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Bátai B, Kiss L, Varga L, Nagy Á, Househam J, Baker AM, László T, Udvari A, Horváth R, Nagy T, Csomor J, Szakonyi J, Schneider T, Graham TA, Alpár D, Fitzgibbon J, Szepesi Á, Bödör C. Profiling of Copy Number Alterations Using Low-Coverage Whole-Genome Sequencing Informs Differential Diagnosis and Prognosis in Primary Cutaneous Follicle Center Lymphoma. Mod Pathol 2024; 37:100465. [PMID: 38460675 PMCID: PMC11092316 DOI: 10.1016/j.modpat.2024.100465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
Primary cutaneous follicle center lymphoma (PCFCL) has an excellent prognosis using local treatment, whereas nodal follicular lymphoma (nFL), occasionally presenting with cutaneous spread, often requires systemic therapy. Distinction of the 2 diseases based on histopathology alone might be challenging. Copy number alterations (CNAs) have scarcely been explored on a genome-wide scale in PCFCL; however, they might serve as potential biomarkers during differential diagnosis and risk stratification. Low-coverage whole-genome sequencing is a robust, high-throughput method for genome-wide copy number profiling. In this study, we analyzed 28 PCFCL samples from 20 patients and compared the copy number profiles with a cohort of diagnostic samples of 64 nFL patients. Although the copy number profile of PCFCL was similar to that of nFL, PCFCL lacked amplifications of 18q, with the frequency peaking at 18q21.33 in nFL cases involving the BCL2 locus (PCFCL: 5.0% vs nFL: 31.3%, P = .018, Fisher exact test). Development of distant cutaneous spread was significantly associated with higher genomic instability including the proportion of genome altered (0.02 vs 0.13, P = .033) and number of CNAs (2 vs 9 P = .017), as well as the enrichment of 2p22.2-p15 amplification involving REL and XPO1 (6.3% vs 60.0%, P = .005), 3q23-q24 amplification (0.0% vs 50.0%, P = .004), 6q16.1-q23.3 deletion (6.3% vs 50.0%, P = .018), and 9p21.3 deletion covering CDKN2A and CDKN2B loci (0.0% vs 40.0%, P = .014, all Fisher exact test) in PCFCL. Analysis of sequential tumor samples in 2 cases harboring an unfavorable clinical course pointed to the acquisition of 2p amplification in the earliest common progenitor underlining its pivotal role in malignant transformation. By performing genome-wide copy number profiling on the largest patient cohort to date, we identified distinctive CNA alterations conceivably facilitating the differential diagnosis of PCFCL and secondary cutaneous involvement of nFL and potentially aiding the risk stratification of patients with PCFCL in the future.
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Affiliation(s)
- Bence Bátai
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Laura Kiss
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Luca Varga
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Ákos Nagy
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
| | - Jacob Househam
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Ann-Marie Baker
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Tamás László
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Anna Udvari
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Róbert Horváth
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Tibor Nagy
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary; Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Csomor
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - József Szakonyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Tamás Schneider
- Department of Hematology and Lymphoma, National Institute of Oncology, Budapest, Hungary
| | - Trevor A Graham
- Genomics and Evolutionary Dynamics Team, Centre for Evolution and Cancer, The Institute for Cancer Research, London, United Kingdom
| | - Donát Alpár
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Jude Fitzgibbon
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Ágota Szepesi
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
| | - Csaba Bödör
- HCEMM-SU Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
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Carreras J, Ikoma H, Kikuti YY, Miyaoka M, Hiraiwa S, Tomita S, Kondo Y, Ito A, Nagase S, Miura H, Kawada H, Roncador G, Campo E, Hamoudi R, Nakamura N. Mutational, immune microenvironment, and clinicopathological profiles of diffuse large B-cell lymphoma and follicular lymphoma with BCL6 rearrangement. Virchows Arch 2024; 484:657-676. [PMID: 38462571 DOI: 10.1007/s00428-024-03774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
BCL6-rearrangement (BCL6-R) is associated with a favorable prognosis of follicular lymphoma (FL), but the mechanism is unknown. We analyzed the clinicopathological, immune microenvironment (immune checkpoint, immuno-oncology markers), and mutational profiles of 10 BCL6-R-positive FL, and 19 BCL6-R-positive diffuse large B-cell lymphoma (DLBCL) cases (both BCL2-R and MYC-R negative). A custom-made panel included 168 genes related to aggressive B-cell lymphomas and FL. FL cases were nodal, histological grade 3A in 70%, low Ki67; and had a favorable overall and progression-free survival. DLBCL cases were extranodal in 60%, IPI high in 63%, non-GCB in 60%, EBER-negative; and had a progression-free survival comparable to that of DLBCL NOS. The microenvironment had variable infiltration of M2-like tumor-associated macrophages (TAMs) that were CD163, CSF1R, LAIR1, PD-L1, and CD85A (LILRB3) positive; but had low IL10 and PTX3 expression. In comparison to FL, DLBCL had higher TAMs, IL10, and PTX3 expression. Both lymphoma subtypes shared a common mutational profile with mutations in relevant pathogenic genes such as KMT2D, OSBPL10, CREBBP, and HLA-B (related to chromatin remodeling, metabolism, epigenetic modification, and antigen presentation). FL cases were characterized by a higher frequency of mutations of ARID1B, ATM, CD36, RHOA, PLOD2, and PRPRD (p < 0.05). DLBCL cases were characterized by mutations of BTG2, and PIM1; and mutations of HIST1H1E and MFHAS1 to disease progression (p < 0.05). Interestingly, mutations of genes usually associated with poor prognosis, such as NOTCH1/2 and CDKN2A, were infrequent in both lymphoma subtypes. Some high-confidence variant calls were likely oncogenic, loss-of-function. MYD88 L265P gain-of-function was found in 32% of DLBCL. In conclusion, both BCL6-R-positive FL and BCL6-R-positive DLBCL had a common mutational profile; but also, differences. DLBCL cases had a higher density of microenvironment markers.
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MESH Headings
- Humans
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Tumor Microenvironment/immunology
- Tumor Microenvironment/genetics
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/immunology
- Proto-Oncogene Proteins c-bcl-6/genetics
- Male
- Female
- Middle Aged
- Aged
- Mutation
- Adult
- Biomarkers, Tumor/genetics
- Aged, 80 and over
- Gene Rearrangement
- DNA Mutational Analysis
- Progression-Free Survival
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Grants
- 23K06454 the Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 15K19061 the Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 18K15100 Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 24590430 Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 2021-B04 Tokai University School of Medicine research incentive assistant plan
- VRI-20-10 ASPIRE, the technology program management pillar of Abu Dhabi's Advanced Technology Research Council (ATRC), via the ASPIRE Precision Medicine Research Institute Abu Dhabi (AS-PIREPMRIAD) award
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Affiliation(s)
- Joaquim Carreras
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan.
| | - Haruka Ikoma
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Yara Yukie Kikuti
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Masashi Miyaoka
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Shinichiro Hiraiwa
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Sakura Tomita
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Yusuke Kondo
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Atsushi Ito
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Shunsuke Nagase
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Hisanobu Miura
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
| | - Hiroshi Kawada
- Department of Hematology, School of Medicine, Tokai University, Tokyo, Japan
| | - Giovanna Roncador
- Monoclonal Antibodies Core Unit, Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Elias Campo
- Department of Pathology, Esther Koplowitz Center (CEK), Centro de Investigacion Biomedica en Red de Cancer (CIBERONC), Hospital Clinic Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Rifat Hamoudi
- Research Institute for Medical and Health Science, Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Division of Surgery and Interventional Science, University College London, London, UK
- BIMAI-Lab, Biomedically Informed Artificial Intelligence Laboratory, University of Sharjah, Sharjah, United Arab Emirates
| | - Naoya Nakamura
- Department of Pathology, School of Medicine, Tokai University, Tokyo, Japan
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Grau M, López C, Martín-Subero JI, Beà S. Cytogenomics of B-cell non-Hodgkin lymphomas: The "old" meets the "new". Best Pract Res Clin Haematol 2023; 36:101513. [PMID: 38092483 DOI: 10.1016/j.beha.2023.101513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 12/18/2023]
Abstract
For the routine diagnosis of haematological neoplasms an integrative approach is used considering the morphology, and the immunophenotypic, and molecular features of the tumor sample, along with clinical information. The identification and characterization of recurrent chromosomal aberrations mainly detected by conventional and molecular cytogenetics in the tumor cells has a major impact on the classification of lymphoid neoplasms. Some of the B-cell non-Hodgkin lymphomas are characterized by particular chromosomal aberrations, highlighting the relevance of conventional and molecular cytogenetic studies in their diagnosis and prognosis. In the current genomics era, next generation sequencing provides relevant information as the mutational profiles of haematological malignancies, improving their classification and also the clinical management of the patients. In addition, other new technologies have emerged recently, such as the optical genome mapping, which can overcome some of the limitations of conventional and molecular cytogenetics and may become more widely used in the cytogenetic laboratories in the upcoming years. Moreover, epigenetic alterations may complement genetic changes for a deeper understanding of the pathogenesis underlying B-cell neoplasms and a more precise risk-based patient stratification. Overall, here we describe the current state of the genomic data integrating chromosomal rearrangements, copy number alterations, and somatic variants, as well as a succinct overview of epigenomic changes, which altogether constitute a comprehensive diagnostic approach in B-cell non-Hodgkin lymphomas.
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Affiliation(s)
- Marta Grau
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina López
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain
| | - José Ignacio Martín-Subero
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Sílvia Beà
- Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain; Universitat de Barcelona, Spain; Hematopathology Section, Pathology Department, Hospital Clínic Barcelona, Barcelona, Spain.
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4
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Kalmbach S, Grau M, Zapukhlyak M, Leich E, Jurinovic V, Hoster E, Staiger AM, Kurz KS, Weigert O, Gaitzsch E, Passerini V, Engelhard M, Herfarth K, Beiske K, Micci F, Möller P, Bernd HW, Feller AC, Klapper W, Stein H, Hansmann ML, Hartmann S, Dreyling M, Holte H, Lenz G, Rosenwald A, Ott G, Horn H. Novel insights into the pathogenesis of follicular lymphoma by molecular profiling of localized and systemic disease forms. Leukemia 2023; 37:2058-2065. [PMID: 37563306 PMCID: PMC10539171 DOI: 10.1038/s41375-023-01995-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
Knowledge on the pathogenesis of FL is mainly based on data derived from advanced/systemic stages of FL (sFL) and only small cohorts of localized FL (lFL) have been characterized intensively so far. Comprehensive analysis with profiling of somatic copy number alterations (SCNA) and whole exome sequencing (WES) was performed in 147 lFL and 122 sFL. Putative targets were analyzed for gene and protein expression. Overall, lFL and sFL, as well as BCL2 translocation-positive (BCL2+) and -negative (BCL2-) FL showed overlapping features in SCNA and mutational profiles. Significant differences between lFL and sFL, however, were detected for SCNA frequencies, e.g., in 18q-gains (14% lFL vs. 36% sFL; p = 0.0003). Although rare in lFL, gains in 18q21 were associated with inferior progression-free survival (PFS). The mutational landscape of lFL and sFL included typical genetic lesions. However, ARID1A mutations were significantly more often detected in sFL (29%) compared to lFL (6%, p = 0.0001). In BCL2 + FL mutations in KMT2D, BCL2, ABL2, IGLL5 and ARID1A were enriched, while STAT6 mutations more frequently occurred in BCL2- FL. Although the landscape of lFL and sFL showed overlapping features, molecular profiling revealed novel insights and identified gains in 18q21 as prognostic marker in lFL.
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Affiliation(s)
- Sabrina Kalmbach
- Department of Clinical Pathology, Robert-Bosch Hospital, Stuttgart, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Michael Grau
- Department of Medicine A, Department of Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Myroslav Zapukhlyak
- Department of Medicine A, Department of Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Ellen Leich
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center Main, Würzburg, Germany
| | - Vindi Jurinovic
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Eva Hoster
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Annette M Staiger
- Department of Clinical Pathology, Robert-Bosch Hospital, Stuttgart, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Katrin S Kurz
- Department of Clinical Pathology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Oliver Weigert
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Erik Gaitzsch
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Verena Passerini
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Marianne Engelhard
- Department for Radiotherapy, University Hospital of Essen, Essen, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - Klaus Beiske
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- KG Jebsen center for B cell malignancies, Oslo, Norway
| | - Francesca Micci
- Section for Cancer Cytogenetics, Oslo University Hospital, Oslo, Norway
| | - Peter Möller
- Institute of Pathology, University Hospital Ulm, Ulm, Germany
| | | | | | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | | | - Sylvia Hartmann
- Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany
| | - Martin Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Harald Holte
- KG Jebsen center for B cell malignancies, Oslo, Norway
| | - Georg Lenz
- Department of Medicine A, Department of Hematology, Oncology and Pneumology, University Hospital Münster, Münster, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center Main, Würzburg, Germany
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch Hospital, Stuttgart, Germany.
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.
| | - Heike Horn
- Department of Clinical Pathology, Robert-Bosch Hospital, Stuttgart, Germany
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
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5
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Carreras J. The pathobiology of follicular lymphoma. J Clin Exp Hematop 2023; 63:152-163. [PMID: 37518274 PMCID: PMC10628832 DOI: 10.3960/jslrt.23014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/10/2023] [Accepted: 06/15/2023] [Indexed: 08/01/2023] Open
Abstract
Follicular lymphoma is one of the most frequent lymphomas. Histologically, it is characterized by a follicular (nodular) growth pattern of centrocytes and centroblasts; mixed with variable immune microenvironment cells. Clinically, it is characterized by diffuse lymphadenopathy, bone marrow involvement, and splenomegaly. It is biologically and clinically heterogeneous. In most patients it is indolent, but others have a more aggressive evolution with relapses; and transformation to diffuse large B-cell lymphoma. Tumorigenesis includes an asymptomatic preclinical phase in which premalignant B-lymphocytes with the t(14;18) chromosomal translocation acquire additional genetic alterations in the germinal centers, and clonal evolution occurs, although not all the cells progress to the tumor stage. This manuscript reviews the pathobiology and clinicopathological characteristics of follicular lymphoma. It includes a description of the physiology of the germinal center, the genetic alterations of BCL2 and BCL6, the mutational profile, the immune checkpoint, precision medicine, and highlights in the lymphoma classification. In addition, a comment and review on artificial intelligence and machine (deep) learning are made.
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Affiliation(s)
- Joaquim Carreras
- Department of Pathology, Tokai University, School of Medicine, Isehara, Kanagawa, Japan
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6
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Lopedote P, Nawaiseh AA, Malek A, Faller G, Hattar M, Dow E, Kozyreva O. Early progression and transformation of a splenic diffuse red pulp small B-cell lymphoma with NOTCH1, ARID2, CREBBP, and TNFRSF14 gene mutations. Leuk Res Rep 2023; 20:100384. [PMID: 37664441 PMCID: PMC10471916 DOI: 10.1016/j.lrr.2023.100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Splenic diffuse red pulp small B-cell lymphoma (SDRPL) is a rare entity. Diagnosis is typically achieved with splenectomy and most patients remain in remission after this intervention. Hemoglobin value less than 10 g/dL and NOTCH1, TP53, and MAP2K1 gene mutations at diagnosis have been associated with worse outcome. Progression after splenectomy of SDRPL is possible, although transformation to aggressive lymphoma has rarely been reported. We herein report the case of a patient formerly diagnosed with SDRPL with gene mutations involving CREBBP, NOTCH1, ARID2, and TNFRSF14 who transformed to diffuse large B-cell lymphoma six months after splenectomy.
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Affiliation(s)
- Paolo Lopedote
- Department of Medicine, St Elizabeth's Medical Center, Boston University, Boston, MA, United States
| | - Ahmad Al Nawaiseh
- Department of Medicine, St Elizabeth's Medical Center, Boston University, Boston, MA, United States
| | - Anita Malek
- Department of Pathology, St Elizabeth's Medical Center, Boston, MA, United States
| | - Garrey Faller
- Department of Pathology, Good Samaritan Medical Center, Brockton, MA, United States
| | - Mariana Hattar
- Department of Medicine, St Elizabeth's Medical Center, Boston University, Boston, MA, United States
| | - Edward Dow
- Norfolk Center for Cancer Care, Brockton, MA, United States
| | - Olga Kozyreva
- Department of Medical Oncology, St Elizabeth's Medical Center, Dana Farber Cancer Institute, Boston, MA, United States
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7
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Minagawa K, Wakahashi K, Fukui C, Kawano Y, Kawano H, Suzuki T, Ishii S, Sada A, Nishikawa S, Asada N, Katayama Y, Matsui T. Tfl deletion induces extraordinary Cxcl13 secretion and cachexia in VavP- Bcl2 transgenic mice. Front Immunol 2023; 14:1197112. [PMID: 37304286 PMCID: PMC10250710 DOI: 10.3389/fimmu.2023.1197112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023] Open
Abstract
STATEMENT OF SIGNIFICANCE Loss of TFL, found in several types of lymphoma, induces excessive CXCL13 secretion through RNA dysregulation contributing to body weight loss and early death in lymphoma model mice. Follicular lymphoma (FL) is associated with overexpressed BCL-2 and other genetic aberrations, including 6q-. We identified a novel gene on 6q25, "Transformed follicular lymphoma (TFL)," from a transformed FL. TFL regulates several cytokines via mRNA degradation, which has been suggested to underlie resolving inflammation. Fluorescence in situ hybridization revealed a deletion of TFL occurred in 13.6% of various B-cell lymphoma samples. We developed VavP-bcl2 transgenic, TFL deficit mice (Bcl2-Tg/Tfl -/-) to seek how TFL affects disease progression in this lymphoma model. While Bcl2-Tg mice developed lymphadenopathy and died around 50 weeks, Bcl2-Tg/Tfl -/- mice lost body weight around 30 weeks and died about 20 weeks earlier than Bcl2-Tg mice. Furthermore, we found a unique B220-IgM+ cell population in the bone marrow of Bcl2-Tg mice. cDNA array in this population revealed that Cxcl13 mRNA in Bcl2-Tg/Tfl -/- mice expressed significantly higher than Bcl2-Tg mice. In addition, bone marrow extracellular fluid and serum showed an extremely high Cxcl13 concentration in Bcl2-Tg/Tfl -/- mice. Among bone marrow cells, the B220-IgM+ fraction was the main producer of Cxcl13 in culture. A reporter assay demonstrated TFL regulates CXCL-13 via induction of 3'UTR mRNA degradation in B lineage cells. These data suggest Tfl regulates Cxcl13 in B220-IgM+ cells in the bone marrow, and a very high concentration of serum Cxcl13 arising from these cells may contribute to early death in lymphoma-bearing mice. Since several reports have suggested the association of CXCL13 expression with lymphoma, these findings provide new insights into cytokine regulation via TFL in lymphoma.
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Affiliation(s)
- Kentaro Minagawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Hematology & Oncology Division, Penn State College of Medicine, Hershey, PA, United States
| | - Kanako Wakahashi
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chie Fukui
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuko Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohide Suzuki
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichi Ishii
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Sada
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Nishikawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noboru Asada
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshio Katayama
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Nishiwaki, Japan
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Stuckey R, Luzardo Henríquez H, de la Nuez Melian H, Rivero Vera JC, Bilbao-Sieyro C, Gómez-Casares MT. Integration of molecular testing for the personalized management of patients with diffuse large B-cell lymphoma and follicular lymphoma. World J Clin Oncol 2023; 14:160-170. [PMID: 37124135 PMCID: PMC10134203 DOI: 10.5306/wjco.v14.i4.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) are the most common forms of aggressive and indolent lymphoma, respectively. The majority of patients are cured by standard R-CHOP immunochemotherapy, but 30%–40% of DLBCL and 20% of FL patients relapse or are refractory (R/R). DLBCL and FL are phenotypically and genetically hereterogenous B-cell neoplasms. To date, the diagnosis of DLBCL and FL has been based on morphology, immunophenotyping and cytogenetics. However, next-generation sequencing (NGS) is widening our understanding of the genetic basis of the B-cell lymphomas. In this review we will discuss how integrating the NGS-based characterization of somatic gene mutations with diagnostic or prognostic value in DLBCL and FL could help refine B-cell lymphoma classification as part of a multidisciplinary pathology work-up. We will also discuss how molecular testing can identify candidates for clinical trials with targeted therapies and help predict therapeutic outcome to currently available treatments, including chimeric antigen receptor T-cell, as well as explore the application of circulating cell-free DNA, a non-invasive method for patient monitoring. We conclude that molecular analyses can drive improvements in patient outcomes due to an increased understanding of the different pathogenic pathways affected by each DLBCL subtype and indolent FL vs R/R FL.
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Affiliation(s)
- Ruth Stuckey
- Department of Hematology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas 35019, Spain
| | - Hugo Luzardo Henríquez
- Department of Hematology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas 35019, Spain
| | | | - José Carlos Rivero Vera
- Department of Anatomical Pathology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas 35019, Spain
| | - Cristina Bilbao-Sieyro
- Department of Hematology, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35019, Las Palmas de Gran Canaria, Spain
- Department of Morphology, Universitario de Las Palmas de Gran Canaria, Las Palmas 35001, Spain
| | - María Teresa Gómez-Casares
- Department of Hematology, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35019, Las Palmas de Gran Canaria, Spain
- Medical Science, Universitario de Las Palmas de Gran Canaria, Las Palmas 35001, Spain
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9
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Genetics of Transformed Follicular Lymphoma. HEMATO 2022. [DOI: 10.3390/hemato3040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Histological transformation (HT) to a more aggressive disease–mostly diffuse large B-cell lymphoma–is considered one of the most dismal events in the clinical course of follicular lymphoma (FL). Current knowledge has not found a single biological event specific for HT, although different studies have highlighted common genetic alterations, such as TP53 and CDKN2A/B loss, and MYC translocations, among others. Together, they increase genomic complexity and mutational burden at HT. A better knowledge of HT pathogenesis would presumably help to find diagnostic biomarkers allowing the identification of patients at high-risk of transformation, as well as the discrimination from patients with FL recurrence, and those who remain in remission. This would also help to identify new drug targets and the design of clinical trials for the treatment of transformation. In the present review we provide a comprehensive overview of the genetic events frequently identified in transformed FL contributing to the switch towards aggressive behaviour, and we will discuss current open questions in the field of HT.
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10
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Los-de Vries GT, Stevens WBC, van Dijk E, Langois-Jacques C, Clear AJ, Stathi P, Roemer MGM, Mendeville M, Hijmering NJ, Sander B, Rosenwald A, Calaminici M, Hoster E, Hiddemann W, Gaulard P, Salles G, Horn H, Klapper W, Xerri L, Burton C, Tooze RM, Smith AG, Buske C, Scott DW, Natkunam Y, Advani R, Sehn LH, Raemaekers J, Gribben J, Kimby E, Kersten MJ, Maucort-Boulch D, Ylstra B, de Jong D. Genomic and microenvironmental landscape of stage I follicular lymphoma, compared with stage III/IV. Blood Adv 2022; 6:5482-5493. [PMID: 35816682 PMCID: PMC9631713 DOI: 10.1182/bloodadvances.2022008355] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 11/18/2022] Open
Abstract
Although the genomic and immune microenvironmental landscape of follicular lymphoma (FL) has been extensively investigated, little is known about the potential biological differences between stage I and stage III/IV disease. Using next-generation sequencing and immunohistochemistry, 82 FL nodal stage I cases were analyzed and compared with 139 FL stage III/IV nodal cases. Many similarities in mutations, chromosomal copy number aberrations, and microenvironmental cell populations were detected. However, there were also significant differences in microenvironmental and genomic features. CD8+ T cells (P = .02) and STAT6 mutations (false discovery rate [FDR] <0.001) were more frequent in stage I FL. In contrast, programmed cell death protein 1-positive T cells, CD68+/CD163+ macrophages (P < .001), BCL2 translocation (BCL2trl+) (P < .0001), and KMT2D (FDR = 0.003) and CREBBP (FDR = 0.04) mutations were found more frequently in stage III/IV FL. Using clustering, we identified 3 clusters within stage I, and 2 clusters within stage III/IV. The BLC2trl+ stage I cluster was comparable to the BCL2trl+ cluster in stage III/IV. The two BCL2trl- stage I clusters were unique for stage I. One was enriched for CREBBP (95%) and STAT6 (64%) mutations, without BLC6 translocation (BCL6trl), whereas the BCL2trl- stage III/IV cluster contained BCL6trl (64%) with fewer CREBBP (45%) and STAT6 (9%) mutations. The other BCL2trl- stage I cluster was relatively heterogeneous with more copy number aberrations and linker histone mutations. This exploratory study shows that stage I FL is genetically heterogeneous with different underlying oncogenic pathways. Stage I FL BCL2trl- is likely STAT6 driven, whereas BCL2trl- stage III/IV appears to be more BCL6trl driven.
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Affiliation(s)
- G. Tjitske Los-de Vries
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | | | - Erik van Dijk
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Carole Langois-Jacques
- Université Lyon 1, Villeurbanne, France, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de recherche (UMR) 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Andrew J. Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, London, United Kingdom
| | - Phylicia Stathi
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Margaretha G. M. Roemer
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Matias Mendeville
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Nathalie J. Hijmering
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, Würzburg, and Comprehensive Cancer Center Mainfranken, Germany
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, London, United Kingdom
| | - Eva Hoster
- Department of Medicine III, University Hospital Grosshadern, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU University, Munich, Germany
| | - Wolfgang Hiddemann
- Department of Medicine III, University Hospital Grosshadern, Munich, Germany
| | - Philippe Gaulard
- Department of Pathology, Henri Mondor University Hospital, Assistance Pyblique- Hospitaux de Paris (APHP), INSERM U955, Université Paris-Est, Créteil, France
| | - Gilles Salles
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Heike Horn
- Institute for Clinical Pathology, Robert-Bosch-Krankenhaus, Dr. Margarete Fischer-Bosch-Institut für Klinische Pharmakologie, Stuttgart, Germany
| | - Wolfram Klapper
- Institute of Pathology, University of Schleswig-Holstein, Kiel, Germany
| | - Luc Xerri
- Département de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, St. James University Hospital, Leeds, United Kingdom
| | - Reuben M. Tooze
- Division of Haematology & Immunology, Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - Alexandra G. Smith
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Christian Buske
- Institute of Experimental Cancer Research, Comprehensive Cancer Center (CCC) Ulm, Universitätsklinikum Ulm, Ulm, Germany
| | - David W. Scott
- BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, BC, Canada
| | | | - Ranjana Advani
- Department of Hematology, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, CA
| | - Laurie H. Sehn
- BC Cancer Centre for Lymphoid Cancer and The University of British Columbia, Vancouver, BC, Canada
| | - John Raemaekers
- Department of Hematology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - John Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary, University of London, London, United Kingdom
| | - Eva Kimby
- Department of Medicine, Division of Hematology, Karolinska Institute, Stockholm, Sweden; and
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Center (UMC), University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Delphine Maucort-Boulch
- Université Lyon 1, Villeurbanne, France, Centre National de la Recherche Scientifique (CNRS), Unité Mixte de recherche (UMR) 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne, France
- Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, Lyon, France
| | - Bauke Ylstra
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Daphne de Jong
- Department of Pathology, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
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11
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Molecular Cytogenetic Profiling Reveals Similarities and Differences Between Localized Nodal and Systemic Follicular Lymphomas. Hemasphere 2022; 6:e767. [PMID: 35974958 PMCID: PMC9371558 DOI: 10.1097/hs9.0000000000000767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Recently, we have developed novel highly promising gene expression (GE) classifiers discriminating localized nodal (LFL) from systemic follicular lymphoma (SFL) with prognostic impact. However, few data are available in LFL especially concerning hotspot genetic alterations that are associated with the pathogenesis and prognosis of SFL. A total of 144 LFL and 527 SFL, enrolled in prospective clinical trials of the German Low Grade Lymphoma Study Group, were analyzed by fluorescence in situ hybridization to detect deletions in chromosomes 1p, 6q, and 17p as well as BCL2 translocations to determine their impact on clinical outcome of LFL patients. The frequency of chromosomal deletions in 1p and 17p was comparable between LFL and SFL, while 6q deletions and BCL2 translocations more frequently occurred in SFL. A higher proportion of 1p deletions was seen in BCL2-translocation–positive LFL, compared with BCL2-translocation–negative LFL. Deletions in chromosomes 1p, 6q, and 17p predicted clinical outcome of patients with SFL in the entire cohort, while only deletions in chromosome 1p retained its negative prognostic impact in R-CHOP–treated SFL. In contrast, no deletions in one of the investigated genetic loci predicted clinical outcome in LFL. Likewise, the presence or absence of BCL2 translocations had no prognostic impact in LFL. Despite representing a genetic portfolio closely resembling SFL, LFL showed some differences in deletion frequencies. BCL2 translocation and 6q deletion frequency differs between LFL and SFL and might contribute to distinct genetic profiles in LFL and SFL.
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12
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Pettengell R, Uddin R, Boumendil A, Johnson R, Metzner B, Martín A, Romejko-Jarosinska J, Bence-Bruckler I, Giri P, Niemann CU, Robinson SP, Kimby E, Schmitz N, Dreger P, Goldstone AH, Montoto S. Durable benefit of rituximab maintenance post-autograft in patients with relapsed follicular lymphoma: 12-year follow-up of the EBMT lymphoma working party Lym1 trial. Bone Marrow Transplant 2021; 56:1413-1421. [PMID: 33452448 DOI: 10.1038/s41409-020-01182-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 01/16/2023]
Abstract
We report the 12-year follow-up of the prospective randomized EBMT LYM1 trial to determine whether the benefit of brief duration rituximab maintenance (RM) on progression-free survival (PFS) in patients with relapsed follicular lymphoma (FL) receiving an autologous stem cell transplant (ASCT) is sustained. One hundred and thirty-eight patients received RM with or without purging. The median follow-up after random assignment is 12 years (range 10-13) for the whole series. The 10-year PFS after ASCT is 47% (95% CI 40-54) with only 4 patients relapsing after 7.5 years. RM continues to significantly improve 10-year PFS after ASCT in comparison with NM [P = 0.002; HR 0.548 (95% CI 0.38-0.80)]. Ten-year non-relapse mortality (NRM) was not significantly different between treatment groups (7% overall). 10-year overall survival (OS) after ASCT was 75% (69-81) for the whole series, with no significant differences according to treatment sub-groups. 10-year OS for patients who progressed within 24 months (POD24T) was 60%, in comparison with 85% for patients without progression. Thus the benefit of rituximab maintenance after ASCT on relapse prevention is sustained at 12 years, suggesting that RM adds to ASCT-mediated disease eradication and may enhance the curative potential of ASCT.
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Affiliation(s)
- R Pettengell
- Institute of Medical & Biomedical Education, St George's University of London, London, United Kingdom.
| | - R Uddin
- EBMT Clinical Trials Office, European Society for Blood and Marrow Transplantation, London, United Kingdom
| | - A Boumendil
- Statistics, European Society for Blood and Marrow Transplantation, Paris, France
| | - R Johnson
- Department of Haematology, St James's University Hospital, Leeds, United Kingdom
| | - B Metzner
- University Clinic for Internal Medicine, Oncology and Haematology, Klinikum Oldenburg, Oldenburg, Germany
| | - A Martín
- Hematology Department, Hospital Universitario de Salamanca, IBSAL, CIBERONC, Salamanca, Spain
| | - J Romejko-Jarosinska
- Department of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute and Oncology Center, Warsaw, Poland
| | | | - P Giri
- Haematology, Royal Adelaide Hospital, Adelaide, Southern Australia, Australia
| | - C U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - S P Robinson
- Department of Haematology, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - E Kimby
- Department of Hematology, Karolinska Institute, Stockholm, Sweden
| | - N Schmitz
- Department of Internal Medicine A, University Hospital Muenster, Muenster, Germany
| | - P Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - A H Goldstone
- University College London Hospital, London, United Kingdom
| | - S Montoto
- Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
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13
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Cascione L, Aresu L, Baudis M, Bertoni F. DNA Copy Number Changes in Diffuse Large B Cell Lymphomas. Front Oncol 2020; 10:584095. [PMID: 33344238 PMCID: PMC7740002 DOI: 10.3389/fonc.2020.584095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/29/2020] [Indexed: 12/24/2022] Open
Abstract
Copy number aberrations (CNV/CNA) represent a major contribution to the somatic mutation landscapes in cancers, and their identification can lead to the discovery of oncogenetic targets as well as improved disease (sub-) classification. Diffuse large B cell lymphoma (DLBCL) is the most common lymphoma in Western Countries and up to 40% of the affected individuals still succumb to the disease. DLBCL is an heterogenous group of disorders, and we call DLBCL today is not necessarily the same disease of a few years ago. This review focuses on types and frequencies of regional DNA CNVs in DLBCL, not otherwise specified, and in two particular conditions, the transformation from indolent lymphomas and the DLBCL in individuals with immunodeficiency.
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Affiliation(s)
- Luciano Cascione
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland.,SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Luca Aresu
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Michael Baudis
- SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland.,Department of Molecular Life Science, University of Zurich, Zurich, Switzerland
| | - Francesco Bertoni
- Institute of Oncology Research, Faculty of Biomedical Sciences, USI, Bellinzona, Switzerland.,Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
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14
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Bailey NG, Elenitoba-Johnson KSJ. Impact of Genetics on Mature Lymphoid Leukemias and Lymphomas. Cold Spring Harb Perspect Med 2020; 10:cshperspect.a035444. [PMID: 31932467 DOI: 10.1101/cshperspect.a035444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Recurrent genetic aberrations have long been recognized in mature lymphoid leukemias and lymphomas. As conventional karyotypic and molecular cloning techniques evolved in the 1970s and 1980s, multiple cytogenetic aberrations were identified in lymphomas, often balanced translocations that juxtaposed oncogenes to the immunoglobulin (IG) or T-cell receptor (TR) loci, leading to dysregulation. However, genetic characterization and classification of lymphoma by conventional cytogenetic methods is limited by the infrequent occurrence of recurrent karyotypic abnormalities in many lymphoma subtypes and by the frequent difficulty in growing clinical lymphoma specimens in culture to obtain informative karyotypes. As higher-resolution genomic techniques developed, such as array comparative genomic hybridization and fluorescence in situ hybridization, many recurrent copy number changes were identified in lymphomas, and copy number assessment of interphase cells became part of routine clinical practice for a subset of diseases. Platforms to globally examine mRNA expression led to major insights into the biology of several lymphomas, although these techniques have not gained widespread application in routine clinical settings. With the advent of next-generation sequencing (NGS) techniques in the early 2000s, numerous insights into the genetic landscape of lymphomas were obtained. In contrast to the myeloid malignancies, most common lymphomas exhibit an at least somewhat mutationally complex genome, with few single driver mutations in the majority of patients. However, many recurrently mutated pathways have been identified across lymphoma subtypes, informing targeted therapeutic approaches that are beginning to make meaningful changes in the treatment of lymphoma. In addition to the ability to identify possible therapeutic targets, NGS techniques are highly amenable to the tracking of residual lymphoma following therapy, because of the presence of unique genetic "fingerprints" in lymphoma cells due to V(D)-J recombination at the antigen receptor loci. This review will provide an overview of the impact of novel genetic technologies on lymphoma classification, biology, and therapy.
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Affiliation(s)
- Nathanael G Bailey
- Division of Hematopathology, Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
| | - Kojo S J Elenitoba-Johnson
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19102, USA
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15
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CREBBP and STAT6 co-mutation and 16p13 and 1p36 loss define the t(14;18)-negative diffuse variant of follicular lymphoma. Blood Cancer J 2020; 10:69. [PMID: 32555149 PMCID: PMC7299932 DOI: 10.1038/s41408-020-0335-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022] Open
Abstract
The diffuse variant of follicular lymphoma (dFL) is a rare variant of FL lacking t(14;18) that was first described in 2009. In this study, we use a comprehensive approach to define unifying pathologic and genetic features through gold-standard pathologic review, FISH, SNP-microarray, and next-generation sequencing of 16 cases of dFL. We found unique morphologic features, including interstitial sclerosis, microfollicle formation, and rounded nuclear cytology, confirmed absence of t(14;18) and recurrent deletion of 1p36, and showed a novel association with deletion/CN-LOH of 16p13 (inclusive of CREBBP, CIITA, and SOCS1). Mutational profiling demonstrated near-uniform mutations in CREBBP and STAT6, with clonal dominance of CREBBP, among other mutations typical of germinal-center B-cell lymphomas. Frequent CREBBP and CIITA codeletion/mutation suggested a mechanism for immune evasion, while subclonal STAT6 activating mutations with concurrent SOCS1 loss suggested a mechanism of BCL-xL/BCL2L1 upregulation in the absence of BCL2 rearrangements. A review of the literature showed significant enrichment for 16p13 and 1p36 loss/CN-LOH, STAT6 mutation, and CREBBP and STAT6 comutation in dFL, as compared with conventional FL. With this comprehensive approach, our study demonstrates confirmatory and novel genetic associations that can aid in the diagnosis and subclassification of this rare type of lymphoma.
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16
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Abstract
Although outcomes for follicular lymphoma (FL) continue to improve, it remains incurable for the majority of patients. Through next generation sequencing (NGS) studies, we now recognize that the genomic landscape of FL is skewed toward highly recurrent mutations in genes that encode epigenetic regulators co-occurring with the pathognomonic t(14;18) translocation. Adopting these technologies to study longitudinal and spatially-derived lymphomas has provided unique insights into the tumoral heterogeneity, clonal evolution of the disease and supports the existence of a tumor-repopulating population, considered the Achilles' heel of this lymphoma. An in-depth understanding of the genomics and its contribution to the disease pathogenesis is identifying new biomarkers and therapeutic targets that can be translated into clinical practice and, in the not too distant future, enable us to start considering precision-based approaches to the management of FL.
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Affiliation(s)
- Lucy Pickard
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Giuseppe Palladino
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
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17
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Tamayo-Orbegozo E, Amo L, Díez-García J, Amutio E, Riñón M, Alonso M, Arana P, Maruri N, Larrucea S. Emerging Role of Podocalyxin in the Progression of Mature B-Cell Non-Hodgkin Lymphoma. Cancers (Basel) 2020; 12:cancers12020396. [PMID: 32046309 PMCID: PMC7072361 DOI: 10.3390/cancers12020396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 02/06/2023] Open
Abstract
Mature B-cell non-Hodgkin lymphoma (B-NHL) constitutes a group of heterogeneous malignant lymphoproliferative diseases ranging from indolent to highly aggressive forms. Although the survival after chemo-immunotherapy treatment of mature B-NHL has increased over the last years, many patients relapse or remain refractory due to drug resistance, presenting an unfavorable prognosis. Hence, there is an urgent need to identify new prognostic markers and therapeutic targets. Podocalyxin (PODXL), a sialomucin overexpressed in a variety of tumor cell types and associated with their aggressiveness, has been implicated in multiple aspects of cancer progression, although its participation in hematological malignancies remains unexplored. New evidence points to a role for PODXL in mature B-NHL cell proliferation, survival, migration, drug resistance, and metabolic reprogramming, as well as enhanced levels of PODXL in mature B-NHL. Here, we review the current knowledge on the contribution of PODXL to tumorigenesis, highlighting and discussing its role in mature B-NHL progression.
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Affiliation(s)
- Estíbaliz Tamayo-Orbegozo
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (E.T.-O.); (L.A.)
| | - Laura Amo
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (E.T.-O.); (L.A.)
| | - Javier Díez-García
- Microscopy Facility, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain;
| | - Elena Amutio
- Blood Cancer Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain;
| | - Marta Riñón
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (M.R.); (M.A.); (P.A.); (N.M.)
| | - Marta Alonso
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (M.R.); (M.A.); (P.A.); (N.M.)
| | - Paula Arana
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (M.R.); (M.A.); (P.A.); (N.M.)
| | - Natalia Maruri
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (M.R.); (M.A.); (P.A.); (N.M.)
| | - Susana Larrucea
- Regulation of the Immune System Group, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain; (M.R.); (M.A.); (P.A.); (N.M.)
- Correspondence:
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18
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Mitsui T, Yokohama A, Koiso H, Saito A, Toyama K, Shimizu H, Ishizaki T, Irisawa H, Takizawa M, Saitoh T, Murayama K, Matsumoto M, Handa H, Hirato J, Kojima M, Murakami H, Tsukamoto N. Prognostic impact of trisomy 21 in follicular lymphoma. Br J Haematol 2018; 184:570-577. [PMID: 30417943 DOI: 10.1111/bjh.15664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
The chromosomal abnormalities associated with follicular lymphoma (FL) prognosis are not fully elucidated. Here, we evaluated the pattern of chromosomal abnormalities in FL, and clarified the correlations between the cytogenetic features and clinical outcome. Cytogenetic analysis was performed using standard methods of Giemsa-banding at diagnosis for 201 FL patients admitted to our hospitals between 2001 and 2013. The identified chromosomal abnormalities were: t(14;18)(q32;q21) (59·2%), +X (17·9%), del(6)(q)/-6 (16·9%), +7 (14·4%), abnormality of 1q12-21/1q (12·9%), del(13)(q)/-13 (11·9%), abnormality of 3q27 (10·4%), abnormality of 10q22-24 (10·0%), +12/dup(12)(q) (10·0%), abnormality of 1p21-22/1p (9·0%), +18 (9·0%), del(17)(p)/-17 (5·0%), and a complex karyotype (54·7%). Patients with trisomy 21 had a significantly shorter progression-free survival (P = 0·00171) and overall survival (OS) (P < 0·001) than those without trisomy 21; additionally, patients with trisomy 21 in the rituximab-treated cohort also had a significantly shorter OS (P = 0·000428). Multivariate analysis identified trisomy 21 as an independent risk factor in our cohorts with or without t(14;18) (P = 0·015). In conclusion, the presence of trisomy 21 was an independent risk factor for in FL. Chromosomal analysis of FL patients at diagnosis can provide useful information about their expected survival.
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Affiliation(s)
- Takeki Mitsui
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihiko Yokohama
- Division of Blood Transfusion Service, Gunma University Hospital, Maebashi, Japan
| | - Hiromi Koiso
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akio Saito
- Fujioka General Hospital, Fujioka, Japan
| | | | - Hiroaki Shimizu
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takuma Ishizaki
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroyuki Irisawa
- Division of Haematology, Gunma Prefectural Cancer Centre, Ohta, Japan
| | - Makiko Takizawa
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Science, Maebashi, Japan
| | - Kayoko Murayama
- Division of Haematology, Gunma Prefectural Cancer Centre, Ohta, Japan
| | - Morio Matsumoto
- Division of Haematology, National Hospital Organization Shibukawa Medical Centre, Shibukawa, Japan
| | - Hiroshi Handa
- Department of Haematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Junko Hirato
- Department of Pathology, Gunma University Hospital, Maebashi, Japan
| | - Masaru Kojima
- Department of Anatomic and Diagnostic Pathology, Dokkyo University School of Medicine, Mibu, Japan
| | - Hirokazu Murakami
- Department of Laboratory Sciences, Gunma University Graduate School of Health Science, Maebashi, Japan
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19
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20
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Godfrey J, Leukam MJ, Smith SM. An update in treating transformed lymphoma. Best Pract Res Clin Haematol 2018; 31:251-261. [PMID: 30213394 DOI: 10.1016/j.beha.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
Indolent lymphomas typically have a prolonged course and favorable prognosis. Recent data support survival times that can reach several decades, even if periodic treatment is needed to manage symptoms or stabilize disease. However, all indolent lymphomas have the potential to undergo transformation to an aggressive phenotype, clinically characterized by a rapid progression of adenopathy, new-onset constitutional symptoms, or laboratory abnormalities, and the immediate need for therapeutic intervention. The most common scenario is transformation of follicular lymphoma to either diffuse large B-cell lymphoma or high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 translocations; however, other indolent subtypes such as marginal zone lymphoma, lymphoplasmacytic lymphoma, small lymphocytic lymphoma/chronic lymphocytic leukemia, or even nodular lymphocyte predominant Hodgkin lymphoma, can undergo similar histologic transformation. The prognosis of transformed lymphomas has historically been quite poor, but there is ample evidence this is changing in the rituximab era. This article will provide a review of transformed lymphomas with an emphasis on treatment and the nuances of diagnosis and clinical management. Unless otherwise specified, all discussion in this review pertains to transformed follicular lymphoma which is the more common scenario and the subtype with the most robust data. In many cases, this information can be extrapolated and applied to other indolent histologies (i.e. transformed marginal zone lymphoma); however, several other clinical scenarios, such as Richter's transformation and "double hit" transformations, warrant a distinct discussion and will be reviewed separately.
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Affiliation(s)
- James Godfrey
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, USA
| | - Michael J Leukam
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, USA
| | - Sonali M Smith
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago, USA.
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21
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Casulo C, Nastoupil L, Fowler NH, Friedberg JW, Flowers CR. Unmet needs in the first-line treatment of follicular lymphoma. Ann Oncol 2018; 28:2094-2106. [PMID: 28430865 DOI: 10.1093/annonc/mdx189] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
For the majority of patients with newly diagnosed follicular lymphoma (FL), current treatments, while not curative, allow for long remission durations. However, several important needs remain unaddressed. Studies have consistently shown that ∼20% of patients with FL experience disease progression within 2 years of first-line treatment, and consequently have a 50% risk of death in 5 years. Better characterization of this group of patients at diagnosis may provide insight into those in need of alternate or intensive therapies, facilitate a precision approach to inform clinical trials, and allow for improved patient counseling. Prognostic methods to date have employed clinical parameters, genomic methods, and a wide assortment of biological and biochemical markers, but none so far has been able to adequately identify this high-risk population. Advances in the first-line treatment of FL with chemoimmunotherapy have led to a median progression-free survival (PFS) of approximately 7 years; creating a challenge in the development of clinical trials where PFS is a primary end point. A surrogate end point that accurately predicts PFS would allow for new treatments to reach patients with FL sooner, or lessen toxicity, time, and expense to those patients requiring little to no therapy. Quality of response to treatment may predict PFS and overall survival in FL; as such complete response rates, either alone or in conjunction with PET imaging or minimal residual disease negativity, are being studied as surrogates, with complete response at 30 months after induction providing the strongest surrogacy evidence to date. A better understanding of how to optimize quality of life in the context of this chronic illness is another important focus deserving of further study. Ongoing efforts to address these important unmet needs are herein discussed.
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Affiliation(s)
- C Casulo
- Department of Medicine, Hematology/Oncology, WIlmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - L Nastoupil
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston
| | - N H Fowler
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, Houston
| | - J W Friedberg
- Department of Medicine, Hematology/Oncology, WIlmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - C R Flowers
- Department of Bone Marrow and Stem Cell Transplantation, Winship Cancer Institute, Emory University, Atlanta, USA
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22
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Chan FC, Lim E, Kridel R, Steidl C. Novel insights into the disease dynamics of B-cell lymphomas in the Genomics Era. J Pathol 2018; 244:598-609. [DOI: 10.1002/path.5043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Fong Chun Chan
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver British Columbia Canada
| | - Emilia Lim
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver British Columbia Canada
| | - Robert Kridel
- Princess Margaret Cancer Centre; University Health Network; Toronto Canada
| | - Christian Steidl
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
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23
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Yi S, Li Z, Zou D, Xiong W, Li H, Cui R, Li C, Yan Y, Liu W, Lv R, Yu Z, Chen W, Xu Y, An G, Wang H, Ru K, Cheng T, Wang J, Qiu L. Del17p does not always significantly influence the survival of B-cell chronic lymphoproliferative disorders. Oncotarget 2017; 9:3353-3364. [PMID: 29423051 PMCID: PMC5790468 DOI: 10.18632/oncotarget.23261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/17/2017] [Indexed: 12/13/2022] Open
Abstract
B-cell chronic lymphoproliferative disorders (B-CLPD) comprise several entities with indolent clinical manifestations but heterogeneous survival. Cytogenetic aberrations are now the standard prognostic predictors in chronic lymphocytic leukemia (CLL) but have been less investigated in other subtypes of B-CLPD. In this study, we detected cytogenetic aberrations by fluorescence in situ hybridization (FISH) in 875 B-CLPD patients, based on a panel probes locating at 13q14, 11q22, 17p13 and CEP12. We identified del17p acted as the independent adverse cytogenetic predictor for overall survival (OS) in CLL. Del13q, del11q and del17p were adverse factors for OS in Waldenström's macroglobulinemia in the univariate analysis but lost their role in the multivariate analysis. Trisomy 12 acted as an independent poor factor for both marginal zone lymphoma (MZL) and unclassified B-CLPD (BCLPD-U) subtype. Del17p did not impact survival in MZL and BCLPD-U patients. These contrasting results indicate different roles of the same cytogenetic aberrations in the pathogenesis of each B-CLPD subtype. As del17p contributed to the poorest survival in CLL and desired extraordinary treatment strategy, the imitation of CLL strategy to other B-CLPD with del17p should be carefully advocated based on this study.
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Affiliation(s)
- Shuhua Yi
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Zengjun Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Wenjie Xiong
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Heng Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Rui Cui
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China.,Department of Hematology, Tianjin First Center Hospital, Tianjin, P.R.China
| | - Chengwen Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Yuting Yan
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Rui Lv
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Zhen Yu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Weiwei Chen
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Yan Xu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Gang An
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Huijun Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Kun Ru
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Tao Cheng
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, P.R.China
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24
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Pathogenesis of follicular lymphoma. Best Pract Res Clin Haematol 2017; 31:2-14. [PMID: 29452662 DOI: 10.1016/j.beha.2017.10.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/23/2017] [Indexed: 12/21/2022]
Abstract
Follicular lymphoma (FL) is presented as a germinal centre B cell lymphoma that is characterized by an indolent clinical course, but remains - paradoxically - largely incurable to date. The last years have seen significant progress in our understanding of FL lymphomagenesis, which is a multi-step process beginning in the bone marrow with the hallmark t(14;18)(q32;q21) translocation. The pathobiology of FL is complex and combines broad somatic changes at the level of both the genome and the epigenome, the latter evidenced by highly recurrent mutations in chromatin-modifying genes such as KMT2D and CREBBP. While the importance of the FL microenvironment has since long been well understood, it has become evident that somatic lesions within tumour cells re-educate normal immune and stromal cells to their advantage. Enhanced understanding of FL pathogenesis is currently leading to refined therapeutic targeting of perturbed biology, paving the way for precision medicine in this lymphoma subtype.
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25
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Jiménez-Ubieto A, Grande C, Caballero D, Yáñez L, Novelli S, Hernández MT, Manzanares M, Arranz R, Ferreiro JJ, Bobillo S, Mercadal S, Galego A, Jiménez JL, Moraleda JM, Vallejo C, Albo C, Pérez E, Marrero C, Magnano L, Palomera L, Jarque I, Coria E, Rodriguez A, Martín A, López-Guillermo A, Salar A, Lahuerta JJ. Progression-free survival at 2 years post-autologous transplant: a surrogate end point for overall survival in follicular lymphoma. Cancer Med 2017; 6:2766-2774. [PMID: 29076254 PMCID: PMC5727300 DOI: 10.1002/cam4.1217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 07/05/2017] [Accepted: 08/31/2017] [Indexed: 01/19/2023] Open
Abstract
Overall survival (OS) is the gold‐standard end point for studies evaluating autologous stem cell transplantation (ASCT) in follicular lymphoma (FL), but assessment may be elusive due to the lengthy disease course. We analyzed the validity of two earlier end points, proposed in the setting of first‐line chemo‐/immunotherapy, as surrogates for OS—progression‐free survival (PFS) status at 24 months (PFS24) and complete response at 30 months (CR30) post‐ASCT. We also have investigated the clinical features of patients with early progression after ASCT. Data were available for 626 chemosensitive FL patients who received ASCT between 1989 and 2007. Median follow‐up was 12.2 years from ASCT. In the PFS24 analysis, 153 (24%) patients progressed within 24 months and 447 were alive and progression‐free at 24 months post‐ASCT (26 who died without disease progressions within 24 months were excluded). Early progression was associated with shorter OS (hazard ratio [HR], 6.8; P = 0.00001). In the subgroup of patients who received an ASCT in the setting or relapse after being exposed to rituximab, the HR was 11.3 (95% CI, 3.9–30.2; P < 0.00001). In the CR30 analysis, 183 of 596 (31%) response‐evaluable patients progressed/died with 30 months post‐ASCT. The absence of CR30 was associated with shorter OS (HR, 7.8; P < 0.00001), including in patients with prior rituximab (HR, 8.2). PFS24 and CR30 post‐ASCT are associated with poor outcomes and should be primary end points. Further research is needed to identify this population to be offered alternative treatments.
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Affiliation(s)
| | - Carlos Grande
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | | | - Lucrecia Yáñez
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | - Reyes Arranz
- Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Santiago Mercadal
- Hospital Universitario de Bellvitge, l'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | - Elena Pérez
- Hospital Universitario Morales de Messeguer, Murcia, Spain
| | - Carmen Marrero
- Hospital Universitario Nuestra Señora de La Candelaria, Tenerife, Spain
| | | | - Luis Palomera
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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26
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Fischer T, Zing NPC, Chiattone CS, Federico M, Luminari S. Transformed follicular lymphoma. Ann Hematol 2017; 97:17-29. [PMID: 29043381 DOI: 10.1007/s00277-017-3151-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 10/05/2017] [Indexed: 12/01/2022]
Abstract
Follicular Lymphoma (FL) is the second most common type of non-Hodgkin lymphoma and is considered to be the prototype of indolent lymphomas. Histologic transformation into an aggressive lymphoma, which is expected to occur at a rate of 2 to 3% each year, is associated with rapid progression, treatment resistance, and poor prognosis. Recent modifications to the physiopathologic mechanism of transformed follicular lymphoma (t-FL) have been proposed, including genetic and epigenetic mechanisms as well as a role for the microenvironment. Although t-FL is considered a devastating complication, as it is associated with treatment-refractory disease and a dismal outcome, recent data in the rituximab era have suggested that not only is the prognosis less severe than reported in the previous literature but the risk of transformation is also lower. Thus, this study aimed to review the most recent research on t-FL in an attempt to better understand the clinical meaning of transformation from FL to diffuse large B cell lymphoma (DLBCL) and the impact of current treatment strategies on the curability of this intriguing subentity of lymphoma.
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Affiliation(s)
- Thais Fischer
- Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Stefano Luminari
- University of Modena and Reggio Emilia, Modena, Italy. .,Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Arcispedale Santa Maria Nuova IRCCS, viale Risorgimento n°80 42123, Reggio Emilia, Italy.
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27
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Sorigue M, Sancho JM. Current prognostic and predictive factors in follicular lymphoma. Ann Hematol 2017; 97:209-227. [PMID: 29032510 DOI: 10.1007/s00277-017-3154-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 10/09/2017] [Indexed: 12/27/2022]
Abstract
Follicular lymphoma (FL) is generally considered an indolent disorder. With modern day treatments, long remissions are often achieved both in the front-line and relapsed setting. However, a subset of patients has a more aggressive course and a worse outcome. Their identification is the main purpose of modern day prognostic tools. In this review, we attempt to summarize the evidence concerning prognostic and predictive factors in FL, including (1) pre-treatment factors, from baseline clinical characteristics and imaging tests to histological grade, the microenvironment and genomic abnormalities; (2) post-treatment factors, i.e., depth of response, measured both by imaging tests and minimal residual disease; (3) factors at relapse and duration of response; and (4) prognostic factors in histological transformation. We conclude that, despite the existence of numerous tools, the availability of some of them is still limited; they generally suffer from notable downsides, and most have unproven predictive value, thus having scarce bearing on the choice of regimen at present. However, with the technological and scientific developments of the last few years, the potential for these prognostic factors is promising, particularly in combination, which will probably, in time, help guide therapeutic decisions.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols
- Bone Marrow/drug effects
- Bone Marrow/metabolism
- Bone Marrow/pathology
- Chromosomes, Human, Pair 14/chemistry
- Chromosomes, Human, Pair 18/chemistry
- Clinical Trials as Topic
- Disease-Free Survival
- Humans
- Lymphoma, Follicular/diagnostic imaging
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/mortality
- Mutation
- Neoplasm Grading
- Neoplasm, Residual/diagnostic imaging
- Neoplasm, Residual/drug therapy
- Neoplasm, Residual/genetics
- Neoplasm, Residual/mortality
- Positron-Emission Tomography
- Prognosis
- Recurrence
- Risk Factors
- Translocation, Genetic
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/metabolism
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Affiliation(s)
- Marc Sorigue
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet, 08916, Badalona, Spain.
| | - Juan-Manuel Sancho
- Department of Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Ctra. Canyet, 08916, Badalona, Spain
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28
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Can histologic transformation of follicular lymphoma be predicted and prevented? Blood 2017; 130:258-266. [DOI: 10.1182/blood-2017-03-691345] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/06/2017] [Indexed: 12/28/2022] Open
Abstract
Abstract
Transformation to aggressive lymphoma is a critical event in the clinical course of follicular lymphoma (FL) patients. Yet, it is a challenge to reliably predict transformation at the time of diagnosis. Understanding the risk of transformation would be useful for guiding and monitoring patients, as well as for evaluating novel treatment strategies that could potentially prevent transformation. Herein, we review the contribution of clinical, pathological, and genetic risk factors to transformation. Patients with multiple clinical high-risk factors are at elevated risk of transformation but we are currently lacking a prognostic index that would specifically address transformation rather than disease progression or overall survival. From the biological standpoint, multiple studies have correlated individual biomarkers with transformation. However, accurate prediction of this event is currently hampered by our limited knowledge of the evolutionary pathways leading to transformation, as well as the scarcity of comprehensive, large-scale studies that assess both the genomic landscape of alterations within tumor cells and the composition of the microenvironment. Liquid biopsies hold great promise for achieving precision medicine. Indeed, mutations detected within circulating tumor DNA may be a better reflection of the inherent intratumoral heterogeneity than the biopsy of a single site. Last, we will assess whether evidence exists in the literature that transformation might be prevented altogether, based on the choice of therapy for FL.
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29
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Grange B, Callet-Bauchu E, Salles G, Sujobert P. Advances in the role of cytogenetic analysis in the molecular diagnosis of B-cell lymphomas. Expert Rev Mol Diagn 2017; 17:623-632. [DOI: 10.1080/14737159.2017.1327811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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30
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Korfi K, Ali S, Heward JA, Fitzgibbon J. Follicular lymphoma, a B cell malignancy addicted to epigenetic mutations. Epigenetics 2017; 12:370-377. [PMID: 28106467 PMCID: PMC5453190 DOI: 10.1080/15592294.2017.1282587] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 01/07/2023] Open
Abstract
While follicular lymphoma (FL) is exquisitely responsive to immuno-chemotherapy, many patients follow a relapsing remitting clinical course driven in part by a common precursor cell (CPC) population. Advances in next generation sequencing have provided valuable insights into the genetic landscape of FL and its clonal evolution in response to therapy, implicating perturbations of epigenetic regulators as a hallmark of the disease. Recurrent mutations of histone modifiers KMT2D, CREBBP, EP300, EZH2, ARIDIA, and linker histones are likely early events arising in the CPC pool, rendering epigenetic based therapies conceptually attractive for treatment of indolent and transformed FL. This review provides a synopsis of the main epigenetic aberrations and the current efforts in development and testing of epigenetic therapies in this B cell malignancy.
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Affiliation(s)
- Koorosh Korfi
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Sara Ali
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - James A. Heward
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
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31
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Epperla N, Pham AQ, Burnette BL, Wiseman GA, Habermann TM, Macon WR, Ansell SM, Inwards DJ, Micallef IN, Johnston PB, Markovic SN, Porrata LF, Colgan JP, Ristow KM, Nowakowski GS, Witzig TE. Risk of histological transformation and therapy-related myelodysplasia/acute myeloid leukaemia in patients receiving radioimmunotherapy for follicular lymphoma. Br J Haematol 2017; 178:427-433. [PMID: 28466487 DOI: 10.1111/bjh.14688] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/02/2017] [Indexed: 01/15/2023]
Abstract
Histological transformation (HT) of follicular lymphoma (FL) to an aggressive lymphoma after chemotherapy remains a key issue. The incidence of HT after radioimmunotherapy (RIT) is unknown. This single institution study analysed the risk of HT in FL after treatment with yttrium-90 ibritumomab tiuxetan in 115 consecutive patients treated during 1987-2012. RIT was administered for progressive FL in 111 (97%) patients and as first-line therapy in the remaining 4. 28% (n = 32) had HT, occurring at a median of 60 months from diagnosis and 20 months after RIT. 48% (12/25) of patients who received fludarabine developed HT. The estimated 10-year risk of HT in the fludarabine and non-fludarabine groups was 67% and 26% respectively (P = 0·015). Only prior fludarabine was significantly associated with predicting the risk of HT after RIT. 8% (9/115) of patients developed therapy-related myelodysplastic syndrome/acute myeloid leukaemia (tMDS/AML) at a median of 41·4 months (range, 5-89). The estimated 10-year risk of tMDS/AML in non-fludarabine treated patients (n = 90) versus fludarabine treated (n = 25) was 13% and 29%, respectively. The estimated overall risk of FL undergoing HT at 10 years without fludarabine exposure appears similar to patients reported in the literature that have not received RIT. Patients with prior purine-analogue therapy are at significantly higher risk of HT.
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Affiliation(s)
- Narendranath Epperla
- Department of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anthony Q Pham
- Department of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - William R Macon
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | - Luis F Porrata
- Department of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Kay M Ristow
- Department of Hematology, Mayo Clinic, Rochester, MN, USA
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Hu X, Baytak E, Li J, Akman B, Okay K, Hu G, Scuto A, Zhang W, Küçük C. The relationship of REL proto-oncogene to pathobiology and chemoresistance in follicular and transformed follicular lymphoma. Leuk Res 2017; 54:30-38. [PMID: 28095352 DOI: 10.1016/j.leukres.2017.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/15/2016] [Accepted: 01/02/2017] [Indexed: 02/05/2023]
Abstract
Follicular lymphoma (FL) is a common type of indolent lymphoma that occasionally transforms to more aggressive B-cell lymphomas. These transformed follicular lymphomas (tFL) are often associated with chemoresistance whose mechanisms are currently unknown. REL, a proto-oncogene located on frequently amplified 2p16.1-p15 locus, promotes tumorigenesis in many cancer types through deregulation of the NF-κB pathway; however, its role in FL pathobiology or chemoresistance has not been addressed. Here, we evaluated REL gene copy number by q-PCR on FFPE FL tumor samples, and observed REL amplification in 30.4% of FL cases that was associated with weak elevation of transcript levels. PCR-Sanger analysis did not show any somatic mutation in FL tumors. In support of a marginal oncogenic role, a REL-transduced FL cell line was positively selected under limiting serum conditions. Interestingly, reanalysis of previously reported gene expression profiles revealed significant enrichment of DNA damage-induced repair and cell cycle arrest pathways in tFL tumors with high REL expression compared to those with low REL expression consistent with the critical role of c-REL in genotoxicity-induced NF-κB signaling, which was reported to lead to drug resistance. In addition to DNA damage repair genes such as ATM and BRCA1, anti-apoptotic BCL2 was significantly elevated in REL-high FL and tFL tumors. Altogether these data suggest that other genes located in amplified 2p16.1-p15 locus may have more oncogenic role in FL etiology; however, high REL expression may be useful as a predictive biomarker of response to immunochemotherapy, and inhibition of c-REL may potentially sensitize resistant FL or tFL cells to chemotherapy.
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Affiliation(s)
- Xiaozhou Hu
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey
| | - Esra Baytak
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey; Department of Medical Biology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Jinnan Li
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Guangxi, China
| | - Burcu Akman
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey
| | - Kaan Okay
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey
| | - Genfu Hu
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey; Department of Clinical Medicine, Guilin Medical University, Guangxi, China
| | - Anna Scuto
- Department of Pathology, City of Hope Medical Center, Duarte, CA, USA
| | - Wenyan Zhang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Guangxi, China.
| | - Can Küçük
- İzmir International Biomedicine and Genome Institute (iBG-izmir), Dokuz Eylul University, İzmir, Turkey; Department of Medical Biology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.
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Detection of chromosomal abnormalities by G-banding and prognostic impact in follicular lymphoma in the rituximab era. Int J Hematol 2016; 105:658-667. [PMID: 27995457 DOI: 10.1007/s12185-016-2166-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 02/04/2023]
Abstract
Disease-specific cytogenetic abnormalities involving BCL2 gene rearrangement frequently co-exist with other cytogenetic abnormalities, contributing to disease progression in follicular lymphoma (FL). In the present study, we retrospectively investigated the prognostic impact of BCL2-unrelated cytogenetic abnormalities in FL. Of 139 consecutively diagnosed patients with FL at two independent institutes, metaphase spreads of tumor cells were obtained for use in G-banding analysis in 77 patients. The recurrent additional cytogenetic abnormalities included chromosome gains +5 (n = 8), +7 (n = 16), +12 (n = 10), and +X (n = 12), and losses -8 (n = 7), -13 (n = 12) -15 (n = 7), and 6q- (n = 7). While -15 was associated with shorter progression-free survival (PFS) in all 77 analyzed patients with evaluable G-banding results (p = 0.04), this negative impact was not evident in 42 patients treated using an R-CHOP-like regimen as first-line treatment. By contrast, 6q- was predictive for shorter PFS in patients who were initially treated with R-CHOP-like regimens without maintenance therapy (p < 0.01), while this negative impact was not evident in all 77 patients with evaluable G-banding results. These results suggest the presence of a molecular region in chromosome 6q that is responsible for the shorter PFS following R-CHOP-like chemotherapy.
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Abstract
The recent application of next-generation sequencing technologies lead to significant improvements in our understanding of genetic underpinnings of non-Hodgkin lymphomas with identification of an unexpectedly high number of novel mutation targets across the different B-cell lymphoma entities. These recently discovered molecular lesions are expected to have a major impact on development of novel biomarkers and targeted therapies as well as patient stratification based on the underlying genetic profile. This review will cover the major discoveries in B-cell lymphomas using next-generation sequencing technologies over the last few years, highlighting alterations associated with relapse and progression of these diseases.
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Affiliation(s)
- Csaba Bödör
- MTA-SE Lendulet Molecular Oncohematology Research Group, Budapest, Hungary.,1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Lilla Reiniger
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary. .,2nd Department of Pathology, MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.
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Histological Transformation and Progression in Follicular Lymphoma: A Clonal Evolution Study. PLoS Med 2016; 13:e1002197. [PMID: 27959929 PMCID: PMC5154502 DOI: 10.1371/journal.pmed.1002197] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/07/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Follicular lymphoma (FL) is an indolent, yet incurable B cell malignancy. A subset of patients experience an increased mortality rate driven by two distinct clinical end points: histological transformation and early progression after immunochemotherapy. The nature of tumor clonal dynamics leading to these clinical end points is poorly understood, and previously determined genetic alterations do not explain the majority of transformed cases or accurately predict early progressive disease. We contend that detailed knowledge of the expansion patterns of specific cell populations plus their associated mutations would provide insight into therapeutic strategies and disease biology over the time course of FL clinical histories. METHODS AND FINDINGS Using a combination of whole genome sequencing, targeted deep sequencing, and digital droplet PCR on matched diagnostic and relapse specimens, we deciphered the constituent clonal populations in 15 transformation cases and 6 progression cases, and measured the change in clonal population abundance over time. We observed widely divergent patterns of clonal dynamics in transformed cases relative to progressed cases. Transformation specimens were generally composed of clones that were rare or absent in diagnostic specimens, consistent with dramatic clonal expansions that came to dominate the transformation specimens. This pattern was independent of time to transformation and treatment modality. By contrast, early progression specimens were composed of clones that were already present in the diagnostic specimens and exhibited only moderate clonal dynamics, even in the presence of immunochemotherapy. Analysis of somatic mutations impacting 94 genes was undertaken in an extension cohort consisting of 395 samples from 277 patients in order to decipher disrupted biology in the two clinical end points. We found 12 genes that were more commonly mutated in transformed samples than in the preceding FL tumors, including TP53, B2M, CCND3, GNA13, S1PR2, and P2RY8. Moreover, ten genes were more commonly mutated in diagnostic specimens of patients with early progression, including TP53, BTG1, MKI67, and XBP1. CONCLUSIONS Our results illuminate contrasting modes of evolution shaping the clinical histories of transformation and progression. They have implications for interpretation of evolutionary dynamics in the context of treatment-induced selective pressures, and indicate that transformation and progression will require different clinical management strategies.
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Slot LM, Hoogeboom R, Smit LA, Wormhoudt TAM, Biemond BJ, Oud MECM, Schilder-Tol EJM, Mulder AB, Jongejan A, van Kampen AHC, Kluin PM, Guikema JEJ, Bende RJ, van Noesel CJM. B-Lymphoblastic Lymphomas Evolving from Follicular Lymphomas Co-Express Surrogate Light Chains and Mutated Gamma Heavy Chains. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:3273-3284. [PMID: 27750045 DOI: 10.1016/j.ajpath.2016.07.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 06/30/2016] [Accepted: 07/28/2016] [Indexed: 01/19/2023]
Abstract
Follicular lymphoma (FL) is an indolent B-cell non-Hodgkin lymphoma able to transform into germinal center-type diffuse large B-cell lymphoma. We describe four extraordinary cases of FL, which progressed to TdT+CD20- precursor B-lymphoblastic lymphoma (B-LBL). Fluorescence in situ hybridization analysis showed that all four B-LBLs had acquired a MYC translocation on transformation. Comparative genomic hybridization analysis of one case demonstrated that in addition to 26 numerical aberrations that were shared between the FL and B-LBL, deletion of CDKN2A/B and 17q11, 14q32 amplification, and copy-neutral loss of heterozygosity of 9p were gained in the B-LBL cells. Whole-exome sequencing revealed mutations in FMN2, NEB, and SYNE1 and a nonsense mutation in KMT2D, all shared by the FL and B-LBL, and TNFRSF14, SMARCA2, CCND3 mutations uniquely present in the B-LBL. Remarkably, all four FL-B-LBL pairs expressed IgG. In two B-LBLs, evidence was obtained for ongoing rearrangement of IG light chain variable genes and expression of the surrogate light chain. IGHV mutation analysis showed that all FL-B-LBL pairs harbored identical or near-identical somatic mutations. From the somatic gene alterations found in the IG and non-IG genes, we conclude that the FLs and B-LBLs did not develop in parallel from early t(14;18)-positive IG-unmutated precursors, but that the B-LBLs developed from preexistent FL subclones that accumulated additional genetic damage.
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Affiliation(s)
- Linda M Slot
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands
| | - Robbert Hoogeboom
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands
| | - Laura A Smit
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Thera A M Wormhoudt
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands
| | - Bart J Biemond
- Department of Haematology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Monique E C M Oud
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands
| | | | - André B Mulder
- Department of Laboratory Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Aldo Jongejan
- Bioinformatics Laboratory, Klinische Epidemiologie, Biostatistiek en Bio-informatica (KEBB), Academic Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Antoine H C van Kampen
- Bioinformatics Laboratory, Klinische Epidemiologie, Biostatistiek en Bio-informatica (KEBB), Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Biosystems Data Analysis, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Philip M Kluin
- Department of Pathology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Jeroen E J Guikema
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands
| | - Richard J Bende
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands
| | - Carel J M van Noesel
- Department of Pathology, Academic Medical Center Amsterdam, Amsterdam, the Netherlands; Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam, the Netherlands.
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Characterization of a variant of t(14;18) negative nodal diffuse follicular lymphoma with CD23 expression, 1p36/TNFRSF14 abnormalities, and STAT6 mutations. Mod Pathol 2016; 29:570-81. [PMID: 26965583 DOI: 10.1038/modpathol.2016.51] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 01/08/2023]
Abstract
A predominantly diffuse growth pattern and CD23 co-expression are uncommon findings in nodal follicular lymphoma and can create diagnostic challenges. A single case series in 2009 (Katzenberger et al) proposed a unique morphologic variant of nodal follicular lymphoma, characterized by a predominantly diffuse architecture, lack of the t(14;18) IGH/BCL2 translocation, presence of 1p36 deletion, frequent inguinal lymph node involvement, CD23 co-expression, and low clinical stage. Other studies on CD23+ follicular lymphoma, while associating inguinal location, have not specifically described this architecture. In addition, no follow-up studies have correlated the histopathologic and cytogenetic/molecular features of these cases, and they remain a diagnostic problem. We identified 11 cases of diffuse, CD23+ follicular lymphoma with histopathologic features similar to those described by Katzenberger et al. Along with pertinent clinical information, we detail their histopathology, IGH/BCL2 translocation status, lymphoma-associated chromosomal gains/losses, and assessment of mutations in 220 lymphoma-associated genes by massively parallel sequencing. All cases showed a diffuse growth pattern around well- to ill-defined residual germinal centers, uniform CD23 expression, mixed centrocytic/centroblastic cytology, and expression of at least one germinal center marker. Ten of 11 involved inguinal lymph nodes, 5 solely. By fluorescence in situ hybridization analysis, the vast majority lacked IGH/BCL2 translocation (9/11). Deletion of 1p36 was observed in five cases and included TNFRSF14. Of the six cases lacking 1p36 deletion, TNFRSF14 mutations were identified in three, highlighting the strong association of 1p36/TNFRSF14 abnormalities with this follicular lymphoma variant. In addition, 9 of the 11 cases tested (82%) had STAT6 mutations and nuclear P-STAT6 expression was detectable in the mutated cases by immunohistochemistry. The proportion of STAT6 mutations is higher than recently reported in conventional follicular lymphoma (11%). These findings lend support for a clinicopathologic variant of t(14;18) negative nodal follicular lymphoma and suggests importance of the interleukin (IL)-4/JAK/STAT6 pathway in this variant.
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Bogusz AM, Bagg A. Genetic aberrations in small B-cell lymphomas and leukemias: molecular pathology, clinical relevance and therapeutic targets. Leuk Lymphoma 2016; 57:1991-2013. [PMID: 27121112 DOI: 10.3109/10428194.2016.1173212] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Small B-cell lymphomas and leukemias (SBCLs) are a clinically, morphologically, immunophenotypically and genetically heterogeneous group of clonal lymphoid neoplasms, including entities such as chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), mantle cell lymphoma (MCL), follicular lymphoma (FL), lymphoplasmacytic lymphoma (LPL), marginal zone lymphoma (MZL) and hairy cell leukemia (HCL). The pathogenesis of some of these lymphoid malignancies is characterized by distinct translocations, for example t(11;14) in the majority of cases of MCL and t(14;18) in most cases of FL, whereas other entities are associated with a variety of recurrent but nonspecific numeric chromosomal abnormalities, as exemplified by del(13q14), del(11q22), and +12 in CLL, and yet others such as LPL and HCL that lack recurrent or specific cytogenetic aberrations. The recent surge in next generation sequencing (NGS) technology has shed more light on the genetic landscape of SBCLs through characterization of numerous driver mutations including SF3B1 and NOTCH1 in CLL, ATM and CCND1 in MCL, KMT2D and EPHA7 in FL, MYD88 (L265P) in LPL, KLF2 and NOTCH2 in splenic MZL (SMZL) and BRAF (V600E) in HCL. The identification of distinct genetic lesions not only provides greater insight into the molecular pathogenesis of these disorders but also identifies potential valuable biomarkers for prognostic stratification, as well as specific targets for directed therapy. This review discusses the well-established and recently identified molecular lesions underlying the pathogenesis of SBCLs, highlights their clinical relevance and summarizes novel targeted therapies.
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Affiliation(s)
- Agata M Bogusz
- a Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
| | - Adam Bagg
- a Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
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Mar N, Digiuseppe JA, Dailey ME. Rubinstein–Taybi syndrome – a window into follicular lymphoma biology. Leuk Lymphoma 2016; 57:2908-2910. [DOI: 10.3109/10428194.2016.1165816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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40
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Etebari M, Navari M, Piccaluga PP. SNPs Array Karyotyping in Non-Hodgkin Lymphoma. MICROARRAYS 2015; 4:551-69. [PMID: 27600240 PMCID: PMC4996401 DOI: 10.3390/microarrays4040551] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/29/2015] [Accepted: 11/04/2015] [Indexed: 02/06/2023]
Abstract
The traditional methods for detection of chromosomal aberrations, which included cytogenetic or gene candidate solutions, suffered from low sensitivity or the need for previous knowledge of the target regions of the genome. With the advent of single nucleotide polymorphism (SNP) arrays, genome screening at global level in order to find chromosomal aberrations like copy number variants, DNA amplifications, deletions, and also loss of heterozygosity became feasible. In this review, we present an update of the knowledge, gained by SNPs arrays, of the genomic complexity of the most important subtypes of non-Hodgkin lymphomas.
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Affiliation(s)
- Maryam Etebari
- Department of Experimental, Diagnostic, and Specialty Medicine; Hematopathology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
| | - Mohsen Navari
- Department of Experimental, Diagnostic, and Specialty Medicine; Hematopathology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
| | - Pier Paolo Piccaluga
- Department of Experimental, Diagnostic, and Specialty Medicine; Hematopathology Unit, S. Orsola-Malpighi Hospital, Bologna 40138, Italy.
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Cell of origin of transformed follicular lymphoma. Blood 2015; 126:2118-27. [PMID: 26307535 DOI: 10.1182/blood-2015-06-649905] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/20/2015] [Indexed: 01/10/2023] Open
Abstract
Follicular lymphoma (FL) is an indolent disease but transforms in 2% to 3% of patients per year into aggressive, large cell lymphoma, a critical event in the course of the disease associated with increased lymphoma-related mortality. Early transformation cannot be accurately predicted at the time of FL diagnosis and the biology of transformed FL (TFL) is poorly understood. Here, we assembled a cohort of 126 diagnostic FL specimens including 40 patients experiencing transformation (<5 years) and 86 patients not experiencing transformation for at least 5 years. In addition, we assembled an overlapping cohort of 155 TFL patients, including 114 cases for which paired samples were available, and assessed temporal changes of routinely available biomarkers, outcome after transformation, as well as molecular subtypes of TFL. We report that the expression of IRF4 is an independent predictor of early transformation (Hazard ratio, 13.3; P < .001). We also show that composite histology at the time of transformation predicts favorable prognosis. Moreover, applying the Lymph2Cx digital gene expression assay for diffuse large B-cell lymphoma (DLBCL) cell-of-origin determination to 110 patients with DLBCL-like TFL, we demonstrate that TFL is of the germinal-center B-cell-like subtype in the majority of cases (80%) but that a significant proportion of cases is of the activated B-cell-like (ABC) subtype (16%). These latter cases are commonly negative for BCL2 translocation and arise preferentially from BCL2 translocation-negative and/or IRF4-expressing FLs. Our study demonstrates the existence of molecular heterogeneity in TFL as well as its relationship to the antecedent FL.
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Casulo C, Byrtek M, Dawson KL, Zhou X, Farber CM, Flowers CR, Hainsworth JD, Maurer MJ, Cerhan JR, Link BK, Zelenetz AD, Friedberg JW. Early Relapse of Follicular Lymphoma After Rituximab Plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Defines Patients at High Risk for Death: An Analysis From the National LymphoCare Study. J Clin Oncol 2015; 33:2516-22. [PMID: 26124482 DOI: 10.1200/jco.2014.59.7534] [Citation(s) in RCA: 570] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Twenty percent of patients with follicular lymphoma (FL) experience progression of disease (POD) within 2 years of initial chemoimmunotherapy. We analyzed data from the National LymphoCare Study to identify whether prognostic FL factors are associated with early POD and whether patients with early POD are at high risk for death. PATIENTS AND METHODS In total, 588 patients with stage 2 to 4 FL received first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Two groups were defined: patients with early POD 2 years or less after diagnosis and those without POD within 2 years, the reference group. An independent validation set, 147 patients with FL who received first-line R-CHOP, was analyzed for reproducibility. RESULTS Of 588 patients, 19% (n = 110) had early POD, 71% (n = 420) were in the reference group, 8% (n = 46) were lost to follow-up, and 2% (n = 12) died without POD less than 2 years after diagnosis. Five-year overall survival was lower in the early-POD group than in the reference group (50% v 90%). This trend was maintained after we adjusted for FL International Prognostic Index (hazard ratio, 6.44; 95% CI, 4.33 to 9.58). Results were similar for the validation set (FL International Prognostic Index-adjusted hazard ratio, 19.8). CONCLUSION In patients with FL who received first-line R-CHOP, POD within 2 years after diagnosis was associated with poor outcomes and should be further validated as a standard end point of chemoimmunotherapy trials of untreated FL. This high-risk FL population warrants further study in directed prospective clinical trials.
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Affiliation(s)
- Carla Casulo
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Michelle Byrtek
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Keith L Dawson
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Xiaolei Zhou
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Charles M Farber
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Christopher R Flowers
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - John D Hainsworth
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Matthew J Maurer
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - James R Cerhan
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Brian K Link
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Andrew D Zelenetz
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA
| | - Jonathan W Friedberg
- Carla Casulo and Jonathan W. Friedberg, University of Rochester, Rochester; Jonathan W. Friedberg, Memorial Sloan Kettering Cancer Center, New York, NY; Michelle Byrtek and Keith L. Dawson, Genentech, South San Francisco, CA; Xiaolei Zhou, RTI Health Solutions, Research Triangle Park, NC; Charles M. Farber, Carol G. Simon Cancer Center, Morristown, NJ; Christopher R. Flowers, Emory University, Atlanta, GA; John D. Hainsworth, Sarah Cannon Research Institute, Nashville, TN; Matthew J. Maurer and James R. Cerhan, Mayo Clinic, Rochester, MN; and Brian K. Link, University of Iowa, Iowa City, IA.
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Takata K, Miyata-Takata T, Sato Y, Yoshino T. Pathology of follicular lymphoma. J Clin Exp Hematop 2015; 54:3-9. [PMID: 24942941 DOI: 10.3960/jslrt.54.3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Follicular lymphoma (FL) is a heterogeneous disease, and there are many different subgroups, such as in terms of age of onset, involved organ (especially extranodal sites such as gastrointestinal tract) and genetic abnormality. Grade 3B is currently regarded as a distinct entity by molecular genetic analyses, but the independence of Grade 3A remains unclear. Variations of clinical course are known in FL. Some cases are very indolent, but others are not. The latter cases show histological transformation to diffuse large B-cell lymphoma (DLBCL) (high-grade transformation) and an aggressive course. Histological transformation to DLBCL is reported to occur in about 30-40% of patients, at a rate of about 3% each year. However, it reaches a plateau at about 16 years, so the stratification of patients in whom transformation would or would not occur is very important for the therapeutic strategy. From genome-wide analysis by next-generation sequencing, EZH2, CREBBP and MLL2, which are histone-modifying genes, have been shown to be frequently mutated in FL and to have an important role in lymphomagenesis. IGH-BCL2 translocation and CREBBP mutations are early events, whereas MLL2 and TNFSFR14 mutations represent late events during disease evolution. In the 2008 WHO classification, three new variants: (1) pediatric follicular lymphoma, (2) primary intestinal follicular lymphoma and (3) in situ follicular lymphoma, are included. Pathologists and clinicians should consider these new developments when deciding on the diagnostic and therapeutic strategy.
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Affiliation(s)
- Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Koues OI, Kowalewski RA, Chang LW, Pyfrom SC, Schmidt JA, Luo H, Sandoval LE, Hughes TB, Bednarski JJ, Cashen AF, Payton JE, Oltz EM. Enhancer sequence variants and transcription-factor deregulation synergize to construct pathogenic regulatory circuits in B-cell lymphoma. Immunity 2015; 42:186-98. [PMID: 25607463 PMCID: PMC4302272 DOI: 10.1016/j.immuni.2014.12.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 10/11/2014] [Accepted: 11/17/2014] [Indexed: 01/06/2023]
Abstract
Most B-cell lymphomas arise in the germinal center (GC), where humoral immune responses evolve from potentially oncogenic cycles of mutation, proliferation, and clonal selection. Although lymphoma gene expression diverges significantly from GC B cells, underlying mechanisms that alter the activities of corresponding regulatory elements (REs) remain elusive. Here we define the complete pathogenic circuitry of human follicular lymphoma (FL), which activates or decommissions REs from normal GC B cells and commandeers enhancers from other lineages. Moreover, independent sets of transcription factors, whose expression was deregulated in FL, targeted commandeered versus decommissioned REs. Our approach revealed two distinct subtypes of low-grade FL, whose pathogenic circuitries resembled GC B or activated B cells. FL-altered enhancers also were enriched for sequence variants, including somatic mutations, which disrupt transcription-factor binding and expression of circuit-linked genes. Thus, the pathogenic regulatory circuitry of FL reveals distinct genetic and epigenetic etiologies for GC B-cell transformation.
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Affiliation(s)
- Olivia I Koues
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Rodney A Kowalewski
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Li-Wei Chang
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Sarah C Pyfrom
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jennifer A Schmidt
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Hong Luo
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Luis E Sandoval
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Tyler B Hughes
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jeffrey J Bednarski
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Amanda F Cashen
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jacqueline E Payton
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA.
| | - Eugene M Oltz
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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Abstract
Follicular lymphoma (FL) is the most common indolent lymphoma. The vast majority of cases are associated with the chromosome translocation t(14;18), a somatic rearrangement that leads to constitutive expression of the anti-apoptotic BCL2 protein. Although t(14;18) clearly represents an important early event in FL pathogenesis, abundant evidence indicates that it is not sufficient. In particular, the recent application of next-generation DNA sequencing technology has uncovered numerous recurrent somatic genomic alterations associated with FL, most of which affect tumor suppressor genes (TSGs). In this article we review the existing literature on TSGs involved in the development and progression of FL. We consider the genes that are most frequently targeted by deleterious mutation, deletion or epigenetic silencing, along with strategies for developing new treatments that exploit the susceptibilities that may be conferred on lymphoma cells by the loss of particular TSGs.
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Disruption of the PRKCD-FBXO25-HAX-1 axis attenuates the apoptotic response and drives lymphomagenesis. Nat Med 2014; 20:1401-9. [PMID: 25419709 DOI: 10.1038/nm.3740] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 10/02/2014] [Indexed: 12/12/2022]
Abstract
We searched for genetic alterations in human B cell lymphoma that affect the ubiquitin-proteasome system. This approach identified FBXO25 within a minimal common region of frequent deletion in mantle cell lymphoma (MCL). FBXO25 encodes an orphan F-box protein that determines the substrate specificity of the SCF (SKP1-CUL1-F-box)(FBXO25) ubiquitin ligase complex. An unbiased screen uncovered the prosurvival protein HCLS1-associated protein X-1 (HAX-1) as the bona fide substrate of FBXO25 that is targeted after apoptotic stresses. Protein kinase Cδ (PRKCD) initiates this process by phosphorylating FBXO25 and HAX-1, thereby spatially directing nuclear FBXO25 to mitochondrial HAX-1. Our analyses in primary human MCL identify monoallelic loss of FBXO25 and stabilizing HAX1 phosphodegron mutations. Accordingly, FBXO25 re-expression in FBXO25-deleted MCL cells promotes cell death, whereas expression of the HAX-1 phosphodegron mutant inhibits apoptosis. In addition, knockdown of FBXO25 significantly accelerated lymphoma development in Eμ-Myc mice and in a human MCL xenotransplant model. Together we identify a PRKCD-dependent proapoptotic mechanism controlling HAX-1 stability, and we propose that FBXO25 functions as a haploinsufficient tumor suppressor and that HAX1 is a proto-oncogene in MCL.
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Copy number variation analysis on a non-Hodgkin lymphoma case-control study identifies an 11q25 duplication associated with diffuse large B-cell lymphoma. PLoS One 2014; 9:e105382. [PMID: 25133503 PMCID: PMC4136881 DOI: 10.1371/journal.pone.0105382] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/23/2014] [Indexed: 11/19/2022] Open
Abstract
Recent GWAS have identified several susceptibility loci for NHL. Despite these successes, much of the heritable variation in NHL risk remains to be explained. Common copy-number variants are important genomic sources of variability, and hence a potential source to explain part of this missing heritability. In this study, we carried out a CNV analysis using GWAS data from 681 NHL cases and 749 controls to explore the relationship between common structural variation and lymphoma susceptibility. Here we found a novel association with diffuse large B-cell lymphoma (DLBCL) risk involving a partial duplication of the C-terminus region of the LOC283177 long non-coding RNA that was further confirmed by quantitative PCR. For chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), known somatic deletions were identified on chromosomes 13q14, 11q22-23, 14q32 and 22q11.22. Our study shows that GWAS data can be used to identify germline CNVs associated with disease risk for DLBCL and somatic CNVs for CLL/SLL.
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Hassan HM, Varney ML, Jain S, Weisenburger DD, Singh RK, Dave BJ. Disruption of chromosomal locus 1p36 differentially modulates TAp73 and ΔNp73 expression in follicular lymphoma. Leuk Lymphoma 2014; 55:2924-31. [PMID: 24660851 DOI: 10.3109/10428194.2014.900759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The TP73 gene is located at the chromosome 1p36 locus that is commonly disrupted or deleted in follicular lymphoma (FL) with poor prognosis. Therefore, we analyzed the expression of the pro-apoptotic TAp73 and anti-apoptotic ΔNp73 isoforms in cases of FL with normal or abnormal 1p36. We observed a significant increase in ΔNp73 expression and ΔNp73:TAp73 ratio, lower expression of cleaved caspase-3 and a higher frequency of Ki-67 and proliferating cell nuclear antigen (PCNA) positive cells in cases of FL with abnormal 1p36. A negative correlation between the ΔNp73:TAp73 ratio and cleaved caspase-3 expression, and a positive correlation between ΔNp73 expression and Ki-67 or PCNA, were observed. The expression of TAp73 and its pro-apoptotic transcriptional targets BIM. PUMA and NOXA were significantly lower in FL compared to reactive follicular hyperplasia. Together, our data demonstrate that 1p36 disruption is associated with increased ΔNp73 expression, decreased apoptosis and increased proliferation in FL.
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Affiliation(s)
- Hesham M Hassan
- Department of Pathology and Microbiology, University of Nebraska Medical Center , Omaha, NE , USA
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Mamessier E, Broussais-Guillaumot F, Chetaille B, Bouabdallah R, Xerri L, Jaffe ES, Nadel B. Nature and importance of follicular lymphoma precursors. Haematologica 2014; 99:802-10. [PMID: 24790058 PMCID: PMC4008113 DOI: 10.3324/haematol.2013.085548] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 02/10/2014] [Indexed: 11/09/2022] Open
Abstract
It is now widely recognized that cancer development is a protracted process requiring the stepwise acquisition of multiple oncogenic events. In humans, this process can take decades, if not a lifetime, blurring the notion of 'healthy' individuals. Follicular lymphoma exemplifies this multistep pathway of oncogenesis. In recent years, variants of follicular lymphoma have been recognized that appear to represent clonal B-cell expansions at an early stage of follicular lymphoma lymphomagenesis. These include follicular lymphoma in situ, duodenal follicular lymphoma, partial involvement by follicular lymphoma, and in the blood circulating follicular lymphoma-like B cells. Recent genetic studies have identified similarities and differences between the early lesions and overt follicular lymphoma, providing important information for understanding their biological evolution. The data indicate that there is already genomic instability at these early stages, even in instances with a low risk for clinical progression. The overexpression of BCL2 in t(14;18)-positive B cells puts them at risk for subsequent genetic aberrations when they re-enter the germinal center and are exposed to the influences of activation-induced cytidine deaminase and somatic hypermutations. The emerging data provide a rationale for clinical management and, in the future, may identify genetic risk factors that warrant early therapeutic intervention.
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50
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Li ZM, Ghielmini M, Moccia AA. Managing newly diagnosed follicular lymphoma: state of the art and future perspectives. Expert Rev Anticancer Ther 2014; 13:313-25. [DOI: 10.1586/era.13.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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