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Jiang C, Huang LY, Zhou JH, Li ZM, Wang Y, Li S, Fu JC, Huang QT, Yan Q, Huang YY, Zuo M, Hu S, Gale RP, Liang Y, Yun JP, Huang YH. Epstein-Barr virus-based prognostic model in nodular sclerosis classic Hodgkin lymphoma. iScience 2024; 27:108630. [PMID: 38188529 PMCID: PMC10770718 DOI: 10.1016/j.isci.2023.108630] [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: 07/05/2023] [Revised: 09/23/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
The role of Epstein-Barr virus (EBV) in lymphoma cells of nodular sclerosis classic Hodgkin lymphoma (NScHL) is controversial. Our aim was to explore this and establish a clinically feasible model for risk stratification. We interrogated data from 542 consecutive subjects with NScHL receiving ABVD therapy and demonstrated EBV-infection in their lymphoma cells with EBV-encoded small RNAs (EBERs) in situ hybridization. Subjects were divided into training and validation datasets. As data from the training dataset suggested EBERs-positivity was the only independent prognostic factor for both progression-free survival (PFS) and overall survival (OS), we developed corresponding prognostic models based on it. Our models showed excellent performance in both training and validation cohort. These data indicate the close association of EBV infection and the outcomes of persons with NScHL receiving ABVD. Additionally, our newly developed models should help physicians estimate prognosis and select individualized therapy.
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Affiliation(s)
- Chen Jiang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Li-Yun Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Ji-Hao Zhou
- Department of Hematology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, P.R. China
| | - Zhi-Ming Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yu Wang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Shuo Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Jian-Chang Fu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qi-Tao Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Qin Yan
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yu-Yuan Huang
- Department of Pathology, Dongguan Children’s Hospital, Dongguan, Guangdong, P.R. China
| | - Min Zuo
- Department of Hematology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, P.R. China
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Peter Gale
- Centre for Haematology, Department of Immunology and Inflammation, Imperial College of Science, Technology and Medicine, London, UK
| | - Yang Liang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Jing-Ping Yun
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Yu-Hua Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
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Current Treatment Options and the Role of Functional Status Assessment in Classical Hodgkin Lymphoma in Older Adults: A Review. Cancers (Basel) 2023; 15:cancers15051515. [PMID: 36900306 PMCID: PMC10000520 DOI: 10.3390/cancers15051515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Along with the fact that classical Hodgkin lymphoma (cHL) in older adults is frequently considered biologically different from cHL in younger patients, its most distinctive feature is its dismal clinical outcome due to the decreased effectiveness and greater toxicity of therapies. Although strategies to mitigate specific toxicities (e.g., cardiological and pulmonary) have obtained some results, in general, reduced-intensity schemes, proposed as an alternative to ABVD, have proved to be less effective. The addition of brentuximab vedotin (BV) to AVD, especially in a sequential scheme, has demonstrated good efficacy. However, the problem of toxicity persists even with this new therapeutic combination, with comorbidities remaining an important prognostic factor. The adequate stratification of functional status is necessary to distinguish between those patients who will benefit from full treatment and those who will benefit from alternative strategies. A simplified geriatric assessment based on the determination of ADL (activity of daily living), IADL (instrumental ADL), and CIRS-G (Cumulative Illness Rating Scale-Geriatric) scores is an easy-to-use tool that permits adequate patient stratification. Other factors of considerable impact on functional status such as sarcopenia and immunosenescence are currently being studied. A fitness-based treatment choice would also be very useful for relapsed or refractory patients, a more frequent and challenging situation than that is found in young cHL patients.
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Gomez K, Schiavoni G, Nam Y, Reynier JB, Khamnei C, Aitken M, Palmieri G, Cossu A, Levine A, van Noesel C, Falini B, Pasqualucci L, Tiacci E, Rabadan R. Genomic landscape of virus-associated cancers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.14.23285775. [PMID: 36824731 PMCID: PMC9949223 DOI: 10.1101/2023.02.14.23285775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
It has been estimated that 15%-20% of human cancers are attributable to infections, mostly by carcinogenic viruses. The incidence varies worldwide, with a majority affecting developing countries. Here, we present a comparative analysis of virus-positive and virus-negative tumors in nine cancers linked to five viruses. We find that virus-positive tumors occur more frequently in males and show geographical disparities in incidence. Genomic analysis of 1,658 tumors reveals virus-positive tumors exhibit distinct mutation signatures and driver gene mutations and possess a lower somatic mutation burden compared to virus-negative tumors of the same cancer type. For example, compared to the respective virus-negative counterparts, virus-positive cases across different cancer histologies had less often mutations of TP53 and deletions of 9p21.3/ CDKN2 A- CDKN1A ; Epstein-Barr virus-positive (EBV+) gastric cancer had more frequent mutations of EIF4A1 and ARID1A and less marked mismatch repair deficiency signatures; and EBV-positive cHL had fewer somatic genetic lesions of JAK-STAT, NF-κB, PI3K-AKT and HLA-I genes and a less pronounced activity of the aberrant somatic hypermutation signature. In cHL, we also identify germline homozygosity in HLA class I as a potential risk factor for the development of EBV-positive Hodgkin lymphoma. Finally, an analysis of clinical trials of PD-(L)1 inhibitors in four virus-associated cancers suggested an association of viral infection with higher response rate in patients receiving such treatments, which was particularly evident in gastric cancer and head and neck squamous cell carcinoma. These results illustrate the epidemiological, genetic, prognostic, and therapeutic trends across virus-associated malignancies.
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Pereira V, Boudjemaa S, Besson C, Leblanc T, Rigaud C, Leruste A, Garnier N, Lambilliotte A, Simonin M, Curtillet C, Bonneau-Lagacherie J, Coulomb A, Landman-Parker J. Epstein-Barr Virus in Childhood and Adolescent Classic Hodgkin Lymphoma in a French Cohort of 301 Patients. J Pediatr Hematol Oncol 2022; 44:e1033-e1038. [PMID: 35091521 DOI: 10.1097/mph.0000000000002403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to analyze the role of Epstein-Barr virus (EBV) in the bioclinical characteristics of patients treated for classic Hodgkin lymphoma (cHL) in France. METHODS Biopathologic data of 301 patients treated for a cHL in/or according to the EuroNet PHL-C1 trial between November 2008 and February 2013 were centrally reviewed. RESULTS Median age at diagnosis was 14 (3 to 18) years and the F/M ratio 0.86, 0.47 before 10 years and 0.9 from 11 to 18. CHL subtypes were nodular sclerosis for 266/301 (88%) patients, mixed cellularity for 22/301 (7%), lymphocyte rich for 2/301 (1%), and 11/301 were unclassified. EBV positivity by in situ hybridization was observed for 68/301 (23%) patients, significantly associated with mixed cellularity subtype and male sex, particularly overrepresented in boys below 10 years: 15/23 (65%) versus 28/139 among other male patients (20%). EBV viral load was detectable in 22 of 108 (22%) tested cases and was overrepresented in EBV cHL (13/28) versus non-EBV cHL (9/80) patients. Detailed semiquantitative histologic analysis showed a high number of B-cell residual follicles in EBV cHL relative to EBV-negative HL. CONCLUSION Distribution of EBV cHL in children and adolescents is associated with young age and male sex, suggesting a specific physiopathology and may require a differential therapeutic approach.
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Affiliation(s)
- Victor Pereira
- Department of Pediatric Hematology and Oncology, Besançon University Hospital, Besançon
| | | | - Caroline Besson
- Department of Hematology Versailles University Hospital, Versailles
| | - Thierry Leblanc
- Department of Pediatric Hematology and Immunology, APHP, Robert Debré Hospital
- Paris Diderot University
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif
| | - Amaury Leruste
- SIREDO, Pediatric Cancer Center, Institut Curie, PSL Research University, Paris
| | - Nathalie Garnier
- Department of Pediatric Hematology and Oncology, Pediatric Hematology and Oncology Institute, Hospices Civils de Lyon, Lyon
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Lille University Hospital, Lille
| | | | - Catherine Curtillet
- Department of Pediatric Hematology and Oncology, APHM, La Timone Hospital, Marseille
| | | | | | - Judith Landman-Parker
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, APHP, Sorbonne University, UMRs938
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Hu J, Zhang X, Tao H, Jia Y. The prognostic value of Epstein-Barr virus infection in Hodgkin lymphoma: A systematic review and meta-analysis. Front Oncol 2022; 12:1034398. [PMID: 36387159 PMCID: PMC9648611 DOI: 10.3389/fonc.2022.1034398] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2023] Open
Abstract
INTRODUCTION Epstein-Barr virus (EBV) contributes significantly to the development and occurrence of B-cell lymphomas. However, the association between EBV infection status and clinical outcomes in Hodgkin lymphoma (HL) patients has long been controversial. Therefore, we aimed to estimate the prognostic significance of EBV infection in HL survival. METHODS We searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant cohort studies from the date of their inception to February 20, 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS), Failure-free survival (FFS), Progression-free survival (PFS), Event-free survival (EFS) and disease-specific survival (DSS) were extracted from the studies or calculated. Subgroup analyses were conducted independently on the five survival outcomes to investigate the source of heterogeneity. RESULTS A total of 42 qualified studies involving 9570 patients were identified in our meta-analysis. There was an association between EBV positivity and significantly poorer OS (HR=1.443, 95% CI: 1.250-1.666) and DSS (HR=2.312, 95% CI: 1.799-2.972). However, the presence of EBV in HL showed no effect on FFS, PFS or EFS. In subgroup analyses of OS, DSS and FFS stratified by age groups, EBV positivity was associated with poorer prognosis in elderly patients. Meanwhile, in children and adolescents with EBV-positive HL, we also observed a trend toward a better prognosis, though the results were not statistically significant. CONCLUSIONS EBV-positive status is associated with poor OS and DSS in HL patients. EBV infection should therefore be considered a valuable prognostic marker and risk-stratifying factor in HL, especially in older patients. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022328708.
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Affiliation(s)
| | | | | | - Yongqian Jia
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
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Zhao X, Ma Y, Bian H, Liu Z. CD20 expression is closely associated with Epstein–Barr virus infection and an inferior survival in nodular sclerosis classical Hodgkin lymphoma. Front Oncol 2022; 12:993768. [PMID: 36147921 PMCID: PMC9486205 DOI: 10.3389/fonc.2022.993768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nodular sclerosis classical Hodgkin lymphoma (NSCHL) is a rare disease in which Epstein–Barr virus (EBV) and CD20 can be detected. The clinical significance of EBV infection, CD20 expression and their relationship are still unclear in NSCHL presently. The aim of this research was to systematically explore the clinical significance of EBV infection, expression of CD20 and their relationship in NSCHL. Methods 109 NSCHL patients diagnosed in Qingdao University’s Affiliated Hospital were chosen from January 2010 to July 2019, and the clinical and survival data of all patients were collected retrospectively. Results Among 109 patients, 33 patients were assigned to the group of EBV-positives, following the results of the EBV-encoded RNA (EBER1). Compared with EBV-negative group patients, those in the group of EBV-positive were older (P=0.004) and their β2-microglobulin (β2-MG) levels were higher (P=0.006). The CD20 positivity rate in the group of EBV-positive was substantially higher than that in the EBV-negative group (54.5% vs 27.6%, P=0.007). Among 109 patients, EBV+ and CD20+ double positive patients acquired the least overall survival (OS), and patients with EBV- and CD20- double negative had the best OS (P < 0.001). Although old age, gender, EBV infection and CD20 positive were the risk factors for OS in NSCHL, multivariate analysis showed that CD20 positivity was the only characteristic that showed to be an independent risk factor for OS in NSCHL patients. Conclusion CD20 was found to be strongly expressed in NSCHL patients who had been infected with EBV, and it was found to be an independent risk factor for NSCHL patients’ survival.
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Affiliation(s)
- Xia Zhao
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yushuo Ma
- Department of Medicine, Medical College of Qingdao University, Qingdao, China
| | - Haiyan Bian
- Department of Medicine, Medical College of Qingdao University, Qingdao, China
| | - Zhihe Liu
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Zhihe Liu,
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Impact of Tumour Epstein–Barr Virus Status on Clinical Outcome in Patients with Classical Hodgkin Lymphoma (cHL): A Review of the Literature and Analysis of a Clinical Trial Cohort of Children with cHL. Cancers (Basel) 2022; 14:cancers14174297. [PMID: 36077832 PMCID: PMC9454639 DOI: 10.3390/cancers14174297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The Epstein–Barr virus (EBV) contributes to different forms of human cancer, including a subset of classical Hodgkin lymphoma (cHL), a B-cell lymphoma with unusual histological features. Although the pathogenesis of EBV-associated cHL remains to be elucidated, biological investigations point to an important aetiological role for the virus in the development of this tumour. This is even more relevant now considering the potential opportunities that exist to treat EBV-associated disorders, for example, with immunotherapeutics or small molecule inhibitors targeting viral proteins. For this reason, we believe it is now timely to review the association between EBV and cHL and in particular to re-evaluate the impact of EBV status on clinical outcomes in cHL patients. Herein, we also report the impact of EBV on clinical outcomes in a cohort of children and adolescents with cHL. Abstract In this study, we have re-evaluated how EBV status influences clinical outcome. To accomplish this, we performed a literature review of all studies that have reported the effect of EBV status on patient outcome and also explored the effect of EBV positivity on outcome in a clinical trial of children with cHL from the UK. Our literature review revealed that almost all studies of older adults/elderly patients have reported an adverse effect of an EBV-positive status on outcome. In younger adults with cHL, EBV-positive status was either associated with a moderate beneficial effect or no effect, and the results in children and adolescents were conflicting. Our own analysis of a series of 166 children with cHL revealed no difference in overall survival between EBV-positive and EBV-negative groups (p = 0.942, log rank test). However, EBV-positive subjects had significantly longer event-free survival (p = 0.0026). Positive latent membrane protein 1 (LMP1) status was associated with a significantly lower risk of treatment failure in a Cox regression model (HR = 0.21, p = 0.005). In models that controlled for age, gender, and stage, EBV status had a similar effect size and statistical significance. This study highlights the age-related impact of EBV status on outcome in cHL patients and suggests different pathogenic effects of EBV at different stages of life.
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Nomoto Y, Fujii K, Nakamura D, Gushi A, Kanekura T. Epstein-Barr virus-positive primary cutaneous Hodgkin lymphoma. J Dermatol 2022; 49:e413-e414. [PMID: 35707891 DOI: 10.1111/1346-8138.16489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Yusuke Nomoto
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuyasu Fujii
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Daisuke Nakamura
- Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan
| | | | - Takuro Kanekura
- Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Santisteban-Espejo A, Perez-Requena J, Atienza-Cuevas L, Moran-Sanchez J, Fernandez-Valle MDC, Bernal-Florindo I, Romero-Garcia R, Garcia-Rojo M. Prognostic Role of the Expression of Latent-Membrane Protein 1 of Epstein–Barr Virus in Classical Hodgkin Lymphoma. Viruses 2021; 13:v13122523. [PMID: 34960792 PMCID: PMC8706848 DOI: 10.3390/v13122523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
The prognostic impact of the presence of Epstein–Barr virus (EBV) in classical Hodgkin lymphoma (cHL) is controversial. Previous studies reported heterogeneous results, rendering difficult the clinical validation of EBV as a prognostic biomarker in this lymphoma. The objective of this study was to evaluate the survival impact of the expression of EBV Latent-Membrane Protein 1 (EBV-LMP1) in tumoral Hodgkin–Reed–Sternberg (HRS) cells of primary diagnostic samples of cHL. Formalin-Fixed Paraffin-Embedded (FFPE) lymph node samples from 88 patients with cHL were analyzed. Patients were treated with the standard first-line chemotherapy (CT) with Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) followed by radiotherapy. The Kaplan–Meier method and the Cox proportional hazards model were used for carrying out the survival analysis. In order to investigate whether the influence of EBV was age-dependent, analyses were performed both for patients of all ages and for age-stratified subgroups. In bivariate analysis, the expression of EBV was associated with older age (p = 0.011), mixed cellularity subtype cHL (p < 0.001) and high risk International Prognostic Score (IPS) (p = 0.023). Overall survival (OS) and progression-free survival (PFS) were associated with the presence of bulky disease (p = 0.009) and advanced disease at diagnosis (p = 0.016). EBV-positive cases did not present a significantly lower OS and PFS in comparison with EBV-negative cases, for all ages and when stratifying for age. When adjusted for covariates, absence of bulky disease at diagnosis (HR: 0.102, 95% CI: 0.02–0.48, p = 0.004) and limited disease stages (I–II) (HR: 0.074, 95% CI: 0.01–0.47, p = 0.006) were associated with a significant better OS. For PFS, limited-disease stages also retained prognostic impact in the multivariate Cox regression (HR: 0.145, 95% CI: 0.04–0.57, p = 0.006). These results are of importance as the early identification of prognostic biomarkers in cHL is critical for guiding and personalizing therapeutic decisions. The prognostic role of EBV in cHL could be modulated by the type of CT protocol employed and interact with the rest of presenting features.
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Affiliation(s)
- Antonio Santisteban-Espejo
- Department of Pathology, Puerta del Mar University Hospital, 11009 Cadiz, Spain; (J.P.-R.); (L.A.-C.); (M.G.-R.)
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), 11009 Cadiz, Spain; (I.B.-F.); (R.R.-G.)
- Department of Medicine, Faculty of Medicine, University of Cadiz, 11003 Cadiz, Spain;
- Correspondence:
| | - Jose Perez-Requena
- Department of Pathology, Puerta del Mar University Hospital, 11009 Cadiz, Spain; (J.P.-R.); (L.A.-C.); (M.G.-R.)
| | - Lidia Atienza-Cuevas
- Department of Pathology, Puerta del Mar University Hospital, 11009 Cadiz, Spain; (J.P.-R.); (L.A.-C.); (M.G.-R.)
| | - Julia Moran-Sanchez
- Department of Medicine, Faculty of Medicine, University of Cadiz, 11003 Cadiz, Spain;
- Department of Hematology and Hemotherapy, Puerta del Mar University Hospital, 11009 Cadiz, Spain;
| | | | - Irene Bernal-Florindo
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), 11009 Cadiz, Spain; (I.B.-F.); (R.R.-G.)
| | - Raquel Romero-Garcia
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), 11009 Cadiz, Spain; (I.B.-F.); (R.R.-G.)
| | - Marcial Garcia-Rojo
- Department of Pathology, Puerta del Mar University Hospital, 11009 Cadiz, Spain; (J.P.-R.); (L.A.-C.); (M.G.-R.)
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), 11009 Cadiz, Spain; (I.B.-F.); (R.R.-G.)
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Wang C, Zou SP, Chen DG, Wang JS, Zheng YB, Chen XR, Yang Y. Latent Epstein-Barr virus infection status and prognosis in patients with newly diagnosed Hodgkin lymphoma in Southeast China: a single-center retrospective study. ACTA ACUST UNITED AC 2021; 26:675-683. [PMID: 34493172 DOI: 10.1080/16078454.2021.1971864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed to investigate the latent Epstein-Barr virus (EBV) infection status of patients with newly diagnosed Hodgkin lymphoma (HL) and to discuss the relationship between tumor cell EBV status and the prognosis of HL patients. PATIENTS AND METHODS A total of 134 previously untreated HL patients were analyzed in the study. Epstein-Barr virus encoded RNAs (EBERs) in situ hybridization was performed to detect the EBV status of tumor cells. RESULTS EBV positive status correlated with sex (p=0.046) and the proportion of extranodal lesions(p=0.037). There was no obvious correlation between EBV status and overall survival (OS) or failure-free survival (FFS) in all cases, but in cases over 50 years old, EBV positive group had an inferior 5-year FFS compared with EBV negative group (38.5%±13.5% vs 90.9%±8.7%, p=0.012). In FFS multivariate analysis of this age subgroup, EBV positive status was associated with significantly inferior survival (HR, 10.10; 95% CI, 1.26-81.08; p=0.030). CONCLUSION This study demonstrates positive tumor cell EBV status is an unfavorable prognostic factor in elder HL patients.
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Affiliation(s)
- Chang Wang
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Si-Ping Zou
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China.,Department of Pathology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Dao-Guang Chen
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Jie-Song Wang
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Yan-Bin Zheng
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Xiu-Rong Chen
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
| | - Yu Yang
- Department of Lymphoma & head and neck tumors, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People's Republic of China
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Zilioli VR, Albano D, Arcari A, Merli F, Coppola A, Besutti G, Marcheselli L, Gramegna D, Muzi C, Manicone M, Camalori M, Ciammella P, Colloca G, Tucci A. Clinical and prognostic role of sarcopenia in elderly patients with classical Hodgkin lymphoma: a multicentre experience. J Cachexia Sarcopenia Muscle 2021; 12:1042-1055. [PMID: 34114749 PMCID: PMC8350211 DOI: 10.1002/jcsm.12736] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/31/2021] [Accepted: 05/21/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Elderly classical Hodgkin lymphoma (cHL) (ecHL) is a rare disease with dismal prognosis and no standard treatment. Fitness-based approaches may help design appropriate treatments. Sarcopenia has been associated with an increased risk of treatment-related toxicities and worse survival in various solid tumours, but its impact in ecHL is unknown. The aim of this retrospective multicentre study was to investigate the prognostic role of sarcopenia in ecHL. METHODS We included newly diagnosed >64 years old cHL patients who performed a baseline comprehensive geriatric assessment and high-dose computed tomography (CT) or 18fluorine-fluorodeoxyglucose positron emission tomography/CT before any treatment. Sarcopenia was measured as skeletal muscle index (SMI, cm2 /m2 ) by the analysis of high-dose CT or low-dose positron emission tomography/CT images at the L3 level. The specific cut-offs for the SMI were determined by receiver operator curve analysis and compared with those proposed in literature and studied in diffuse large B-cell lymphoma. Survival functions [progression-free survival [PFS] and overall survival (OS)] were calculated for the whole population and for different subgroups defined as per different sarcopenia cut-off levels. RESULTS We included 154 patients (median age 71 years old, 76 female). The median L3-SMI was 42 cm2 /m2 . The specific cut-off derived in our male population was 45 cm2 /m2 ; using this cut-off, 27 male patients (35%) were defined as sarcopenic. After a median follow-up of 5.9 years, the overall 5-year PFS and OS rates were 53% and 65%, respectively, and were significantly shorter in sarcopenic male patients compared with non-sarcopenic (PFS 31% vs. 61%, P = 0.008; OS 51% vs. 74%, P = 0.042). Applying diffuse large B-cell lymphoma-derived sarcopenic thresholds, there were no significant differences between sarcopenic and non-sarcopenic patients for both PFS and OS, with a sole exception of a significant reduced PFS in sarcopenic male patients using Namakura cut-off. The comprehensive geriatric assessment-determined frail functional status was an independent adverse prognostic factor for both female and male patients. CONCLUSIONS Baseline evaluation of sarcopenia through radiological examinations performed for ecHL staging may help define a proportion of male patients with unfavourable outcome with current treatment strategies. Also the functional status evaluation could allow to identify a frail subgroup of patients with worse outcome.
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Affiliation(s)
| | - Domenico Albano
- Division of Nuclear Medicine, ASST Spedali Civili, Brescia, Italy
| | - Annalisa Arcari
- Division of Hematology, Ospedale Guglielmo da Saliceto, Piacenza, Italy
| | - Francesco Merli
- Division of Hematology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Coppola
- Division of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giulia Besutti
- Division of Radiology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Marcheselli
- Fondazione Italiana Linfomi Onlus, Trial Office Modena, Modena, Italy
| | | | - Cristina Muzi
- Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Moana Manicone
- Clinical and Experimental PhD Program, University of Modena and Reggio Emilia, Modena, Italy.,Division of Radiotherapy, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Manuela Camalori
- Division of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Patrizia Ciammella
- Division of Radiotherapy, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppe Colloca
- Division of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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12
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Antel K, Chetty D, Oosthuizen J, Mohamed Z, Van der Vyver L, Verburgh E. CD68-positive tumour associated macrophages, PD-L1 expression, and EBV latent infection in a high HIV-prevalent South African cohort of Hodgkin lymphoma patients. Pathology 2021; 53:628-634. [PMID: 33558066 DOI: 10.1016/j.pathol.2020.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/30/2020] [Accepted: 11/02/2020] [Indexed: 10/22/2022]
Abstract
A higher proportion of CD68-positive tumour associated macrophages (TAMs) has been associated with poorer outcomes in HIV-negative patients with Hodgkin lymphoma (HL), but whether this is true in HIV-positive patients with HL is not known. In this study, we investigated the number of CD68-positive TAMs and expression of programmed cell death-ligand 1 (PD-L1) in lymph node specimens from HL patients and correlated expression with clinical features (HIV status, disease severity and survival) and histopathological features (EBV latent positivity and subtype of HL). We stained archived lymph node specimens from 77 patients diagnosed with HL for CD68 and PD-L1. Stains were graded as: CD68 low (≤25%), CD68 high (>25%), PD-L1 low (≤50%), and PD-L1 high (>50%). Expression levels were correlated with the clinical and histopathological features using bivariate and multivariate analyses. Survival was analysed by overall and progression-free survival. Thirty-four of the 77 included patients (44%) were HIV-positive. EBV latency was detected in 97% of HIV-positive HL patients and in 14% of HIV-negative HL patients. A high CD68 score was associated with lower median haemoglobin levels (9.4 vs 11.4 g/dL; p=0.02), platelet numbers (262 vs 424 cells ×109/L; p=0.01), and lymphocyte numbers (0.99 vs 1.70 cells ×109/L, p=0.01) and a trend towards advanced disease (international prognostic score ≥4; hazard ratio 2.4; confidence interval 0.89-6.47; p=0.08). HIV status did not affect CD68 or PD-L1 expression. A higher proportion of CD68-positive TAMs was found in samples that were EBV-positive. HIV positivity and EBV negativity correlated with poorer survival. CD68 and PD-L1 expression were not predictive of survival. High CD68 expression was associated with EBV positivity but not HIV positivity and did not predict adverse outcomes. PD-L1 expression was unaffected by HIV status or EBV positivity and did predict adverse outcomes.
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Affiliation(s)
- Katherine Antel
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - D Chetty
- Division of Anatomical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - J Oosthuizen
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Z Mohamed
- Department of Radiation Oncology, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - L Van der Vyver
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - E Verburgh
- Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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13
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Werner L, Dreyer JH, Hartmann D, Barros MHM, Büttner-Herold M, Grittner U, Niedobitek G. Tumor-associated macrophages in classical Hodgkin lymphoma: hormetic relationship to outcome. Sci Rep 2020; 10:9410. [PMID: 32523087 PMCID: PMC7287068 DOI: 10.1038/s41598-020-66010-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
Commonly attributed to the prevalence of M2 macrophages, tumor-associated macrophages (TAM) are linked to poor outcome in Hodgkin lymphoma (HL). MYC is supposed to control the expression of M2-specific genes in macrophages, and deficiency in MYC-positive macrophages inhibits tumor growth in mouse models. To verify this hypothesis for HL, seventy-six samples were subjected to immunohistochemical double staining using CD68 or CD163 macrophage-specific antibodies and a reagent detecting MYC. For each cell population, labelled cells were grouped according to low, intermediate and high numbers and related to disease-free survival (DFS) and overall survival (OS). MYC+ cells accounted for 21% and 18% of CD68+ and CD163+ cells, respectively. Numbers of MYC- macrophages were significantly higher in EBV+ cases while no differences were observed for MYC+ macrophages between EBV+ and EBV- cases. Cases with highest numbers of macrophages usually showed worst DFS and OS. In most scenarios, intermediate numbers of macrophages were associated with better outcome than very low or very high numbers. Our observations are reminiscent of the "hormesis hypothesis" and suggest that a relative lack of TAM may allow HL growth while macrophages display an inhibitory effect with increasing numbers. Above a certain threshold, TAM may again support tumor growth.
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Affiliation(s)
- Laura Werner
- Institute for Pathology, Unfallkrankenhaus Berlin, Berlin, Germany.
| | | | - David Hartmann
- Institute for Pathology, Unfallkrankenhaus Berlin, Berlin, Germany
| | | | - Maike Büttner-Herold
- Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen Nuremberg, Erlangen, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Gerald Niedobitek
- Institute for Pathology, Unfallkrankenhaus Berlin, Berlin, Germany.,Institute for Pathology, Sana Klinikum Lichtenberg, Berlin, Germany
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14
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Kotaki R, Kawashima M, Yamamoto Y, Higuchi H, Nagashima E, Kurosaki N, Takamatsu M, Kikuti YY, Imadome KI, Nakamura N, Kotani A. Dasatinib exacerbates splenomegaly of mice inoculated with Epstein-Barr virus-infected lymphoblastoid cell lines. Sci Rep 2020; 10:4355. [PMID: 32152351 PMCID: PMC7062761 DOI: 10.1038/s41598-020-61300-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 02/17/2020] [Indexed: 12/25/2022] Open
Abstract
Latent infection of Epstein-Barr virus (EBV) is associated with a poor prognosis in patients with B cell malignancy. We examined whether dasatinib, a multi kinase inhibitor, which is broadly used for chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia is effective on EBV-positive B cell malignancies, using lymphoblastoid cell lines (LCLs) in vitro and in vivo. As a result, in vitro experiments showed that dasatinib induced cell death of the EBV-LCLs which was not accompanied with a lytic reactivation of EBVs. To evaluate the effectiveness in EBV latency type III represented by immunodeficiency lymphoma, LCL-inoculated immunodeficient NOD/shi-scid/Il2rgnul (NOG) mice were treated with dasatinib. However, in vivo experiments revealed that dasatinib treatment exacerbated tumor cell infiltration into the spleen of LCL-inoculated NOG mice, whereas tumor size at the inoculated site was not affected by the treatment. These results suggest that dasatinib exacerbates the pathogenesis at least in some situations although the drug is effective in vitro. Hence, we should carefully examine a possibility of dasatinib repositioning for EBV+ B cell malignancies.
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Affiliation(s)
- Ryutaro Kotaki
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Masaharu Kawashima
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan.,Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Yuichiro Yamamoto
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Hiroshi Higuchi
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan.,Research Institute of Science and Technology, Tokai University, 4-1-1 Kitakinme, Hiratsuka, Kanagawa, Japan
| | - Etsuko Nagashima
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Natsumi Kurosaki
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Masako Takamatsu
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Yara Yukie Kikuti
- Department of Pathology, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Ken-Ichi Imadome
- Department of Infectious Diseases, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa, Japan
| | - Ai Kotani
- Department of Hematological Malignancy, Institute of Medical Science, Tokai University, Shimokasuya 143, Isehara, Kanagawa, Japan. .,Precursory Research for Embryonic Science and Technology, Japan Science and Technology Agency, Saitama, Japan. .,AMED-PRIME, Japan Agency for Medical Research and Development, Tokyo, Japan.
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15
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Hodgkin lymphoma: a review of pathological features and recent advances in pathogenesis. Pathology 2020; 52:154-165. [DOI: 10.1016/j.pathol.2019.09.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 02/08/2023]
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16
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An etiological role for the Epstein-Barr virus in the pathogenesis of classical Hodgkin lymphoma. Blood 2019; 134:591-596. [DOI: 10.1182/blood.2019000568] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/06/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
Although a pathogenic role for the Epstein-Barr virus (EBV) is largely undisputed for tumors that are consistently EBV genome positive (eg, nasopharyngeal carcinoma, endemic Burkitt lymphoma), this is not the case for classical Hodgkin lymphoma (cHL), a tumor with only a variable EBV association. In light of recent developments in immunotherapeutics and small molecules targeting EBV, we believe it is now timely to reevaluate the role of EBV in cHL pathogenesis.
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17
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Abstract
Although about 90% of the world's population is infected by EBV only a small subset of the related infections result in neoplastic transformation. EBV is a versatile oncogenic agent involved in a multitude of hematopoietic, epithelial, and mesenchymal neoplasms, but the precise role of EBV in the pathogenesis of many of the associated lymphoid/histiocytic proliferations remains hypothetical or not completely understood. Additional studies and use of evolving technologies such as high-throughput next-generation sequencing may help address this knowledge gap and may lead to enhanced diagnostic assessment and the development of potential therapeutic interventions.
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18
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Salvi F, Luminari S, Tucci A, Massidda S, Liberati AM, Stelitano C, Zanni M, Re A, Centurioni R, Freilone R, Musuraca G, Nassi L, Patti C, Arcari A, Tani M, Pulsoni A, Pavone V, Volpetti S, Peli A, Evangelista A, Spina M, Ladetto M, Merli F. Bleomycin, vinblastine and dacarbazine combined with nonpegylated liposomal doxorubicin (MBVD) in elderly (≥70 years) or cardiopathic patients with Hodgkin lymphoma: a phase-II study from Fondazione Italiana Linfomi (FIL). Leuk Lymphoma 2019; 60:2890-2898. [PMID: 31282794 DOI: 10.1080/10428194.2019.1608529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This phase-II study assessed activity and toxicity of substituting conventional doxorubicin with nonpegylated liposomal doxorubicin in the conventional ABVD regimen for the treatment of elderly or cardiopathic patients with HL. Stage I-IIA and IIB-IV patients were treated with three courses of MBVD plus radiotherapy, or six courses of MBVD, respectively, plus radiotherapy limited to bulky or residual disease areas. The primary endpoints were CR rate and the rate of cardiac events. Forty-seven patients were enrolled. Median age was 75 years, 13 had stage I-II disease. Overall, CR was achieved by 36 patients (77%, 95% CI: 62-88), 100% and 68% in stage I-II and III-IV, respectively. With a median follow-up of 40 months (IQR: 36-45). Three-year overall survival (OS) and progression-free survival (PFS) were 70% and 43%, respectively. Cardiac events grades 3-5 were reported in two patients. In conclusion, MBVD's activity and safety profile was comparable to historical ABVD data.
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Affiliation(s)
- Flavia Salvi
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Tucci
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Stefania Massidda
- Hematology and Transplant Center, Ospedale Oncologico di Riferimento Regionale Armando Businco, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Anna Marina Liberati
- Oncohematology and autotransplantation Unit, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Caterina Stelitano
- Division of Hematology, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria, Italy
| | - Manuela Zanni
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Alessandro Re
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Riccardo Centurioni
- Internal medicine and hematology Unit, Azienda Sanitaria Unica Regionale Marche AV3, Civitanova Marche, Italy
| | | | - Gerardo Musuraca
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luca Nassi
- Division of Hematology Department of Translational Medicine, Università del Piemonte Orientale and AOU Maggiore della Carità, Novara, Italy
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Annalisa Arcari
- Hematology Unit and Transplantion Center, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Monica Tani
- Hematology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | - Stefano Volpetti
- Department of Haematology, DISM Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy
| | - Annalisa Peli
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Evangelista
- Clinical and Evaluative Epidemiology Unit, AOU Città della Salute e della Scienza di Torino e CPO Piemonte, Torino, Italy
| | - Michele Spina
- Division of Medical Oncology and Immunorelated Tumors, National Cancer Institute, Aviano, Italy
| | - Marco Ladetto
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy
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19
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Rezk SA, Zhao X, Weiss LM. Epstein-Barr virus (EBV)-associated lymphoid proliferations, a 2018 update. Hum Pathol 2018; 79:18-41. [PMID: 29885408 DOI: 10.1016/j.humpath.2018.05.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/14/2018] [Accepted: 05/29/2018] [Indexed: 12/12/2022]
Abstract
Epstein-Barr virus (EBV) has been linked to many human neoplasms including hematopoietic, epithelial, and mesenchymal tumors. Since our original review of EBV-associated lymphoproliferative disorders in 2007, many advances and developments have been reported. In this review, we will examine the recent advances in EBV-associated lymphoid/histiocytic proliferations, dividing them into reactive, B cell, T/NK cell, immunodeficiency-related, and histiocytic/dendritic cell proliferations.
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Affiliation(s)
- Sherif A Rezk
- Department of Pathology & Laboratory Medicine, University of California Irvine (UCI) Medical Center, Orange, 92868, CA.
| | - Xiaohui Zhao
- Department of Pathology & Laboratory Medicine, University of California Irvine (UCI) Medical Center, Orange, 92868, CA
| | - Lawrence M Weiss
- Department of Pathology & Laboratory Medicine, University of California Irvine (UCI) Medical Center, Orange, 92868, CA; NeoGenomics Laboratories, Aliso Viejo, 92656, CA
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20
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Nagaharu K, Masuya M, Kageyama Y, Yamaguchi T, Ito R, Kawakami K, Ito M, Katayama N. Successful treatment of primary bone marrow Hodgkin lymphoma with brentuximab vedotin: a case report and review of the literature. J Med Case Rep 2018; 12:151. [PMID: 29843820 PMCID: PMC5975584 DOI: 10.1186/s13256-018-1693-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/17/2018] [Indexed: 12/27/2022] Open
Abstract
Background Hodgkin lymphoma usually presents with sequential enlargement of peripheral lymph nodes, and bone marrow invasion rarely occurs (approximately 3–5%). However, several cases have been reported as “primary” bone marrow Hodgkin lymphoma, especially among patients with human immunodeficiency virus and the elderly. This type of Hodgkin lymphoma is characterized by no peripheral lymphadenopathies and has been reported to have poorer prognosis. Case presentation A 38-year-old Japanese man was admitted to our hospital because of fever of unknown origin and pancytopenia without lymphadenopathies. Bone marrow examination revealed Hodgkin cells mimicking abnormal cells. These were positive for CD30, EBER-1, CD15, PAX-5, and Bob-1 and negative for Oct-2, CD3, CD20, surface immunoglobulin, CD56. On the basis of systemic evaluation and bone marrow examination, he was diagnosed with primary bone marrow Hodgkin lymphoma. We initiated therapy with DeVIC (dexamethasone, etoposide, ifosfamide, and carboplatin) therapy, but remission was not achieved. Then, the patient was treated with brentuximab vedotin combined with systemic chemotherapy (Adriamycin, vinblastine and dacarbazine), which was effective. Conclusions There is no established treatment strategy for Hodgkin lymphoma, and therapeutic outcomes using ABVD (Adriamycin, bleomycin, vinblastine and dacarbazine)-like or CHOP (cyclophosphamide, Adriamycin, vincristine, and prednisone)-like regimens are reportedly poor. Only a few patients have been reported to achieve long-term remission. Through this case report, we suggest an alternative therapeutic option for primary bone marrow Hodgkin lymphoma.
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Affiliation(s)
- Keiki Nagaharu
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan. .,Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
| | - Masahiro Masuya
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan
| | - Yuki Kageyama
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan
| | - Takanori Yamaguchi
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Ryugo Ito
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Keiki Kawakami
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
| | - Masafumi Ito
- Department of Pathology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Naoyuki Katayama
- Department of Hematology and Oncology, Suzuka General Hospital, Mie, Japan
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21
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The Microenvironment in Epstein-Barr Virus-Associated Malignancies. Pathogens 2018; 7:pathogens7020040. [PMID: 29652813 PMCID: PMC6027429 DOI: 10.3390/pathogens7020040] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/08/2018] [Accepted: 04/11/2018] [Indexed: 12/27/2022] Open
Abstract
The Epstein–Barr virus (EBV) can cause a wide variety of cancers upon infection of different cell types and induces a highly variable composition of the tumor microenvironment (TME). This TME consists of both innate and adaptive immune cells and is not merely an aspecific reaction to the tumor cells. In fact, latent EBV-infected tumor cells utilize several specific mechanisms to form and shape the TME to their own benefit. These mechanisms have been studied largely in the context of EBV+ Hodgkin lymphoma, undifferentiated nasopharyngeal carcinoma, and EBV+ gastric cancer. This review describes the composition, immune escape mechanisms, and tumor cell promoting properties of the TME in these three malignancies. Mechanisms of susceptibility which regularly involve genes related to immune system function are also discussed, as only a small proportion of EBV-infected individuals develops an EBV-associated malignancy.
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22
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Kafita D, Kaile T, Malyangu E, Tembo R, Zulu E, Chisanga C, Kalonda A, Samutela M, Polepole P, Kwenda G. Evidence of EBV infection in lymphomas diagnosed in Lusaka, Zambia. Pan Afr Med J 2018; 29:181. [PMID: 30061959 PMCID: PMC6061862 DOI: 10.11604/pamj.2018.29.181.11847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/02/2018] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Epstein-Barr virus (EBV) is a ubiquitous virus that infects more than 90% of the world's population, and is implicated in lymphoma pathogenesis. However, in Zambia during the diagnosis of these lymphomas, the association of the virus with the lymphomas is not established. Since most patients with lymphomas have poor prognosis, the identification of the virus within the lymphoma lesion will allow for more targeted therapy. The aim of this study was to provide evidence of the presence of the EBV in lymphomas diagnosed at the University Teaching Hospital (UTH) in Lusaka, Zambia. METHODS One hundred and fifty archival formalin-fixed paraffin embedded suspected lymphoma tissues stored over a 4-year period in the Histopathology Laboratory at the UTH in Lusaka, Zambia, were analysed. Histological methods were used to identify the lymphomas, and the virus was detected using Polymerase Chain Reaction (PCR). Subtyping of the virus was achieved through DNA sequencing of the EBNA-2 region of the viral genome. Chi square or fisher's exact test was used to evaluate the association between EBV status, type of lymphoma and gender. RESULTS The majority of the lymphomas identified were non-Hodgkin's lymphoma (NHL) (80%) followed by Hodgkin's lymphoma (HL) (20%). EBV was detected in 51.8% of the cases, 54.5% of which were associated with NHL cases, while 40.9% associated with HL cases. The predominant subtype of the virus in both types of lymphomas was subtype 1. One of the lymphoma cases harboured both subtype 1 and 2 of the virus. CONCLUSION This study showed that EBV is closely associated with lymphomas. Therefore, providing evidence of the presence of the virus in lymphoma tissues will aid in targeted therapy. To our knowledge this is the first time such data has been generated in Zambia.
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Affiliation(s)
- Doris Kafita
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Trevor Kaile
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Evans Malyangu
- Department of Pathology, Maina Soko Military Hospital, Lusaka, Zambia
| | - Rabecca Tembo
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Ephraim Zulu
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Chrispin Chisanga
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Mulemba Samutela
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Pascal Polepole
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Medicine, University of Zambia, Lusaka, Zambia
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23
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Diefenbach CS, Connors JM, Friedberg JW, Leonard JP, Kahl BS, Little RF, Baizer L, Evens AM, Hoppe RT, Kelly KM, Persky DO, Younes A, Kostakaglu L, Bartlett NL. Hodgkin Lymphoma: Current Status and Clinical Trial Recommendations. J Natl Cancer Inst 2016; 109:2742050. [PMID: 28040700 DOI: 10.1093/jnci/djw249] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/24/2016] [Accepted: 09/26/2016] [Indexed: 12/12/2022] Open
Abstract
The National Clinical Trials Network lymphoid malignancies Clinical Trials Planning Meeting (CTPM) occurred in November of 2014. The scope of the CTPM was to prioritize across the lymphoid tumors clinically significant questions and to foster strategies leading to biologically informed and potentially practice changing clinical trials. This review from the Hodgkin lymphoma (HL) subcommittee of the CTPM discusses the ongoing clinical challenges in HL, outlines the current standard of care for HL patients from early to advanced stage, and surveys the current science with respect to biomarkers and the landscape of ongoing clinical trials. Finally, we suggest areas of unmet need in HL and elucidate promising therapeutic strategies to guide future HL clinical trials planning across the NCTN.
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Affiliation(s)
- Catherine S Diefenbach
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Joseph M Connors
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Jonathan W Friedberg
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - John P Leonard
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Brad S Kahl
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Richard F Little
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Lawrence Baizer
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Andrew M Evens
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Richard T Hoppe
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Kara M Kelly
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Daniel O Persky
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Anas Younes
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Lale Kostakaglu
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
| | - Nancy L Bartlett
- Affiliations of authors: NYU Perlmutter Cancer Center, New York, NY (CSD); BC Cancer Agency Centre for Lymphoid Cancer, Vancouver, BC, Canada (JMC); Wilmot Cancer Center and Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY (JWF); Department of Medicine, Weil Cornell University, New York, NY (JPL); Oncology Division, Department of Medicine, Washington University, St. Louis, MO (BSK, NLB); Division of Cancer Treatment and Diagnosis (RFL) and Coordinating Center for Clinical Trials (LB), Tufts Cancer Center and Division of Hematology/Oncology, Tufts University School of Medicine, Boston, MA (AME); Stanford Cancer Institute, Stanford University Medical School, Stanford, CA (RTH); Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, NY (KMK); Department of Medicine, University of Arizona Cancer Center, Tucson, AZ (DOP); Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY (AY); Department of Radiology, Mount Sinai Hospital, New York, NY (LK)
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Chang KC, Chen PCH, Chang Y, Wu YH, Chen YP, Lai CH, Medeiros LJ, Su IJ, Wang HW. Epstein-Barr virus latent membrane protein-1 up-regulates cytokines and correlates with older age and poorer prognosis in Hodgkin lymphoma. Histopathology 2016; 70:442-455. [PMID: 27632954 DOI: 10.1111/his.13085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 09/13/2016] [Indexed: 01/28/2023]
Abstract
AIMS Previously, we reported an association between Epstein-Barr virus (EBV)-positive Hodgkin lymphoma (HL), older age, and poorer prognosis. The aim of this study was to investigate the mechanisms underlying this association. METHODS AND RESULTS Transfection of HL cell lines with EBV latent membrane protein-1 (LMP1) resulted in up-regulation of many cytokine genes as assessed by the use of oligonucleotide microarrays. The up-regulation of cytokines was validated by using an inflammatory cytokine protein array: macrophage inflammatory protein (MIP)-1α, MIP-1β, and interleukin (IL)-13. Immunostaining of HL samples (n = 104) showed that expression of MIP-1α, MIP-1β and IL-13 correlated with EBV infection and LMP1 expression. Combined expression of these cytokines was more common in patients aged >60 years (P < 0.001), and was associated with a poorer prognosis (P = 0.042). In another cohort, serum levels of MIP-1α, MIP-1β and IL-13 were increased in HL patients (n = 53) and highest in EBV-positive HL patients as compared with healthy controls (n = 40). Xenograft mice injected with EBV-positive HL cells had higher serum levels of MIP-1α, MIP-1β and IL-13 than mice injected with EBV-negative HL cells, although there was no difference in growth. CONCLUSIONS EBV infection appears to promote the release of cytokines in HL patients, and negatively impacts on patient survival. Physiological immunosenescence probably explains the association between EBV infection and older age. Cytokine modulation is a potential therapeutic target for EBV-positive HL patients.
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Affiliation(s)
- Kung-Chao Chang
- Department of Pathology, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Paul C-H Chen
- Department of Pathology, Veterans General Hospital-Taipei, Taipei, Taiwan
| | - Yao Chang
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
| | - Yu-Hsuan Wu
- Department of Life Sciences, Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Ping Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University and Hospital, Taipei, Taiwan
| | - Chien-Hsien Lai
- Institute of Bioinformatics and Biosignal Transduction, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ih-Jen Su
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan
| | - Hsei-Wei Wang
- Department of Life Sciences, Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
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25
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Sun R, Medeiros LJ, Young KH. Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine. Mod Pathol 2016; 29:1118-42. [PMID: 27363492 DOI: 10.1038/modpathol.2016.92] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/13/2016] [Accepted: 04/14/2016] [Indexed: 02/07/2023]
Abstract
Lymphomas are a group of hematological malignancies derived from lymphocytes. Lymphomas are clinically and biologically heterogeneous and have overlapping diagnostic features. With the advance of new technologies and the application of efficient and feasible detection platforms, an unprecedented number of novel biomarkers have been discovered or are under investigation at the genetic, epigenetic, and protein level as well as the tumor microenvironment. These biomarkers have enabled new clinical and pathological insights into the mechanisms underlying lymphomagenesis and also have facilitated improvements in the diagnostic workup, sub-classification, outcome stratification, and personalized therapy for lymphoma patients. However, integrating these biomarkers into clinical practice effectively and precisely in daily practice is challenging. More in-depth studies are required to further validate these novel biomarkers and to assess other parameters that can affect the reproducibility of these biomarkers such as the selection of detection methods, biological reagents, interpretation of data, and cost efficiency. Despite these challenges, there are many reasons to be optimistic that novel biomarkers will facilitate better algorithms and strategies as we enter a new era of precision medicine to better refine diagnosis, prognostication, and rational treatment design for patients with lymphomas.
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Affiliation(s)
- Ruifang Sun
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Pathology, Shanxi Cancer Hospital, Shanxi, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Science, Houston, TX, USA
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26
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Agostinelli C, Gallamini A, Stracqualursi L, Agati P, Tripodo C, Fuligni F, Sista MT, Fanti S, Biggi A, Vitolo U, Rigacci L, Merli F, Patti C, Romano A, Levis A, Trentin L, Stelitano C, Borra A, Piccaluga PP, Hamilton-Dutoit S, Kamper P, Zaucha JM, Małkowski B, Kulikowski W, Tajer J, Subocz E, Rybka J, Steidl C, Broccoli A, Argnani L, Gascoyne RD, d'Amore F, Zinzani PL, Pileri SA. The combined role of biomarkers and interim PET scan in prediction of treatment outcome in classical Hodgkin's lymphoma: a retrospective, European, multicentre cohort study. LANCET HAEMATOLOGY 2016; 3:e467-e479. [PMID: 27692305 DOI: 10.1016/s2352-3026(16)30108-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Early-interim fluorodeoxyglucose (FDG)-PET scan after two ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy courses (PET-2) represents the most effective predictor of treatment outcome in classical Hodgkin's lymphoma. We aimed to assess the predictive value of PET-2 combined with tissue biomarkers in neoplastic and microenvironmental cells for this disease. METHODS We enrolled 208 patients with classical Hodgkin's lymphoma and treated with ABVD (training set), from Jan 1, 2002, to Dec 31, 2009, and validated the results in a fully matched independent cohort of 102 patients with classical Hodgkin's lymphoma (validation set), enrolled from Jan 1, 2008, to Dec 31, 2012. The inclusion criteria for both the training and validation sets were: the availability of a representative formalin-fixed, paraffin-embedded tissue sample collected at diagnosis; treatment with ABVD with or without radiotherapy; baseline staging and interim restaging after two ABVD courses with FDG-PET; no treatment change based solely on interim PET result; and HIV-negative status. We used Cox multivariate analysis classification and regression tree (CART) to compare the predictive values of these markers with that of PET-2 and to assess the biomarkers' ability to correctly classify patients whose outcome was incorrectly predicted by PET-2. FINDINGS In multivariate analysis, PET-2 was the only factor able to predict both progression-free survival (hazard ratio [HR] 33·3 [95% CI 13·6-83·3]; p<0·0001) and overall survival (HR 31·3 [95% CI 3·7-58·9]; p=0·002). In the training set, no factor had a stronger adverse predictive value than a positive PET-2 scan and none was able to correctly reclassify PET-2 positive patients. In PET-2 negative patients, expression of CD68 (≥25%) and PD1 (diffuse or rosetting pattern) in microenvironmental cells, and STAT1 negativity in Hodgkin Reed Sternberg cells identified a subset of PET-2 negative patients with a 3 year progression-free survival significantly lower than that of the remaining PET-2 negative population (21 [64%] of 33 [95% CI 45·2-79·0] vs 130 [95%] of 137 [95% CI 89·4-97·7]; p<0·0001). These findings were reproduced in the validation set. INTERPRETATION The CART algorithm correctly predicted the response to treatment in more than a half of patients who had a relapse or disease progression despite a negative PET-2 scan, thus increasing the negative predictive value of PET-2. In keeping with preliminary results from interim PET response adapted clinical trials of patients with advanced Hodgkin's lymphoma, there might be a non-negligible proportion of treatment failures in the interim PET negative group treated with standard ABVD. FUNDING Italian Association for Cancer Research, Bologna Association against leukaemia, lymphoma and myeloma, and Bologna University.
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27
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Lee HG, Kim H, Kim EJ, Park PG, Dong SM, Choi TH, Kim H, Chong CR, Liu JO, Chen J, Ambinder RF, Hayward SD, Park JH, Lee JM. Targeted therapy for Epstein-Barr virus-associated gastric carcinoma using low-dose gemcitabine-induced lytic activation. Oncotarget 2016; 6:31018-29. [PMID: 26427042 PMCID: PMC4741585 DOI: 10.18632/oncotarget.5041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/24/2015] [Indexed: 12/26/2022] Open
Abstract
The constant presence of the viral genome in Epstein-Barr virus (EBV)-associated gastric cancers (EBVaGCs) suggests the applicability of novel EBV-targeted therapies. The antiviral nucleoside drug, ganciclovir (GCV), is effective only in the context of the viral lytic cycle in the presence of EBV-encoded thymidine kinase (TK)/protein kinase (PK) expression. In this study, screening of the Johns Hopkins Drug Library identified gemcitabine as a candidate for combination treatment with GCV. Pharmacological induction of EBV-TK or PK in EBVaGC-originated tumor cells were used to study combination treatment with GCV in vitro and in vivo. Gemcitabine was found to be a lytic inducer via activation of the ataxia telangiectasia-mutated (ATM)/p53 genotoxic stress pathway in EBVaGC. Using an EBVaGC mouse model and a [125I] fialuridine (FIAU)-based lytic activation imaging system, we evaluated gemcitabine-induced lytic activation in an in vivo system and confirmed the efficacy of gemcitabine-GCV combination treatment. This viral enzyme-targeted anti-tumor strategy may provide a new therapeutic approach for EBVaGCs.
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Affiliation(s)
- Hyun Gyu Lee
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyemi Kim
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Jung Kim
- Radiopharmaceutical Research Team, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Pil-Gu Park
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Myung Dong
- Research Institute, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Tae Hyun Choi
- Radiopharmaceutical Research Team, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hyunki Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Curtis R Chong
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, MA, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, MA, USA
| | - Jun O Liu
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jianmeng Chen
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard F Ambinder
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Diane Hayward
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeon Han Park
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Myun Lee
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
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Gallamini A, Hutchings M, Ramadan S. Clinical presentation and staging of Hodgkin lymphoma. Semin Hematol 2016; 53:148-54. [DOI: 10.1053/j.seminhematol.2016.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Cui Q, Gandhi MK. Whole blood EBV-DNA: A surrogate for immune dysfunction in aggressive lymphoma? Leuk Lymphoma 2015; 57:507-8. [PMID: 26317147 DOI: 10.3109/10428194.2015.1087522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Qingyan Cui
- a University of Queensland Diamantina Institute, Translational Research Institute, University of Queensland , Australia and
| | - Maher K Gandhi
- a University of Queensland Diamantina Institute, Translational Research Institute, University of Queensland , Australia and.,b Princess Alexandra Hospital , Brisbane , Queensland , Australia
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Elsayed AA, Asano N, Ohshima K, Izutsu K, Kinoshita T, Nakamura S. Prognostic significance of CD20 expression and Epstein-Barr virus (EBV) association in classical Hodgkin lymphoma in Japan: a clinicopathologic study. Pathol Int 2015; 64:336-45. [PMID: 25047504 DOI: 10.1111/pin.12175] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 05/28/2014] [Indexed: 01/07/2023]
Abstract
To investigate the clinicopathological significance of CD20 expression and Epstein-Barr virus (EBV) association in Hodgkin and Reed-Sterberg cells of classical Hodgkin lymphoma (CHL), CD20 expression and EBV positivity (by EBER in situ hybridization) were investigated in 389 CHL patients in Japan. They included 74 CD20-positive cases (19%) and 315 CD20-negative cases (81%). CD20-positive cases showed significantly older age at onset (P = 0.018) and higher association with EBV (P = 0.002). Multivariate analysis identified EBV-positivity (but not CD20-positivity), presence of B symptoms, thrombocytopenia, elevated serum lactate dehydrogenase and performance status >1 as poor prognostic factors for overall survival (OS). We constructed a new prognostic model with these five factors classifying patients into three groups: low risk, 0-1 adverse factor; intermediate risk, 2-3 factors; high risk, 4-5 factors. This prognostic model could stratify the prognosis of CHL patients (P < 0.0001). For 144 patients (58%) classified into the low-risk group, the 5-year OS was 91%. For 92 patients (37%) in the intermediate group, the 5-year OS was 66%; for 11 patients (5%) in the high-risk group, the 5-year OS was 36%. In conclusion, EBV is identified as an independent poor prognostic factor for CHL patients. Therefore, examination of EBV association in CHL is recommended as routine pathologic practice especially in countries where EBV infection prevails.
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Affiliation(s)
- Ahmed Ali Elsayed
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Fernandez-Alvarez R, Gonzalez-Rodriguez AP, Gonzalez ME, Rubio-Castro A, Dominguez-Iglesias F, Solano J, Alonso-Nogues E, Fernandez-Alvarez C, Zanabili Y, Alonso JM, Payer AR, Vicente JM, Medina J, Sancho JM. Serum ferritin as prognostic marker in classical Hodgkin lymphoma treated with ABVD-based therapy. Leuk Lymphoma 2015; 56:3096-102. [DOI: 10.3109/10428194.2015.1038709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Abstract
Treatment of Hodgkin lymphoma is associated with 2 major types of risk: that the treatment may fail to cure the disease or that the treatment will prove unacceptably toxic. Careful assessment of the amount of the lymphoma (tumor burden), its behavior (extent of invasion or specific organ compromise), and host related factors (age; coincident systemic infection; and organ dysfunction, especially hematopoietic, cardiac, or pulmonary) is essential to optimize outcome. Elaborately assembled prognostic scoring systems, such as the International Prognostic Factors Project score, have lost their accuracy and value as increasingly effective chemotherapy and supportive care have been developed. Identification of specific biomarkers derived from sophisticated exploration of Hodgkin lymphoma biology is bringing promise of further improvement in targeted therapy in which effectiveness is increased at the same time off-target toxicity is diminished. Parallel developments in functional imaging are providing additional potential to evaluate the efficacy of treatment while it is being delivered, allowing dynamic assessment of risk during chemotherapy and adaptation of the therapy in real time. Risk assessment in Hodgkin lymphoma is continuously evolving, promising ever greater precision and clinical relevance. This article explores the past usefulness and the emerging potential of risk assessment for this imminently curable malignancy.
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Hong JY, Yoon DH, Suh C, Huh J, Do IG, Sohn I, Jo J, Jung SH, Hong ME, Yoon H, Ko YH, Kim SJ, Kim WS. EBV-positive diffuse large B-cell lymphoma in young adults: is this a distinct disease entity? Ann Oncol 2015; 26:548-55. [PMID: 25475080 DOI: 10.1093/annonc/mdu556] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) of the elderly is defined only in adults older than 50 years. However, EBV-positive DLBCL can affect younger patients. We investigated the prevalence, clinical characteristics and survival outcomes of EBV-positive DLBCL in young adults. PATIENTS AND METHODS We analyzed patients with de novo DLBCL who were registered in the Samsung Medical Center (SMC) retrospective lymphoma cohort and prospective SMC Lymphoma Cohort Study I (ClinicalTrials.gov: NCT00822731). RESULTS A total of 571 cases were included in the analysis. The prevalence of EBV positivity was 6.7% (13/195) and 9.3% (35/376) in the young group (≤50 years) and in the elderly group (>50 years), respectively. EBV status was closely associated with unique unfavorable clinical characteristics [older age, more advanced stage, two or more sites of extranodal involvement, higher International Prognostic Index (IPI), and age-adjusted IPI risk] only in the elderly group. Poor prognostic impact of EBV positivity on overall survival was observed only in the elderly group [hazard ratio (HR) 2.86; 95% confidence interval (CI) 1.83-4.47; P < 0.001], but not in the young group (HR 1.17; 95% CI 0.35-3.89; P = 0.801). CONCLUSION A substantial proportion of EBV-positive DLBCL of the elderly can occur in young adults. EBV positivity of DLBCL in young adults was not associated with unfavorable clinical characteristics or worse outcomes. We suggest that EBV-positive DLBCL should not be confined only in the elderly and 'EBV-positive DLBCL in young adults' needs to be considered as a clinically distinct disease entity. ClinicalTrials.gov: NCT02060435.
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Affiliation(s)
- J Y Hong
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul
| | | | | | - J Huh
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - I-G Do
- Department of Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Korea
| | - I Sohn
- Department of Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Korea
| | - J Jo
- Department of Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Korea
| | - S-H Jung
- Department of Samsung Cancer Research Institute, Samsung Medical Center, Seoul, Korea Department of Biostatistics and Bioinformatics, Duke University, Durham, USA
| | | | | | | | - S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W S Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Satoh T, Wada R, Yajima N, Imaizumi T, Yagihashi S. Tumor microenvironment and RIG-I signaling molecules in Epstein Barr virus-positive and -negative classical Hodgkin lymphoma of the elderly. J Clin Exp Hematop 2015; 54:75-84. [PMID: 24942949 DOI: 10.3960/jslrt.54.75] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Classical Hodgkin lymphoma (CHL) is a B-cell neoplasm characterized by Hodgkin and Reed-Sternberg (HRS) cells. Its prevalence exhibits a bimodal pattern of peaking in young adults and the elderly. There is an association with Epstein-Barr virus (EBV) infection in about 50% of cases of CHL of the elderly, and the outcome of these patients is unfavorable. It is not well known how the latent infection of EBV is involved in the pathophysiology of CHL of the elderly. To address this issue, we examined the tumor microenvironment (TME) and the expression of molecules related to EBV infection in HRS cells in 10 EBV-positive CHL and 7 EBV-negative CHL patients older than 50 years. In EBV-positive CHL, we found an increased population of FOXP3(+) cells, while that of granzyme B(+) cells was reduced, compared with those in EBV-negative CHL. The expression of inhibitory chemokine CCL20 was increased in EBV-positive HRS cells compared with that in EBV-negative HRS cells. In addition, despite increased expression of a pattern recognition receptor, RIG-I, in intracellular innate immunity, there was no evidence of interferon regulatory factor 3 activation or interferon-ß induction in EBV-positive HRS cells in CHL of the elderly. The disease recurred frequently (50%) in EBV-positive CHL. The current study thus suggests the possibility that the latent infection of EBV alters the expression of chemokines and the innate immunity response in HRS cells and modulates TME to an immunosuppressive state, which may account for the unfavorable disease course in CHL of the elderly.
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Affiliation(s)
- Tsugumi Satoh
- Department of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine
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35
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Vase MØ, Maksten EF, Bendix K, Hamilton-Dutoit S, Andersen C, Møller MB, Sørensen SS, Jespersen B, Kampmann J, Søndergård E, Nielsen PS, D'amore F. Occurrence and prognostic relevance of CD30 expression in post-transplant lymphoproliferative disorders. Leuk Lymphoma 2015; 56:1677-85. [PMID: 25248878 DOI: 10.3109/10428194.2014.966242] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Post-transplant lymphoproliferative disorders (PTLDs) are potentially fatal, often Epstein-Barr virus (EBV)-driven neoplasias developing in immunocompromised hosts. Initial treatment usually consists of a reduction in immunosuppressive therapy and/or rituximab with or without chemotherapy. However, patients who relapse do poorly, and new treatment options are warranted. With the introduction of the immunoconjugate brentuximab vedotin, the CD30 antigen has become an effectively targetable molecule. Therefore, we investigated the frequency and level of CD30 expression in PTLDs. We identified 108 patients with PTLDs diagnosed during 1994-2011, of whom 62 had adequate paraffin-embedded tissue for tissue microarray construction. Immunohistochemical expression of CD30 was consistently detected in all types of PTLD (overall 85.25%), including the monomorphic subtypes, and was correlated with a more favorable outcome. For diffuse large B-cell lymphoma (DLBCL)-type PTLD this was regardless of EBV status, and remained significant in multivariate analysis. Cell-of-origin had no independent prognostic value in our series of DLBCL PTLD.
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Affiliation(s)
- Maja Ølholm Vase
- Department of Hematology, Aarhus University Hospital , Aarhus , Denmark
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Ludvigsen M, Kamper P, Hamilton-Dutroit SJ, Bendix K, Møller MB, d'Amore FA, Honoré B. Relationship of intratumoural protein expression patterns to age and Epstein-Barr virus status in classical Hodgkin lymphoma. Eur J Haematol 2014; 95:137-49. [DOI: 10.1111/ejh.12463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Maja Ludvigsen
- Department of Biomedicine; Aarhus University; Aarhus Denmark
| | - Peter Kamper
- Department of Haematology; Aarhus University Hospital; Aarhus Denmark
| | | | - Knud Bendix
- Institute of Pathology; Aarhus University Hospital; Aarhus Denmark
| | | | | | - Bent Honoré
- Department of Biomedicine; Aarhus University; Aarhus Denmark
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Prognostic factors in hodgkin lymphoma. Mediterr J Hematol Infect Dis 2014; 6:e2014053. [PMID: 25045461 PMCID: PMC4103502 DOI: 10.4084/mjhid.2014.053] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 07/02/2014] [Indexed: 12/12/2022] Open
Abstract
Hodgkin lymphoma (HL) is among the neoplastic diseases that has the best long-term outcome after cytotoxic treatment. Cure rates approach 80–90%; however, 15–20% of patients will be resistant to therapy (primary refractory) or relapse after treatment. Prognostic factors should help to stratify treatment according to the risk profile and identify patients at risk for failure. Significance of prognostic factors partly depends on the efficacy of the treatments administered, since new effective therapies can variably counterbalance the adverse effects of some unfavorable clinical determinants. As a consequence, some prognostic factors thought to be important in the past may become meaningless when modern successful therapies are used. Therefore, the value of prognostic factors has to be updated periodically, and then adapted to new emerging biomarkers. Besides the prognostic role of PET imaging, tissue and circulating biomarkers, as the number of tumor-infiltrating macrophages, cytokine and chemokine levels and profiling of circulating nucleic acids (DNA and microRNAs) have shown promise.
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38
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Prevalence and Prognostic Significance of Epstein–Barr Virus Infection in Classical Hodgkin's Lymphoma: A Meta-analysis. Arch Med Res 2014; 45:417-31. [DOI: 10.1016/j.arcmed.2014.06.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 06/04/2014] [Indexed: 12/21/2022]
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39
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Kunkler IH, Audisio R, Belkacemi Y, Betz M, Gore E, Hoffe S, Kirova Y, Koper P, Lagrange JL, Markouizou A, Pfeffer R, Villa S. Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force. Ann Oncol 2014; 25:2134-2146. [PMID: 24625455 DOI: 10.1093/annonc/mdu104] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Radiotherapy (RT) is a key component of the management of older cancer patients. Level I evidence in older patients is limited. The International Society of Geriatric Oncology (SIOG) established a task force to make recommendations for curative RT in older patients and to identify future research priorities. Evidence-based guidelines are provided for breast, lung, endometrial, prostate, rectal, pancreatic, oesophageal, head and neck, central nervous system malignancies and lymphomas. Patient selection should include comorbidity and geriatric evaluation. Advances in radiation planning and delivery improve target coverage, reduce toxicity and widen eligibility for treatment. Shorter courses of hypofractionated whole breast RT are safe and effective. Conformal RT and involved-field techniques without elective nodal irradiation have improved outcomes in non-small-cell lung cancer (NSCLC) without increasing toxicity. Where comorbidities preclude surgery, stereotactic body radiotherapy (SBRT) is an option for early-stage NSCLC and pancreatic cancer. Modern involved-field RT for lymphoma based on pre-treatment positron emission tomography data has reduced toxicity. Significant comorbidity is a relative contraindication to aggressive treatment in low-risk prostate cancer (PC). For intermediate-risk disease, 4-6 months of hormones are combined with external beam radiotherapy (EBRT). For high-risk PC, combined modality therapy (CMT) is advised. For high-intermediate risk, endometrial cancer vaginal brachytherapy is recommended. Short-course EBRT is an alternative to CMT in older patients with rectal cancer without significant comorbidities. Endorectal RT may be an option for early disease. For primary brain tumours, shorter courses of postoperative RT following maximal debulking provide equivalent survival to longer schedules. MGMT methylation status may help select older patients for temozolomide alone. Stereotactic RT provides an alternative to whole-brain RT in patients with limited brain metastases. Intensity-modulated radiation therapy provides an excellent technique to reduce dose to the carotids in head and neck cancer and improves locoregional control in oesophageal cancer. Best practice and research priorities are summarised.
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Affiliation(s)
- I H Kunkler
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh.
| | - R Audisio
- Department of Surgical Oncology, University of Liverpool, St Helens, UK
| | - Y Belkacemi
- Service de Radiothérapie, APHP-GH Henri Mondor, and UPEC (Université Paris Est Créteil), Créteil, France
| | - M Betz
- Institut de Radio-oncologie, Hirslanden Lausanne, Lausanne, Switzerland
| | - E Gore
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee
| | - S Hoffe
- Moffitt Cancer Center, Tampa, USA
| | - Y Kirova
- Service D'Oncologie Radiothérapie, Institut Curie, Paris, France
| | - P Koper
- Radiotherapy Center West (RCWest), The Hague, The Netherlands
| | - J-L Lagrange
- Service de Radiothérapie, APHP-GH Henri Mondor, and UPEC (Université Paris Est Créteil), Créteil, France
| | - A Markouizou
- Department of Radiation Oncology, Metaxa Cancer Hospital, Piraeus, Greece
| | - R Pfeffer
- Department of Radiation Oncology, Assuta Medical Center and Tel Aviv University, Tel Aviv, Israel
| | - S Villa
- Department of Radiation Oncology, Catalan Institute of Oncology, Badalona, Catalonia, Spain
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Klein JL, Nguyen TT, Bien-Willner GA, Chen L, Foyil KV, Bartlett NL, Duncavage EJ, Hassan A, Frater JL, Kreisel F. CD163 immunohistochemistry is superior to CD68 in predicting outcome in classical Hodgkin lymphoma. Am J Clin Pathol 2014; 141:381-7. [PMID: 24515766 DOI: 10.1309/ajcp61tlmxlsljys] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES In recent years, research has increasingly focused on the microenvironment of classical Hodgkin lymphoma (CHL) as a predictor of treatment outcome. The focus of this study was to assess the interobserver reproducibility in interpreting macrophage-associated immunohistochemistry (IHC) for CD68 and CD163 in a retrospective cohort of 88 patients with CHL. METHODS Staining results were correlated with clinical outcome in all patients and those with a high international prognostic score (IPS). RESULTS The intraclass correlation (ICC) for the five hematopathologists interpreting the IHC was stronger for CD163 (0.70) than for CD68 (0.50). Using a cutoff of 25% mean macrophage reactivity and including all patients, a statistically significant difference in overall survival (OS) was seen only for CD163 (P = .0006) and not for CD68 (P = .414). Patients with a mean CD163 reactivity of 25% or more had a median OS of 71 months vs 101 months for patients with less than 25% reactivity. CD163 retained statistical significance in multivariate analysis. In patients with advanced-stage CHL with high IPS, OS was also significantly worse for those with a mean CD163 reactivity of 25% or higher. CONCLUSIONS Our study confirms previous reports of a prognostic role of tumor-infiltrating macrophages in CHL, but only for CD163. Although most of the literature supports an increasing role of macrophage IHC as a predictor of clinical outcome, successful clinical translation will require a standardized method and reporting system.
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Affiliation(s)
- Jonathan L. Klein
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
| | - TuDung T. Nguyen
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
| | | | - Ling Chen
- Divisions of Biostatistics, Washington University School of Medicine, St Louis, MO
| | - Kelley V. Foyil
- Oncology, Washington University School of Medicine, St Louis, MO
| | | | - Eric J. Duncavage
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
| | - Anjum Hassan
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
| | - John L. Frater
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
| | - Friederike Kreisel
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO
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Campos AH, Vassallo J, Soares FA. Matrix metalloproteinase-9 expression by Hodgkin-Reed-Sternberg cells is associated with reduced overall survival in young adult patients with classical Hodgkin lymphoma. PLoS One 2013; 8:e74793. [PMID: 24086377 PMCID: PMC3782492 DOI: 10.1371/journal.pone.0074793] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 08/06/2013] [Indexed: 12/31/2022] Open
Abstract
Previous studies have investigated the prognostic relevance of MMP9 in classical Hodgkin lymphoma (cHL), with negative results. However, we have found that MMP9 immunoistochemical expression by Hodgkin-Reed-Sternberg cells is associated with reduced overall survival in a subset of young adult Brazilian patients diagnosed with cHL. Additionally, we have observed that MMP9 expression by neoplastic cells in cHL is associated with EBV positivity. These results may support a rational basis for additional studies on the role of this metalloproteinase as a target for therapy in classical Hodgkin lymphoma.
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Affiliation(s)
- Antonio Hugo Campos
- Department of Anatomic Pathology, A C Camargo Cancer Care Center, São Paulo, SP, Brazil
- * E-mail:
| | - Jose Vassallo
- Department of Anatomic Pathology, A C Camargo Cancer Care Center, São Paulo, SP, Brazil
- Laboratory of Investigative and Molecular Pathology – CIPED, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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Ghesquières H, Maurer MJ, Casasnovas O, Ansell SM, Larrabee BR, Lech-Maranda E, Novak AJ, Borrel AL, Slager SL, Brice P, Allmer C, Brion A, Ziesmer SC, Morschhauser F, Habermann TM, Gaillard I, Link BK, Stamatoullas A, Fermé C, Dogan A, Macon WR, Audouin J, Cerhan JR, Salles G. Cytokine gene polymorphisms and progression-free survival in classical Hodgkin lymphoma by EBV status: results from two independent cohorts. Cytokine 2013; 64:523-31. [PMID: 24008079 DOI: 10.1016/j.cyto.2013.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 06/18/2013] [Accepted: 08/06/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cytokines are important immune mediators of classical Hodgkin lymphoma (CHL) pathogenesis, and circulating levels at diagnosis may help predict prognosis. Germline single nucleotide polymorphisms (SNPs) in immune genes have been correlated with cytokine production and function. METHODS We investigated whether selected germline SNPs in IL10 (rs1800890, rs1800896, rs1800871, rs1800872), TNFA (rs1800629), IL6 (rs1800795), ILRN (rs419598), INFG (rs2430561) and CCL17 (rs223828) were associated with circulating levels of related cytokines at diagnosis and progression-free survival (PFS) in CHL. Patients were from France (GELA, N=464; median age=32years) and the United States (Iowa/Mayo Specialized Program Of Research Excellence [SPORE], N=239; median age=38years); 22% of 346 CHL cases with EBV tumor status were positive. RESULTS There was no association with any of the SNPs with cytokine levels. Overall, there was no association of any of the SNPs with PFS. In exploratory analyses by EBV status, TNFA rs1800629 (HRAA/AG=2.41; 95%CI, 1.17-4.94) was associated with PFS in EBV-negative GELA patients, with similar trends in the SPORE patients (HRAA/AG=1.63; 95%CI, 0.61-4.40). In a meta-analysis of the two studies, TNFA (HRAA/AG=2.11; 95%CI, 1.18-3.77; P=0.01) was statistically significant, and further adjustment for the international prognostic system did not alter this result. CONCLUSIONS This study showed that germline variation in TNFA was associated with CHL prognosis for EBV-negative patients, which will require confirmation. These results support broader studies on the differential impact of genetic variation in immune genes on EBV-positive vs. EBV-negative CHL pathogenesis.
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Affiliation(s)
- Hervé Ghesquières
- Onco-Hematology, Centre Léon Bérard, UMR CNRS 5239, Université Lyon 1, Lyon, France; Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
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MET and MST1R as prognostic factors for classical Hodgkin's lymphoma. Mod Pathol 2013; 26:1172-82. [PMID: 23558571 DOI: 10.1038/modpathol.2013.64] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 11/06/2012] [Accepted: 01/10/2013] [Indexed: 01/18/2023]
Abstract
MST1R (RON) and MET are receptor tyrosine kinase gene family members that form a noncovalent complex on the cell surface, a critical step in tumor progression. A recent study suggested a prognostic role of MET expression in Hodgkin/Reed-Sternberg (HRS) cells in classical Hodgkin's lymphoma (cHL). The purpose of this study was to examine the prognostic significance of MET and MST1R expression in cHL. The prognostic impact of MET and MST1R was examined in 100 patients with cHL (median age: 32 years) by immunohistochemistry and mRNA in situ hybridization. The median follow-up time was 95 months (interquartile range: 42-126 months). MET or MST1R protein expression was associated with high MET or MST1R mRNA expression, respectively. Thirty-eight patients (38%) expressed MET protein in HRS cell, which was associated with better overall survival (P=0.004). Twenty-six patients (26%) expressed MST1R protein, which was associated with better overall survival (P=0.022) and event-free survival (P=0.021). Multivariate analysis identified MET protein as an independent prognostic factor for overall survival and MST1R protein as an independent prognostic factor for event-free survival. Subgroup analysis according to Ann Arbor stage showed that expressions of MET and MST1R protein have prognostic impact in the advanced stage only. In particular, coexpression of MST1R and MET protein was associated with a better survival outcome than MET or MST1R expression alone or no expression. This study suggests that MET and MST1R are independent prognostic factors in classical cHL, and may allow the identification of a subgroup of cHL patients who require more intensive therapy.
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Liu Y, van den Berg A, Veenstra R, Rutgers B, Nolte I, van Imhoff G, Visser L, Diepstra A. PML nuclear bodies and SATB1 are associated with HLA class I expression in EBV+ Hodgkin lymphoma. PLoS One 2013; 8:e72930. [PMID: 24009715 PMCID: PMC3757028 DOI: 10.1371/journal.pone.0072930] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 07/16/2013] [Indexed: 12/28/2022] Open
Abstract
Tumor cells of classical Hodgkin lymphoma (cHL) are characterized by a general loss of B cell phenotype, whereas antigen presenting properties are commonly retained. HLA class I is expressed in most EBV+ cHL cases, with an even enhanced expression in a proportion of the cases. Promyelocytic leukemia protein (PML) and special AT-rich region binding protein 1 (SATB1) are two global chromatin organizing proteins that have been shown to regulate HLA class I expression in Jurkat cells. We analyzed HLA class I, number of PML nuclear bodies (NBs) and SATB1 expression in tumor cells of 54 EBV+ cHL cases and used 27 EBV- cHL cases as controls. There was a significant difference in presence of HLA class I staining between EBV+ and EBV- cases (p<0.0001). We observed normal HLA class I expression in 35% of the EBV+ and in 19% of the EBV- cases. A stronger than normal HLA class I expression was observed in approximately 40% of EBV+ cHL and not in EBV- cHL cases. 36 EBV+ cHL cases contained less than 10 PML-NBs per tumor cell, whereas 16 cases contained more than 10 PML-NBs. The number of PML-NBs was positively correlated to the level of HLA class I expression (p<0.01). The percentage of SATB1 positive cells varied between 0% to 100% in tumor cells and was inversely correlated with the level of HLA class I expression, but only between normal and strong expression (p<0.05). Multivariable analysis indicated that the number of PML-NBs and the percentage of SATB1+ tumor cells are independent factors affecting HLA class I expression in EBV+ cHL. In conclusion, both PML and SATB1 are correlated to HLA class I expression levels in EBV+ cHL.
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Affiliation(s)
- Yuxuan Liu
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anke van den Berg
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rianne Veenstra
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bea Rutgers
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ilja Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gustaaf van Imhoff
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lydia Visser
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Diepstra
- Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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Prognostic Significance of COX-2 Expression and Correlation With Bcl-2 and VEGF Expression, Microvessel Density, and Clinical Variables in Classical Hodgkin Lymphoma. Am J Surg Pathol 2013; 37:1242-51. [DOI: 10.1097/pas.0b013e31828b6ad3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gupta S, Yeh S, Chami R, Punnett A, Chung C. The prognostic impact of tumour-associated macrophages and Reed-Sternberg cells in paediatric Hodgkin lymphoma. Eur J Cancer 2013; 49:3255-61. [PMID: 23791542 DOI: 10.1016/j.ejca.2013.05.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/16/2013] [Accepted: 05/25/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Tumour-associated macrophages (TAM) are associated with treatment failure in adults with Hodgkin lymphoma (HL). Equivalent data in paediatric HL are sparse. We aimed to determine the prognostic significance of TAM and Reed-Sternberg (RS) cells in paediatric HL. METHODS All children aged 0-18 with HL between 1980 and 2009 with available diagnostic biopsy material were identified. A treatment failure-enriched cohort was assembled. Demographic, disease and outcome data were abstracted. Tissue microarrays with duplicate cores were constructed from diagnostic biopsy material and stained with immunohistochemical markers for TAM (CD68, CD163) and RS (CD30). A high score was defined as >5% positive cells relative to overall cellularity in any core. The association of candidate variables with event-free survival (EFS) was determined using Cox proportional hazards. RESULTS The final study cohort comprised 96 patients with a median age of 14 years (interquartile range 11-15). Agreement on scores between cores from the same biopsy revealed weighted kappas of 0.60, 0.68 and 0.73 for CD30, CD68 and CD163 respectively, indicating moderate tumour heterogeneity. In univariate analysis, a high CD30 score was significantly associated with treatment failure (hazard ratio (HR) 2.27; 95th confidence interval 1.01-5.11; p<0.05). High CD68 and CD163 scores were not associated with EFS. CONCLUSIONS Unlike adult HL, a higher percentage of RS cells was associated with poor outcome, while a higher percentage of TAM was not. Adult HL findings may not extend to paediatric HL. Cooperative group trials of paediatric HL should prospectively determine the association of different components of the tumour microenvironment with outcome.
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Affiliation(s)
- Sumit Gupta
- Division of Hematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
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Styczynski J, Gil L, Tridello G, Ljungman P, Donnelly JP, van der Velden W, Omar H, Martino R, Halkes C, Faraci M, Theunissen K, Kalwak K, Hubacek P, Sica S, Nozzoli C, Fagioli F, Matthes S, Diaz MA, Migliavacca M, Balduzzi A, Tomaszewska A, Camara RDL, van Biezen A, Hoek J, Iacobelli S, Einsele H, Cesaro S. Response to rituximab-based therapy and risk factor analysis in Epstein Barr Virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: a study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Clin Infect Dis 2013; 57:794-802. [PMID: 23771985 DOI: 10.1093/cid/cit391] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The objective of this analysis was to investigate prognostic factors that influence the outcome of Epstein-Barr virus (EBV)-related posttransplant lymphoproliferative disorder (PTLD) after a rituximab-based treatment in the allogeneic hematopoietic stem cell transplant (HSCT) setting. METHODS A total of 4466 allogeneic HSCTs performed between 1999 and 2011 in 19 European Group for Blood and Marrow Transplantation centers were retrospectively analyzed for PTLD, either biopsy-proven or probable disease. RESULTS One hundred forty-four cases of PTLD were identified, indicating an overall EBV-related PTLD frequency of 3.22%, ranging from 1.16% for matched-family donor, 2.86% for mismatched family donor, 3.97% in matched unrelated donors, and 11.24% in mismatched unrelated donor recipients. In total, 69.4% patients survived PTLD. Multivariable analysis showed that a poor response of PTLD to rituximab was associated with an age ≥30 years, involvement of extralymphoid tissue, acute GVHD, and a lack of reduction of immunosuppression upon PTLD diagnosis. In the prognostic model, the PTLD mortality increased with the increasing number of factors: 0-1, 2, or 3 factors being associated with mortality of 7%, 37%, and 72%, respectively (P < .0001). Immunosuppression tapering was associated with a lower PTLD mortality (16% vs 39%), and a decrease of EBV DNAemia in peripheral blood during therapy was predictive of better survival. CONCLUSIONS More than two-thirds of patients with EBV-related PTLD survived after rituximab-based treatment. Reduction of immunosuppression was associated with improved outcome, whereas older age, extranodal disease, and acute graft-vs-host disease predicted poor outcome.
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Affiliation(s)
- Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
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Scott DW, Chan FC, Hong F, Rogic S, Tan KL, Meissner B, Ben-Neriah S, Boyle M, Kridel R, Telenius A, Woolcock BW, Farinha P, Fisher RI, Rimsza LM, Bartlett NL, Cheson BD, Shepherd LE, Advani RH, Connors JM, Kahl BS, Gordon LI, Horning SJ, Steidl C, Gascoyne RD. Gene expression-based model using formalin-fixed paraffin-embedded biopsies predicts overall survival in advanced-stage classical Hodgkin lymphoma. J Clin Oncol 2013; 31:692-700. [PMID: 23182984 PMCID: PMC3574267 DOI: 10.1200/jco.2012.43.4589] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Our aim was to reliably identify patients with advanced-stage classical Hodgkin lymphoma (cHL) at increased risk of death by developing a robust predictor of overall survival (OS) using gene expression measured in routinely available formalin-fixed paraffin-embedded tissue (FFPET). METHODS Expression levels of 259 genes, including those previously reported to be associated with outcome in cHL, were determined by digital expression profiling of pretreatment FFPET biopsies from 290 patients enrolled onto the E2496 Intergroup trial comparing doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and Stanford V regimens in locally extensive and advanced-stage cHL. A model for OS separating patients into low- and high-risk groups was produced using penalized Cox regression. The model was tested in an independent cohort of 78 patients enriched for treatment failure but otherwise similar to patients in a population-based registry of patients treated with ABVD. Weighted analysis methods generated unbiased estimates of predictor performance in the population-based registry. RESULTS A 23-gene outcome predictor was generated. The model identified a population at increased risk of death in the validation cohort. There was a 29% absolute difference in 5-year OS between the high- and low-risk groups (63% v 92%, respectively; log-rank P < .001; hazard ratio, 6.7; 95% CI, 2.6 to 17.4). The predictor was superior to the International Prognostic Score and CD68 immunohistochemistry in multivariate analyses. CONCLUSION A gene expression-based predictor, developed in and applicable to routinely available FFPET biopsies, identifies patients with advanced-stage cHL at increased risk of death when treated with standard-intensity up-front regimens.
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Affiliation(s)
- David W. Scott
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Fong Chun Chan
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Fangxin Hong
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Sanja Rogic
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - King L. Tan
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Barbara Meissner
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Susana Ben-Neriah
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Merrill Boyle
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Robert Kridel
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Adele Telenius
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Bruce W. Woolcock
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Pedro Farinha
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Richard I. Fisher
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Lisa M. Rimsza
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Nancy L. Bartlett
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Bruce D. Cheson
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Lois E. Shepherd
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Ranjana H. Advani
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Joseph M. Connors
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Brad S. Kahl
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Leo I. Gordon
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Sandra J. Horning
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Christian Steidl
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Randy D. Gascoyne
- David W. Scott, Fong Chun Chan, King L. Tan, Barbara Meissner, Susana Ben-Neriah, Merrill Boyle, Robert Kridel, Adele Telenius, Bruce W. Woolcock, Joseph M. Connors, Christian Steidl, and Randy D. Gascoyne, Centre for Lymphoid Cancer, BC Cancer Agency; Sanja Rogic, Centre for High-Throughput Biology, University of British Columbia, Vancouver, British Columbia; Lois E. Shepherd, National Cancer Institute of Canada Clinical Trials Group, Queen's University, Kingston, Ontario, Canada; Fangxin Hong, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA; Richard I. Fisher, James P. Wilmot Cancer Centre, University of Rochester, Rochester, NY; Lisa M. Rimsza, University of Arizona, Tucson, AZ; Nancy L. Bartlett, Washington University School of Medicine, St Louis, MO; Bruce D. Cheson, Georgetown University Hospital, Washington, DC; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Brad S. Kahl, University of Wisconsin, Madison, WI; Leo I. Gordon, Northwestern University Feinberg School of Medicine, Chicago, IL; and Pedro Farinha, Centro Hospitalar Lisboa Central, Lisbon, Portugal
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Relationship of Epstein-Barr virus and interleukin 10 promoter polymorphisms with the risk and clinical outcome of childhood Burkitt lymphoma. PLoS One 2012; 7:e46005. [PMID: 23029361 PMCID: PMC3459931 DOI: 10.1371/journal.pone.0046005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 08/27/2012] [Indexed: 01/12/2023] Open
Abstract
Epstein-Barr virus (EBV) is an important environmental factor associated to the development of Burkitt lymphoma (BL) in endemic and intermediate risk regions. However, little is known about the contribution of genetic constitution to the development and clinical response of the disease. The aim of this work was to investigate the role of EBV and Interleukin 10 (IL10) single nucleotide polymorphisms (-1082A/G, -819C/T, -592C/A) and microsatellites (IL10.R and IL10.G) in susceptibility and clinical outcome in pediatric BL patients, in a region with intermediate EBV association frequency. The frequencies of IL10 promoter Single nucleotide polymorphisms -1082A/G, -819C/T, -592C/A, and IL10.R and IL10.G microsatellites were compared in 62 pediatric patients and 216 healthy donors. IL10 -1082GG and GCC/GCC genotypes were more frequent in patients than in controls, and associated to a higher risk of BL development (GG genotype OR 2.62, 95% CI, 1.25-5.51; P = 0.008; Pc = 0.024). EBV was detected in tumor samples by EBER-ISH in 54.1% of cases. EBV+ patients exhibited a better event free survival (EFS) (P = 0.019) than EBV- patients. Carriers of IL10 R3-GCC had worse EFS (P = 0.028). Our results suggest a risk effect and an independent prognostic value of IL10 polymorphisms and EBV in childhood BL patients.
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Evens AM, Antillón M, Aschebrook-Kilfoy B, Chiu BCH. Racial disparities in Hodgkin's lymphoma: a comprehensive population-based analysis. Ann Oncol 2012; 23:2128-2137. [PMID: 22241896 DOI: 10.1093/annonc/mdr578] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Racial disparity has been investigated in a number of cancers; however, there remains a comparative paucity of data in Hodgkin's lymphoma (HL). PATIENTS AND METHODS We examined time-, age-, and gender-specific incidence, disease characteristics, and survival across and within races for adolescent/adult HL (age 10-79 years) diagnosed during 1992-2007 in the SEER 13 registries. RESULTS A total of 15 662 HL cases were identified [11,211 non-Hispanic whites, 2067 Hispanics, 1662 blacks, and 722 Asian/Pacific Islanders (A/PI)]. Similar to whites, A/PIs had bimodal age-specific incidence, while blacks and Hispanics did not. Further, HL was significantly more common in Hispanics versus whites age>65 years (7.0/1×10(6) versus 4.5/1×10(6), respectively, P<0.01). By place of birth, US-born Hispanics and A/PIs age 20-39 years had higher incidence of HL versus their foreign-born counterparts (P<0.05), however, rates converged age>40 years. Interestingly, from 1992-1997 to 2003-2007, A/PI incidence rates increased >50% (P<0.001). Moreover, this increase was restricted to US-born A/PI. We also identified a number of disease-related differences based on race. Finally, 5-, 10-, and 15-year overall survival rates were inferior for blacks and Hispanics compared with whites (P<0.005 and P<0.001, respectively) and A/PI (P<0.018 and P<0.001, respectively). These differences persisted on multivariate analysis. CONCLUSION Collectively, we identified multiple racial disparities, including survival, in adolescent/adult HL.
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Affiliation(s)
- A M Evens
- Division of Hematology/Oncology, The University of Massachusetts Medical School and the UMass Memorial Cancer Center, Worcester.
| | - M Antillón
- Department of Health Studies, The University of Chicago, Chicago
| | | | - B C-H Chiu
- Department of Health Studies, The University of Chicago, Chicago; The University of Chicago Comprehensive Cancer Center, Chicago, USA
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