tissues.
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43
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Dai J, Hu Z, Dong J, Xu L, Pan S, Jiang Y, Jin G, Chen Y, Shen H. Host immune gene polymorphisms were associated with the prognosis of non-small-cell lung cancer in Chinese. Int J Cancer 2011; 130:671-6. [DOI: 10.1002/ijc.26067] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/02/2011] [Indexed: 12/30/2022]
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Kumar V, Matsuo K, Takahashi A, Hosono N, Tsunoda T, Kamatani N, Kong SY, Nakagawa H, Cui R, Tanikawa C, Seto M, Morishima Y, Kubo M, Nakamura Y, Matsuda K. Common variants on 14q32 and 13q12 are associated with DLBCL susceptibility. J Hum Genet 2011; 56:436-9. [PMID: 21471979 DOI: 10.1038/jhg.2011.35] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is one of the most aggressive cancers of B-lymphocytes. To investigate genetic susceptibility factors for DLBCL, we performed single-nucleotide polymorphism based genome-wide association study (GWAS) in a total of 399 DLBCL cases and 4243 controls of Japanese population. By following two-stage GWAS approach and an independent replication study, we identified disease susceptibility locus within intron 3 of the CDC42BPB gene on 14q32 (rs751837; P=3.30 × 10(-7) and odds ratio (OR) of 3.5), a region of frequent chromosomal translocations in lymphoma, and variant on 13q12 (rs7097; P=6.57 × 10(-6) and OR of 1.43) which harbors the notch signaling mediator, LNX2 gene. Our findings would contribute to the understanding of DLBCL risk and also may lead to the elucidation of its molecular pathogenesis.
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Affiliation(s)
- Vinod Kumar
- Laboratory of Molecular Medicine, Human Genome Center, Institute of Medical Science, the University of Tokyo, Tokyo, Japan
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45
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Clonal B cells in patients with hepatitis C virus-associated mixed cryoglobulinemia contain an expanded anergic CD21low B-cell subset. Blood 2011; 117:5425-37. [PMID: 21421840 DOI: 10.1182/blood-2010-10-312942] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is associated with the B-cell lymphoproliferative disorders mixed cryoglobulinemia (MC) and non-Hodgkin lymphoma. We have previously reported that HCV(+)MC(+) patients have clonal expansions of hypermutated, rheumatoid factor-bearing marginal zone-like IgM(+)CD27(+) peripheral B cells using the V(H)1-69 gene. Here we coupled transcriptional profiling with immunophenotypic and functional studies to ascertain these cells' role in MC pathogenesis. Despite their fundamental role in MC disease, these B cells have overall transcriptional features of anergy and apoptosis instead of neoplastic transformation. Highly up-regulated genes include SOX5, CD11C, galectin-1, and FGR, similar to a previously described FCRL4(+) memory B-cell subset and to an "exhausted," anergic CD21(low) memory B-cell subset in HIV(+) patients. Moreover, HCV(+)MC(+) patients' clonal peripheral B cells are enriched with CD21(low), CD11c(+), FCRL4(high), IL-4R(low) memory B cells. In contrast to the functional, rheumatoid factor-secreting CD27(+)CD21(high) subset, the CD27(+)CD21(low) subpopulation exhibits decreased calcium mobilization and does not efficiently differentiate into rheumatoid factor-secreting plasmablasts, suggesting that a large proportion of HCV(+)MC(+) patients' clonally expanded peripheral B cells is prone to anergy and/or apoptosis. Down-regulation of multiple activation pathways may represent a homeostatic mechanism attenuating otherwise uncontrolled stimulation of circulating HCV-containing immune complexes.
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46
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The host genetic background of DNA repair mechanisms is an independent predictor of survival in diffuse large B-cell lymphoma. Blood 2011; 117:2405-13. [DOI: 10.1182/blood-2010-07-296244] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract
Several drugs used for diffuse large B-cell lymphoma (DLBCL) treatment rely on DNA damage for tumor cell killing. We verified the prognostic impact of the host DNA repair genotype in 2 independent cohorts of DLBCL treated with R-CHOP21 (training cohort, 163 cases; validation cohort, 145 cases). Among 35 single nucleotide polymorphisms analyzed in the training series, MLH1 rs1799977 was the sole predicting overall survival. DLBCL carrying the MLH1 AG/GG genotype displayed an increased death risk (hazard ratio [HR] = 3.23; P < .001; q =0 .009) compared with patients carrying the AA genotype. Multivariate analysis adjusted for International Prognostic Index identified MLH1 AG/GG as an independent OS predictor (P < .001). The poor prognosis of MLH1 AG/GG was the result of an increased risk of failing both R-CHOP21 (HR = 2.02; P = .007) and platinum-based second-line (HR = 2.26; P = .044) treatment. Survival analysis in the validation series confirmed all outcomes predicted by MLH1 rs1799977. The effect on OS of MLH1, a component of the DNA mismatch repair system, is consistent with its role in regulating the genotoxic effects of doxorubicin and platinum compounds, which are a mainstay of DLBCL first- and second-line treatment.
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47
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Monroy CM, Cortes AC, Lopez MS, D'Amelio AM, Etzel CJ, Younes A, Strom SS, El-Zein RA. Hodgkin disease risk: role of genetic polymorphisms and gene-gene interactions in inflammation pathway genes. Mol Carcinog 2011; 50:36-46. [PMID: 21061265 DOI: 10.1002/mc.20688] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Inflammation is a critical component of cancer development. The clinical and pathological features of Hodgkin disease (HD) reflect an abnormal immunity that results from cytokines secreted by Reed-Sternberg cells and the surrounding tumor. Numerous studies have reported the association between genetic polymorphisms in cytokine genes and the susceptibility to different hematologic cancers. However, the effects of such SNPs on modulating HD risk have not yet been investigated. We hypothesized that gene-gene interactions between candidate genes in the anti- and pro-inflammatory pathways carrying suspicious polymorphisms may contribute to susceptibility to HD. To test this hypothesis, we conducted a study on 200 HD cases and 220 controls to assess associations between HD risk and 38 functional SNPs in inflammatory genes. We evaluated potential gene-gene interactions using a multi-analytic strategy combining logistic regression, multi-factor dimensionality reduction, and classification and regression tree (CART) approaches. We observed that, in combination, allelic variants in the COX2, IL18, ILR4, and IL10 genes modify the risk for developing HD. Moreover, the cumulative genetic risk score (CGRS) revealed a significant trend where the risk for developing HD increases as the number of adverse alleles in the cytokine genes increase. These findings support the notion that epigenetic-interactions between these cytokines may influence pathogenesis of HD modulating the proliferation of regulatory T cells. In this way, the innate and adaptative immune responses may be altered and defy their usual functions in the host anti-tumor response. Our study is the first to report the association between polymorphisms in inflammation genes and HD susceptibility risk.
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Affiliation(s)
- Claudia M Monroy
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-1439, USA
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48
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Han X, Li Y, Huang J, Zhang Y, Holford T, Lan Q, Rothman N, Zheng T, Kosorok MR, Ma S. Identification of predictive pathways for non-hodgkin lymphoma prognosis. Cancer Inform 2010; 9:281-92. [PMID: 21245948 PMCID: PMC3021201 DOI: 10.4137/cin.s6315] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Despite decades of intensive research, NHL (non-Hodgkin lymphoma) still remains poorly understood and is largely incurable. Recent molecular studies suggest that genomic variants measured with SNPs (single nucleotide polymorphisms) in genes may have additional predictive power for NHL prognosis beyond clinical risk factors. We analyzed a genetic association study. The prognostic cohort consisted of 346 patients, among whom 138 had DLBCL (diffuse large B-cell lymphoma) and 101 had FL ( follicular lymphoma). For DLBCL, we analyzed 1229 SNPs which represented 122 KEGG pathways. For FL, we analyzed 1228 SNPs which represented 122 KEGG pathways. Unlike in existing studies, we targeted at identifying pathways with significant additional predictive power beyond clinical factors. In addition, we accounted for the joint effects of multiple SNPs within pathways, whereas some existing studies drew pathway-level conclusions based on separate analysis of individual SNPs. For DLBCL, we identified four pathways, which, combined with the clinical factors, had medians of the prediction logrank statistics as 2.535, 2.220, 2.094, 2.453, and 2.512, respectively. As a comparison, the clinical factors had a median of the prediction logrank statistics around 0.552. For FL, we identified two pathways, which, combined with the clinical factors, had medians of the prediction logrank statistics as 4.320 and 3.532, respectively. As a comparison, the clinical factors had a median of the prediction logrank statistics around 1.212. For NHL overall, we identified three pathways, which, combined with the clinical factors, had medians of the prediction logrank statistics as 5.722, 5.314, and 5.441, respective. As a comparison, the clinical factors had a median of the prediction logrank statistics around 4.411. The identified pathways have sound biological bases. In addition, they are different from those identified using existing approaches. They may provide further insights into the biological mechanisms underlying the prognosis of NHL.
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Affiliation(s)
- Xuesong Han
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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49
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Zitvogel L, Kepp O, Aymeric L, Ma Y, Locher C, Delahaye NF, André F, Kroemer G. Integration of Host-Related Signatures with Cancer Cell–Derived Predictors for the Optimal Management of Anticancer Chemotherapy. Cancer Res 2010; 70:9538-43. [DOI: 10.1158/0008-5472.can-10-1003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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50
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Thunberg U, Enblad G, Turesson I, Berglund M. Genetic variation in tumor necrosis factor and risk of diffuse large B-cell lymphoma and follicular lymphoma: differences between subgroups in Swedish patients. Leuk Lymphoma 2010; 51:1563-6. [PMID: 20578820 DOI: 10.3109/10428194.2010.492486] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
MESH Headings
- B-Lymphocytes/metabolism
- B-Lymphocytes/pathology
- Case-Control Studies
- Cohort Studies
- Humans
- Lymphoma, Follicular/classification
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Polymorphism, Single Nucleotide/genetics
- Sweden
- Tumor Necrosis Factor-alpha/genetics
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