1
|
Chan A, Auclair R, Gao Q, Ghione P, Horwitz S, Dogan A, Roshal M, Lin O. Role of flow cytometric immunophenotyping in the diagnosis of breast implant-associated anaplastic large cell lymphoma: A 6-year, single-institution experience. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2024; 106:117-125. [PMID: 38297808 PMCID: PMC10978229 DOI: 10.1002/cyto.b.22162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/05/2024] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon mature T-cell neoplasm occurring in patients with textured breast implants, typically after 7-10 years of exposure. Although cytopathologic or histopathologic assessment is considered the gold standard diagnostic method for BIA-ALCL, flow cytometry (FC)-based immunophenotyping is recommended as an adjunct test. However, the diagnostic efficacy of FC is not well reported. We reviewed 290 FC tests from breast implant pericapsular fluid and capsule tissue from 182 patients, including 16 patients with BIA-ALCL over a 6-year period, calculating diagnostic rates and test efficacy. FC showed an overall sensitivity of 75.9%, specificity of 100%, and negative and positive predictive values of 95.4% and 100%, respectively. Blinded expert review of false-negative cases identified diagnostic pitfalls, improving sensitivity to 96.6%. Fluid samples had better rates of adequate samples for FC testing compared with tissue samples. Paired with FC testing of operating room (OR)-acquired fluid samples, capsulectomy FC specimens added no diagnostic value in patients with concurrent fluid samples; no cases had positive capsule FC with negative fluid FC. Fluid samples are adequate for FC testing more often than tissue. Capsule tissue FC specimens do not improve FC efficacy when paired with OR-acquired fluid FC samples and are often inadequate samples. FC is 100% specific for BIA-ALCL and can serve as a confirmatory test but should not be the sole diagnostic method. Awareness of sample-specific diagnostic pitfalls greatly improves the sensitivity of BIA-ALCL testing by FC.
Collapse
Affiliation(s)
- Alexander Chan
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| | - Romany Auclair
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| | - Qi Gao
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| | - Paola Ghione
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center
| | - Steven Horwitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center
| | - Ahmet Dogan
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| | - Mikhail Roshal
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| | - Oscar Lin
- Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center
| |
Collapse
|
2
|
Ally F, Gajzer D, Fromm JR. A Review of the Flow Cytometric Findings in Classic Hodgkin Lymphoma, Nodular Lymphocyte Predominant Hodgkin Lymphoma and T Cell/Histiocyte-Rich Large B Cell Lymphoma. Clin Lab Med 2023; 43:427-444. [PMID: 37481321 DOI: 10.1016/j.cll.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Classic Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, and T cell/histiocyte-rich large B cell lymphoma form a unique set of lymphomas with similar morphologic growth patterns (occasional neoplastic cells within a prominent cellular cell background) that are pathobiologically related. Distinguishing these entities has been historically difficult by flow cytometry; however, our laboratory has developed antibody-fluorochrome combinations capable of immunophenotyping these lymphomas. Additionally, characterization of the background reactive lymphocytes can aid in narrowing the differential diagnosis. This review summarizes the immunophenotypic features and insights of the neoplastic and reactive populations found in this unique group of lymphomas.
Collapse
Affiliation(s)
- Feras Ally
- Department of Laboratory Medicine and Pathology, University of Washington
| | - David Gajzer
- Department of Laboratory Medicine and Pathology, University of Washington
| | - Jonathan R Fromm
- Department of Laboratory Medicine and Pathology, University of Washington.
| |
Collapse
|
3
|
Li Z, Mu W, Xiao M. Genetic lesions and targeted therapy in Hodgkin lymphoma. Ther Adv Hematol 2023; 14:20406207221149245. [PMID: 36654739 PMCID: PMC9841868 DOI: 10.1177/20406207221149245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023] Open
Abstract
Hodgkin lymphoma is a special type of lymphoma in which tumor cells frequently undergo multiple genetic lesions that are associated with accompanying pathway abnormalities. These pathway abnormalities are dominated by active signaling pathways, such as the JAK-STAT (Janus kinase-signal transducer and activator of transcription) pathway and the NFκB (nuclear factor kappa-B) pathway, which usually result in hyperactive survival signaling. Targeted therapies often play an important role in hematologic malignancies, such as CAR-T therapy (chimeric antigen receptor T-cell immunotherapy) targeting CD19 and CD22 in diffuse large B-cell lymphoma, while in Hodgkin lymphoma, the main targets of targeted therapies are CD30 molecules and PD1 molecules. Drugs targeting other molecules are also under investigation. This review summarizes the actionable genetic lesions, current treatment options, clinical trials for Hodgkin lymphoma and the potential value of those genetic lesions in clinical applications.
Collapse
Affiliation(s)
- Zhe Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Mu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | |
Collapse
|
4
|
Veldman J, Rodrigues Plaça J, Chong L, Terpstra MM, Mastik M, van Kempen LC, Kok K, Aoki T, Steidl C, van den Berg A, Visser L, Diepstra A. CD4+ T cells in classical Hodgkin lymphoma express exhaustion associated transcription factors TOX and TOX2. Oncoimmunology 2022; 11:2033433. [PMID: 35111387 PMCID: PMC8803106 DOI: 10.1080/2162402x.2022.2033433] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In classical Hodgkin lymphoma (cHL), the highly abundant CD4+ T cells in the vicinity of tumor cells are considered essential for tumor cell survival, but are ill-defined. Although they are activated, they consistently lack expression of activation marker CD26. In this study, we compared sorted CD4+CD26- and CD4+CD26+ T cells from cHL lymph node cell suspensions by RNA sequencing and T cell receptor variable gene segment usage analysis. This revealed that although CD4+CD26- T cells are antigen experienced, they have not clonally expanded. This may well be explained by the expression of exhaustion associated transcription factors TOX and TOX2, immune checkpoints PDCD1 and CD200, and chemokine CXCL13, which were amongst the 100 significantly enriched genes in comparison with the CD4+CD26+ T cells. Findings were validated in single-cell RNA sequencing data from an independent cohort. Interestingly, immunohistochemistry revealed predominant and high frequency of staining for TOX and TOX2 in the T cells attached to the tumor cells. In conclusion, the dominant CD4+CD26- T cell population in cHL is antigen experienced, polyclonal, and exhausted. This population is likely a main contributor to the very high response rates to immune checkpoint inhibitors in cHL.
Collapse
Affiliation(s)
- Johanna Veldman
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jessica Rodrigues Plaça
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- National Institute of Science and Technology in Stem Cell and Cell Therapy (INCT/CNPq) and Center for Cell-Based Therapy, CEPID/FAPESP, Ribeirão Preto, São Paulo, Brazil
| | - Lauren Chong
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
| | - Miente Martijn Terpstra
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mirjam Mastik
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Léon C. van Kempen
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Klaas Kok
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tomohiro Aoki
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian Steidl
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anke van den Berg
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lydia Visser
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Diepstra
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
5
|
Martig DS, Fromm JR. A comparison and review of the flow cytometric findings in classic Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, T cell/histiocyte rich large B cell lymphoma, and primary mediastinal large B cell lymphoma. CYTOMETRY. PART B, CLINICAL CYTOMETRY 2022; 102:14-25. [PMID: 34878224 DOI: 10.1002/cyto.b.22045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 06/13/2023]
Abstract
The "Hodgkin-like" lymphomas including classic Hodgkin lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, T cell/histiocyte rich large B cell lymphoma, and primary mediastinal large B cell lymphoma have been shown to be pathobiologically related. With the exception of primary mediastinal large B cell lymphoma, these lymphomas have similar morphologic growth patterns with occasional neoplastic cells within a prominent reactive cell background. Historically, distinguishing these entities was difficult by flow cytometry; however, over the past 15 years, our laboratory has developed antibody-fluorochrome combinations capable of accurately distinguishing these entities by their immunoprofile. Additionally, an algorithmic approach based on characterization of the background reactive B-cell and T-cell populations can aid in narrowing the differential diagnosis. This review summarizes both the morphologic and immunophenotypic features and the current flow cytometric insights of the neoplastic and reactive populations found in this unique subset of lymphomas.
Collapse
Affiliation(s)
- Daniel S Martig
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Jonathan R Fromm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| |
Collapse
|
6
|
Simonson PD, Wu Y, Wu D, Fromm JR, Lee AY. De Novo Identification and Visualization of Important Cell Populations for Classic Hodgkin Lymphoma Using Flow Cytometry and Machine Learning. Am J Clin Pathol 2021; 156:1092-1102. [PMID: 34175918 PMCID: PMC8573674 DOI: 10.1093/ajcp/aqab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Automated classification of flow cytometry data has the potential to reduce errors and accelerate flow cytometry interpretation. We desired a machine learning approach that is accurate, is intuitively easy to understand, and highlights the cells that are most important in the algorithm's prediction for a given case. METHODS We developed an ensemble of convolutional neural networks for classification and visualization of impactful cell populations in detecting classic Hodgkin lymphoma using two-dimensional (2D) histograms. Data from 977 and 245 clinical flow cytometry cases were used for training and testing, respectively. Seventy-eight nongated 2D histograms were created per flow cytometry file. Shapley additive explanation (SHAP) values were calculated to determine the most impactful 2D histograms and regions within histograms. SHAP values from all 78 histograms were then projected back to the original cell data for gating and visualization using standard flow cytometry software. RESULTS The algorithm achieved 67.7% recall (sensitivity), 82.4% precision, and 0.92 area under the receiver operating characteristic. Visualization of the important cell populations for individual predictions demonstrated correlations with known biology. CONCLUSIONS The method presented enables model explainability while highlighting important cell populations in individual flow cytometry specimens, with potential applications in both diagnosis and discovery of previously overlooked key cell populations.
Collapse
Affiliation(s)
- Paul D Simonson
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Yue Wu
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - David Wu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Jonathan R Fromm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| |
Collapse
|
7
|
Chan A, Scarpa Carniello JV, Gao Q, Sigler A, Baik J, Roshal M, Lin O. Role of Flow Cytometric Immunophenotyping for Classic Hodgkin Lymphoma in Small Biopsy and Cytology Specimens. Arch Pathol Lab Med 2021; 146:462-468. [PMID: 34293084 DOI: 10.5858/arpa.2020-0795-oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The diagnosis of classic Hodgkin lymphoma (CHL) traditionally requires surgical tissue biopsy because of the paucity of diagnostic Hodgkin and Reed-Sternberg cells. Diagnosis can be challenging in small core needle and cytologic biopsies, which are increasingly used because of reduced costs and minimal invasiveness. Flow cytometric (FC) identification of Hodgkin and Reed-Sternberg cells is possible, but FC test efficacy is not well studied outside of validation settings, especially in small specimens. OBJECTIVE.— To assess the testing efficacy of FC performed on small biopsy and cytology specimens for the diagnosis of CHL. DESIGN.— We reviewed 131 patients with CHL and 459 patients without CHL during a 3-year period who underwent a small biopsy procedure, including core biopsy and/or cytology evaluation, with concurrent routine clinical FC testing for CHL, assessing performance of FC in small specimens. RESULTS.— Evaluating testing efficacy, sensitivity was 95.4% and specificity was 98.2%, whereas positive and negative predictive values were 92.2% and 99.0%, respectively. Although there were more false-positive results than compared with published validation studies, expert review identified distinct diagnostic pitfalls; awareness of these may improve testing efficacy. CONCLUSIONS.— Although FC diagnosis of CHL was historically considered unfeasible, our findings in a real-world clinical setting suggest that FC adds diagnostic value to small biopsy evaluation, reducing time to treatment, costs, and invasive excisional procedures.
Collapse
Affiliation(s)
- Alexander Chan
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jose Victor Scarpa Carniello
- Cytopathology (Scarpa Carniello, Lin) Services, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Qi Gao
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allison Sigler
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jeeyeon Baik
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mikhail Roshal
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York.,Roshal and Lin contributed equally as senior authors
| | - Oscar Lin
- From the Hematopathology (Chan, Gao, Sigler, Baik, Roshal, Lin), Memorial Sloan Kettering Cancer Center, New York, New York.,Cytopathology (Scarpa Carniello, Lin) Services, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.,Roshal and Lin contributed equally as senior authors
| |
Collapse
|
8
|
Rosetting T cells in Hodgkin lymphoma are activated by immunological synapse components HLA class II and CD58. Blood 2021; 136:2437-2441. [PMID: 32589698 DOI: 10.1182/blood.2020005546] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022] Open
Abstract
A unique feature of Hodgkin lymphoma (HL) is the presence of CD4+ T cells that surround, protect, and promote survival of tumor cells. The adhesion molecules involved in this so-called T-cell rosetting are important components of the immunological synapse (IS). However, it is unknown whether this synapse is fully assembled and leads to T-cell activation by enabling interaction between the T-cell receptor (TCR) and human leukocyte antigen class II (HLA-II). We established a novel rosetting model by coculturing HLA-II-matched peripheral blood mononuclear cells with HL cell lines and showed IS formation with activation of rosetting T cells. HLA-II downregulation by class II transactivator knockout did not affect the extent of rosetting, but almost completely abrogated T-cell activation. Intriguingly, the level of CD58 expression correlated with the extent of rosette formation, and CD58 knockout or CD2 blockade reduced both rosette formation and T-cell activation. The extension of our findings to primary HL tissue by immunohistochemistry and proximity ligation assays showed interaction of CD2 with CD58 and of TCR-associated CD4 with HLA-II. In conclusion, T-cell rosetting in HL is established by formation of the IS, and activation of rosetting T cells critically depends on the interaction of both TCR-HLA-II and CD2-CD58.
Collapse
|
9
|
Genomic Landscape of Hodgkin Lymphoma. Cancers (Basel) 2021; 13:cancers13040682. [PMID: 33567641 PMCID: PMC7915917 DOI: 10.3390/cancers13040682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Hodgkin lymphoma (HL) is composed of many reactive and only a few cancer cells, so-called Hodgkin and Reed-Sternberg (HRS) or lymphocyte predominant (LP) cells. Due to the scarcity of these cells, it was difficult to perform high-throughput molecular investigations on them for a long time. With the help of recently developed methods, it is now possible to analyze their genomes. This review summarizes the genetic alterations found in HRS and LP cells that impact immune evasion, proliferation and circumvention of programmed cell death in HL. Understanding these underlying molecular mechanisms is essential, as they may be of prognostic and predictive value and help to improve the therapy especially for patients with recurrent or treatment-resistant disease. Abstract Background: Hodgkin lymphoma (HL) is predominantly composed of reactive, non-neoplastic cells surrounding scarcely distributed tumor cells, that is, so-called Hodgkin and Reed-Sternberg (HRS) or lymphocyte predominant (LP) cells. This scarcity impeded the analysis of the tumor cell genomes for a long time, but recently developed methods (especially laser capture microdissection, flow cytometry/fluorescence-activated cell sorting) facilitated molecular investigation, elucidating the pathophysiological principles of “Hodgkin lymphomagenesis”. Methods: We reviewed the relevant literature of the last three decades focusing on the genomic landscape of classic and nodular lymphocyte predominant HL (NLPHL) and summarized molecular cornerstones. Results: Firstly, the malignant cells of HL evade the immune system by altered expression of PDL1/2, B2M and MHC class I and II due to various genetic alterations. Secondly, tumor growth is promoted by permanently activated JAK/STAT signaling due to pervasive mutations of multiple genes involved in the pathway. Thirdly, apoptosis of neoplastic cells is prevented by alterations of NF-κB compounds and the PI3K/AKT/mTOR axis. Additionally, Epstein-Barr virus infection can simultaneously activate JAK/STAT and NF-κB, similarly leading to enhanced survival and evasion of apoptosis. Finally, epigenetic phenomena such as promoter hypermethylation lead to the downregulation of B-lineage-specific, tumor-suppressor and immune regulation genes. Conclusion: The blueprint of HL genomics has been laid, paving the way for future investigations into its complex pathophysiology.
Collapse
|
10
|
Genomic analyses of flow-sorted Hodgkin Reed-Sternberg cells reveal complementary mechanisms of immune evasion. Blood Adv 2020; 3:4065-4080. [PMID: 31816062 DOI: 10.1182/bloodadvances.2019001012] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 12/14/2022] Open
Abstract
Classical Hodgkin lymphoma (cHL) is composed of rare malignant Hodgkin Reed-Sternberg (HRS) cells within an extensive, but ineffective, inflammatory/immune cell infiltrate. HRS cells exhibit near-universal somatic copy gains of chromosome 9p/9p24.1, which increase expression of the programmed cell death protein 1 (PD-1) ligands. To define genetic mechanisms of response and resistance to PD-1 blockade and identify complementary treatment targets, we performed whole-exome sequencing of flow cytometry-sorted HRS cells from 23 excisional biopsies of newly diagnosed cHLs, including 8 Epstein-Barr virus-positive (EBV+) tumors. We identified significantly mutated cancer candidate genes (CCGs) as well as somatic copy number alterations and structural variations and characterized their contribution to disease-defining immune evasion mechanisms and nuclear factor κB (NF-κB), JAK/STAT, and PI3K signaling pathways. EBV- cHLs had a higher prevalence of genetic alterations in the NF-κB and major histocompatibility complex class I antigen presentation pathways. In this young cHL cohort (median age, 26 years), we identified a predominant mutational signature of spontaneous deamination of cytosine- phosphate-guanines ("Aging"), in addition to apolipoprotein B mRNA editing catalytic polypeptide-like, activation-induced cytidine deaminase, and microsatellite instability (MSI)-associated hypermutation. In particular, the mutational burden in EBV- cHLs was among the highest reported, similar to that of carcinogen-induced tumors. Together, the overall high mutational burden, MSI-associated hypermutation, and newly identified genetic alterations represent additional potential bases for the efficacy of PD-1 blockade in cHL. Of note, recurrent cHL alterations, including B2M, TNFAIP3, STAT6, GNA13, and XPO1 mutations and 2p/2p15, 6p21.32, 6q23.3, and 9p/9p24.1 copy number alterations, were also identified in >20% of primary mediastinal B-cell lymphomas, highlighting shared pathogenetic mechanisms in these diseases.
Collapse
|
11
|
Cowan AJ, Green DJ, Karami M, Becker PS, Tuazon S, Coffey DG, Hyun TS, Libby EN, Gopal AK, Holmberg LA. KRD-PACE Mobilization for Multiple Myeloma Patients With Significant Residual Disease Before Autologous Stem-Cell Transplantation. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:602-609. [PMID: 32457024 DOI: 10.1016/j.clml.2020.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/11/2020] [Accepted: 04/03/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Bortezomib has been incorporated into thalidomide and dexamethasone provided with cisplatin, doxorubicin, cyclophosphamide, and etoposide (PACE) as an intensive regimen before autologous stem-cell transplantation for multiple myeloma (MM). We examined MM patients at our center who received chemomobilization with a regimen that substituted carfilzomib and lenalidomide for bortezomib and thalidomide (KRD-PACE). PATIENTS AND METHODS This was a retrospective study of 27 MM patients who received KRD-PACE for chemomobilization. Our analysis included patients who had circulating plasma cells (CPCs) by flow cytometry, ≥ 10% bone marrow plasma cells (BMPC), a monoclonal protein ≥ 1 g/dL, or an involved serum free light chain ≥ 10 mg/dL. RESULTS The most common indication for KRD-PACE was BMPC ≥ 10% in 16 patients (60%), followed by CPCs in 11 (41%). The median (range) age was 61 (35-69) years, and the median (range) BMPC before treatment was 10% (5%-47%). The overall response rate was 43%, and a median (range) of 20.24 (8.08-69.88) × 106 CD34+ cells/kg were collected. CPC clearance rate was 50%, and the median reduction in BMPC was 75%. Two patients had sinus bradycardia and 5 (19%) had neutropenic fever. CONCLUSION KRD-PACE is an effective therapy to mobilize peripheral blood stem cells in MM patients with residual disease burden. This regimen was successful at clearing CPCs and reducing BMPC burden, with an overall response rate of 43%. Despite theoretical concern regarding the combination of 3 cardiotoxic agents, we observed a low frequency of cardiac issues.
Collapse
Affiliation(s)
- Andrew J Cowan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Damian J Green
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Mehdi Karami
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Pamela S Becker
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA; Division of Hematology, Department of Medicine, University of Washington, Seattle, WA
| | - Sherilyn Tuazon
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - David G Coffey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Teresa S Hyun
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Pathology, University of Washington, Seattle, WA
| | - Edward N Libby
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Ajay K Gopal
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA
| | - Leona A Holmberg
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Seattle Cancer Care Alliance, Seattle, WA.
| |
Collapse
|
12
|
Goncharova O, Flinner N, Bein J, Döring C, Donnadieu E, Rikirsch S, Herling M, Küppers R, Hansmann ML, Hartmann S. Migration Properties Distinguish Tumor Cells of Classical Hodgkin Lymphoma from Anaplastic Large Cell Lymphoma Cells. Cancers (Basel) 2019; 11:cancers11101484. [PMID: 31581676 PMCID: PMC6827161 DOI: 10.3390/cancers11101484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 01/01/2023] Open
Abstract
Anaplastic large cell lymphoma (ALCL) and classical Hodgkin lymphoma (cHL) are lymphomas that contain CD30-expressing tumor cells and have numerous pathological similarities. Whereas ALCL is usually diagnosed at an advanced stage, cHL more frequently presents with localized disease. The aim of the present study was to elucidate the mechanisms underlying the different clinical presentation of ALCL and cHL. Chemokine and chemokine receptor expression were similar in primary ALCL and cHL cases apart from the known overexpression of the chemokines CCL17 and CCL22 in the Hodgkin and Reed-Sternberg (HRS) cells of cHL. Consistent with the overexpression of these chemokines, primary cHL cases encountered a significantly denser T cell microenvironment than ALCL. Additionally to differences in the interaction with their microenvironment, cHL cell lines presented a lower and less efficient intrinsic cell motility than ALCL cell lines, as assessed by time-lapse microscopy in a collagen gel and transwell migration assays. We thus propose that the combination of impaired basal cell motility and differences in the interaction with the microenvironment hamper the dissemination of HRS cells in cHL when compared with the tumor cells of ALCL.
Collapse
Affiliation(s)
- Olga Goncharova
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
| | - Nadine Flinner
- Institute of Informatics/Frankfurt Institute for Advanced Studies, Goethe University, 60438 Frankfurt am Main, Germany.
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
| | - Claudia Döring
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
| | - Emmanuel Donnadieu
- Inserm, U1016, Institut Cochin, CNRS, UMR8104 and Université Paris Descartes, F-75014 Paris, France.
| | - Sandy Rikirsch
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
| | - Marco Herling
- The Laboratory of Lymphocyte Signaling and Oncoproteome, Department I of Internal Medicine, Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Duesseldorf, CECAD and CMMC, University of Cologne, 50937 Cologne, Germany.
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, 45122 Essen, Germany.
| | - Martin-Leo Hansmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
- Reference and Consultant Center for Lymph Node and Lymphoma diagnostics, 60590 Frankfurt, Germany.
- Frankfurt Institute of Advanced Studies, 60438 Frankfurt am Main, Germany.
| | - Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany.
- Reference and Consultant Center for Lymph Node and Lymphoma diagnostics, 60590 Frankfurt, Germany.
| |
Collapse
|
13
|
Fromm JR, Edlefsen KL, Cherian S, Wood BL, Soma L, Wu D. Flow cytometric features of incidental indolent T lymphoblastic proliferations. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 98:282-287. [DOI: 10.1002/cyto.b.21845] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Jonathan R. Fromm
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - Kerstin L. Edlefsen
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - Sindhu Cherian
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - Brent L. Wood
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - Lori Soma
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| | - David Wu
- UW Hematopathology Laboratory, Department of Laboratory MedicineUniversity of Washington Seattle Washington
| |
Collapse
|
14
|
Glynn E, Fromm JR. Immunophenotypic Characterization and Purification of Neoplastic Cells from Lymph Nodes Involved by T-Cell/Histiocyte-rich Large B-cell Lymphoma by Flow Cytometry and Flow Cytometric Cell Sorting. CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 98:88-98. [PMID: 31254446 DOI: 10.1002/cyto.b.21834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/26/2019] [Accepted: 06/11/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND T-cell/histiocyte rich large B-cell lymphoma (THRLBCL) is B-cell lymphoma in which rare neoplastic cells are embedded in a reactive infiltrate. We describe the first characterization of the neoplastic cells by flow cytometry (FC). METHODS Using FC, we immunophenotyped the neoplastic cells of 11 cases of THRLBCL and 11 cases of DLBCL, NOS (controls). Neoplastic THRLBCL cells were also purified by flow cytometric cell sorting (FCCS). RESULTS A neoplastic THRLBCL population was detected by FC in 9 of 11 cases (82%). Neoplastic THRLBCL cells demonstrated an aberrant germinal center B-cell immunophenotype (bright CD20, bright CD40; positive for Bcl-6 and CD75; weakly positive for CD32; negative for IgH). With regard to adhesion molecules, CD54 was overexpressed, CD58 expression varied between cases, and CD50 expression was intermediate. Evaluation of immunomodulatory receptors demonstrated that PD-L2 was weakly expressed and PD-L1 was variably expressed. Finally, FCCS of two cases showed large multi-lobated cells with morphology consistent with neoplastic cells of THRLBCL. CONCLUSIONS The immunophenotype identified and the morphology of the FCCS purified cells confirms the FC defined populations are neoplastic cells from THRLBCL. While the cohort is small, neoplastic THRLBCL cells lack surface immunoglobulins. CD40, CD50, and CD54 were overexpressed in THRLBCL relative to DLBCL, NOS, perhaps contributing to the predominance of T cells in THRLBCL. Expression of CD32, PD-L1, and PD-L2 may be useful in distinguishing THRLBCL and NLPHL. Finally, the FC assays will be useful for purifying neoplastic cells of THRLBCL and for diagnostic immunophenotyping of THRLBCL. © 2019 International Clinical Cytometry Society.
Collapse
Affiliation(s)
- Emily Glynn
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
15
|
Wallace PK. Issue Highlights-May 2018 (94B3). CYTOMETRY PART B-CLINICAL CYTOMETRY 2019; 94:387-391. [PMID: 29734502 DOI: 10.1002/cyto.b.21640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Paul K Wallace
- Department of Flow and Image Cytometry, Roswell Park Cancer Institute, Elm & Carlton Streets, New York, 14263 Buffalo
| |
Collapse
|
16
|
Juskevicius D, Jucker D, Dietsche T, Perrina V, Rufle A, Ruiz C, Dirnhofer S, Tzankov A. Novel cell enrichment technique for robust genetic analysis of archival classical Hodgkin lymphoma tissues. J Transl Med 2018; 98:1487-1499. [PMID: 30087457 DOI: 10.1038/s41374-018-0096-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 04/27/2018] [Accepted: 05/14/2018] [Indexed: 11/09/2022] Open
Abstract
Approximately 15% of patients with classical Hodgkin lymphoma (cHL) die after relapse or progressive disease. Comprehensive genetic characterization is required to better understand its molecular pathology and improve management. However, genetic information on cHL is hard to obtain mainly due to rare malignant Hodgkin- and Reed-Sternberg cells (HRSC), whose overall frequencies in the affected tissues ranges from 0.1 to 10%. Therefore, enrichment of neoplastic cells is necessary for the majority of genetic investigations. We have developed a new high-throughput method for marker-based enrichment of archival formalin-fixed and paraffin-embedded (FFPE) tissue-derived HRSC nuclei by fluorescence-assisted flow sorting (FACS) and successfully applied it on ten cHL cases. Genomic DNA extracted from sorted nuclei was used for targeted high-throughput sequencing (HTS) of 68 genes that are frequently affected in lymphomas. Chromosomal copy number aberrations were investigated by the Agilent SurePrint 180k microarray. Our method enabled HRSC nuclei enrichment to 40-90% in sorted populations. This level of enrichment was sufficient for reliable identification of tumor-specific mutations and copy number aberrations. Genetic analysis revealed that components of JAK-STAT signaling pathway were affected in all investigated tumors by frequent mutations of SOCS1 and STAT6 as well as copy number gains of JAK2. Involvement of nuclear factor-κB (NF-κB) pathway compounds was evident from recurrent gains of the locus containing the REL gene and mutations in TNFAIP3 and CARD11. Finally, genetic alterations of PD-L1 and B2M suggested immune evasion as mechanisms of oncogenesis in some patients. In this work, we present a new method for HRSC enrichment from FFPE tissue blocks by FACS and demonstrate the feasibility of a wide-scale genetic analysis by cutting-edge molecular methods. Our work opens the door to a large resource of archived clinical cHL samples and lays foundation to more complex studies aimed to answer important biological and clinical questions that are critical to improve cHL management.
Collapse
Affiliation(s)
| | - David Jucker
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Tanja Dietsche
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Valeria Perrina
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Alex Rufle
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Christian Ruiz
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Stefan Dirnhofer
- University Hospital Basel, Institute of Pathology, Basel, Switzerland
| | - Alexandar Tzankov
- University Hospital Basel, Institute of Pathology, Basel, Switzerland.
| |
Collapse
|
17
|
Grewal RK, Chetty M, Abayomi EA, Tomuleasa C, Fromm JR. Use of flow cytometry in the phenotypic diagnosis of hodgkin's lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:116-127. [PMID: 30350336 DOI: 10.1002/cyto.b.21724] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/18/2018] [Accepted: 06/26/2018] [Indexed: 12/22/2022]
Abstract
Hodgkin's lymphoma (HL) has a unique immunophenotype derived from immunohistochemistry (positive for CD15, CD30, and Pax-5; negative for CD3, CD20 in most cases, and CD45). The knowledge gained over recent years enables better diagnosis, prognosis, and treatment of HL. Flow cytometry as a tool for the diagnosis of classic HL has not been useful in the past due to the difficulty in isolating Reed-Sternberg cells as they are admixed in a rich inflammatory background which consists mainly of T cells, B cells, eosinophils, histiocytes, and plasma cells. However, in the recent past, several studies have tried to identify Reed-Sternberg cells using flow cytometry on fine needle aspiration or tissue biopsy of lymph nodes to confirm or supplement immunohistochemistry staining in diagnosis. Newer and more sensitive tools such as flow cytometry can be used for diagnosis, technology that may have been difficult in the past for diagnosis of this lymphoma subtype. Using flow cytometry, diagnosis is faster and could lead to point-of-care technology especially where we have typical immunophenotype signatures. © 2018 International Clinical Cytometry Society.
Collapse
Affiliation(s)
- Ravnit-Kaur Grewal
- MBCHB South African National Bioinformatics Institute, University of the Western Cape, Bellville, South Africa
| | - Manogari Chetty
- Department of Oral and Molecular Biology, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | | | - Ciprian Tomuleasa
- Department of Hematology/Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy-Ion Chiricuta Oncology Institute, Cluj Napoca, Romania
| | - Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
18
|
Circulating Plasma Cells at the Time of Collection of Autologous PBSC for Transplant in Multiple Myeloma Patients is a Negative Prognostic Factor Even in the Age of Post-Transplant Maintenance Therapy. Biol Blood Marrow Transplant 2018; 24:1386-1391. [DOI: 10.1016/j.bbmt.2018.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/14/2018] [Indexed: 11/21/2022]
|
19
|
Mass cytometry of Hodgkin lymphoma reveals a CD4 + regulatory T-cell-rich and exhausted T-effector microenvironment. Blood 2018; 132:825-836. [PMID: 29880615 DOI: 10.1182/blood-2018-04-843714] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/02/2018] [Indexed: 12/12/2022] Open
Abstract
In classical Hodgkin lymphoma (cHL), the host antitumor immune response is ineffective. Hodgkin Reed-Sternberg (HRS) cells have multifaceted mechanisms to evade the immune system, including 9p24.1/CD274(PD-L1)/PDCD1LG2(PD-L2) genetic alterations, overexpression of PD-1 ligands, and associated T-cell exhaustion and additional structural bases of aberrant antigen presentation. The clinical success of PD-1 blockade in cHL suggests that the tumor microenvironment (TME) contains reversibly exhausted T effector cells (Teffs). However, durable responses are observed in patients with β2-microglobulin/major histocompatibility complex (MHC) class I loss on HRS cells, raising the possibility of non-CD8+ T cell-mediated mechanisms of efficacy of PD-1 blockade. These observations highlight the need for a detailed analysis of the cHL TME. Using a customized time-of-flight mass cytometry panel, we simultaneously assessed cell suspensions from diagnostic cHL biopsies and control reactive lymph node/tonsil (RLNT) samples. Precise phenotyping of immune cell subsets revealed salient differences between cHLs and RLNTs. The TME in cHL is CD4+ T-cell rich, with frequent loss of MHC class I expression on HRS cells. In cHLs, we found concomitant expansion of T helper 1 (Th1)-polarized Teffs and regulatory T cells (Tregs). The cHL Th1 Tregs expressed little or no PD-1, whereas the Th1 Teffs were PD-1+ The differential PD-1 expression and likely functional Th1-polarized CD4+ Tregs and exhausted Teffs may represent complementary mechanisms of immunosuppression in cHL.
Collapse
|
20
|
Cherian S, Fromm JR. Evaluation of primary mediastinal large B cell lymphoma by flow cytometry. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:459-467. [DOI: 10.1002/cyto.b.21544] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/17/2017] [Accepted: 07/18/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Sindhu Cherian
- Department of Laboratory Medicine; University of Washington; Seattle Washington
| | - Jonathan R. Fromm
- Department of Laboratory Medicine; University of Washington; Seattle Washington
| |
Collapse
|
21
|
Grange B, Callet-Bauchu E, Salles G, Sujobert P. Advances in the role of cytogenetic analysis in the molecular diagnosis of B-cell lymphomas. Expert Rev Mol Diagn 2017; 17:623-632. [DOI: 10.1080/14737159.2017.1327811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
22
|
Fromm JR, Thomas A, Wood BL. Characterization and Purification of Neoplastic Cells of Nodular Lymphocyte Predominant Hodgkin Lymphoma from Lymph Nodes by Flow Cytometry and Flow Cytometric Cell Sorting. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 187:304-317. [PMID: 27998726 DOI: 10.1016/j.ajpath.2016.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/16/2016] [Accepted: 10/18/2016] [Indexed: 11/28/2022]
Abstract
We report the flow cytometric (FC) identification and characterization of lymphocyte predominant (LP) cells from tissues involved by nodular lymphocyte predominant Hodgkin lymphoma (NLPHL). First, we immunophenotyped the NLPHL cell line (DEV) confirming a germinal center immunophenotype, lack of expression of CD32 and CD58, and expression of CD54. Nineteen of 26 lymph nodes involved by NLPHL demonstrated a population with an LP immunophenotype (73%), which included expression of germinal center markers (CD75/Bcl-6-positive, CD32-weak/negative without CD10), a B-cell immunophenotype (CD19/CD20/CD40+), IgD and/or IgM expression (67%), and lack of programmed death-ligand 1/ligand 2. The LP cells demonstrated an adhesion macromolecule expression pattern distinct from Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma (CHL) (uniform CD50 and variable CD58 for NLPHL; minimal CD50, bright CD58 expression for CHL). A two-tube consensus assay identified LP cells in all seven NLPHL cases examined and only one non-NLPHL case (94 cases evaluated). Finally, FC cell sorting studies confirm that FC-defined populations have an LP cytomorphology. Taken together, these findings demonstrate a two-tube consensus assay can be used to immunophenotype NLHPL with high specificity and sensitivity and rapidly purify LP cells for genetic studies. This study also confirms aneuploidy in LP cells, provides antigens that may be helpful in distinguishing NLPHL from CHL, and suggests that T cells interact less avidly with LP cells than with Hodgkin and Reed-Sternberg cells.
Collapse
Affiliation(s)
- Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, Washington.
| | | | - Brent L Wood
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| |
Collapse
|
23
|
Rengstl B, Schmid F, Weiser C, Döring C, Heinrich T, Warner K, Becker PSA, Wistinghausen R, Kameh-Var S, Werling E, Billmeier A, Seidl C, Hartmann S, Abken H, Küppers R, Hansmann ML, Newrzela S. Tumor-infiltrating HLA-matched CD4(+) T cells retargeted against Hodgkin and Reed-Sternberg cells. Oncoimmunology 2016; 5:e1160186. [PMID: 27471632 DOI: 10.1080/2162402x.2016.1160186] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/18/2016] [Accepted: 02/25/2016] [Indexed: 10/22/2022] Open
Abstract
Hodgkin lymphoma (HL) presents with a unique histologic pattern. Pathognomonic Hodgkin and Reed-Sternberg (HRS) cells usually account for less than 1% of the tumor and are embedded in a reactive infiltrate mainly comprised of CD4(+) T cells. HRS cells induce an immunosuppressive microenvironment and thereby escape antitumor immunity. To investigate the impact of interactions between HRS cells and T cells, we performed long-term co-culture studies that were further translated into a xenograft model. Surprisingly, we revealed a strong antitumor potential of allogeneic CD4(+) T cells against HL cell lines. HRS and CD4(+) T cells interact by adhesion complexes similar to immunological synapses. Tumor-cell killing was likely based on the recognition of allogeneic major histocompatibility complex class II (MHC-II) receptor, while CD4(+) T cells from MHC-II compatible donors did not develop any antitumor potential in case of HL cell line L428. However, gene expression profiling (GEP) of co-cultured HRS cells as well as tumor infiltration of matched CD4(+) T cells indicated cellular interactions. Moreover, matched CD4(+) T cells could be activated to kill CD30(+) HRS cells when redirected with a CD30-specific chimeric antigen receptor. Our work gives novel insights into the crosstalk between HRS and CD4(+) T cells, suggesting the latter as potent effector cells in the adoptive cell therapy of HL.
Collapse
Affiliation(s)
- Benjamin Rengstl
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Frederike Schmid
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Christian Weiser
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Claudia Döring
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Tim Heinrich
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Kathrin Warner
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School, Frankfurt am Main, Germany; Center for Molecular Medicine Cologne, University of Cologne, and Department I of Internal Medicine, University Hospital Cologne, Cologne, Germany
| | - Petra S A Becker
- Institute for Transfusion Medicine and Immunohematology, Red Cross Blood Donor Service , Baden-Württemberg-Hessen, Frankfurt, Germany
| | - Robin Wistinghausen
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Sima Kameh-Var
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Eva Werling
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Arne Billmeier
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Christian Seidl
- Institute for Transfusion Medicine and Immunohematology, Red Cross Blood Donor Service , Baden-Württemberg-Hessen, Frankfurt, Germany
| | - Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Hinrich Abken
- Center for Molecular Medicine Cologne, University of Cologne, and Department I of Internal Medicine, University Hospital Cologne , Cologne, Germany
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School , Essen, Germany
| | - Martin-Leo Hansmann
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| | - Sebastian Newrzela
- Dr. Senckenberg Institute of Pathology, Goethe-University of Frankfurt, Medical School , Frankfurt am Main, Germany
| |
Collapse
|
24
|
Cowan AJ, Stevenson PA, Cassaday RD, Graf SA, Fromm JR, Wu D, Holmberg LA, Till BG, Chauncey TR, Smith SD, Philip M, Orozco JJ, Shustov AR, Green DJ, Libby EN, Bensinger WI, Shadman M, Maloney DG, Press OW, Gopal AK. Pretransplantation Minimal Residual Disease Predicts Survival in Patients with Mantle Cell Lymphoma Undergoing Autologous Stem Cell Transplantation in Complete Remission. Biol Blood Marrow Transplant 2016; 22:380-385. [PMID: 26348890 PMCID: PMC4716882 DOI: 10.1016/j.bbmt.2015.08.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/31/2015] [Indexed: 01/22/2023]
Abstract
Autologous stem cell transplantation (ASCT) is standard therapy for mantle cell lymphoma (MCL) in remission after induction chemotherapy, with the best results for patients in complete remission (CR). We hypothesized that evaluation of minimal residual disease (MRD) before ASCT could further stratify outcomes for these patients. Patients with MCL who underwent ASCT in clinical CR between 1996 and 2011 with pretransplantation MRD testing were eligible. Presence of a clonal IgH rearrangement, t(11; 14) by PCR or positive flow cytometry from blood or bone marrow, was considered positive. An adjusted proportional hazards model for associations with progression-free (PFS) and overall survival (OS) was performed. Of 75 MCL patients in CR, 8 (11%) were MRD positive. MRD positivity was associated with shorter OS and PFS. The median OS for MRD-negative patients was not reached, with 82% survival at 5 years, whereas for the MRD-positive patients, median OS was 3.01 years (hazard ratio [HR], 4.04; P = .009), with a median follow-up of 5.1 years. The median PFS for MRD-negative patients was not reached with 75% PFS at 5 years, whereas for MRD-positive patients, it was 2.38 years (HR, 3.69; P = .002). MRD positivity is independently associated with poor outcomes after ASCT for MCL patients in CR.
Collapse
Affiliation(s)
- Andrew J Cowan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Philip A Stevenson
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Ryan D Cassaday
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Solomon A Graf
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Jonathan R Fromm
- Marrow Transplant Unit, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - David Wu
- Marrow Transplant Unit, Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Leona A Holmberg
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Brian G Till
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Thomas R Chauncey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington; VA Puget Sound Health Care System, Seattle, Washington
| | - Stephen D Smith
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Mary Philip
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Johnnie J Orozco
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Andrei R Shustov
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Damian J Green
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Edward N Libby
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington
| | - William I Bensinger
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Mazyar Shadman
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - David G Maloney
- Transplantation Biology Department, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Oliver W Press
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
| | - Ajay K Gopal
- Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington.
| |
Collapse
|
25
|
Salipante SJ, Adey A, Thomas A, Lee C, Liu YJ, Kumar A, Lewis AP, Wu D, Fromm JR, Shendure J. Recurrent somatic loss of TNFRSF14 in classical Hodgkin lymphoma. Genes Chromosomes Cancer 2015; 55:278-87. [PMID: 26650888 DOI: 10.1002/gcc.22331] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 12/21/2022] Open
Abstract
Investigation of the genetic lesions underlying classical Hodgkin lymphoma (CHL) has been challenging due to the rarity of Hodgkin and Reed-Sternberg (HRS) cells, the pathognomonic neoplastic cells of CHL. In an effort to catalog more comprehensively recurrent copy number alterations occurring during oncogenesis, we investigated somatic alterations involved in CHL using whole-genome sequencing-mediated copy number analysis of purified HRS cells. We performed low-coverage sequencing of small numbers of intact HRS cells and paired non-neoplastic B lymphocytes isolated by flow cytometric cell sorting from 19 primary cases, as well as two commonly used HRS-derived cell lines (KM-H2 and L1236). We found that HRS cells contain strikingly fewer copy number abnormalities than CHL cell lines. A subset of cases displayed nonintegral chromosomal copy number states, suggesting internal heterogeneity within the HRS cell population. Recurrent somatic copy number alterations involving known factors in CHL pathogenesis were identified (REL, the PD-1 pathway, and TNFAIP3). In eight cases (42%) we observed recurrent copy number loss of chr1:2,352,236-4,574,271, a region containing the candidate tumor suppressor TNFRSF14. Using flow cytometry, we demonstrated reduced TNFRSF14 expression in HRS cells from 5 of 22 additional cases (23%) and in two of three CHL cell lines. These studies suggest that TNFRSF14 dysregulation may contribute to the pathobiology of CHL in a subset of cases.
Collapse
Affiliation(s)
| | - Andrew Adey
- Department of Genome Sciences, University of Washington, Seattle, WA
| | - Anju Thomas
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Choli Lee
- Department of Genome Sciences, University of Washington, Seattle, WA
| | - Yajuan J Liu
- Department of Pathology, University of Washington, Seattle, WA
| | - Akash Kumar
- Department of Genome Sciences, University of Washington, Seattle, WA
| | - Alexandra P Lewis
- Department of Genome Sciences, University of Washington, Seattle, WA
| | - David Wu
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Jay Shendure
- Department of Genome Sciences, University of Washington, Seattle, WA
| |
Collapse
|
26
|
Ng DP, Wu D, Wood BL, Fromm JR. Computer-aided detection of rare tumor populations in flow cytometry: an example with classic Hodgkin lymphoma. Am J Clin Pathol 2015; 144:517-24. [PMID: 26276783 DOI: 10.1309/ajcpy8e2lyhcgufp] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Diagnosing classical Hodgkin lymphoma (cHL) by flow cytometry (FC) relies on an observer gating rare populations of Hodgkin/Reed Sternberg (HRS) cells. Here, we apply machine-learning methods to aid in the detection of rare tumor cell populations using data derived from clinical FC analysis of cHL as a model disease. METHODS FC data from 144 clinical cases using a nine-color FC reagent panel were analyzed using Python 2.7 and the "scikit-learn" module. RESULTS Seventy-eight 50 × 50 two-dimensional histograms were generated from routine FC data and a reciprocal power function applied to favor rare events. Data were classified by support vector machine (SVM), gradient boosting, and random forest classifiers. All three classifiers showed no statistical difference in performance, with 89%-92% accuracy on cross-validation. Nearly all classifiers misclassified the same set of cases, with more false-positive than false-negative cases. Dimensionality reduction by ensemble methods selected for data points in a CD5+/ CD40+/CD64- region. CONCLUSIONS All classifiers provide probabilistic confidences for each result, and diagnostic cutoffs can be chosen to minimize false negatives and serve as a screening tool. Computational exclusion of manually gated HRS cells had little impact on the overall performance of selected support vectors in SVM or dimensionality reduction, suggesting that features of the immune response in cHL may dictate the method accuracy. We hypothesize there are distinct inflammatory cells that suggest cHL.
Collapse
Affiliation(s)
- David P. Ng
- Department of Laboratory Medicine, University of Washington, Seattle
| | - David Wu
- Department of Laboratory Medicine, University of Washington, Seattle
| | - Brent L. Wood
- Department of Laboratory Medicine, University of Washington, Seattle
| | - Jonathan R. Fromm
- Department of Laboratory Medicine, University of Washington, Seattle
| |
Collapse
|
27
|
Wein F, Küppers R. The role of T cells in the microenvironment of Hodgkin lymphoma. J Leukoc Biol 2015; 99:45-50. [PMID: 26320264 DOI: 10.1189/jlb.3mr0315-136r] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/15/2015] [Indexed: 12/23/2022] Open
Abstract
The cellular microenvironment in HL is dominated by a mixed infiltrate of inflammatory cells with typically only 1 or a few percent of HRS tumor cells. HRS cells orchestrate this infiltrate by the secretion of a multitude of chemokines. T cells are usually the largest population of cells in the HL tissue, encompassing Th cells, T(regs), and CTLs. Th cells and T(regs) presumably provide essential survival signals for the HRS cells, and the T(regs) also play an important role in rescuing HRS cells from an attack by CTLs and NK cells. The interference with this complex interplay of HRS cells with other immune cells in the microenvironment may provide novel strategies for targeted immunotherapies.
Collapse
Affiliation(s)
- Frederik Wein
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
28
|
Schneider M, Schneider S, Zühlke-Jenisch R, Klapper W, Sundström C, Hartmann S, Hansmann ML, Siebert R, Küppers R, Giefing M. Alterations of theCD58gene in classical Hodgkin lymphoma. Genes Chromosomes Cancer 2015; 54:638-45. [DOI: 10.1002/gcc.22276] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 01/15/2023] Open
Affiliation(s)
- Markus Schneider
- Faculty of Medicine, Institute of Cell Biology (Cancer Research), University of Duisburg-Essen; Essen Germany
| | - Stefanie Schneider
- Faculty of Medicine, Institute of Cell Biology (Cancer Research), University of Duisburg-Essen; Essen Germany
| | - Reina Zühlke-Jenisch
- Institute of Human Genetics, Christian-Albrechts University Kiel & University Hospital Schleswig-Holstein, Campus Kiel; Kiel Germany
| | - Wolfram Klapper
- Department of Pathology; Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Campus Kiel/Christian-Albrechts-University Kiel; Kiel Germany
| | - Christer Sundström
- Department of Immunology; Genetics and Pathology, Uppsala University Hospital; Uppsala Sweden
| | - Sylvia Hartmann
- Senckenberg Institute of Pathology, University of Frankfurt, Medical School; Frankfurt Germany
| | - Martin-Leo Hansmann
- Senckenberg Institute of Pathology, University of Frankfurt, Medical School; Frankfurt Germany
| | - Reiner Siebert
- Institute of Human Genetics, Christian-Albrechts University Kiel & University Hospital Schleswig-Holstein, Campus Kiel; Kiel Germany
| | - Ralf Küppers
- Faculty of Medicine, Institute of Cell Biology (Cancer Research), University of Duisburg-Essen; Essen Germany
| | - Maciej Giefing
- Institute of Human Genetics, Christian-Albrechts University Kiel & University Hospital Schleswig-Holstein, Campus Kiel; Kiel Germany
- Institute of Human Genetics, Polish Academy of Sciences; Poznan Poland
- Department of Otolaryngology; Head and Neck Surgery; Poznan University of Medical Sciences; Poznan Poland
| |
Collapse
|
29
|
Wu D, Thomas A, Fromm JR. Reactive T cells by flow cytometry distinguish Hodgkin lymphomas from T cell/histiocyte-rich large B cell lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:424-32. [DOI: 10.1002/cyto.b.21261] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/21/2015] [Accepted: 06/02/2015] [Indexed: 11/07/2022]
Affiliation(s)
- David Wu
- Department of Laboratory Medicine; University of Washington; Seattle Washington 98109
| | - Anju Thomas
- Department of Laboratory Medicine; University of Washington; Seattle Washington 98109
| | - Jonathan R. Fromm
- Department of Laboratory Medicine; University of Washington; Seattle Washington 98109
| |
Collapse
|
30
|
Separating the wheat from the chaff in cHL. Blood 2015; 125:1051-2. [PMID: 25678431 DOI: 10.1182/blood-2014-12-617555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
31
|
Flow sorting and exome sequencing reveal the oncogenome of primary Hodgkin and Reed-Sternberg cells. Blood 2014; 125:1061-72. [PMID: 25488972 DOI: 10.1182/blood-2014-11-610436] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Classical Hodgkin lymphoma (cHL) is characterized by sparsely distributed Hodgkin and Reed-Sternberg (HRS) cells amid reactive host background, complicating the acquisition of neoplastic DNA without extensive background contamination. We overcame this limitation by using flow-sorted HRS and intratumor T cells and optimized low-input exome sequencing of 10 patient samples to reveal alterations in genes involved in antigen presentation, chromosome integrity, transcriptional regulation, and ubiquitination. β-2-microglobulin (B2M) is the most commonly altered gene in HRS cells, with 7 of 10 cases having inactivating mutations that lead to loss of major histocompatibility complex class I (MHC-I) expression. Enforced wild-type B2M expression in a cHL cell line restored MHC-I expression. In an extended cohort of 145 patients, the absence of B2M protein in the HRS cells was associated with lower stage of disease, younger age at diagnosis, and better overall and progression-free survival. B2M-deficient cases encompassed most of the nodular sclerosis subtype cases and only a minority of mixed cellularity cases, suggesting that B2M deficiency determines the tumor microenvironment and may define a major subset of cHL that has more uniform clinical and morphologic features. In addition, we report previously unknown genetic alterations that may render selected patients sensitive to specific targeted therapies.
Collapse
|
32
|
Flow cytometry of ALK-negative anaplastic large cell lymphoma of breast implant-associated effusion and capsular tissue. CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 88:58-63. [DOI: 10.1002/cyto.b.21178] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 06/06/2014] [Accepted: 06/24/2014] [Indexed: 11/07/2022]
|
33
|
Johansson U, Bloxham D, Couzens S, Jesson J, Morilla R, Erber W, Macey M. Guidelines on the use of multicolour flow cytometry in the diagnosis of haematological neoplasms. British Committee for Standards in Haematology. Br J Haematol 2014; 165:455-88. [PMID: 24620735 DOI: 10.1111/bjh.12789] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
34
|
Kongruttanachok N, Cayre YE, Knecht H, Mai S. Rapid Separation of Mononuclear Hodgkin from Multinuclear Reed-Sternberg Cells. ACTA ACUST UNITED AC 2014; 20:2-6. [DOI: 10.1532/lh96.12023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
35
|
Fromm JR, Wood BL. A six-color flow cytometry assay for immunophenotyping classical Hodgkin lymphoma in lymph nodes. Am J Clin Pathol 2014; 141:388-96. [PMID: 24515767 DOI: 10.1309/ajcp0q1svoxbhmam] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES We have recently demonstrated that classical Hodgkin lymphoma (CHL) can be immunophenotyped by flow cytometry (FC), thus obviating the need for immunohistochemistry in many cases. The previously described nine-color assay, however, cannot be used by laboratories that do not have access to a nine- or ten-color flow cytometer. Therefore, a six-color FC tube was designed employing the following combination: CD64-FITC/CD30-PE/CD40-PeCy5.5/CD20-PECy7/CD95-APC/CD3-APC-H7. METHODS To validate this assay, we analyzed 408 tissue specimens (including 55 CHL cases, 26 of which had been previously cryopreserved). Specimen inclusion criteria included the identification of an abnormal population by FC or (if no abnormal population was identified) greater than 50,000 viable events and specimen age less than 4 days. All FC studies were examined blinded to any clinical, laboratory, or histologic information. RESULTS The diagnostic sensitivity and specificity of the six-color FC assay was 85.4% and 99.7%, respectively. CONCLUSIONS Taken together, these results suggest that the six-color FC assay has acceptable sensitivity and specificity for clinical use, allowing more FC laboratories to immunophenotype CHL by this method.
Collapse
Affiliation(s)
- Jonathan R. Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Brent L. Wood
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| |
Collapse
|
36
|
Parekh P, Kamble S, Zhao N, Zeng Z, Wen J, Yuan B, Zu Y. Biostable ssDNA aptamers specific for Hodgkin lymphoma. SENSORS (BASEL, SWITZERLAND) 2013; 13:14543-57. [PMID: 24233078 PMCID: PMC3871109 DOI: 10.3390/s131114543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 02/07/2023]
Abstract
As a "chemical antibody", oligonucleotide aptamers can specifically bind to their target molecules. However, clinical potential of aptamers in disease diagnosis is not yet fully explored. Using a tumor cell-based selection protocol, we developed single-stranded DNA aptamers for Hodgkin lymphoma (HL) tumor cells. The aptamers specifically bound to HL cells with a high affinity, reaching maximal cell binding at 10 nM final concentration. Importantly, the aptamers were able to selectively detect HL cells and did not react to other tumor or blood cells in mixed samples, indicating that the aptamers can be used as a specific probe for in vitro analysis of HL cells. Moreover, due to the inherent properties of DNA, the aptamers were stable in human serum, suggesting potential for in vivo detection of HL tumor cells.
Collapse
Affiliation(s)
- Parag Parekh
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Sanchit Kamble
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Nianxi Zhao
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Zihua Zeng
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Jianguo Wen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Bin Yuan
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| | - Youli Zu
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, and Cancer Pathology Research Laboratory, Houston Methodist Research Institute, Houston, TX 77030, USA; E-Mails: (P.P.); (S.K.); (N.Z.); (Z.Z.); (J.W.); (B.Y.)
| |
Collapse
|
37
|
Barteneva NS, Ketman K, Fasler-Kan E, Potashnikova D, Vorobjev IA. Cell sorting in cancer research--diminishing degree of cell heterogeneity. Biochim Biophys Acta Rev Cancer 2013; 1836:105-22. [PMID: 23481260 DOI: 10.1016/j.bbcan.2013.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 12/18/2022]
Abstract
Increasing evidence of intratumor heterogeneity and its augmentation due to selective pressure of microenvironment and recent achievements in cancer therapeutics lead to the need to investigate and track the tumor subclonal structure. Cell sorting of heterogeneous subpopulations of tumor and tumor-associated cells has been a long established strategy in cancer research. Advancement in lasers, computer technology and optics has led to a new generation of flow cytometers and cell sorters capable of high-speed processing of single cell suspensions. Over the last several years cell sorting was used in combination with molecular biological methods, imaging and proteomics to characterize primary and metastatic cancer cell populations, minimal residual disease and single tumor cells. It was the principal method for identification and characterization of cancer stem cells. Analysis of single cancer cells may improve early detection of tumors, monitoring of circulating tumor cells, evaluation of intratumor heterogeneity and chemotherapeutic treatments. The aim of this review is to provide an overview of major cell sorting applications and approaches with new prospective developments such as microfluidics and microchip technologies.
Collapse
Affiliation(s)
- Natasha S Barteneva
- Program in Cellular and Molecular Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | |
Collapse
|
38
|
Abstract
Multiparametric flow cytometry is a powerful diagnostic tool that permits rapid assessment of cellular antigen expression to quickly provide immunophenotypic information suitable for disease classification. This chapter describes a general approach for the identification of abnormal lymphoid populations by flow cytometry, including B, T, and Hodgkin lymphoma cells suitable for the clinical and research environment. Knowledge of the common patterns of antigen expression of normal lymphoid cells is critical to permit identification of abnormal populations at disease presentation and for minimal residual disease assessment. We highlight an overview of procedures for processing and immunophenotyping non-Hodgkin B- and T-cell lymphomas and also describe our strategy for the sensitive and specific diagnosis of classical Hodgkin lymphoma.
Collapse
Affiliation(s)
- David Wu
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | | | | |
Collapse
|
39
|
Fromm JR, McEarchern JA, Kennedy D, Thomas A, Shustov AR, Gopal AK. Clinical binding properties, internalization kinetics, and clinicopathologic activity of brentuximab vedotin: an antibody-drug conjugate for CD30-positive lymphoid neoplasms. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2012; 12:280-3. [PMID: 22542449 DOI: 10.1016/j.clml.2012.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 01/26/2012] [Accepted: 01/30/2012] [Indexed: 11/19/2022]
Affiliation(s)
- Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195, USA.
| | | | | | | | | | | |
Collapse
|
40
|
Fromm JR, Wood BL. Strategies for immunophenotyping and purifying classical Hodgkin lymphoma cells from lymph nodes by flow cytometry and flow cytometric cell sorting. Methods 2012; 57:368-75. [PMID: 22487184 DOI: 10.1016/j.ymeth.2012.03.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 03/23/2012] [Accepted: 03/24/2012] [Indexed: 01/23/2023] Open
Abstract
Flow cytometry is an established technique to immunophenotype hematopoietic neoplasms. While the diagnosis of classical Hodgkin lymphoma (CHL) has commonly been made using paraffin sections, we have recently demonstrated that the neoplastic Hodgkin and Reed-Sternberg (HRS) cells of CHL can be identified by flow cytometry. Using 6- and 9-color flow cytometric assays, CHL can be immunophenotyped with 85-90% sensitivity and nearly 100% specificity. Analysis of this data requires using established gating strategies to help in the identification of putative HRS cell populations. Interestingly, HRS cells bind to reactive T cells (HRS-T cell rosetting) and this phenomenon can be identified and utilized diagnostically by flow cytometry. In addition, the reactive T cells of CHL show characteristic immunophenotypic changes by flow cytometry and these changes can suggest a diagnosis of CHL. Finally, these principles can be employed to rapidly purify HRS cells using flow cytometric cell sorting. This manuscript provides experimental protocols for immunophenotyping CHL by flow cytometry as well as purifying the HRS cells via flow cytometric cell sorting.
Collapse
Affiliation(s)
- Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington, Seattle 98195, USA.
| | | |
Collapse
|
41
|
Shen H, Tang Y, Xu X, Wang L, Wang Q, Xu W, Song H, Zhao Z, Wang J. Rapid detection of neoplastic cells in serous cavity effusions in children with flow cytometry immunophenotyping. Leuk Lymphoma 2012; 53:1509-14. [DOI: 10.3109/10428194.2012.661050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
42
|
Fromm JR, Savage E, Sabath DE, Wood BL, Syrbu S, Jensen C. Diagnostic usefulness of flow cytometry for immunophenotyping classical Hodgkin lymphoma. Am J Clin Pathol 2011; 136:157-8; author reply 158. [PMID: 21685044 DOI: 10.1309/ajcp45luyqsokrve] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
43
|
Olteanu H. Case study interpretation-Houston: Case 2. CYTOMETRY PART B-CLINICAL CYTOMETRY 2011; 80:258-60. [DOI: 10.1002/cyto.b.20598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
44
|
Diaz T, Navarro A, Ferrer G, Gel B, Gaya A, Artells R, Bellosillo B, Garcia-Garcia M, Serrano S, Martínez A, Monzo M. Lestaurtinib inhibition of the Jak/STAT signaling pathway in hodgkin lymphoma inhibits proliferation and induces apoptosis. PLoS One 2011; 6:e18856. [PMID: 21533094 PMCID: PMC3080386 DOI: 10.1371/journal.pone.0018856] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 03/22/2011] [Indexed: 11/23/2022] Open
Abstract
Standard cytotoxic chemotherapy for Hodgkin Lymphoma (HL) has changed little in 30 years; the treatment for patients with relapsed or refractory disease remains challenging and novel agents are under development. JAK/STAT constitutive activation plays an important role in the pathogenesis of HL. Lestaurtinib is an orally bioavailable multikinase inhibitor that has recently been shown to inhibit JAK2 in myeloproliferative disorders. The potential role of Lestaurtinib in HL therapy is unknown. We have analyzed the effect of Lestaurtinib treatment in five HL cell lines from refractory patients, L-428, L-1236, L-540, HDML-2 and HD-MY-Z. At 48 h, a dose-dependent cell growth inhibition (23%–66% at 300 nM) and apoptotic increment (10%–64% at 300 nM) were observed. Moreover, Lestaurtinib inhibited JAK2, STAT5 and STAT3 phosphorylation and reduced the mRNA expression of its downstream antiapoptotic target Bcl-xL. In addition, we have analyzed the effect of Lestaurtinib treatment in lymph nodes from four classic HL patients. We observed a decrease in cell viability at 24 hours of treatment in three patients (mean decrease of 27% at 300 nM). Our findings provide, for the first time, a molecular rationale for testing JAK2 inhibitors, specifically Lestaurtinib, in HL patients.
Collapse
Affiliation(s)
- Tania Diaz
- Human Anatomy Unit, Molecular Oncology and Embryology Laboratory, University of Barcelona Medical School, IDIBAPS, Barcelona, Spain
| | - Alfons Navarro
- Human Anatomy Unit, Molecular Oncology and Embryology Laboratory, University of Barcelona Medical School, IDIBAPS, Barcelona, Spain
- * E-mail:
| | - Gerardo Ferrer
- Institute of Hematology and Oncology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Bernat Gel
- Software Department, Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Anna Gaya
- Institute of Hematology and Oncology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Rosa Artells
- Human Anatomy Unit, Molecular Oncology and Embryology Laboratory, University of Barcelona Medical School, IDIBAPS, Barcelona, Spain
| | | | | | - Sergi Serrano
- Pathology Department, Hospital del Mar, Barcelona, Spain
| | - Antonio Martínez
- Hematopathology Section, Laboratory of Pathology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Mariano Monzo
- Human Anatomy Unit, Molecular Oncology and Embryology Laboratory, University of Barcelona Medical School, IDIBAPS, Barcelona, Spain
| |
Collapse
|
45
|
Chisholm C, Cockerell CJ. Functions and uses of immunohistochemical stains in cutaneous infiltrates of hematopoietic origin: a review for the practicing dermatologist. J Cutan Med Surg 2011; 15:65-83. [PMID: 21477554 DOI: 10.2310/7750.2011.10024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Immunohistochemical stains, particularly those for cutaneous lymphomas, have similar-sounding names, which may lead to confusion among dermatologists who are not well versed in the terminology of the tools used for pathologic diagnosis. Also aiding in this is the fact that some familiar stains are constantly investigated for novel utility in different tumors, and a plethora of new stains regularly emerge in the peer-reviewed literature. OBJECTIVE To review the major stains encountered in dermatopathologic reports for cutaneous lymphomas. A select number of other stains are reviewed that are either new and under investigation in several cutaneous processes or have a new use described in recent reports. METHODS The peer-reviewed literature was searched and analyzed for the accepted purposes of using these markers. RESULTS All pertinent findings for these immunostains are reported with the purpose of educating the dermatology community. CONCLUSION This review serves as a reference to clarify potentially confusing immunohistochemical stains.
Collapse
Affiliation(s)
- Cary Chisholm
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | |
Collapse
|
46
|
Fromm JR. Flow cytometric analysis of CD123 is useful for immunophenotyping classical Hodgkin lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 80:91-9. [PMID: 20809502 DOI: 10.1002/cyto.b.20561] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 07/21/2010] [Accepted: 07/28/2010] [Indexed: 11/06/2022]
Abstract
Although the diagnosis of classical Hodgkin lymphoma (CHL) is traditionally made morphologically in tissue sections, it is now possible to diagnose CHL by flow cytometry (FC). In an effort to identify additional antigens on Hodgkin and Reed-Sternberg (HRS) cells that might be useful for immunophenotyping this lymphoma by FC, we examined the expression of CD123 (α chain of the IL-3R) on HRS cells and compared this with the expression of CD123 in other lymph node samples (372 tissue specimens, including 98 reactive and 274 neoplastic cases), using a nine-color FC reagent combination including anti-CD123. CD123 was found to be expressed on the majority of HRS cell populations (59% of 59 CHL lymph nodes examined), rarely on B-cell non-Hodgkin lymphomas (NHLs) (3 of 3 hairy cell leukemia cases, 3 of 29 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) cases, 1 of 55 large B-cell lymphoma cases, but not on 95 other B-cell NHL examined), and in none of the 16 T-cell NHL cases examined. In reactive lymph nodes, CD123 expression was largely limited to plasmacytoid dendritic cells and rare histiocyte populations that can readily be distinguished from HRS populations. As the expression of this antigen is shown to be relatively limited in B- and T-NHL and in reactive lymph node populations, assessment of CD123 expression is useful for supporting the FC diagnosis of CHL.
Collapse
Affiliation(s)
- Jonathan R Fromm
- Department of Laboratory Medicine, University of Washington Medical Center, Seattle, Washington 98195, USA.
| |
Collapse
|
47
|
Shafer JA, Cruz CR, Leen AM, Ku S, Lu A, Rousseau A, Heslop HE, Rooney CM, Bollard CM, Foster AE. Antigen-specific cytotoxic T lymphocytes can target chemoresistant side-population tumor cells in Hodgkin lymphoma. Leuk Lymphoma 2010; 51:870-80. [PMID: 20367572 DOI: 10.3109/10428191003713968] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Side-population (SP) analysis has been used to identify progenitor cells from normal and malignant tissues as well as revealing tumor cells with increased resistance to radiation and chemotherapy. Despite enhanced chemoresistance, tumor SP cells may still express tumor-associated antigens (TAAs), which may render them susceptible to elimination by the immune system. In this study, we show that both Hodgkin lymphoma (HL) cell lines and primary HL tumor samples contain a distinct SP phenotype. Importantly, while these cells showed increased resistance to gemcitabine, a commonly used drug for the treatment of refractory HL, HL SP cells also expressed higher levels of the TAAs MAGEA4, SSX2, survivin, and NY-ESO-1, which allowed them to be specifically recognized and killed by TAA-specific cytotoxic T lymphocytes. This study suggests that chemoresistant HL SP cells can be targeted by the immune system, providing a rationale for combined chemotherapy and immunotherapy for the treatment of HL.
Collapse
Affiliation(s)
- Jessica A Shafer
- Center for Cell and Gene Therapy, Department of Pediatrics, Baylor College of Medicine, The Methodist Hospital and Texas Children's Cancer Center, Houston, TX 77030, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Fromm JR, Thomas A, Wood BL. Increased expression of T cell antigens on T cells in classical Hodgkin lymphoma. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 78:387-8. [DOI: 10.1002/cyto.b.20535] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
49
|
Flowcytometric immunophenotyping in the diagnosis of pediatric lymphoma: how reliable is it and how can we optimize its use? J Pediatr Hematol Oncol 2010; 32:298-303. [PMID: 20224437 DOI: 10.1097/mph.0b013e3181ca86f5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We aimed to evaluate the role of flowcytometric immunophenotyping (FCI) as an adjunct to histologic examination in pediatric lymphoma. We conducted a retrospective review of 39 fresh tissue samples and 2 pleural fluids submitted to the histopathology department with a clinical suspicion of lymphoma during a 4-year period, where FCI was performed. The FCI results were correlated with the final histologic diagnosis. The study comprised 38 lymphoid lesions and 3 nonlymphoid tumors. The concordance of FCI for all lesions was 71% and that for non-Hodgkin lymphoma was 75%. When Hodgkin lymphoma was excluded, the correlation was 93.1%. In 3 cases of nonhematologic tumors, FCI was useful in excluding a lymphoma. In one of them, FCI supported the diagnosis of neuroblastoma when CD81, CD9, GD2, and CD56 were added to the FCI panel. FCI produced rapid same-day results with a high sensitivity for benign lymphoid lesions and non-Hodgkin lymphoma. It was not helpful for Hodgkin lymphoma. Although the main application of FCI was to assess lymphoid lesions, it was also useful in the identification of nonlymphoid tumors, especially neuroblastoma. As the prevalence of lymphomas in children differ from that in adults, we believe that the algorithm proposed by us to triage specimens using imprint cytology can optimize the use of FCI in routine pediatric pathology practice.
Collapse
|
50
|
Affiliation(s)
- Ralf Küppers
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, D-45122, Essen, Germany.
| |
Collapse
|