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Wang W, Li Y, Ali H, Zhao L, Mei D, Hu W, Jiang B. Aberrant expression of CD54 detected by flow cytometry is a characteristic of B-lymphoma cells in bone marrow specimens. BMC Cancer 2021; 21:1315. [PMID: 34879826 PMCID: PMC8653582 DOI: 10.1186/s12885-021-09061-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background Flow cytometry (FC) is a popular method to detect bone marrow (BM) involvement in patients with B-cell non-Hodgkin lymphoma (B-NHL). The majority of screen panels of FC still rely on finding monoclonal B-cells, e.g., B-cells with immunoglobin (Ig) light-chain restriction, which has many limitations. Therefore, exploring new markers is warranted. Methods A total of 52 cases of B-NHL with BM involvement were collected. The median age was 60 years. Out of these 52 cases, 34 were male, and 18 were female. A 10-color FC panel was used to detect the expression of CD54 on lymphoma cells. The expression of CD54 was calculated as the mean fluorescence index ratio (MFIR) and was described as the mean ± standard error of the mean (SEM). Results Up to 18/52 (34.62%) of BM specimens abnormally expressed an increased level of CD54, including 1/10 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 9/13 cases of mantle cell lymphoma (MCL), 2/14 cases of follicular lymphoma (FL), 5/9 cases of marginal zone lymphoma (MZL), and 1/3 cases of high-grade B-NHL (HG B-NHL). The expression level of CD54 was significantly increased in MCL cases (53.41 ± 11.04) compared with CLL/SLL cases (11.66 ± 2.79) and FL cases (13.49 ± 2.81). The lowest percentage of CD54-positive B-cells attained 0.13%. In 5/9 cases of MZL and 1/3 cases of HG B-NHL, increased expression of CD54 was the only abnormal immunophenotype detected besides Ig light-chain restriction. No aberrant CD54 expression was identified by FC in lymphoplasmacytic lymphoma (LPL) (0/2) and Burkitt lymphoma (BL) (0/1) cases. Aberrant expression of CD54 was not related to plasma cell differentiation. Conclusion Lymphoma cells, especially in MCL and MZL cases, frequently show increased expression of CD54. Such aberrant expression is not related to plasma cell differentiation. We highly recommend adding CD54 to the FC screening panel to detect BM involvement in patients with B-NHL.
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Affiliation(s)
- Wei Wang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Yan Li
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Haval Ali
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX, USA
| | - Linjun Zhao
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Di Mei
- Department of Lymphoma, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Wenqing Hu
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China
| | - Bin Jiang
- Department of Hematology, Peking University International Hospital, Zhong-Guan-Cun Life Science Park Road, Beijing, China.
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Sorigue M, Cañamero E, Miljkovic MD. Systematic review of staging bone marrow involvement in B cell lymphoma by flow cytometry. Blood Rev 2020; 47:100778. [PMID: 33187810 DOI: 10.1016/j.blre.2020.100778] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/22/2020] [Accepted: 09/02/2020] [Indexed: 12/15/2022]
Abstract
The clinical relevance of flow cytometry (FC)-based bone marrow involvement (BMI) in B cell non-Hodgkin lymphoma (B-NHL) is not well established. We conducted a systematic review of MEDLINE regarding the use of FC to establish BMI in B-NHL to determine the prevalence of BMI by FC, to understand the interrelation between FC and bone marrow biopsy (BMB), and to explore the prognostic impact of BMI by FC. Relevant exclusion criteria included publication before 2010. Eleven publications (of 18 screened) were included, with 2803 patients involved. Relevant methodological details were often unreported. The prevalence of BMI by FC varied based on histological subtypes included. The median kappa agreement between BMB and FC was 0.68 and the type of discordance (FC+/BMB- vs. FC-/BMB+) was highly variable across studies. Only 4 studies (all in diffuse large B cell lymphoma) assessed the prognostic impact of BMI by FC. Two found a worse prognosis for patients with FC+/BMB- than those without BMI. To conclude, studies assessing BMI by FC are retrospective, of low methodological quality and with heterogeneous findings.
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Affiliation(s)
- Marc Sorigue
- Hematology Laboratory, ICO-Hospital Germans Trias i Pujol, Functional cytomics-IJC, Universitat Autònoma de Barcelona, Badalona, Spain.
| | - Eloi Cañamero
- Hematology Laboratory, ICO-Hospital Germans Trias i Pujol, Functional cytomics-IJC, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Milos D Miljkovic
- Lymphoid Malignancies Branch, National Cancer Institute, Bethesda, MD, USA
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Yang CF, Hsiao LT, Chang HY, Hsu CY. Large B-cell lymphoma presenting primarily in bone marrow is frequently associated with haemophagocytic lymphohistiocytosis and has distinct cytogenetic features. Pathology 2020; 52:561-567. [PMID: 32561209 DOI: 10.1016/j.pathol.2020.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 11/25/2022]
Abstract
The criteria for primary bone marrow large B-cell lymphoma (PBMLBCL) have not yet been clearly established. We aimed to investigate the clinicopathological features of PBMLBCLs (27 cases) and large B-cell lymphomas (LBCLs) with secondary marrow involvement (55 cases). PBMLBCL was defined as LBCLs presenting initially in bone marrow without lymphadenopathy, extramedullary tumour or localised bone tumour, and no evidence of transformation from low grade B-cell lymphoma. Compared with the patients in the secondary group, more patients in the primary group had haemophagocytic lymphohistiocytosis, cytogenetic aberrations, cytopenias, and atypical lymphocytes in peripheral blood. The most common chromosome abnormality in both groups was 6q deletion. The primary group had additional chromosome 10, 2, and 3 abnormalities. The acquired chromosome 10 aberration was associated with the risk of haemophagocytic lymphohistiocytosis. The 1-year survival rate was lower in the primary group than in the secondary group; however, the difference was not significant when the cases without chemotherapy plus rituximab were excluded. Moreover, multivariate analysis revealed that relatively high white blood cell count, not receiving chemotherapy plus rituximab, and cytogenetic aberrations were poor prognostic factors in the secondary group, but only not receiving chemotherapy plus rituximab was retained in the primary group. In conclusion, PBMLBCL is genetically and clinically distinct. Although patients with PBMLBCL generally have a poor outcome, the disease is treatable and some patients become long-term survivors.
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Affiliation(s)
- Ching-Fen Yang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Liang-Tsai Hsiao
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Haematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Haemophilia Comprehensive Care Centre, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yi Chang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Yi Hsu
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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Greenbaum U, Levi I, Madmoni O, Lior Y, Al-Athamen K, Perry ZH, Hatzkelzon L, Shubinsky G. The prognostic significance of bone marrow involvement in diffuse large B cell lymphoma according to the flow cytometry. Leuk Lymphoma 2019; 60:2477-2482. [DOI: 10.1080/10428194.2019.1587755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Uri Greenbaum
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
| | - Itai Levi
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
| | - Odelia Madmoni
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
| | - Yotam Lior
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
- Soroka Clinical Research Center, Soroka University Medical Center, Beer Sheba, Israel
| | - Kayed Al-Athamen
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
| | - Zvi Howard Perry
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
- Surgery Ward A, Soroka University Medical Center, Beer Sheba, Israel
| | - Lev Hatzkelzon
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
| | - George Shubinsky
- Department of Hematology, Soroka University Medical Center, Beer Sheba, Israel
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheba, Israel
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Miyake T, Iida T, Masaki Y, Onodera K, Kubo T, Yamashita K, Yamano H, Nakase H. A case of nodal malignant lymphoma presenting with arterial bleeding related to its duodenal penetration. Clin J Gastroenterol 2018; 11:229-234. [PMID: 29411246 DOI: 10.1007/s12328-018-0827-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/31/2018] [Indexed: 12/28/2022]
Abstract
A 62-year-old man with a chief complaint of dysphagia visited our hospital. Enhanced computed tomography showed the tumor near the duodenal wall and lymphadenopathy in the left supraclavicular fossa and para-aortic lymph node. Upper gastrointestinal endoscopy showed an ulcer accompanied with a fistula in the anterior wall of duodenal bulb, suggesting that the tumor penetrated into duodenal wall. Biopsy from the lymph node in the left supraclavicular fossa indicated diffuse large B-cell lymphoma. Although chemotherapy was planned, massive arterial bleeding occurred from the part of duodenal penetration. Endoscopic hemostasis was unsuccessfully performed. Therefore, we performed transcathether arterial embolization for hemostasis. After the procedure, the patient received six cycles of chemotherapy, and he achieved complete response. He has been alive 5 years without recurrence. There were many cases of gastrointestinal bleeding from primary gastrointestinal lymphomas, while there were few cases with nodal involvement by malignant lymphoma resulting in bleeding from gastrointestinal tract. We herein report a case of duodenal bleeding by nodal involvement of diffuse large B-cell lymphoma with review of literature.
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Affiliation(s)
- Takakazu Miyake
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Tomoya Iida
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Yoshiharu Masaki
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Kei Onodera
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Toshiyuki Kubo
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Kentaro Yamashita
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Hiroo Yamano
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Hiroshi Nakase
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan
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Abstract
INTRODUCTION We report an unusual and interesting case of non-Hodgkin lymphoma involving 7 extranodal sites.In this case, a 43-year-old woman with diffuse large B-cell lymphoma, including stomach, breasts, pancreas, adrenal glands, ovary and bones, was confirmed by biopsy and positron emission tomography/computed tomography scan. The patient achieved a complete response after 2 cycles of chemotherapy with combined rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone, but subsequently developed central nervous system involvement. CONCLUSION This case illustrated the usefulness of positron emission tomography/computed tomography in diagnosis, disease staging, and assessment of response to therapy. Selection of the optimal treatment regimen is challenging and needs further research.
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Affiliation(s)
- Chao Li
- Department of Oncology, Beijing Hospital
- Correspondence: Chao Li, Department of Oncology, Beijing Hospital, Beijing, 100730, China (e-mail: )
| | - Lin Li
- Department of Oncology, Beijing Hospital
| | - Ping Zhang
- Department of Oncology, Beijing Hospital
| | | | - Ting Gao
- Cancer Hospital, Chinese Academy of Medical Science
| | - Yan Xu
- Department of Oncology, Beijing Hospital
| | - Wen-Chan Li
- Department of Nuclear Medicine, Beijing Hospital, Beijing, China
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Gavrilina OA, Parovichnikova EN, Zvonkov EE, Troitskaya VV, Kravchenko SK, Savchenko VG. [Diffuse large B-cell lymphoma with monoclonal immunoglobulin secretion]. TERAPEVT ARKH 2016; 88:56-61. [PMID: 27459616 DOI: 10.17116/terarkh201688756-61] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM to provide the clinical characteristics of patients with diffuse large B-cell lymphoma (DLBCL) with monoclonal immunoglobulin secretion and to evaluate the efficiency of intensified mNHL-BFM-90 or R-DA-EPOCH/R-HMA therapy programs in patients with Ig-secreting DLBCL. SUBJECTS AND METHODS A clinical trial was conducted in 93 patients with newly diagnosed DLBCL, among whom 21 (22.6%) were found to have monoclonal immunoglobulin secretion. RESULTS Ig-secreting DLBCL is shown to be characterized by bone marrow involvement (p<0.001), as well as generalized injury (Ann Arbor Stage 4) and a high risk in accordance with the international prognostic index (p=0.001 and p=0.026, respectively). Analysis of overall and event-free survival rates has indicated that the patients have a poor prognosis versus those with non-Ig-secreting DLBCL and poor prognostic factors even when implementing intensified therapy programs, such as mNHL-BFM-90 or R-DA-EPOCH/R-HMA ones. CONCLUSION The investigation has demonstrated that there is a high association of the secretion of monoclonal paraproteins with bone marrow involvement in DLBCL (p<0.001). The intensified therapy using the mNHL-BFM-90 and R-DA-EPOCH/R-HMA programs involving autologous hematopoietic stem cell transplantation also permits the patients with Ig-secreting DLBCL to achieve long-term sustained remissions in not all cases.
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Affiliation(s)
- O A Gavrilina
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - E N Parovichnikova
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - E E Zvonkov
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - V V Troitskaya
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - S K Kravchenko
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
| | - V G Savchenko
- National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russia
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Zhang L, Lin Q, Zhang L, Dong L, Li Y. Primary skeletal muscle diffuse large B cell lymphoma: A case report and review of the literature. Oncol Lett 2015; 10:2156-2160. [PMID: 26622811 PMCID: PMC4579810 DOI: 10.3892/ol.2015.3505] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 06/02/2015] [Indexed: 12/16/2022] Open
Abstract
The occurrence of primary extranodal non-Hodgkin's lymphoma (NHL) of soft tissue is rare, particularly in skeletal muscle. The present study describes a case of diffuse large B cell lymphoma of the right lower extremity and provides a detailed review of the literature associated with this disorder, with the aim of improving the future diagnosis and therapy of extranodal NHL. The present case report was of a 76-year-old woman who presented with a right thigh and calf mass. In view of the tumor's location and the patient's age, soft tissue tumors were considered to be soft tissue sarcoma. Imaging scans were performed to determine the location and size of the tumor, followed by a biopsy of the muscle. Histopathological examination then yielded a diagnosis of diffuse large B cell lymphoma. The patient then underwent 4 cycles of chemotherapy. There was evident relief of pain and swelling in the right extremity; however, positron emission tomography/computed tomography (PET/CT) determined insufficient treatment efficacy. Chemotherapy was adjusted for 2 cycles; however, the patient suffered an aggravation of edema, so a different chemotherapy regimen of bleomycin, cytarabine, vincristine, cyclosphamide and dexamethasone (BCOAD) was performed for a further 2 cycles. The edema was alleviated and magnetic resonance imaging revealed shrinkage of the lower limb mass and the right thigh mass was undetectable. In conclusion, the present case report demonstrated that PET/CT may help determine the efficacy of chemotherapy treatment and that the BCOAD chemotherapy regimen may be more effective than standard treatments in certain cases.
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Affiliation(s)
- Lijuan Zhang
- Transplantation Department of Internal Medicine, 302 Hospital of the Chinese People's Liberation Army, Beijing 100039, P.R. China
| | - Quande Lin
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Lina Zhang
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Lihua Dong
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
| | - Yufu Li
- Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
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Torlakovic EE, Brynes RK, Hyjek E, Lee SH, Kreipe H, Kremer M, McKenna R, Sadahira Y, Tzankov A, Reis M, Porwit A. ICSH guidelines for the standardization of bone marrow immunohistochemistry. Int J Lab Hematol 2015; 37:431-49. [DOI: 10.1111/ijlh.12365] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/02/2015] [Indexed: 12/25/2022]
Affiliation(s)
- E. E. Torlakovic
- Department of Laboratory Hematology; University Health Network; University of Toronto; Toronto ON Canada
| | - R. K. Brynes
- Department of Pathology; Keck School of Medicine; University of Southern California; Los Angeles CA USA
| | - E. Hyjek
- Department of Pathology; University of Chicago; Chicago IL USA
| | - S.-H. Lee
- Department of Haematology; St George Hospital; SEALS Central; Sydney NSW Australia
| | - H. Kreipe
- Department of Pathology; Hannover Medical School; Hannover Germany
| | - M. Kremer
- Munich Municipal Hospital; Institute of Pathology; Munich Germany
| | - R. McKenna
- Special Hematology; Department of Laboratory Medicine and Pathology; University of Minnesota; Minneapolis MN USA
| | - Y. Sadahira
- Department of Pathology; Kawasaki Medical School; Kurashiki Japan
| | - A. Tzankov
- Institute of Pathology; University Hospital Basel; Basel Switzerland
| | - M. Reis
- Department of Clinical Pathology; Sunnybrook Health Sciences Centre; Toronto ON Canada
| | - A. Porwit
- Department of Laboratory Hematology; University Health Network; University of Toronto; Toronto ON Canada
- Department of Pathology; Karolinska Institute; Stockholm Sweden
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Berget E, Helgeland L, Liseth K, Løkeland T, Molven A, Vintermyr OK. Prognostic value of bone marrow involvement by clonal immunoglobulin gene rearrangements in follicular lymphoma. J Clin Pathol 2014; 67:1072-7. [PMID: 25233852 PMCID: PMC4251203 DOI: 10.1136/jclinpath-2014-202382] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Aims We aimed to evaluate the prognostic value of routine use of PCR amplification of immunoglobulin gene rearrangements in bone marrow (BM) staging in patients with follicular lymphoma (FL). Methods Clonal rearrangements were assessed by immunoglobulin heavy and light-chain gene rearrangement analysis in BM aspirates from 96 patients diagnosed with FL and related to morphological detection of BM involvement in biopsies. In 71 patients, results were also compared with concurrent flow cytometry analysis. Results BM involvement was detected by PCR in 34.4% (33/96) of patients. The presence of clonal rearrangements by PCR was associated with advanced clinical stage (I–III vs IV; p<0.001), high FL International Prognostic Index (FLIPI) score (0–1, 2 vs ≥3; p=0.003), and detection of BM involvement by morphology and flow cytometry analysis (p<0.001 for both). PCR-positive patients had a significantly poorer survival than PCR-negative patients (p=0.001, log-rank test). Thirteen patients positive by PCR but without morphologically detectable BM involvement, had significantly poorer survival than patients with negative morphology and negative PCR result (p=0.002). The poor survival associated with BM involvement by PCR was independent of the FLIPI score (p=0.007, Cox regression). BM involvement by morphology or flow cytometry did not show a significant impact on survival. Conclusions Our results showed that routine use of PCR-based clonality analysis significantly improved the prognostic impact of BM staging in patients with FL. BM involvement by PCR was also an independent adverse prognostic factor.
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Affiliation(s)
- Ellen Berget
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Lars Helgeland
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Knut Liseth
- Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway
| | - Turid Løkeland
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - Anders Molven
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Olav Karsten Vintermyr
- The Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway Department of Pathology, Haukeland University Hospital, Bergen, Norway
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Wolach O, Fraser A, Luchiansky M, Shapiro C, Radnay J, Shpilberg O, Lishner M, Lahav M. Can flow cytometry of bone marrow aspirate predict outcome of patients with diffuse large B cell lymphoma? A retrospective single centre study. Hematol Oncol 2014; 33:42-7. [DOI: 10.1002/hon.2127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 11/14/2013] [Accepted: 11/14/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Ofir Wolach
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital; Rabin Medical Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Abigail Fraser
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol and School of Social and Community Medicine; University of Bristol; Bristol UK
| | - Michael Luchiansky
- Department of Medicine; Rabin Medical Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Chava Shapiro
- Department of Medicine; Meir Medical Center; Kfar Saba Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Judith Radnay
- Department of Medicine; Meir Medical Center; Kfar Saba Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Ofer Shpilberg
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Michael Lishner
- Department of Medicine; Meir Medical Center; Kfar Saba Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Meir Lahav
- Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital; Rabin Medical Center; Petah Tikva Israel
- Department of Medicine; Rabin Medical Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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Kim S, Kim H, Kang H, Kim J, Eom H, Kim T, Yoon SS, Suh C, Lee D. Clinical significance of cytogenetic aberrations in bone marrow of patients with diffuse large B-cell lymphoma: prognostic significance and relevance to histologic involvement. J Hematol Oncol 2013; 6:76. [PMID: 24220305 PMCID: PMC3851800 DOI: 10.1186/1756-8722-6-76] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022] Open
Abstract
Background Although knowledge of the genetics of diffuse large B-cell lymphoma (DLBCL) has been increasing, little is known about the characteristics and prognostic significance of cytogenetic abnormalities and the clinical utility of cytogenetic studies performed on bone marrow (BM) specimens. To investigate the significance of isolated cytogenetic aberrations in the absence of histologic BM involvement, we assessed the implication of cytogenetic staging and prognostic stratification by a retrospective multicenter analysis of newly diagnosed DLBCL patients. Methods We analyzed cytogenetic and clinical data from 1585 DLBCL patients whose BM aspirates had been subjected to conventional karyotyping for staging. If available, interphase fluorescence in situ hybridization (FISH) data were also collected from patients. Results Histologic BM involvement were found in 259/1585 (16.3%) patients and chromosomal abnormalities were detected in 192 (12.1%) patients (54 patients with single abnormalities and 138 patients with 2 or more abnormalities). Isolated cytogenetic aberrations (2 or more abnormalities) without histologic involvement were found in 21 patients (1.3%). Two or more cytogenetic abnormalities were associated with inferior overall survival (OS) compared with a normal karyotype or single abnormality in both patients with histologic BM involvement (5-year OS, 16.5% vs. 52.7%; P < 0.001) and those without BM involvement (31.8% vs. 66.5%; P < 0.001). This result demonstrated that BM cytogenetic results have a significant prognostic impact that is independent of BM histology. The following abnormalities were most frequently observed: rearrangements involving 14q32, 19q13, 19p13, 1p, 3q27, and 8q24; del(6q); dup(1q); and trisomy 18. In univariate analysis, several specific abnormalities including abnormalities at 16q22-q24, 6p21-p25, 12q22-q24, and -17 were associated with poor prognosis. Multivariate analyses performed for patients who had either chromosomal abnormalities or histologic BM involvement, revealed IPI high risk, ≥ 2 cytogenetic abnormalities, and several specific chromosomal abnormalities, including abnormalities at 19p13, 12q22-q24, 8q24, and 19q13 were significantly associated with a worse prognosis. Conclusions We suggest that isolated cytogenetic aberrations can be regarded as BM involvement and cytogenetic evaluation of BM improves staging accuracy along with prognostic information for DLBCL patients.
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Marconato L, Martini V, Aresu L, Sampaolo M, Valentini F, Rinaldi V, Comazzi S. Assessment of bone marrow infiltration diagnosed by flow cytometry in canine large B cell lymphoma: prognostic significance and proposal of a cut-off value. Vet J 2013; 197:776-81. [PMID: 23735731 DOI: 10.1016/j.tvjl.2013.05.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 12/11/2022]
Abstract
The aims of this study were to assess the prognostic significance of bone marrow (BM) infiltration in canine large B cell lymphoma (LBCL) and to establish cut-off values for designating the BM as infiltrated by lymphoid blasts. The degree of BM infiltration by large CD21 positive cells in dogs with LBCL was assessed by flow cytometry (FC) and related to time to progression (TTP) and lymphoma-specific survival (LSS). Forty-six dogs were prospectively enrolled, staged and treated with a dose-intense chemotherapeutic protocol. BM infiltration was directly correlated with peripheral blood infiltration (P=0.001), high lactate dehydrogenase activity (P=0.0024) and substage b disease (P<0.001). In the univariate analysis, there was a significant association between BM infiltration diagnosed by FC and both TTP (P=0.001) and LSS (P<0.001). Substage was the only factor associated with TTP in the multivariate analysis (P=0.002), whereas substage (P<0.001) and anaemia (P=0.008) were associated with LSS. A cut-off of 3% BM infiltration had the strongest prognostic value, since it discriminated between dogs with a poorer prognosis (median TTP 69 days; median LSS 155 days) and dogs with a better prognosis (median TTP 149 days; median LSS 322 days). BM analysis is an essential step in the staging of LBCL. The presence of BM infiltration by FC at diagnosis is a negative prognostic indicator in canine LBCL.
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Affiliation(s)
- Laura Marconato
- Centro Oncologico Veterinario, via San Lorenzo 1-4, 40037 Sasso Marconi, BO, Italy.
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Arima H, Maruoka H, Nasu K, Tabata S, Kurata M, Matsushita A, Imai Y, Takahashi T, Ishikawa T. Impact of occult bone marrow involvement on the outcome of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone therapy for diffuse large B-cell lymphoma. Leuk Lymphoma 2013; 54:2645-53. [DOI: 10.3109/10428194.2013.788697] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Martini V, Melzi E, Comazzi S, Gelain ME. Peripheral blood abnormalities and bone marrow infiltration in canine large B-cell lymphoma: is there a link? Vet Comp Oncol 2013; 13:117-23. [PMID: 23419006 DOI: 10.1111/vco.12024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 12/06/2012] [Accepted: 01/22/2013] [Indexed: 12/21/2022]
Abstract
Official guidelines do not consider bone marrow (BM) assessment mandatory in staging canine lymphoma unless blood cytopenias are present. The aim of this study was to find out if blood abnormalities can predict marrow involvement in canine large B-cell lymphoma. BM infiltration was assessed via flow cytometry. No difference was found between dogs without haematological abnormalities and dogs with at least one. However, the degree of infiltration was significantly higher in dogs with thrombocytopenia, leucocytosis or lymphocytosis and was negatively correlated to platelet count and positively to blood infiltration. Our results suggest that blood abnormalities are not always predictive of marrow involvement, even if thrombocytopenia, leucocytosis or lymphocytosis could suggest a higher infiltration. BM evaluation should therefore be included in routine staging in order not to miss infiltrated samples and to improve classification. However, its clinical relevance and prognostic value are still not defined and further studies are needed.
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Affiliation(s)
- V Martini
- Department of Veterinary Sciences and Public Health, Faculty of Veterinary Medicine, University of Milan, Milan, Italy
| | - E Melzi
- Department of Veterinary Sciences and Public Health, Faculty of Veterinary Medicine, University of Milan, Milan, Italy
| | - S Comazzi
- Department of Veterinary Sciences and Public Health, Faculty of Veterinary Medicine, University of Milan, Milan, Italy
| | - M E Gelain
- Department of Comparative Biomedicine and Food Science, Faculty of Veterinary Medicine, University of Padua, Padua, Italy
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High nuclear expression of STAT3 is associated with unfavorable prognosis in diffuse large B-cell lymphoma. J Hematol Oncol 2011; 4:31. [PMID: 21806788 PMCID: PMC3163635 DOI: 10.1186/1756-8722-4-31] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 08/01/2011] [Indexed: 12/28/2022] Open
Abstract
Background The purpose of the study was to investigate the expression and prognostic value of STAT3 in diffuse large B-cell lymphoma (DLBCL). Methods Seventy-four DLBCL patients from 2001 to 2007 were reviewed in the study. The STAT3 expression in their tumor tissues was examined using the immunohistochemistry (IHC) method, and evaluated for its association with clinicopathological parameters. Results Strong nuclear staining of STAT3 and phosphorylated-STAT3tyr705 (P-STAT3) were observed in 19 cases (25.7%) and 24 cases (32.4%), respectively, and the expression levels were highly consistent between them (P = 0.001). The high nuclear expression of STAT3 was more frequent in the non-germinal center B cell-like (non-GCB) DLBCL than that in the GCB subtype, but not reaching significance (P < 0.061). The high nuclear expression of STAT3 was found to be correlated with poor overall survival (OS) (P = 0.005). Multivariate Cox regression analysis showed that the STAT3 expression was an independent prognostic factor for DLBCL patients regardless of CHOP or R-CHOP regimen used as the first-line therapy. Conclusion STAT3 is more frequently expressed in non-GCB DLBCL than that in GCB subtype, and its strong nuclear expression is correlated with poor OS in DLBCL.
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