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Kurosawa S, Yoshimura Y, Takada Y, Yokota T, Hibi M, Hirahara A, Yoshida T, Okubo S, Masuda M, So Y, Miyata N, Nakayama H, Sakurai A, Sato K, Ito C, Aisa Y, Nakazato T. A predictive model for HIV-related lymphoma. AIDS 2024; 38:1627-1637. [PMID: 38831732 PMCID: PMC11296280 DOI: 10.1097/qad.0000000000003949] [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: 02/09/2024] [Revised: 04/24/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES To address the paucity of HIV-related lymphoma (HRL)-specific prognostic scores for the Japanese population by analyzing domestic cases of HRL and constructing a predictive model. DESIGN A single-center retrospective study coupled with a review of case reports of HRL. METHODS We reviewed all patients with HRL treated at our hospital between 2007 and 2023 and conducted a comprehensive search for case reports of HRL from Japan using public databases. A multivariate analysis for overall survival (OS) was performed using clinical parameters, leading to the formulation of the HIV-Japanese Prognostic Index (HIV-JPI). RESULTS A total of 19 patients with HRL were identified in our institution, whereas the literature review yielded 44 cases. In the HIV-JPI, a weighted score of 1 was assigned to the following factors: age at least 45 years, HIV-RNA at least 8.0×10 4 copies/ml, Epstein-Barr virus-encoded small RNA positivity, and Ann Arbor classification stage IV. The overall score ranged from 0 to 4. We defined the low-risk group as scores ranging from 0 to 2 and the high-risk group as scores ranging from 3 to 4. The 3-year OS probability of the high-risk group [30.8%; 95% confidence interval (CI): 9.5-55.4%) was significantly poorer than that of the low-risk group (76.8%; 95% CI: 52.8-89.7%; P < 0.01). CONCLUSION This retrospective analysis established pivotal prognostic factors for HRL in Japanese patients. The HIV-JPI, derived exclusively from Japanese patients, highlights the potential for stratified treatments and emphasizes the need for broader studies to further refine this clinical prediction model.
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Affiliation(s)
| | - Yukihiro Yoshimura
- Division of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | | | | | | | | | | | | | | | - Yuna So
- Division of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Nobuyuki Miyata
- Division of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | | | | | - Kosuke Sato
- Division of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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2
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Feng Q, Li Q, Zhou H, Wang Z, Lin C, Jiang Z, Liu T, Wang D. CRISPR technology in human diseases. MedComm (Beijing) 2024; 5:e672. [PMID: 39081515 PMCID: PMC11286548 DOI: 10.1002/mco2.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/01/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Gene editing is a growing gene engineering technique that allows accurate editing of a broad spectrum of gene-regulated diseases to achieve curative treatment and also has the potential to be used as an adjunct to the conventional treatment of diseases. Gene editing technology, mainly based on clustered regularly interspaced palindromic repeats (CRISPR)-CRISPR-associated protein systems, which is capable of generating genetic modifications in somatic cells, provides a promising new strategy for gene therapy for a wide range of human diseases. Currently, gene editing technology shows great application prospects in a variety of human diseases, not only in therapeutic potential but also in the construction of animal models of human diseases. This paper describes the application of gene editing technology in hematological diseases, solid tumors, immune disorders, ophthalmological diseases, and metabolic diseases; focuses on the therapeutic strategies of gene editing technology in sickle cell disease; provides an overview of the role of gene editing technology in the construction of animal models of human diseases; and discusses the limitations of gene editing technology in the treatment of diseases, which is intended to provide an important reference for the applications of gene editing technology in the human disease.
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Affiliation(s)
- Qiang Feng
- Laboratory Animal CenterCollege of Animal ScienceJilin UniversityChangchunChina
- Research and Development CentreBaicheng Medical CollegeBaichengChina
| | - Qirong Li
- Laboratory Animal CenterCollege of Animal ScienceJilin UniversityChangchunChina
| | - Hengzong Zhou
- Laboratory Animal CenterCollege of Animal ScienceJilin UniversityChangchunChina
| | - Zhan Wang
- Laboratory Animal CenterCollege of Animal ScienceJilin UniversityChangchunChina
| | - Chao Lin
- School of Grain Science and TechnologyJilin Business and Technology CollegeChangchunChina
| | - Ziping Jiang
- Department of Hand and Foot SurgeryThe First Hospital of Jilin UniversityChangchunChina
| | - Tianjia Liu
- Research and Development CentreBaicheng Medical CollegeBaichengChina
| | - Dongxu Wang
- Laboratory Animal CenterCollege of Animal ScienceJilin UniversityChangchunChina
- Department of Hand and Foot SurgeryThe First Hospital of Jilin UniversityChangchunChina
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3
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Agrawal A, Lamichhane P, Baral R, Thapaliya S. Acute Leukaemia following Dengue Infection in Nepalese Patients: A Report of Two Cases. Case Rep Hematol 2024; 2024:8747138. [PMID: 39104430 PMCID: PMC11298969 DOI: 10.1155/2024/8747138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/23/2024] [Accepted: 07/09/2024] [Indexed: 08/07/2024] Open
Abstract
Dengue is a mosquito-borne, acute febrile illness caused by dengue viruses. The association between hematological malignancies and dengue infection is obscure, and the literature on this occurrence is also limited. We report two cases of acute leukaemia following dengue infection in a recent outbreak in Nepal. Our case reports suggest a possible association of acute leukaemia with dengue infection. The relationship should be explored further with observational studies.
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Affiliation(s)
- Anushka Agrawal
- Maharajgunj Medical CampusInstitute of Medicine, Kathmandu, Nepal
| | | | - Rituraj Baral
- Department of PathologyTribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sabin Thapaliya
- Department of Internal MedicineTribhuvan University Teaching Hospital, Kathmandu, Nepal
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4
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Fan S, Zhou Q, Zhou Z, Wang D, Lin S, Bi H, Wang H, Min H. Acute myeloid leukemia following remission of AIDS-associated extra-nodal NK/T-cell lymphoma. Heliyon 2024; 10:e33622. [PMID: 39091951 PMCID: PMC11292489 DOI: 10.1016/j.heliyon.2024.e33622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 08/04/2024] Open
Abstract
Background AIDS-related NK/T-cell lymphoma is a rare subtype of AIDS-related lymphomas, characterized by a poor prognosis and lack of standardized treatment protocols. To date, there have been no reported cases of AIDS-associated NK/T-cell lymphoma in remission followed by treatment-related acute myeloid leukemia (t-AML), where both the lymphoma and AML achieved remission and long-term survival through chemotherapy alone. Case presentation We report a case of a patient diagnosed with AIDS-related extra-nodal NK/T-cell lymphoma (ENKTCL). The patient achieved complete remission after receiving six cycles of chemotherapy, local radiotherapy, and combination antiretroviral therapy (cART). Throughout the follow-up period, the patient continued cART treatment, maintaining an HIV-RNA level below the lower limit of detection. However, 70 months later, the patient developed new symptoms and was subsequently diagnosed with acute myeloid leukemia (AML) M4 subtype. Following the completion of 10 cycles of chemotherapy and ongoing cART, the patient achieved complete remission of AML, with an overall survival time exceeding 103 months from the initial ENKTCL diagnosis. Conclusions This case highlights the effectiveness of chemotherapy combined with cART in the treatment of AIDS-associated NK/T-cell lymphoma and secondary treatment-related leukemia. This approach may serve as a viable option for patients who are not candidates for bone marrow transplantation. Furthermore, this case underscores the importance of long-term follow-up in the management of AIDS-associated malignancies.
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Affiliation(s)
- Shanshan Fan
- Department of Infectious Diseases, Yunnan Provincial Infectious Diseases Hospital/Yunnan AIDS Care Center, Kunming, 650301, China
| | - Qiwen Zhou
- Department of Infectious Diseases, Yunnan Provincial Infectious Diseases Hospital/Yunnan AIDS Care Center, Kunming, 650301, China
| | - Zeping Zhou
- Department of Hematology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China
| | - Danqing Wang
- Department of Infectious Diseases, Yunnan Provincial Infectious Diseases Hospital/Yunnan AIDS Care Center, Kunming, 650301, China
| | - Sen Lin
- Department of Infectious Diseases, Yunnan Provincial Infectious Diseases Hospital/Yunnan AIDS Care Center, Kunming, 650301, China
| | - Hui Bi
- Department of Hematology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China
| | - Honghui Wang
- Department of Hematology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China
| | - Haiyan Min
- Department of Infectious Diseases, Yunnan Provincial Infectious Diseases Hospital/Yunnan AIDS Care Center, Kunming, 650301, China
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Liang X, Aouizerat BE, So‐Armah K, Cohen MH, Marconi VC, Xu K, Justice AC. DNA methylation-based telomere length is associated with HIV infection, physical frailty, cancer, and all-cause mortality. Aging Cell 2024; 23:e14174. [PMID: 38629454 PMCID: PMC11258465 DOI: 10.1111/acel.14174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 07/21/2024] Open
Abstract
Telomere length (TL) is an important indicator of cellular aging. Shorter TL is associated with several age-related diseases including coronary heart disease, heart failure, diabetes, osteoporosis, and cancer. Recently, a DNA methylation-based TL (DNAmTL) estimator has been developed as an alternative method for directly measuring TL. In this study, we examined the association of DNAmTL with cancer prevalence and mortality risk among people with and without HIV in the Veterans Aging Cohort Study Biomarker Cohort (VACS, N = 1917) and Women's Interagency HIV Study Cohort (WIHS, N = 481). We profiled DNAm in whole blood (VACS) or in peripheral blood mononuclear cells (WIHS) using an array-based method. Cancer prevalence was estimated from electronic medical records and cancer registry data. The VACS Index was used as a measure of physiologic frailty. Models were adjusted for self-reported race and ethnicity, batch, smoking status, alcohol consumption, and five cell types (CD4, CD8, NK, B cell, and monocyte). We found that people with HIV had shorter average DNAmTL than those without HIV infection [beta = -0.25, 95% confidence interval (-0.32, -0.18), p = 1.48E-12]. Greater value of VACS Index [beta = -0.002 (-0.003, -0.001), p = 2.82E-05] and higher cancer prevalence [beta = -0.07 (-0.10, -0.03), p = 1.37E-04 without adjusting age] were associated with shortened DNAmTL. In addition, one kilobase decrease in DNAmTL was associated with a 40% increase in mortality risk [hazard ratio: 0.60 (0.44, 0.82), p = 1.42E-03]. In summary, HIV infection, physiologic frailty, and cancer are associated with shortening DNAmTL, contributing to an increased risk of all-cause mortality.
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Affiliation(s)
- Xiaoyu Liang
- Department of Epidemiology and BiostatisticsMichigan State UniversityEast LansingMichiganUSA
| | - Bradley E. Aouizerat
- Translational Research Center, College of DentistryNew York UniversityNew YorkNew YorkUSA
- Department of Oral and Maxillofacial Surgery, College of DentistryNew York UniversityNew YorkNew YorkUSA
| | - Kaku So‐Armah
- Boston University School of MedicineBostonMassachusettsUSA
| | - Mardge H. Cohen
- Department of MedicineStroger Hospital of Cook CountyChicagoIllinoisUSA
| | - Vincent C. Marconi
- Emory University School of Medicine and Rollins School of Public HealthThe Atlanta Veterans Affairs Medical CenterAtlantaGeorgiaUSA
| | - Ke Xu
- Department of PsychiatryYale School of MedicineNew HavenConnecticutUSA
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
| | - Amy C. Justice
- VA Connecticut Healthcare SystemWest HavenConnecticutUSA
- Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
- Yale School of Public HealthNew HavenConnecticutUSA
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6
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Zhao H, Zhu C, Lian Y, Cheng Y, Zhu F, Wang J, Zheng Q. Identifying Factors Affecting the Survival of Patients with HIV-Associated B-Cell Lymphoma Using a Random Survival Forest Model. Clin Med Insights Oncol 2024; 18:11795549241260572. [PMID: 38911454 PMCID: PMC11193342 DOI: 10.1177/11795549241260572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Background There have been no reports about the application of random survival forest (RSF) model to predict disease progression of HIV-associated B-cell lymphoma. Methods A total of 44 patients with HIV-associated B-cell lymphoma who were referred to Nanjing Second Hospital from 2012 to 2019 were included. The RSF model was used to find predictors of survival, and the results of the RSF model were compared with those of the Cox model. The data were analyzed using R software (version 4.1.1). Results One-, 2-, and 3-year survival rates were 74.5%, 57.7%, and 48.6%, respectively, and the median survival was 59.0 months. The first 3 most important predictors of survival included lactate dehydrogenase (LDH), absolute monocyte count (AMC), and white blood cells (WBCs) count. The median survival of high-risk patients was only 4.0 months. Areas under the curve (AUCs) of the RSF model remained at more than 0.90 at 1, 2, and 3 years. The RSF model displayed a lower prediction error rate (21.9%) than the Cox model (25.4%). Conclusions Lactate dehydrogenase, AMC, and WBCs count are the most important prognostic predictors for patients with HIV-associated B-cell lymphoma. Much larger prospective and/or multicentre studies are required to validtae this RSF model.
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Affiliation(s)
- Huihui Zhao
- Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chuandong Zhu
- Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Lian
- Department of Hematology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yu Cheng
- Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fang Zhu
- Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Wang
- Department of Hematology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qin Zheng
- Department of Oncology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
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7
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Münz C. Altered EBV specific immune control in multiple sclerosis. J Neuroimmunol 2024; 390:578343. [PMID: 38615370 DOI: 10.1016/j.jneuroim.2024.578343] [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: 02/03/2024] [Revised: 03/23/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
Since the 1980s it is known that immune responses to the Epstein-Barr virus (EBV) are elevated in multiple sclerosis (MS) patients. Recent seroepidemiologial data have shown that this alteration after primary EBV infection identifies individuals with a more than 30-fold increased risk to develop MS. The mechanisms by which EBV infection might erode tolerance for the central nervous system (CNS) in these individuals, years prior to clinical MS onset, remain unclear. In this review I will discuss altered frequencies of EBV life cycle stages and their tissue distribution, EBV with CNS autoantigen cross-reactive immune responses and loss of immune control for autoreactive B and T cells as possible mechanisms. This discussion is intended to stimulate future studies into these mechanisms with the aim to identify candidates for interventions that might correct EBV specific immune control and/or resulting cross-reactivities with CNS autoantigens in MS patients and thereby ameliorate disease activity.
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Affiliation(s)
- Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Switzerland.
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8
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Dudek AM, Feist WN, Sasu EJ, Luna SE, Ben-Efraim K, Bak RO, Cepika AM, Porteus MH. A simultaneous knockout knockin genome editing strategy in HSPCs potently inhibits CCR5- and CXCR4-tropic HIV-1 infection. Cell Stem Cell 2024; 31:499-518.e6. [PMID: 38579682 PMCID: PMC11212398 DOI: 10.1016/j.stem.2024.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 12/29/2023] [Accepted: 03/06/2024] [Indexed: 04/07/2024]
Abstract
Allogeneic hematopoietic stem and progenitor cell transplant (HSCT) of CCR5 null (CCR5Δ32) cells can be curative for HIV-1-infected patients. However, because allogeneic HSCT poses significant risk, CCR5Δ32 matched bone marrow donors are rare, and CCR5Δ32 transplant does not confer resistance to the CXCR4-tropic virus, it is not a viable option for most patients. We describe a targeted Cas9/AAV6-based genome editing strategy for autologous HSCT resulting in both CCR5- and CXCR4-tropic HIV-1 resistance. Edited human hematopoietic stem and progenitor cells (HSPCs) maintain multi-lineage repopulation capacity in vivo, and edited primary human T cells potently inhibit infection by both CCR5-tropic and CXCR4-tropic HIV-1. Modification rates facilitated complete loss of CCR5-tropic replication and up to a 2,000-fold decrease in CXCR4-tropic replication without CXCR4 locus disruption. This multi-factor editing strategy in HSPCs could provide a broad approach for autologous HSCT as a functional cure for both CCR5-tropic and CXCR4-tropic HIV-1 infections.
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Affiliation(s)
- Amanda M Dudek
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - William N Feist
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Elena J Sasu
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sofia E Luna
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kaya Ben-Efraim
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Rasmus O Bak
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark; Aarhus Institute of Advanced Studies (AIAS), Aarhus University, 8000 Aarhus, Denmark
| | - Alma-Martina Cepika
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Matthew H Porteus
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Zhao H, Cai S, Xiao Y, Xia M, Chen H, Xie Z, Tang X, He H, Peng J, Chen J. Expression and prognostic significance of the PD-1/PD-L1 pathway in AIDS-related non-Hodgkin lymphoma. Cancer Med 2024; 13:e7195. [PMID: 38613207 PMCID: PMC11015146 DOI: 10.1002/cam4.7195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVE Immune tolerance and evasion play a critical role in virus-driven malignancies. However, the phenotype and clinical significance of programmed cell death 1 (PD-1) and its ligands, PD-L1 and PD-L2, in aggressive acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) remain poorly understood, particularly in the Epstein-Barr virus (EBV)-positive subset. METHODS We used in situ hybridization with EBV-encoded RNA (EBER) to assess the EBV status. We performed immunohistochemistry and flow cytometry analysis to evaluate components of the PD-1/PD-L1/L2 pathway in a multi-institutional cohort of 58 patients with AR-NHL and compared EBV-positive and EBV-negative cases. RESULTS The prevalence of EBV+ in AR-NHL was 56.9% and was associated with a marked increase in the expression of PD-1/PD-L1/PD-L2 in malignant cells. Patients with AR-NHLs who tested positive for both EBER and PD-1 exhibited lower survival rates compared to those negative for these markers (47.4% vs. 93.8%, p = 0.004). Similarly, patients positive for both EBER and PD-L1 also demonstrated poorer survival (56.5% vs. 93.8%, p = 0.043). Importantly, PD-1 tissue-expression demonstrated independent prognostic significance for overall survival in multivariate analysis and was correlated to elevated levels of LDH (r = 0.313, p = 0.031), increased PD-1+ Tregs (p = 0.006), and robust expression of EBER (r = 0.541, p < 0.001) and PD-L1 (r = 0.354, p = 0.014) expression. CONCLUSIONS These data emphasize the importance of PD-1-mediated immune evasion in the complex landscape of immune oncology in AR-NHL co-infected with EBV, and contribute to the diagnostic classification and possible definition of immunotherapeutic strategies for this unique subgroup.
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Affiliation(s)
- Han Zhao
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
- Infectious Diseases Center, Guangzhou Eighth People's HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Shaohang Cai
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Yanhua Xiao
- Pathology department, Guangzhou Eighth People's HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Muye Xia
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Hongjie Chen
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Zhiman Xie
- Guangxi AIDS Clinical Treatment Center, the Fourth People's Hospital of NanningNanningChina
| | - Xiaoping Tang
- Infectious Diseases Center, Guangzhou Eighth People's HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Haolan He
- Infectious Diseases Center, Guangzhou Eighth People's HospitalGuangzhou Medical UniversityGuangzhouChina
| | - Jie Peng
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
| | - Juanjuan Chen
- Department of Infectious Diseases, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
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Haghtalab A, Hejazi M, Goharnia N, Yekanlou A, Hazhir K, Barghi A, Bazzaz Z, Allahverdizadeh I, GhalibafSabbaghi A. Investigating the correlation between prominent viruses and hematological malignancies: a literature review. Med Oncol 2024; 41:102. [PMID: 38546893 DOI: 10.1007/s12032-024-02345-1] [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: 01/11/2024] [Accepted: 02/23/2024] [Indexed: 04/02/2024]
Abstract
Extensive research has been conducted on the correlation between viral infections and hematological cancers ever since the identification of the Rous Sarcoma Virus as a cancer-causing agent. Numerous viruses, such as the Epstein-Barr virus, hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus 1, and severe acute respiratory syndrome-related coronavirus 2, have been identified as potential contributors to the development and progression of cancer by disrupting normal cellular processes. Different viruses are associated with distinct forms of blood cancers, each exhibiting unique infection mechanisms, pathogenesis, and clinical symptoms. Understanding these connections is crucial for the development of effective prevention and treatment strategies. Healthcare professionals who possess a solid understanding of these associations can offer precise treatments and closely monitor potential complications in individuals with blood cancers and viral infections. By leveraging this information, healthcare providers can optimize patient care and improve outcomes for those affected by both viral infections and hematological cancers.
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Affiliation(s)
- Arian Haghtalab
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
| | - Milad Hejazi
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Naeem Goharnia
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Yekanlou
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Kousha Hazhir
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Asma Barghi
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Zahra Bazzaz
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Carbone A, Chadburn A, Gloghini A, Vaccher E, Bower M. Immune deficiency/dysregulation -associated lymphoproliferative disorders. Revised classification and management. Blood Rev 2024; 64:101167. [PMID: 38195294 DOI: 10.1016/j.blre.2023.101167] [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: 08/02/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024]
Abstract
Significant advances in the field of lymphoma have resulted in two recent classification proposals, the International Consensus Classification (ICC) and the 5th edition WHO. A few entities are categorized differently in the ICC compared to the WHO. Nowhere is this more apparent than the immunodeficiency lymphoproliferative disorders. The three previous versions of the WHO classification (3rd, 4th and revised 4th editions) and the ICC focused on four clinical settings in which these lesions arise for primary categorization. In contrast the 2023 WHO 5th edition includes pathologic characteristics including morphology and viral status, in addition to clinical setting, as important information for lesion classification. In addition, the 2023 WHO recognizes a broader number of clinical scenarios in which these lesions arise, including not only traditional types of immune deficiency but also immune dysregulation. With this classification it is hoped that new treatment strategies will be developed leading to better patient outcomes.
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Affiliation(s)
- Antonino Carbone
- Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute, Aviano, Italy.
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, United States of America.
| | - Annunziata Gloghini
- Department of Advanced Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Emanuela Vaccher
- Infectious Diseases and Tumors Unit, Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy.
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London SW109NH, UK.
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12
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Chen J, Wu Y, Zhao H, Ruan G, Qin S. Ratio of hemoglobin to red cell distribution width: an inflammatory predictor of survival in AIDS-related DLBCL. Front Immunol 2024; 15:1354325. [PMID: 38426083 PMCID: PMC10901994 DOI: 10.3389/fimmu.2024.1354325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Background Despite the introduction of combined antiretroviral therapy, AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) remains a prominent cancer among individuals living with HIV with a suboptimal prognosis. Identifying independent prognostic markers could improve risk stratification. Methods In this multicenter retrospective cohort study spanning years 2011 to 2019, 153 eligible patients with AR-DLBCL were examined. Overall survival (OS) factors were analyzed using Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards models. The discriminatory ability of the risk score was evaluated by examining the area under the receiver operating characteristic curve. Results The study included 153 patients with a median age of 47 years (interquartile range [IQR] 39-58), 83.7% of whom were men. The median follow-up was 12.0 months (95% confidence interval [CI], 8.5-15.5), with an OS rate of 35.9%. Among the potential inflammatory markers examined, only the ratio of hemoglobin (g/dL) to red cell distribution width (%) (Hb/RDW) emerged as an independent prognostic parameter for OS in the training (hazard ratios [HR] = 2.645, 95% CI = 1.267-5.522, P = 0.010) and validation cohorts (HR = 2.645, 95% CI = 1.267-5.522, P = 0.010). A lower Hb/RDW ratio was strongly correlated with adverse clinical factors, including advanced Ann Arbor stage, increased extranodal sites, reduced CD4 count, elevated lactate dehydrogenase levels, poorer Eastern Cooperative Oncology Group performance status (ECOG PS), and a higher International Prognostic Index (IPI) score. The addition of the Hb/RDW ratio to the IPI produced a highly discriminatory prognostic composite score, termed Hb/RDW-IPI. Conclusion We identified a cost-effective and readily available inflammatory biomarker, the Hb/RDW ratio, as an independent predictor of outcomes in patients with AR-DLBCL. Its integration into the IPI score partially improves prognostic accuracy.
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Affiliation(s)
- Juanjuan Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, China
| | - Yihua Wu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, China
| | - Han Zhao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- State Key Laboratory of Organ Failure Research, Key Laboratory of Infectious Diseases Research in South China, Ministry of Education, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Clinical Research Center for Viral Hepatitis, Guangdong Institute of Hepatology, Guangzhou, China
- Infectious Diseases Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Guangjing Ruan
- Guangxi AIDS Clinical Treatment Center, The Fourth People’s Hospital of Nanning, Nanning, China
| | - Shanfang Qin
- Guangxi AIDS Diagnosis and Treatment Quality Control Center, Chest Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
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13
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Leopizzi M, Mundo L, Messina E, Campolo F, Lazzi S, Angeloni A, Marchese C, Leoncini L, Giordano C, Slack F, Trivedi P, Anastasiadou E. Epstein-Barr virus-encoded EBNA2 downregulates ICOSL by inducing miR-24 in B-cell lymphoma. Blood 2024; 143:429-443. [PMID: 37847858 PMCID: PMC10862363 DOI: 10.1182/blood.2023021346] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/12/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
ABSTRACT Hematological malignancies such as Burkitt lymphoma (BL), Hodgkin lymphoma (HL), and diffuse large B-cell lymphoma (DLBCL) cause significant morbidity in humans. A substantial number of these lymphomas, particularly HL and DLBCLs have poorer prognosis because of their association with Epstein-Barr virus (EBV). Our earlier studies have shown that EBV-encoded nuclear antigen (EBNA2) upregulates programmed cell death ligand 1 in DLBCL and BLs by downregulating microRNA-34a. Here, we investigated whether EBNA2 affects the inducible costimulator (ICOS) ligand (ICOSL), a molecule required for efficient recognition of tumor cells by T cells through the engagement of ICOS on the latter. In virus-infected and EBNA2-transfected B-lymphoma cells, ICOSL expression was reduced. Our investigation of the molecular mechanisms revealed that this was due to an increase in microRNA-24 (miR-24) by EBNA2. By using ICOSL 3' untranslated region-luciferase reporter system, we validated that ICOSL is an authentic miR-24 target. Transfection of anti-miR-24 molecules in EBNA2-expressing lymphoma cells reconstituted ICOSL expression and increased tumor immunogenicity in mixed lymphocyte reactions. Because miR-24 is known to target c-MYC, an oncoprotein positively regulated by EBNA2, we analyzed its expression in anti-miR-24 transfected lymphoma cells. Indeed, the reduction of miR-24 in EBNA2-expressing DLBCL further elevated c-MYC and increased apoptosis. Consistent with the in vitro data, EBNA2-positive DLBCL biopsies expressed low ICOSL and high miR-24. We suggest that EBV evades host immune responses through EBNA2 by inducing miR-24 to reduce ICOSL expression, and for simultaneous rheostatic maintenance of proproliferative c-MYC levels. Overall, these data identify miR-24 as a potential therapeutically relevant target in EBV-associated lymphomas.
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Affiliation(s)
- Martina Leopizzi
- Department of Medico-surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Lucia Mundo
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Elena Messina
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Federica Campolo
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Stefano Lazzi
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Cinzia Marchese
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Lorenzo Leoncini
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Carla Giordano
- Department of Radiology, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Frank Slack
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Pankaj Trivedi
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Eleni Anastasiadou
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
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14
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Shi Y, Dai X, Huang L, Xu J. A retrospective observation of virologically suppressed people living with HIV by comparing switching to BIC/TAF/FTC with initial use BIC/TAF/FTC. Ann Med 2024; 55:2305692. [PMID: 38237196 PMCID: PMC10798279 DOI: 10.1080/07853890.2024.2305692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The objective of this study was to observe retrospectively the clinical response of virologically suppressed people living with HIV (PLWH) by comparing switching to BIC/TAF/FTC with initial use BIC/TAF/FTC. METHODS PLWH using BIC/TAF/FTC was divided into 'initial use' group and 'switching to' group. Immune response, metabolic parameters and renal function between the two groups were analysed. RESULTS The CD4 cell counts was higher in post- treatment than pre- treatment in the 'switching to' group (416.54 ± 212.11 cells/mm3 vs. 243.72 ± 156.64 cells/mm3, p < .001); however, significant differences were not observed in the 'initial use' group (p = .658). The effect of BIC/TAF/FTC on metabolism was not obvious. Serum creatinine (SCr) was improved in post-treatment than in pre-treatment in 'switching to' group (69.03 ± 18.78 vs. 77.52 ± 20.18, p < .001). Platelet count was lower in post-treatment than pre-treatment both in the 'initial use' group (175.81 ± 69.27 vs. 202.90 ± 66.56, p = .070) and in the 'switching to' group (177.04 ± 64.48 vs. 212.53 ± 63.43, p < .001). CONCLUSIONS 'Switching to' is superior to 'initial use' BIC/TAF/FTC in immune response among PLWH. The effect of BIC/TAF/FTC on metabolism is not obvious. BIC/TAF/FTC related thrombocytopenia needs to be further explored.
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Affiliation(s)
- Yuzhi Shi
- Department of Pharmacy, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Xianghua Dai
- Department of Infectious Diseases, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Li Huang
- Department of Infectious Diseases, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Jian Xu
- Department of Infectious Diseases, The People’s Hospital of Yubei District of Chongqing City, Chongqing, China
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Bibas M. Plasmablastic Lymphoma. A State-of-the-Art Review: Part 1-Epidemiology, Pathogenesis, Clinicopathologic Characteristics, Differential Diagnosis, Prognostic Factors, and Special Populations. Mediterr J Hematol Infect Dis 2024; 16:e2024007. [PMID: 38223486 PMCID: PMC10786126 DOI: 10.4084/mjhid.2024.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
This two-part review aims to present a current and comprehensive understanding of the diagnosis and management of plasmablastic lymphoma. The first section, as presented in this paper, reviews epidemiology, etiology, clinicopathological characteristics, differential diagnosis, prognostic variables, and the impact of plasmablastic lymphoma on specific populations. Plasmablastic lymphoma (PBL) is a rare and aggressive form of lymphoma. Previous and modern studies have demonstrated a significant association between the human immunodeficiency virus (HIV) and the development of the disease. The limited occurrence of PBL contributes to a need for a more comprehensive understanding of the molecular mechanisms involved in its etiology. Consequently, the diagnostic procedure for PBL poses a significant difficulty. Among the group of CD20-negative large B-cell lymphomas, PBL can be correctly diagnosed by identifying its exact clinical characteristics, anatomical location, and morphological characteristics. PBL cells do not express CD20 or PAX5 but possess plasmacytic differentiation markers such as CD38, CD138, MUM1/IRF4, Blimp1, and XBP1. PBL must be distinguished from other B-cell malignancies that lack the CD20 marker, including primary effusion lymphoma, anaplastic lymphoma kinase-positive large B-cell lymphoma, and large B-cell lymphoma (LBCL). This condition is frequently associated with infections caused by the Epstein-Barr virus and genetic alterations involving the MYC gene. Despite advances in our comprehension of this disease, the prognosis remains dismal, resulting in a low overall survival rate, although recent reports suggest an apparent tendency towards substantial improvement.
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Affiliation(s)
- Michele Bibas
- Department of Clinical Research, Hematology. National Institute for Infectious Diseases "Lazzaro Spallanzani" I.R.C.S.S. Rome, Italy
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16
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Omland LH, Gerstoft J, Kronborg G, Johansen IS, Larsen CS, Wiese L, Dalager-Pedersen M, Leth S, Obel N. Cancer risk and temporal trends in people with HIV during a quarter of a century - a nationwide population-based matched cohort study. Infect Dis (Lond) 2024; 56:11-18. [PMID: 37755422 DOI: 10.1080/23744235.2023.2260864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND It is important to understand current trends in cancer risk among people living with HIV (PLWH) to improve outcomes and to commission and delivery appropriate services. METHODS Nationwide, population-based, matched cohort study on all adult PLWH treated at Danish HIV health care centres since 1 January 1995 and a comparison cohort, randomly selected from the background population and matched on sex and date of birth. RESULTS We included 6327 PLWH and 63,270 individuals in the comparison cohort - 74% were men and median age was 37 (interquartile range: 30-46). For both smoking related cancers, virological cancers and other cancers, incidence was substantially higher in the first year of observation for PLWH than for the remaining observation period. The risk of smoking related cancer remained stably increased throughout the observation period, whereas the relative risk of virological cancers decreased, especially in the first year of follow up. Finally, the risk of other cancers for PLWH decreased to a level below that of the background population during the study period. CONCLUSION The fact that the risk of other cancers was probably not higher among PLWH than in the comparison cohort is encouraging, as the excess risk of virological and smoking related cancers is potentially preventable by timely treatment of HIV and smoking cessation.
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Affiliation(s)
- Lars H Omland
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jan Gerstoft
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gitte Kronborg
- Department of Infectious Diseases, Copenhagen University Hospital, Amager-Hvidovre Hospital, Copenhagen, Denmark
| | - Isik S Johansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Carsten S Larsen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Michael Dalager-Pedersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Steffen Leth
- Department of Infectious Diseases & Internal Medicine, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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17
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Münz C. Modulation of Epstein-Barr-Virus (EBV)-Associated Cancers by Co-Infections. Cancers (Basel) 2023; 15:5739. [PMID: 38136285 PMCID: PMC10741436 DOI: 10.3390/cancers15245739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
The oncogenic and persistent Epstein Barr virus (EBV) is carried by more than 95% of the human adult population. While asymptomatic in most of these, EBV can cause a wide variety of malignancies of lymphoid or epithelial cell origin. Some of these are also associated with co-infections that either increase EBV-induced tumorigenesis or weaken its immune control. The respective pathogens include Kaposi-sarcoma-associated herpesvirus (KSHV), Plasmodium falciparum and human immunodeficiency virus (HIV). In this review, I will discuss the respective tumor entities and possible mechanisms by which co-infections increase the EBV-associated cancer burden. A better understanding of the underlying mechanisms could allow us to identify crucial features of EBV-associated malignancies and defects in their immune control. These could then be explored to develop therapies against the respective cancers by targeting EBV and/or the respective co-infections with pathogen-specific therapies or vaccinations.
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Affiliation(s)
- Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
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18
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Karsten H, Matrisch L, Cichutek S, Fiedler W, Alsdorf W, Block A. Broadening the horizon: potential applications of CAR-T cells beyond current indications. Front Immunol 2023; 14:1285406. [PMID: 38090582 PMCID: PMC10711079 DOI: 10.3389/fimmu.2023.1285406] [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: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
Engineering immune cells to treat hematological malignancies has been a major focus of research since the first resounding successes of CAR-T-cell therapies in B-ALL. Several diseases can now be treated in highly therapy-refractory or relapsed conditions. Currently, a number of CD19- or BCMA-specific CAR-T-cell therapies are approved for acute lymphoblastic leukemia (ALL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), multiple myeloma (MM), and follicular lymphoma (FL). The implementation of these therapies has significantly improved patient outcome and survival even in cases with previously very poor prognosis. In this comprehensive review, we present the current state of research, recent innovations, and the applications of CAR-T-cell therapy in a selected group of hematologic malignancies. We focus on B- and T-cell malignancies, including the entities of cutaneous and peripheral T-cell lymphoma (T-ALL, PTCL, CTCL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), classical Hodgkin-Lymphoma (HL), Burkitt-Lymphoma (BL), hairy cell leukemia (HCL), and Waldenström's macroglobulinemia (WM). While these diseases are highly heterogenous, we highlight several similarly used approaches (combination with established therapeutics, target depletion on healthy cells), targets used in multiple diseases (CD30, CD38, TRBC1/2), and unique features that require individualized approaches. Furthermore, we focus on current limitations of CAR-T-cell therapy in individual diseases and entities such as immunocompromising tumor microenvironment (TME), risk of on-target-off-tumor effects, and differences in the occurrence of adverse events. Finally, we present an outlook into novel innovations in CAR-T-cell engineering like the use of artificial intelligence and the future role of CAR-T cells in therapy regimens in everyday clinical practice.
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Affiliation(s)
- Hendrik Karsten
- Faculty of Medicine, University of Hamburg, Hamburg, Germany
| | - Ludwig Matrisch
- Department of Rheumatology and Clinical Immunology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Faculty of Medicine, University of Lübeck, Lübeck, Germany
| | - Sophia Cichutek
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Eppendorf, Hamburg, Germany
| | - Walter Fiedler
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Eppendorf, Hamburg, Germany
| | - Winfried Alsdorf
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Eppendorf, Hamburg, Germany
| | - Andreas Block
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Eppendorf, Hamburg, Germany
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19
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Hu Y, Hu Q, Li Y, Lu L, Xiang Z, Yin Z, Kabelitz D, Wu Y. γδ T cells: origin and fate, subsets, diseases and immunotherapy. Signal Transduct Target Ther 2023; 8:434. [PMID: 37989744 PMCID: PMC10663641 DOI: 10.1038/s41392-023-01653-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 11/23/2023] Open
Abstract
The intricacy of diseases, shaped by intrinsic processes like immune system exhaustion and hyperactivation, highlights the potential of immune renormalization as a promising strategy in disease treatment. In recent years, our primary focus has centered on γδ T cell-based immunotherapy, particularly pioneering the use of allogeneic Vδ2+ γδ T cells for treating late-stage solid tumors and tuberculosis patients. However, we recognize untapped potential and optimization opportunities to fully harness γδ T cell effector functions in immunotherapy. This review aims to thoroughly examine γδ T cell immunology and its role in diseases. Initially, we elucidate functional differences between γδ T cells and their αβ T cell counterparts. We also provide an overview of major milestones in γδ T cell research since their discovery in 1984. Furthermore, we delve into the intricate biological processes governing their origin, development, fate decisions, and T cell receptor (TCR) rearrangement within the thymus. By examining the mechanisms underlying the anti-tumor functions of distinct γδ T cell subtypes based on γδTCR structure or cytokine release, we emphasize the importance of accurate subtyping in understanding γδ T cell function. We also explore the microenvironment-dependent functions of γδ T cell subsets, particularly in infectious diseases, autoimmune conditions, hematological malignancies, and solid tumors. Finally, we propose future strategies for utilizing allogeneic γδ T cells in tumor immunotherapy. Through this comprehensive review, we aim to provide readers with a holistic understanding of the molecular fundamentals and translational research frontiers of γδ T cells, ultimately contributing to further advancements in harnessing the therapeutic potential of γδ T cells.
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Affiliation(s)
- Yi Hu
- Microbiology and Immunology Department, School of Medicine, Faculty of Medical Science, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Qinglin Hu
- Microbiology and Immunology Department, School of Medicine, Faculty of Medical Science, Jinan University, Guangzhou, Guangdong, 510632, China
- Guangdong Provincial Key Laboratory of Tumour Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, Guangdong, 519000, China
| | - Yongsheng Li
- Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Ligong Lu
- Guangdong Provincial Key Laboratory of Tumour Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, Guangdong, 519000, China
| | - Zheng Xiang
- Microbiology and Immunology Department, School of Medicine, Faculty of Medical Science, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Zhinan Yin
- Biomedical Translational Research Institute, Jinan University, Guangzhou, Guangdong, 510632, China.
| | - Dieter Kabelitz
- Institute of Immunology, Christian-Albrechts-University Kiel, Kiel, Germany.
| | - Yangzhe Wu
- Guangdong Provincial Key Laboratory of Tumour Interventional Diagnosis and Treatment, Zhuhai Institute of Translational Medicine, Zhuhai People's Hospital Affiliated with Jinan University, Jinan University, Zhuhai, Guangdong, 519000, China.
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20
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Zhou C, Li T, Xia M, Wu Z, Zhong X, Li A, Rashid HK, Ma C, Zhou R, Duan H, Zhang X, Peng J, Li L. Bcl-2 Antagonist Obatoclax Reactivates Latent HIV-1 via the NF-κB Pathway and Induces Latent Reservoir Cell Apoptosis in Latently Infected Cells. ACS Infect Dis 2023; 9:2105-2118. [PMID: 37796279 DOI: 10.1021/acsinfecdis.3c00218] [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] [Indexed: 10/06/2023]
Abstract
The implementation of combined antiretroviral therapy (cART) has rendered HIV-1 infection clinically manageable and efficiently improves the quality of life for patients with AIDS. However, the persistence of a latent HIV-1 reservoir is a major obstacle to achieving a cure for AIDS. A "shock and kill" strategy aims to reactivate latent HIV and then kill it by the immune system or cART drugs. To date, none of the LRA candidates has yet demonstrated effectiveness in achieving a promising functional cure. Interestingly, the phosphorylation and activation of antiapoptotic Bcl-2 protein induce resistance to apoptosis during HIV-1 infection and the reactivation of HIV-1 latency in central memory CD4+ T cells from HIV-1-positive patients. Therefore, a Bcl-2 antagonist might be an effective LRA candidate for HIV-1 cure. In this study, we reported that a pan-Bcl-2 antagonist obatoclax induces HIV-1 reactivation in latently infected cell lines in vitro and in PBMCs/CD4+ T cells of HIV-infected individuals ex vivo. Obatoclax promotes HIV-1 transcriptional initiation and elongation by regulating the NF-κB pathway. Obatoclax activates caspase 8 and does not induce the phosphorylation of the antiapoptotic protein Bcl-2 in latent HIV-1 infected cell lines. More importantly, it preferentially induces apoptosis in latently infected cells. In addition, obatoclax exhibited potent anti-HIV-1 activity on target cells. The abilities to reactivate latent HIV-1 reservoirs, inhibit HIV-1 infection, and induce HIV-1 latent cell apoptosis make obatoclax worth investigating for development as an ideal LRA for use in the "shock and kill" approach.
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Affiliation(s)
- Chenliang Zhou
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Ting Li
- Aviation Hygiene Management Division, China Southern Airlines Company Limited, Guangzhou 510406, P. R. China
| | - Muye Xia
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Ziyao Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Xuelin Zhong
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Axing Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Huba Khamis Rashid
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Chengnuo Ma
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Ruijing Zhou
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
| | - Heng Duan
- Department of Pharmacy, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, Guangdong, P. R. China
| | - Xuanxuan Zhang
- Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou 510006, Guangdong, P. R. China
| | - Jie Peng
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, P. R. China
| | - Lin Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism, Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, P. R. China
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21
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Gupta S, Craig JW. Classic Hodgkin lymphoma in young people. Semin Diagn Pathol 2023; 40:379-391. [PMID: 37451943 DOI: 10.1053/j.semdp.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
Classic Hodgkin lymphoma (CHL) is a unique form of lymphoid cancer featuring a heterogeneous tumor microenvironment and a relative paucity of malignant Hodgkin and Reed-Sternberg (HRS) cells with characteristic phenotype. Younger individuals (children, adolescents and young adults) are affected as often as the elderly, producing a peculiar bimodal age-incidence profile that has generated immense interest in this disease and its origins. Decades of epidemiological investigations have documented the populations most susceptible and identified multiple risk factors that can be broadly categorized as either biological or environmental in nature. Most risk factors result in overt immunodeficiency or confer more subtle alterations to baseline health, physiology or immune function. Epstein Barr virus, however, is both a risk factor and well-established driver of lymphomagenesis in a significant subset of cases. Epigenetic changes, along with the accumulation of somatic driver mutations and cytogenetic abnormalities are required for the malignant transformation of germinal center-experienced HRS cell precursors. Chromosomal instability and the influence of endogenous mutational processes are critical in this regard, by impacting genes involved in key signaling pathways that promote the survival and proliferation of HRS cells and their escape from immune destruction. Here we review the principal features, known risk factors and lymphomagenic mechanisms relevant to newly diagnosed CHL, with an emphasis on those most applicable to young people.
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Affiliation(s)
- Srishti Gupta
- Department of Pathology, University of Virginia Health System, 1215 Lee Street, 3rd Floor Hospital Expansion Room 3032, PO Box 800904, Charlottesville, VA 22908, USA
| | - Jeffrey W Craig
- Department of Pathology, University of Virginia Health System, 1215 Lee Street, 3rd Floor Hospital Expansion Room 3032, PO Box 800904, Charlottesville, VA 22908, USA.
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22
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Hendricks CL, Mellet J, Durandt C, Brittain D, Pepper MS. Haematopoietic stem-cell transplantation in an HIV endemic area: time to consider donors exposed to or living with HIV. Lancet HIV 2023; 10:e742-e749. [PMID: 37837978 DOI: 10.1016/s2352-3018(23)00198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 10/16/2023]
Abstract
South Africa has more than 8 million people living with HIV. However, the number of patients undergoing haematopoietic stem-cell transplantation (HSCT) in South Africa is far below the target number. Donor numbers are insufficient to meet demand. Both HSCT and solid organ transplantation have proved successful in people living with HIV. Solid organ transplantation also has good outcomes when both donors and recipients have HIV. This Personal View explores the possible inclusion of people living with HIV and umbilical cord blood from HIV-negative infants exposed to HIV as donor sources for HSCT. Beyond the risk of HIV transmission, additional complications must be considered, such as delayed or inadequate immune reconstitution and an increased risk of haematological abnormalities and malignancies. Interactions between antiretroviral drugs and drugs used in the conditioning regimen, as well as the need to maintain virological suppression when gastrointestinal absorption deteriorates, are additional complicating factors. The process also requires more stringent ethical processes to be in place to minimise physical and emotional harm. However, in an HIV endemic country, people living with HIV or donors exposed to HIV must be considered as part of a multidisciplinary collaborative effort to provide more patients with the opportunity to have a life-saving HSCT.
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Affiliation(s)
- Candice Laverne Hendricks
- Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Juanita Mellet
- Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Chrisna Durandt
- Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - David Brittain
- Alberts Cellular Therapy, Netcare Pretoria East Hospital, Pretoria, South Africa
| | - Michael Sean Pepper
- Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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23
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Vaccher E, Chadburn A, Gloghini A, Antinori A, Bower M, Carbone A. Lymphomas included in the AIDS case definition: an update 30 years later. Lancet HIV 2023; 10:e635. [PMID: 37689074 DOI: 10.1016/s2352-3018(23)00199-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 09/11/2023]
Affiliation(s)
- Emanuela Vaccher
- Infectious Diseases and Tumors Unit, Department of Medical Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, National Cancer Institute, Aviano, Italy
| | - Amy Chadburn
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Annunziata Gloghini
- Department of Advanced Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Antinori
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Mark Bower
- Department of Oncology and National Centre for HIV Malignancy, Chelsea & Westminster Hospital, London, UK
| | - Antonino Carbone
- Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute, Aviano 33081, Italy.
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24
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El Homsi M, Golia Pernicka JS, Lall C, Nougaret S, Paspulati RM, Pickhardt PJ, Sheedy SP, Petkovska I. Beyond squamous cell carcinoma: MRI appearance of uncommon anal neoplasms and mimickers. Abdom Radiol (NY) 2023; 48:2898-2912. [PMID: 37027015 PMCID: PMC10775174 DOI: 10.1007/s00261-023-03891-4] [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: 12/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023]
Abstract
Anal cancer is an uncommon malignancy. In addition to squamous cell carcinoma, there are a variety of other less common malignancies and benign pathologies that may afflict the anal canal, with which abdominal radiologists should be familiar. Abdominal radiologists should be familiar with the imaging features that can help distinguish different rare anal tumors beyond squamous cell carcinoma and that can aid in diagnosis therefore help steer management. This review discusses these uncommon pathologies with a focus on their imaging appearance, management, and prognosis.
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Affiliation(s)
- Maria El Homsi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Jennifer S Golia Pernicka
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Chandana Lall
- Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Stephanie Nougaret
- Department of Radiology, Montpellier Cancer Research Institute (IRCM), Montpellier, France
| | - Raj M Paspulati
- Department of Radiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | | | - Iva Petkovska
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
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25
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Peng fei T, Ru Xi H, Hai yan M. HIV-associated splenic diffuse large B-cell lymphoma combined with hepatitis C and tuberculous meningitis:A case report. Heliyon 2023; 9:e20073. [PMID: 37809999 PMCID: PMC10559805 DOI: 10.1016/j.heliyon.2023.e20073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/10/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive B-lymphocyte-derived malignant proliferative disease that is currently one of the leading causes of death in HIV patients. The incidence of lymphoma in HIV patients is 60-200 times higher than in the general population compared to the non-HIV population, and diffuse large B-cell lymphoma can cause numerous disease manifestations, especially in severely immunocompromised individuals. We treated a case of HIV-associated splenic diffuse large B-cell lymphoma combined with hepatitis C and tuberculous meningitis. In this case, diffuse large B-cell lymphoma of the spleen was difficult to diagnose. Second, simultaneous treatment of multiple diseases requires consideration of drug interactions. Our case highlights the diagnostic value of early tissue biopsy and the importance of avoiding drug interactions during treatment, and the selection of appropriate CART, anti-hepatitis C, and anti-tuberculosis protocols to reduce mortality from diffuse large B-cell lymphoma comorbidification.
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Affiliation(s)
- Tao Peng fei
- Department of Infectious, Yunnan Provincial Infectious Diseases Hospital, Kunming 650301, China
| | - Hui Ru Xi
- Department of Infectious, Baoshan People's Hospital, Baoshan, 678000, China
| | - Min Hai yan
- Department of Infectious, Yunnan Provincial Infectious Diseases Hospital, Kunming 650301, China
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26
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Szychowiak P, Boulain T, Timsit JF, Elabbadi A, Argaud L, Ehrmann S, Issa N, Canet E, Martino F, Bruneel F, Quenot JP, Wallet F, Azoulay É, Barbier F. Clinical spectrum and prognostic impact of cancer in critically ill patients with HIV: a multicentre cohort study. Ann Intensive Care 2023; 13:74. [PMID: 37608140 PMCID: PMC10444715 DOI: 10.1186/s13613-023-01171-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/04/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Both AIDS-defining and non-AIDS-defining cancers (ADC/NADC) predispose people living with HIV (PLHIV) to critical illnesses. The objective of this multicentre study was to investigate the prognostic impact of ADC and NADC in PLHIV admitted to the intensive care unit (ICU). METHODS All PLHIV admitted over the 2015-2020 period in 12 university-affiliated ICUs in France were included in the study cohort. The effect of ADC and NADC on in-hospital mortality (primary study endpoint) was measured through logistic regression with augmented backward elimination of potential independent variables. The association between ADC/NADC and treatment limitation decision (TLD) during the ICU stay (secondary study endpoint) was analysed. One-year mortality in patients discharged alive from the index hospital admission (exploratory study endpoint) was compared between those with ADC, NADC or no cancer. RESULTS Amongst the 939 included PLHIV (median age, 52 [43-59] years; combination antiretroviral therapy, 74.4%), 97 (10.3%) and 106 (11.3%) presented with an active NADC (mostly lung and intestinal neoplasms) and an active ADC (predominantly AIDS-defining non-Hodgkin lymphoma), respectively. Inaugural admissions were common. Bacterial sepsis and non-infectious neoplasm-related complications accounted for most of admissions in these subgroups. Hospital mortality was 12.4% in patients without cancer, 30.2% in ADC patients and 45.4% in NADC patients (P < 0.0001). NADC (adjusted odds ratio [aOR], 7.00; 95% confidence interval [CI], 4.07-12.05) and ADC (aOR, 3.11; 95% CI 1.76-5.51) were independently associated with in-hospital death after adjustment on severity and frailty markers. The prevalence of TLD was 8.0% in patients without cancer, 17.9% in ADC patients and 33.0% in NADC patients (P < 0.0001)-organ failures and non-neoplastic comorbidities were less often considered in patients with cancer. One-year mortality in survivors of the index hospital admission was 7.8% in patients without cancer, 17.0% in ADC patients and 33.3% in NADC patients (P < 0.0001). CONCLUSIONS NADC and ADC are equally prevalent, stand as a leading argument for TLD, and strongly predict in-hospital death in the current population of PLHIV requiring ICU admission.
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Affiliation(s)
- Piotr Szychowiak
- Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, 14, Avenue de L'Hôpital, 45100, Orléans, France
| | - Thierry Boulain
- Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, 14, Avenue de L'Hôpital, 45100, Orléans, France
| | - Jean-François Timsit
- Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Universitaire Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alexandre Elabbadi
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurent Argaud
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Stephan Ehrmann
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Nahema Issa
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Emmanuel Canet
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Frédéric Martino
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire de La Guadeloupe, Pointe-À-Pitre, France
| | - Fabrice Bruneel
- Réanimation et Unité de Surveillance Continue, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Jean-Pierre Quenot
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Dijon-Bourgogne, Dijon, France
| | - Florent Wallet
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Élie Azoulay
- Médecine Intensive Réanimation, Centre Hospitalier Universitaire Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Barbier
- Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, 14, Avenue de L'Hôpital, 45100, Orléans, France.
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27
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Lopez-Garcia A, Solan L, Alvarez B, Caballero JC, Cornago J, Pardo L, Diaz de la Pinta FJ, Cordoba R, Rodriguez-Pinilla M. Hemophagocytic Lymphohistiocytosis Secondary to Hodgkin's Lymphoma with Isolated Bone Marrow Involvement in a Newly Diagnosed HIV Patient. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1274. [PMID: 37512086 PMCID: PMC10383783 DOI: 10.3390/medicina59071274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
Human immunodeficiency virus (HIV) infection is known to be associated with the development of Hodgkin's lymphoma (HL). Exclusive extranodal bone marrow involvement is less common. Co-infection by other viruses, such as the Epstein-Barr virus (EBV), increases the incidence of a frequent complication denominated by hemophagocytic lymphohistocytosis (HLH). We present the case of a 50-year-old patient with the above clinical spectrum who develops several serious complications during treatment.
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Affiliation(s)
- Alberto Lopez-Garcia
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
- Instituto de Investigacion Sanitaria, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Laura Solan
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
- Instituto de Investigacion Sanitaria, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Beatriz Alvarez
- Department of Infectious Diseases, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Juan Carlos Caballero
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Javier Cornago
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Laura Pardo
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | | | - Raul Cordoba
- Department of Hematology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
- Instituto de Investigacion Sanitaria, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
| | - Maria Rodriguez-Pinilla
- Instituto de Investigacion Sanitaria, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
- Department of Pathology, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain
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28
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Huguet M, Navarro JT, Moltó J, Ribera JM, Tapia G. Diffuse Large B-Cell Lymphoma in the HIV Setting. Cancers (Basel) 2023; 15:3191. [PMID: 37370801 DOI: 10.3390/cancers15123191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the widespread use of combined antiretroviral therapy (cART) and the subsequent decrease in AIDS-defining cancers, HIV-related lymphomas remain a leading cause of morbidity and mortality in people with HIV (PWH). Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL) subtype in PWH. This lymphoma is a heterogeneous disease including morphological variants and molecular subtypes according to the cell of origin or the mutation profile. In the pre-cART era, treatment with standard-dose chemotherapy induced high rates of toxicity and outcomes were very poor. The introduction of cART and the incorporation of infection prophylaxis allowed the use of conventional intensive chemotherapy regimens used in the general population, such as R-CHOP or R-EPOCH. The use of cART during chemotherapy treatment was initially controversial due to the potential risk of adverse drug-drug interactions. However, the availability of current cART regimens with less potential to cause drug interactions and evidence that cART improves survival rates in NHL strongly support the use of cART in PWH with DLBCL. Consequently, interdisciplinary collaboration between HIV specialists and hemato-oncologists for the management of potential interactions and overlapping toxicities between antiretroviral and antineoplastic drugs is crucial for the optimal treatment of PWH with NHL.
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Affiliation(s)
- Maria Huguet
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José-Tomás Navarro
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - José Moltó
- Fundació Lluita Contra les Infeccions, Infectious Diseases Department, Germans Trias i Pujol University Hospital, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Josep-Maria Ribera
- Department of Hematology, Institut Català d'Oncologia, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
- Josep Carreras Leukaemia Research Institute, 08916 Badalona, Spain
| | - Gustavo Tapia
- Department of Pathology, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Ctra. de Canyet, S/N, 08916 Badalona, Spain
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29
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Caballero JC, Pardo L, Rodriguez-Pinilla MS, Piris MA, Alvarez B, Solan L, Cornago J, Lopez-Lorenzo JL, Llamas P, Cordoba R, Lopez-Garcia A. Primary Effusion Lymphoma, Multicentric Castleman's Disease, and Kaposi's Sarcoma in an HHV-8 and HIV-Positive Patient: A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1049. [PMID: 37374253 DOI: 10.3390/medicina59061049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Primary effusion lymphoma (PEL), Kaposi's sarcoma (KS), and multicentric Castleman's disease (MCD) is an uncommon group of diseases included in the same spectrum with related characteristics. The coexistence of all of them in the same individual is a rare occurrence. We present the case of a 25-year-old patient diagnosed with human immunodeficiency virus (HIV) and the development of all these related pathologies. Despite the use of intensive treatment according to the latest recommendations, the evolution was unfavorable. This case reflects the need for new therapies and research in this field.
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Affiliation(s)
- Juan Carlos Caballero
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Laura Pardo
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | | | - Miguel Angel Piris
- Department of Pathology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Beatriz Alvarez
- Department of Internal Medicine, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Laura Solan
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Javier Cornago
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | | | - Pilar Llamas
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Raul Cordoba
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
| | - Alberto Lopez-Garcia
- Department of Hematology, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
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30
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Chen J, Wu Y, Kang Z, Qin S, Ruan G, Zhao H, Tao X, Xie Z, Peng J. A promising prognostic model for predicting survival of patients with HIV-related diffuse large B-cell lymphoma in the cART era. Cancer Med 2023. [PMID: 37081761 DOI: 10.1002/cam4.5957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/25/2023] [Accepted: 04/01/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Optimization of risk stratification is important for facilitating prognoses and therapeutic decisions regarding diffuse large B-cell lymphoma (DLBCL). However, a simple and applicable prognostic tool is lacking for individuals with human immunodeficiency virus (HIV)-related DLBCL in the era of combined antiretroviral therapy (cART). METHODS This retrospective multicenter observational study included 147 HIV-related DLBCL patients with histologically confirmed DLBCL from 2013 to 2020. The total group was divided into training (n = 78) and validation (n = 69) cohorts to derive the best prognostic score. Clinicopathological and characteristic biomarkers correlated with clinical outcomes were analyzed. RESULTS Age, Ann Arbor stage, lactate dehydrogenase (LDH) ratio, bulky disease, and red blood cell distribution width (RDW) ratio retained robust independent correlations with overall survival (OS) in multivariate analysis. A new and practical prognostic model was generated and externally validated, classifying patients into three categories with significantly different survival rates. Moreover, the new index outperformed the International Prognostic Index (IPI) score (area under the curve values of 0.94 vs. 0.81 in the training cohort and 0.85 vs. 0.74 in the validation cohort, C-indices of 0.80 vs. 0.70 in the training cohort and 0.74 vs. 0.70 in the validation cohort, and integrated discrimination improvement values of 0.203 in the training cohort and 0.175 in the validation cohort) and was better at defining intermediate- and high-risk groups. The calibration curves performed satisfactorily for predicting 3-year OS in the training and validation cohorts. CONCLUSIONS We developed and validated a simple and feasible prognostic model for patients with HIV-related DLBCL that had more discriminative and predictive accuracy than the IPI score for risk stratification and individualized treatment in the cART era.
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Affiliation(s)
- Juanjuan Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yihua Wu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zixin Kang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shanfang Qin
- Guangxi AIDS Diagnosis and Treatment Quality Control Center, Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Guangjing Ruan
- Guangxi AIDS Clinical Treatment Center, The Fourth People's Hospital of Nanning, Nanning, China
| | - Han Zhao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Infectious Diseases Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xin Tao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiman Xie
- Guangxi AIDS Clinical Treatment Center, The Fourth People's Hospital of Nanning, Nanning, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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31
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Duarte NL, Bueno APS, Sanches BS, Ramos GA, Santos JMBD, Silva HFHE, Pondé JDO, Sá JGD, Rossi PM, Horn PRCB, Sztajnbok DCDN, Rubini NDPM, da Costa ES, Milito CB, de Abreu TF, Land MGP. Prognostic Factors in Children and Adolescents with Lymphomas and Vertical Transmission of HIV in Rio de Janeiro, Brazil: A Multicentric Hospital-Based Survival Analysis Study. Cancers (Basel) 2023; 15:cancers15082292. [PMID: 37190220 DOI: 10.3390/cancers15082292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Lymphomas related to HIV are generally aggressive and have a poor prognosis, despite the use of combined antiretroviral therapy (cART) and effective chemotherapy treatment. To determine survival and prognostic factors in children and adolescents living with HIV (CLWH) in Rio de Janeiro (RJ), Brazil, who developed lymphomas, we performed a retrospective and observational study of vertically infected CLWH aged from 0 to 20 incomplete years during1995 to 2018 at five reference centers for cancer and HIV/AIDS treatment. Of the 25 lymphomas, 19 were AIDS-defining malignancies (ADM) and 6 were non-AIDS-defining malignancies (NADM). The 5-year overall survival (OS) and 5-year event-free survival (EFS) probabilities were both 32.00% (95% CI = 13.72-50.23%), and the 5-year disease-free survival (DFS) probability was 53.30% (95% CI = 28.02-78.58%). In the multivariate Cox regression analysis, performance status 4 (PS 4) was considered a poor prognostic factor for OS (HR 4.85, 95% CI = 1.81-12.97, p = 0.002) and EFS (HR 4.95, 95% CI = 1.84-13.34, p = 0.002). For the DFS, higher CD4+ T-cell counts were considered a better prognostic factor (HR 0.86, 95% CI = 0.76-0.97, p = 0.017) in the multivariate Cox regression analysis. This study demonstrates, for the first time, survival and prognostic factors for CLWH who developed lymphomas in RJ, Brazil.
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Affiliation(s)
- Nathalia Lopez Duarte
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Internal Medicine Postgraduate Program, Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Ana Paula Silva Bueno
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
- Pediatric Hematology Service, Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Bárbara Sarni Sanches
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Gabriella Alves Ramos
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
- Faculty of Medical Sciences (FCM), Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil
| | - Julia Maria Bispo Dos Santos
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Henrique Floriano Hess E Silva
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Janaina de Oliveira Pondé
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - José Gilberto de Sá
- Department of Infectious and Parasitic Diseases, Hospital Municipal Jesus (HMJ), Municipal Health Secretariat (SMS-RJ), Rio de Janeiro 20550-200, Brazil
| | - Priscila Mazucanti Rossi
- Department of Infectious and Parasitic Diseases, Hospital Municipal Jesus (HMJ), Municipal Health Secretariat (SMS-RJ), Rio de Janeiro 20550-200, Brazil
| | | | - Denise Cardoso das Neves Sztajnbok
- Pediatric Infectious Diseases Division, Department of Pediatrics, Pedro Ernesto University Hospital (HUPE), State University of Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil
| | - Norma de Paula Motta Rubini
- Department of Allergy and Immunology, School of Medicine and Surgery, Gaffrée and Guinle University Hospital (HUGG), Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 20270-004, Brazil
| | - Elaine Sobral da Costa
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Internal Medicine Postgraduate Program, Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
- Pediatric Hematology Service, Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Cristiane Bedran Milito
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Department of Pathology, Faculty of Medicine (FM), Clementino Fraga Filho University Hospital (HUCFF), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Thalita Fernandes de Abreu
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Infectious and Parasitic Diseases Service, Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
| | - Marcelo Gerardin Poirot Land
- Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Internal Medicine Postgraduate Program, Faculty of Medicine (FM), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
- Transdisciplinary Center for Research in Child and Adolescent Health (NTISCA), Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
- Pediatric Hematology Service, Institute of Pediatrics and Childcare Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-612, Brazil
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Wang C, Wu Y, Liu J, Min H, Huang Y, Wei G, Zhang W, Wang M, Tang X, Zhou H, Chen Y, Liu Y. Impact of initial chemotherapy cycles and clinical characteristics on outcomes for HIV-associated diffuse large B cell lymphoma patients: The Central and Western China AIDS Lymphoma League 001 study (CALL-001 study). Front Immunol 2023; 14:1153790. [PMID: 37063928 PMCID: PMC10090414 DOI: 10.3389/fimmu.2023.1153790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionLittle is known about the first line induction chemotherapy cycles for HIV-associated diffuse large B-cell lymphoma (DLBCL) as these are less common than HIV-negative lymphoma. Currently, the optimal treatment cycles option remains undefined. Therefore, we performed a multi-center study to analyze the clinical characteristics and outcomes of HIV-associated DLBCL patients in different treatment modes in China.MethodsTotally 273 newly diagnosed HIV-associated DLBCL patients at eleven large academic centers from October 2008 to October 2021, were analyzed.ResultsIn the entire cohort, the median age was 47 years (range, 21-90) at lymphoma diagnosis, and 223 patients were male (81.7%). One hundred and ninety-four (71.1%) patients were germinal center B-cell-like lymphoma (GCB) subtype. Most patients (65.2%, 178/273) had elevated lactate dehydrogenase (LDH), and advanced Ann Arbor stage (78.9% 213/273) at diagnosis. High international prognostic index (IPI) score (3-5) at diagnosis was found in 65.2% (178/273) of patients. One hundred and fifty-five patients (56.8%) had extranodal involvement. The median CD4 cell count was 168/μl (range, 2-1067), of whom 174 (63.7%) had a CD4 cell count below 200/μl. The median follow‐up of our cohort was 10.1 (0.1-160) months. The overall 2-year OS rates 58.0%. Median OS times in the 0, 1-3, 4-6, and >6 cycles chemotherapy cohort were 7.1 months, 20.0 months, not reached, and not reached, respectively (Hazard Ratio (HR)=0.549, 95% Confidence interval (CI) 0.451-0.667; p<0.001). Cox multivariate analysis showed that age ≥60 (HR=2.207, 95%CI 1.321-3.690; p=0.003), high IPI score (3-5) (HR=2.926, 95% CI 1.716-4.988; p<0.001), B symptoms (HR=1.928, 95%CI 1.192-3.119; p=0.007), elevated LDH (HR=1.696, 95%CI 1.031-2.791; p=0.038) and received less than 4 cycles chemotherapy (HR=0.520, 95%CI 0.424-0.637; p<0.001) were independent risk factor for adverse prognosis based on overall survival (OS).DiscussionThese results demonstrated that 4-6 cycles chemotherapy were significantly associated with improved outcomes in HIV-associated DLBCL patients. However, >6 cycles chemotherapy did not further improve the survival of patients.
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Affiliation(s)
- Chaoyu Wang
- Department of Hematology-Oncology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Yan Wu
- Henan Infectious Disease Hospital, The Sixth People’s Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Jun Liu
- Department of Hematology-Oncology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
- Department of Hematology, Kunming Third People’s Hospital, Kunming, Yunnan, China
| | - Haiyan Min
- Infectious Disease Department, Yunnan Provincial Hospital of Infectious Diseases, Kunming, Yunnan, China
| | - Yunhong Huang
- Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Guo Wei
- Oncology Surgery, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Wei Zhang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, China
| | - Min Wang
- Department of Infection and Immunology, The First Hospital of Changsha, Changsha, Hunan, China
| | - Xiaoqiong Tang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hui Zhou
- The Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha, Hunan, China
- *Correspondence: Hui Zhou, ; Yaokai Chen, ; Yao Liu,
| | - Yaokai Chen
- Department of Infectious Medicine, Chongqing Public Health Medical Center, Chongqing, China
- *Correspondence: Hui Zhou, ; Yaokai Chen, ; Yao Liu,
| | - Yao Liu
- Department of Hematology-Oncology, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
- *Correspondence: Hui Zhou, ; Yaokai Chen, ; Yao Liu,
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Pereira LJ, Mohrbacher S, Neves PDMDM, Zacchi FFS, Medeiros IUD, Sato VAH, Oliveira ÉS, Pereira LVB, Cuvello-Neto AL, Baiocchi O, Chocair PR. Primary Effusion Lymphoma: A Rare and Challenging Diagnosis for Recurrent Pleural Effusion. Diagnostics (Basel) 2023; 13:diagnostics13030370. [PMID: 36766474 PMCID: PMC9914331 DOI: 10.3390/diagnostics13030370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 01/21/2023] Open
Abstract
Primary Effusion Lymphoma is an extremely rare and aggressive subtype of B-cell lymphoma, accounting for only <1% of all cases of this neoplasm. It has a unique clinical presentation because it has a predilection for appearing in body cavities, such as the pleural space, pericardium and peritoneum. It mainly affects immunocompromised individuals and may also affect individuals in the Mediterranean region and in areas endemic for human herpesvirus 8 (HHV-8). Herein, we report the case of an 83-year-old immunocompetent male complaining of coughing, fever and progressive dyspnea for 3 days. His past medical history revealed a recurrent pleural effusion for the last three years, as well as losing weight and malaise. A subsequent investigation revealed a PEL diagnosis of the pleura.
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Affiliation(s)
| | - Sara Mohrbacher
- Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo 01323-020, Brazil
| | | | | | | | | | - Érico Souza Oliveira
- Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo 01323-020, Brazil
| | | | | | - Otávio Baiocchi
- Oncology Center, Oswaldo Cruz German Hospital, São Paulo 01323-020, Brazil
| | - Pedro Renato Chocair
- Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo 01323-020, Brazil
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Classification of B-Cell Lymphomas and Immunodeficiency-Related Lymphoproliferations: What’s New? HEMATO 2023. [DOI: 10.3390/hemato4010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
New insights from genomic studies have had an impact on the definition and the diagnosis of several lymphoid tumors including follicular B-cell lymphomas, aggressive diffuse large B-cell lymphomas, and lymphoproliferations associated with acquired and posttransplant immunodeficiencies. Follicular lymphoma (FL) includes tumors whose behavior varies widely from indolent/early lesions to aggressive/transformed lymphomas. Although some large B-cell lymphomas can be subclassified as specific entities, the majority lack the characteristics necessary for subclassification and, thus, are termed diffuse large B-cell lymphoma, NOS. There have been, however, some changes in the classification of specific subtypes of large B-cell lymphoma as well as the addition of new entities, a few of which are highlighted in this article. The immunodeficiency-related lymphoproliferative disorders are currently divided into four major categories based on the clinical setting in which they arose: primary immune deficiency, post-transplant, HIV infection, and iatrogenic immunosuppression. In the two upcoming classifications systems for hematolymphoid neoplasms, International Consensus Classification (ICC) and WHO-HAEM-5, there is a divergence in the approach to categorize these lesions. Furthermore, whereas the WHO-HAEM-5 confirms the ability to classify a spectrum of EBV+ lesions as EBV+ DLBCL, NOS, the ICC has separated out lesions that are composed of a heterogenous cellular infiltrate into a new separate category, “EBV-positive polymorphic B cell lymphoproliferative disorder, NOS”. Both WHO-HAEM-5 and ICC recognize a number of KSHV/HHV8-associated lymphoid lesions and acknowledge that there is significant overlap among the different lesions. In the future, translation of these innovations in general practice requires further validation.
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Incidence and Clinical Description of Lymphomas in Children and Adolescents with Vertical Transmission of HIV in Rio de Janeiro, Brazil, in Pre- and Post-Combined Antiretroviral Therapy Eras: A Multicentric Hospital-Based Survival Analysis Study. Cancers (Basel) 2022; 14:cancers14246129. [PMID: 36551614 PMCID: PMC9776495 DOI: 10.3390/cancers14246129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/25/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022] Open
Abstract
The incidence of cancer in children living with HIV (CLWH) is high and lymphomas are the most common type of cancer in this population. The combined antiretroviral therapy (cART) changed the natural history of HIV infection. To determine the incidence and profile of these CLWH malignancies in Rio de Janeiro (RJ), Brazil, we conducted a retrospective and observational study of vertically infected CLWH, ranging from 0−20 incomplete years, from 1995 to 2018, at five reference centers. The study period was divided into three eras in accordance with the widespread use of cART in Brazil. 1306 patients were included. Of the 25 lymphomas found, 19 were AIDS-defining malignancies (ADM); 6 were non-AIDS-defining malignancies (NADM). The incidence rate (IR) of lymphoma developing was 1.70 per 1000 children-year (95% CI 1.09−2.50). ADM development IR decreased from 2.09−1.75−0.19 per 1000 children-year (p < 0.001) through cART eras. Cumulative Nelson−Aalen hazards of developing ADM over a 20-year period were 3.73% in the Early-cART era, 3.07% in the Mid-cART era, and 0.32% in the Late-cART era (p = 0.013). This study demonstrates the IR of lymphoma in CLWH in RJ, Brazil, as well as the benefit of cART in reducing ADM and death occurrence in the Post-cART era.
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Lurain K, Ramaswami R, Yarchoan R. The role of viruses in HIV-associated lymphomas. Semin Hematol 2022; 59:183-191. [PMID: 36805886 PMCID: PMC9971650 DOI: 10.1053/j.seminhematol.2022.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/15/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
Lymphomas are among the most common cancers in people with HIV (PWH). The lymphoma subtypes and pathogenesis of lymphoma in PWH are different from the immunocompetent population. It is well-known that HIV causes severe CD4+ T cell lymphopenia in the absence of antiretroviral therapy (ART); however, the risk of developing certain subtypes of lymphoma remains elevated even in people receiving ART with preserved CD4+ T cells. HIV contributes to lymphomagenesis and causes decreased immune surveillance via T cell depletion and dysregulation, B cell dysregulation, and the potential contribution of HIV-encoded proteins. The oncogenic gammaherpesviruses, Epstein-Barr virus (EBV) and Kaposi sarcoma herpesvirus (KSHV, also known as human herpesvirus 8), are the causative agents in the majority of HIV-associated lymphomas. HIV-associated T cell depletion and dysregulation allows EBV and KSHV to proliferate in infected B cells. Specific EBV- and KSHV-encoded proteins participate in B cell activation, and proliferation leading to B cell transformation. Understanding the distinct pathogenesis of HIV-associated lymphomas affords opportunities to develop therapies that specifically target these unique aspects and improve lymphoma outcomes in PWH. Agents being studied that target the specific roles of HIV, EBV, and KSHV in lymphomagenesis include immunotherapies, targeted agents, and cellular therapies.
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Affiliation(s)
- Kathryn Lurain
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD.
| | - Ramya Ramaswami
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Robert Yarchoan
- HIV & AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
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Abstract
PURPOSE OF REVIEW To summarize the recent evidence on the pathology, current standard of care and recent advances in the treatment of HIV-related lymphomas. RECENT FINDINGS Lymphomas remain a major cause of morbidity and mortality in people living with HIV, even in the era of combination antiretroviral therapy (cART). However, treatment outcomes for these malignancies have improved in recent decades, due to full-dose chemotherapy, effective cART and supportive care. Recent advances include the identification of novel driving signaling pathways as promising molecular targets to improve lymphoma outcomes. SUMMARY Patients with HIV-related lymphomas who receive effective cART should be treated like the general population.
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Zhang J, Xie Z, Cai S, Qin S, Ruan G, Lu A, Wu Y, Chen J, Peng J. Hypoalbuminemia predicts inferior outcome in patients with AIDS-related lymphoma. Infect Agent Cancer 2022; 17:33. [PMID: 35717275 PMCID: PMC9206320 DOI: 10.1186/s13027-022-00448-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background The prognostic value of serum albumin in acquired immunodeficiency syndrome (AIDS)-related lymphoma (ARL) remains covered. Methods We retrospectively analyzed de novo ARL patients from 2013 to 2019 across three centers. Factors correlated with progression-free survival (PFS) and overall survival (OS) were evaluated in Kaplan–Meier, univariate and multivariate Cox proportional hazard models. Results A total of 86 ARL patients were enrolled with a median follow-up of 34 months. In the cohort, the OS and 2-year PFS rates were 37.5% and 35.4%, respectively. In multivariate models, older age (PFS, hazard ratios [HR] = 1.035, p = 0.037; OS, HR = 1.034, p = 0.041) and hypoalbuminemia (OS, HR = 0.910, p = 0.038) predicted inferior survival. ARL patients with hypoalbuminemia showed worse OS and 2-year PFS (p = 0.028 and p = 0.01, respectively), which was associated with poor Eastern Cooperative Oncology Group performance status (ECOG PS) and higher International Prognosis Index (IPI) score. Conclusion In conclusion, serum albumin at diagnosis is an independent prognostic factor for overall survival in AIDS-related lymphoma.
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Affiliation(s)
- Jinxin Zhang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue, Guangzhou, China.,Department of Respiratory Medicine, University of Chinese Academy of Sciences Shenzhen Hospital, Guangzhou, China
| | - Zhiman Xie
- Department of Infectious Diseases, the Fourth Hospital of Nanning, Nanning, China
| | - Shaohang Cai
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue, Guangzhou, China
| | - Shanfang Qin
- Guangxi AIDS Diagnosis and Treatment Quality Control Center, Longtan Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Guangjing Ruan
- Department of Infectious Diseases, the Fourth Hospital of Nanning, Nanning, China
| | - Aili Lu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue, Guangzhou, China
| | - Yihua Wu
- Department of Infectious Diseases, the Fourth Hospital of Nanning, Nanning, China
| | - Juanjuan Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue, Guangzhou, China.
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue, Guangzhou, China.
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Dreyling M, André M, Gökbuget N, Tilly H, Jerkeman M, Gribben J, Ferreri A, Morel P, Stilgenbauer S, Fox C, Maria Ribera J, Zweegman S, Aurer I, Bödör C, Burkhardt B, Buske C, Dollores Caballero M, Campo E, Chapuy B, Davies A, de Leval L, Doorduijn J, Federico M, Gaulard P, Gay F, Ghia P, Grønbæk K, Goldschmidt H, Kersten MJ, Kiesewetter B, Landman-Parker J, Le Gouill S, Lenz G, Leppä S, Lopez-Guillermo A, Macintyre E, Mantega MVM, Moreau P, Moreno C, Nadel B, Okosun J, Owen R, Pospisilova S, Pott C, Robak T, Spina M, Stamatopoulos K, Stary J, Tarte K, Tedeschi A, Thieblemont C, Trappe RU, Trümper LH, Salles G. The EHA Research Roadmap: Malignant Lymphoid Diseases. Hemasphere 2022; 6:e726. [PMID: 35620592 PMCID: PMC9126526 DOI: 10.1097/hs9.0000000000000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/21/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Marc André
- Université Catholique de Louvain, CHU UcL Namur, Yvoir, Belgium
| | - Nicola Gökbuget
- Department of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Hervé Tilly
- INSERM U1245, Department of Hematology, Centre Henri Becquerel and Université de Rouen, France
| | | | - John Gribben
- Barts Cancer Institute, Queen Mary University of London, United Kingdom
| | - Andrés Ferreri
- Lymphoma Unit, Department of Onco-hematology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Pierre Morel
- Service Hematologie Clinique Therapie Cellulaire, CHU Amiens Picardie, Amiens, France
| | - Stephan Stilgenbauer
- Comprehensive Cancer Center Ulm (CCCU), Sektion CLL Klinik für Innere Medizin III, Universität Ulm, Germany
| | - Christopher Fox
- School of Medicine, University of Nottingham, United Kingdom
| | - José Maria Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain
| | - Sonja Zweegman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Igor Aurer
- University Hospital Centre Zagreb and Medical School, University of Zagreb, Croatia
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Birgit Burkhardt
- Experimentelle und Translationale päd. Hämatologie u Onkologie, Leitung der Bereiche Lymphome und Stammzelltransplantation, Universitätsklinikum Münster (UKM), Klinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Munich, Germany
| | - Christian Buske
- Institute of Experimental Cancer Research, CCC Ulm, University Hospital Ulm, Germany
| | - Maria Dollores Caballero
- Clinical and Transplant Unit, University Hospital of Salamanca, Spain
- Department of Medicine at the University of Salamanca, Spain
- El Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Elias Campo
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Bjoern Chapuy
- Department of Hematology, Oncology and Tumor Immunology, Charité, University Medical Center Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Andrew Davies
- Southampton NCRI/UK Experimental Cancer Medicines Centre, Faculty of Medicine, University of Southampton, United Kingdom
| | - Laurence de Leval
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Jeanette Doorduijn
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Philippe Gaulard
- Département de Pathologie, Hôpital Henri Mondor, AP-HP, Créteil, France
| | - Francesca Gay
- Clinical Trial Unit, Division of Hematology 1, AOU Città Della Salute e Della Scienza, University of Torino, Italy
| | - Paolo Ghia
- Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Kirsten Grønbæk
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Denmark
| | - Hartmut Goldschmidt
- University Hospital Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Marie-Jose Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam and LYMMCARE, Amsterdam, the Netherlands
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Austria
| | - Judith Landman-Parker
- Pediatric Hematology Oncology, Sorbonne Université APHP/hôpital A Trousseau, Paris, France
| | - Steven Le Gouill
- Service d’Hématologie, Clinique du Centre Hospitalier Universitaire (CHU) de Nantes, France
| | - Georg Lenz
- Medical Department A for Hematology, Oncology and Pneumology, University Hospital Münster, Germany
| | - Sirpa Leppä
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre, Helsinki, Finland
| | | | - Elizabeth Macintyre
- Onco-hematology, Université de Paris and Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, France
| | | | - Philippe Moreau
- Hematology Department, University Hospital Hotel-Dieu, Nantes, France
| | - Carol Moreno
- Hospital de la Santa Creu I Sant Pau, Autonomous University of Barcelona, Spain
| | - Bertrand Nadel
- Aix Marseille Univ, CNRS, INSERM, CIML, Marseille, France
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, United Kingdom
| | - Roger Owen
- St James’s Institute of Oncology, Leeds, United Kingdom
| | - Sarka Pospisilova
- Department of Internal Medicine—Hematology and Oncology and Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Czech Republic
| | - Christiane Pott
- Klinisch-experimentelle Hämatologie, Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany
| | | | - Michelle Spina
- Division of Medical Oncology and Immune-related Tumors, National Cancer Institute, Aviano, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Jan Stary
- Department of Pediatric Hematology and Oncology 2nd Faculty of Medicine, Charles University Prague University Hospital, Prague, Czech Republic
| | - Karin Tarte
- Immunology and Cell Therapy Lab at Rennes University Hospital, Rennes, France
| | | | - Catherine Thieblemont
- Department of Hemato-Oncology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Ralf Ulrich Trappe
- Department of Internal Medicine II: Haematology and Oncology, DIAKO Hospital Bremen, Germany
| | - Lorenz H. Trümper
- Hematology and Medical Oncology, University Medicine Goettingen, Germany
| | - Gilles Salles
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA
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40
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Münz C. Natural killer cell responses to human oncogenic γ-herpesvirus infections. Semin Immunol 2022; 60:101652. [PMID: 36162228 DOI: 10.1016/j.smim.2022.101652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 01/15/2023]
Abstract
The two γ-herpesviruses Epstein Barr virus (EBV) and Kaposi sarcoma associated herpesvirus (KSHV) are each associated with more than 1% of all tumors in humans. While EBV establishes persistent infection in nearly all adult individuals, KSHV benefits from this widespread EBV prevalence for its own persistence. Interestingly, EBV infection expands early differentiated NKG2A+KIR- NK cells that protect against lytic EBV infection, while KSHV co-infection drives accumulation of poorly functional CD56-CD16+ NK cells. Thus persistent γ-herpesvirus infections are sculptors of human NK cell repertoires and the respectively stimulated NK cell subsets should be considered for immunotherapies of EBV and KSHV associated malignancies.
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Affiliation(s)
- Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Switzerland.
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41
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KSHV/HHV8-Associated Lymphoproliferative Disorders: Lessons Learnt from People Living with HIV. HEMATO 2021. [DOI: 10.3390/hemato2040047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In 1992, Kaposi sarcoma herpesvirus (KSHV/HHV8) was discovered and identified as the causative agent for Kaposi sarcoma. Subsequently, the presence of this virus has been detected in a number of lymphoproliferative disorders in people living with HIV (PLWH), including: KSHV-associated multicentric Castleman disease, primary effusion lymphoma, KSHV-positive diffuse large B-cell lymphoma, and germinotropic lymphoproliferative disorder. Each of these rare entities has subsequently been diagnosed in HIV-negative individuals. The recognition of some of these KSHV/HHV8-associated lymphoproliferative disorders has led to their inclusion in the WHO classification of lymphomas in 2008 and the revision of 2016; however, further revision is under way to update the classification. The relatively recent recognition of these lymphoproliferative disorders and their low incidence, particularly in the HIV-negative population, means that there is little published evidence and consensus on their clinical features and management. The publication of a new WHO classification of lymphomas should yield diagnostic clarity, providing an impetus for retrospective case series and prospective clinical trials in these KSHV/HHV8-associated lymphoproliferative disorders.
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