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Muntañola A, Villalobos MT, González-Villambrosia S, Rodríguez-Salazar MJ, Jiménez-Ubieto A, Bastidas-Mora G, Córdoba R, Infante M, Vidal MJ, Díaz FJ, Baile M, Bastos-Oreiro M, Panizo C, Sancho JM, Navarro B, García T, Escoda L, Abrisqueta P, Terol MJ, de Campo R, Mozas P, López-Guillermo A, Salar A, Montalbán C. Low-risk HPLLs/ABC score patients with splenic marginal zone lymphoma can be safely managed without treatment: Results from a prospective Spanish study. Br J Haematol 2023; 202:776-784. [PMID: 37386877 DOI: 10.1111/bjh.18912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 07/01/2023]
Abstract
The aims of our study were to analyse compliance with the 2014 GELTAMO SMZL Guidelines, in patients with splenic marginal zone lymphoma (SMZL), and to evaluate the outcome according to the HPLLs/ABC-adapted therapeutic strategy. Observational prospective multicenter study of 181 SMZL patients diagnosed between 2014 and 2020. Lymphoma-specific survival (LSS), composite event-free survival (CEFS) and response rates were assessed. 57% of the 168 patients included in the analysis followed the Guidelines. The overall response rate was higher in the rituximab chemotherapy and in the rituximab arms compared with the splenectomy arm (p < 0.001). The 5-year overall survival was 77% and the 5-year LSS of 93%. There were no differences in the 5-year LSS according to the treatment received (p = 0.68). The 5-year CEFS in the overall series was 45%, and there were significant differences between scores A and B (p = 0.036). There were no significant differences when comparing LSS and progression-free survival in patients treated with rituximab or rituximab chemotherapy at diagnosis or after observation. Our data support HPLLs/ABC score as a practical tool for the management of SMZL, observation as the best approach for patients in group A and rituximab as the best treatment for group B.
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Affiliation(s)
- Ana Muntañola
- Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | | | | | | | | | | | - Raúl Córdoba
- Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria IIS-FDJ, Madrid, Spain
| | | | | | | | - Mónica Baile
- Complejo Asistencial Universitario de Salamanca/IBSAL, Salamanca, Spain
| | - Mariana Bastos-Oreiro
- Hospital Universitario Gregorio Marañón/Gregorio Marañón Health Institute (IiSGM), Madrid, Spain
| | | | - Juan Manuel Sancho
- ICO-Hospital Germans Trias i Pujol-ICO Badalona, Badalona, Barcelona, Spain
| | | | - Tomás García
- Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | | | | | | | | | - Pablo Mozas
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | - Carlos Montalbán
- Departamento de Patología e Investigación Traslacional, Fundación MD Anderson, Madrid, Spain
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Cabeçadas J, Nava VE, Ascensao JL, Gomes da Silva M. How to Diagnose and Treat CD5-Positive Lymphomas Involving the Spleen. Curr Oncol 2021; 28:4611-4633. [PMID: 34898558 PMCID: PMC8628806 DOI: 10.3390/curroncol28060390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022] Open
Abstract
Patients with CD5-expressing lymphomas presenting with splenomegaly are frequently diagnosed with chronic lymphocytic leukemia. The most important differential diagnosis is mantle cell lymphoma, both in its classical and leukemic, non-nodal forms, given its prognostic and therapeutic implications. Other small B-cell neoplasms that frequently involve the spleen and occasionally express CD5 include the splenic marginal zone lymphoma, hairy cell leukemia and, rarely, lymphoplasmacytic lymphoma. The frequency of CD5 positivity depends in part on the sensitivity of the detection methods employed. Usually, a combination of morphological, immunophenotypic and molecular findings allows for a precise sub-classification of CD5-positive, low-grade B-cell lymphomas of the spleen. Some of these tumors may display a mixture of small and larger B cells, raising the possibility of more aggressive lymphomas, such as diffuse large B-cell lymphomas (DLBCL). Approximately 5-10% of DLBCL are CD5-positive and some may manifest as primary splenic lesions. When available, the morphology of DLBCL in the splenic tissue is distinctive and a leukemic picture is very rare. In conclusion, the appropriate morphological and clinical context assisted by flow cytometry panels and/or immunohistochemistry allows the differential diagnosis of CD5-positive, non-Hodgkin, B-cell lymphomas involving the spleen.
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Affiliation(s)
- José Cabeçadas
- Department of Pathology, Portuguese Institute of Oncology Lisbon, 1099-023 Lisboa, Portugal;
| | - Victor E. Nava
- Department of Pathology, The George Washington University, Washington, DC 20037, USA;
- Department of Pathology, Veterans Health Administration Medical Center, Washington, DC 20422, USA
| | - Joao L. Ascensao
- School of Medicine, The George Washington University, Washington, DC 20037, USA;
| | - Maria Gomes da Silva
- Department of Hematology, Portuguese Institute of Oncology Lisbon, 1099-023 Lisboa, Portugal
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3
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Tarris G, de Rougemont A, Estienney MA, Journet J, Lariotte AC, Aubignat D, Rebibou JM, De La Vega MF, Legendre M, Belliot G, Martin L. Chronic kidney disease linked to SARS-CoV-2 infection: a case report. BMC Nephrol 2021; 22:278. [PMID: 34376184 PMCID: PMC8353426 DOI: 10.1186/s12882-021-02490-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/02/2021] [Indexed: 12/23/2022] Open
Abstract
Background The recent COVID-19 pandemic has raised concerns about patient diagnosis and follow-up of chronically ill patients. Patients suffering from chronic illnesses, concomitantly infected by SARS-CoV-2, globally tend to have a worse prognosis and poor outcomes. Renal tropism and acute kidney injury following SARS-CoV-2 infection has recently been described in the literature, with elevated mortality rates. Furthermore, patients with pre-existing chronic kidney disease, infected by SARS-CoV-2, should be monitored carefully. Here, we report the case of a 69-year-old patient with splenic marginal zone lymphoma, suffering from longstanding chronic kidney disease following SARS-CoV-2 infection. Case presentation A 69-year-old male patient previously diagnosed with pulmonary embolism and splenic marginal zone lymphoma (Splenomegaly, Matutes 2/5, CD5 negative and CD23 positive), was admitted to the hospital with shortness of breath, fever and asthenia. A nasopharyngeal swab test was performed in addition to a CT-scan, which confirmed SARS-CoV-2 infection. Blood creatinine increased following SARS-CoV-2 infection at 130 μmol/l, with usual values at 95 μmol/l. The patient was discharged at home with rest and symptomatic medical treatment (paracetamol and hydration), then readmitted to the hospital in August 2020. A kidney biopsy was therefore conducted as blood creatinine levels were abnormally elevated. Immunodetection performed in a renal biopsy specimen confirmed co-localization of SARS-CoV2 nucleocapsid and protease 3C proteins with ACE2, Lewis x and sialyl-Lewis x antigens in proximal convoluted tubules and podocytes. Co-localization of structural and non-structural viral proteins clearly demonstrated viral replication in proximal convoluted tubules in this chronically ill patient. Additionally, we observed the co-localization of sialyl-Lewis x and ACE2 receptors in the same proximal convoluted tubules. Reverse Transcriptase-Polymerase Chain Reaction test performed on the kidney biopsy was negative, with very low Ct levels (above 40). The patient was finally readmitted to the haematology department for initiation of chemotherapy, including CHOP protocol and Rituximab. Conclusions Our case emphasizes on the importance of monitoring kidney function in immunosuppressed patients and patients suffering from cancer following SARS-CoV-2 infection, through histological screening. Further studies will be required to decipher the mechanisms underlying chronic kidney disease and the putative role of sialyl-Lewis x and HBGA during SARS-CoV-2 infection. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02490-z.
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Affiliation(s)
- Georges Tarris
- Department of Pathology, University Hospital of Dijon, F-21000, Dijon, France. .,National Reference Centre for Gastroenteritis Viruses, Laboratory of Virology, University Hospital of Dijon, F-21000, Dijon, France.
| | - Alexis de Rougemont
- National Reference Centre for Gastroenteritis Viruses, Laboratory of Virology, University Hospital of Dijon, F-21000, Dijon, France
| | - Marie-Anaïs Estienney
- National Reference Centre for Gastroenteritis Viruses, Laboratory of Virology, University Hospital of Dijon, F-21000, Dijon, France
| | - Julien Journet
- Department of Nephrology, William Morey Hospital, F-71100, Chalon-sur-Saône, France
| | | | - Damien Aubignat
- Department of Pathology, University Hospital of Dijon, F-21000, Dijon, France
| | - Jean-Michel Rebibou
- Department of Nephrology, University Hospital of Dijon, F-21000, Dijon, France
| | | | - Mathieu Legendre
- Department of Nephrology, University Hospital of Dijon, F-21000, Dijon, France
| | - Gael Belliot
- National Reference Centre for Gastroenteritis Viruses, Laboratory of Virology, University Hospital of Dijon, F-21000, Dijon, France
| | - Laurent Martin
- Department of Pathology, University Hospital of Dijon, F-21000, Dijon, France
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Complex karyotype involving six chromosomes, with one dicentric and three yet unreported acquired chromosomal aberrations in a case of splenic marginal zone lymphoma. GENE REPORTS 2017. [DOI: 10.1016/j.genrep.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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5
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Miao Y, Cao L, Sun Q, Li XT, Wang Y, Qiao C, Wang L, Wang R, Qiu HR, Xu W, Li JY, Wu YJ, Fan L. Spectrum and immunophenotyping of 653 patients with B-cell chronic lymphoproliferative disorders in China: A single-centre analysis. Hematol Oncol 2017; 36:121-127. [PMID: 28752619 DOI: 10.1002/hon.2461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 05/05/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Yi Miao
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Lei Cao
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Qian Sun
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Xiao-Tong Li
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Yan Wang
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Chun Qiao
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Li Wang
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Rong Wang
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Hai-Rong Qiu
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Wei Xu
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Jian-Yong Li
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
- Collaborative Innovation Center for Cancer Personalized Medicine; Nanjing Medical University; Nanjing China
| | - Yu-Jie Wu
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
| | - Lei Fan
- Department of Hematology, First Affiliated Hospital of Nanjing Medical University; Jiangsu Province Hospital; Nanjing China
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6
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Pata G, Bartoli M, Damiani E, Solari S, Anastasia A, Pagani C, Tucci A. Still a role for surgery as first-line therapy of splenic marginal zone lymphoma? Results of a prospective observational study. Int J Surg 2017; 41:143-149. [DOI: 10.1016/j.ijsu.2017.03.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/13/2017] [Accepted: 03/28/2017] [Indexed: 02/07/2023]
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7
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Splenic marginal zone lymphoma: a literature review of diagnostic and therapeutic challenges. Rev Bras Hematol Hemoter 2016; 39:146-154. [PMID: 28577652 PMCID: PMC5457460 DOI: 10.1016/j.bjhh.2016.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/26/2016] [Accepted: 09/09/2016] [Indexed: 12/11/2022] Open
Abstract
Splenic marginal zone lymphoma (SMZL) is a low-grade B-cell non-Hodgkin's lymphoma characterized by massive splenomegaly, moderate lymphocytosis with or without villous lymphocytes, rare involvement of peripheral lymph nodes and indolent clinical course. As a rare disease, with no randomized prospective trials, there is no standard of care for SMZL so far. Splenectomy has been done for many years as an attempt to control disease, but nowadays it has not been encouraged as first line because of new advances in therapy as rituximab, that are as effective with minimal toxicity. Facing these controversies, this review highlights advances in the literature regarding diagnosis, prognostic factors, treatment indications and therapeutic options.
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8
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Abstract
B-cell non-Hodgkin lymphomas with plasmacytic differentiation are a diverse group of entities with extremely variable morphologic features. Diagnostic challenges can arise in differentiating lymphoplasmacytic lymphoma from marginal zone lymphoma and other low-grade B-cell lymphomas. In addition, plasmablastic lymphomas can be difficult to distinguish from diffuse large B-cell lymphoma or other high-grade lymphomas. Judicious use of immunohistochemical studies and molecular testing can assist in appropriate classification.
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MESH Headings
- Diagnosis, Differential
- Humans
- Immunophenotyping
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/immunology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Plasmacytoma/diagnosis
- Plasmacytoma/immunology
- Plasmacytoma/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Prognosis
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/immunology
- Waldenstrom Macroglobulinemia/pathology
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Affiliation(s)
- Charles M Harmon
- Department of Pathology, University of Michigan Hospitals and Health Systems, 1301 Catherine Street, Ann Arbor, MI 48109, USA
| | - Lauren B Smith
- Department of Pathology, University of Michigan Hospitals and Health Systems, 5320 Medical Science I, 1301 Catherine Street, Ann Arbor, MI 48109-5602, USA.
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9
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Shi F, Zhou Q, Gao Y, Cui XQ, Chang H. Primary splenic B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma: A case report. Oncol Lett 2016; 12:1925-1928. [PMID: 27602118 DOI: 10.3892/ol.2016.4840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/15/2016] [Indexed: 02/06/2023] Open
Abstract
B-cell lymphoma (BCL), unclassifiable, with features intermediate between diffuse large BCL (DLBCL) and classical Hodgkin's lymphoma (CHL), is a novel entity to the World Health Organization classification system. These tumors are rare aggressive lymphomas that have a poor prognosis. The present study reports the case of a patient with one such lymphoma that occurred in the spleen, which expressed cluster of differentiation (CD)20, CD79α, melanoma associated antigen (mutated) 1, BCL6, CD15 and CD30. Polymerase chain reaction analysis demonstrated a clonal rearrangement of the genes coding for immunoglobulin heavy chains. The tumor cells demonstrated a negative reaction in the Epstein-Barr virus-encoded small RNA assay. Following the diagnosis of unclassifiable BCL, with intermediate features between DLBCL and CHL, the patient received 7 cycles of the CHOP regimen, and so far, has been in good general condition and tumor-free for 17 months.
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Affiliation(s)
- Feng Shi
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
| | - Quan Zhou
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
| | - Ying Gao
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
| | - Xiang-Qing Cui
- Department of Pathology, Pu Ren Hospital, Beijing 100062, P.R. China
| | - Hong Chang
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China
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10
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Srikumar T, Markow M, Centeno B, Hoffe S, Tao J, Fernandez H, Strosberg J, Shibata D. Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. ACTA ACUST UNITED AC 2016; 23:e70-4. [PMID: 26966416 DOI: 10.3747/co.23.2711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Synchronous cancers of different primary origin are rare. Here, we describe the case of a patient with concomitant diagnoses of rectal adenocarcinoma and splenic marginal zone lymphoma (smzl). A 57-year-old woman initially presented with abdominal pain. Physical examination and computed tomography demonstrated massive splenomegaly, and a complete blood count revealed microcytic anemia and lymphopenia. During the subsequent evaluation, she presented with hematochezia, melena, and constipation, which prompted gastroenterology referral. Subsequent endoscopic rectal ultrasonography revealed a T3N1 moderately differentiated rectal adenocarcinoma, with computed tomography imaging of chest, abdomen, and pelvis confirming no metastasis. Thus, the cancer was classified as clinical stage T3N1M0, stage iii. Bone marrow biopsy confirmed co-existing marginal zone lymphoma, and with the clinical presentation of massive splenomegaly, a diagnosis of smzl was made. The patient's management was individually tailored for simultaneous optimal treatment of both conditions. Concurrent treatment with neoadjuvant rituximab and 5-fluorouracil chemotherapy, with external-beam radiation therapy to the pelvis, was administered, followed by surgery consisting of en bloc splenectomy and distal pancreatectomy, and low anterior resection. The patient completed a standard course of adjuvant folfox (fluorouracil-leucovorin-oxaliplatin) chemotherapy and has remained disease-free for 7 years. To our knowledge, this report is the first to specifically describe simultaneous diagnoses of locally advanced rectal cancer and smzl. We also describe the successful combined neoadjuvant treatment combination of 5-fluorouracil, rituximab, and pelvic radiation.
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Affiliation(s)
- T Srikumar
- Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A.;; Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - M Markow
- Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A.;; Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - B Centeno
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - S Hoffe
- Department of Radiation Oncology and Therapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - J Tao
- Department of Hematopathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - H Fernandez
- Department of Blood and Marrow Transplant, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - J Strosberg
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - D Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, U.S.A
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11
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Fonte E, Agathangelidis A, Reverberi D, Ntoufa S, Scarfò L, Ranghetti P, Cutrona G, Tedeschi A, Xochelli A, Caligaris-Cappio F, Ponzoni M, Belessi C, Davis Z, Piris MA, Oscier D, Ghia P, Stamatopoulos K, Muzio M. Toll-like receptor stimulation in splenic marginal zone lymphoma can modulate cell signaling, activation and proliferation. Haematologica 2015; 100:1460-8. [PMID: 26294727 DOI: 10.3324/haematol.2014.119933] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 08/14/2015] [Indexed: 11/09/2022] Open
Abstract
Recent studies on splenic marginal zone lymphoma identified distinct mutations in genes belonging to the B-cell receptor and Toll-like receptor signaling pathways, thus pointing to their potential implication in the biology of the disease. However, limited data is available regarding the exact role of TLRs. We aimed at characterizing the expression pattern of TLRs in splenic marginal zone lymphoma cells and their functional impact on the activation, proliferation and viability of malignant cells in vitro. Cells expressed significant levels of TLR1, TLR6, TLR7, TLR8, TLR9 and TLR10 mRNA; TLR2 and TLR4 showed a low, variable pattern of expression among patients whereas TLR3 and TLR5 mRNAs were undetectable; mRNA specific for TLR signaling molecules and adapters was also expressed. At the protein level, TLR1, TLR6, TLR7, TLR9 and TLR10 were detected. Stimulation of TLR1/2, TLR2/6 and TLR9 with their respective ligands triggered the activation of IRAK kinases, MAPK and NF-κB signaling pathways, and the induction of CD86 and CD25 activation molecules, although in a heterogeneous manner among different patient samples. TLR-induced activation and cell viability were also inhibited by a specific IRAK1/4 inhibitor, thus strongly supporting the specific role of TLR signaling in these processes. Furthermore, TLR2/6 and TLR9 stimulation also significantly increased cell proliferation. In conclusion, we demonstrate that splenic marginal zone lymphoma cells are equipped with functional TLR and signaling molecules and that the stimulation of TLR1/2, TLR2/6 and TLR9 may play a role in regulating disease pathobiology, likely promoting the expansion of the neoplastic clone.
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Affiliation(s)
- Eleonora Fonte
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy Università degli studi di Pavia, Italy
| | - Andreas Agathangelidis
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Daniele Reverberi
- UOC Patologia Molecolare, IRCCS AOU S. Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Stavroula Ntoufa
- Institute of Applied Biosciences, Centre For Research and Technology Hellas, Thessaloniki, Greece
| | - Lydia Scarfò
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy Department of Onco-Hematology, San Raffaele Hospital, Milano, Italy Università Vita-Salute San Raffaele, Milano, Italy
| | - Pamela Ranghetti
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Giovanna Cutrona
- UOC Patologia Molecolare, IRCCS AOU S. Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | | | - Aliki Xochelli
- Institute of Applied Biosciences, Centre For Research and Technology Hellas, Thessaloniki, Greece
| | - Federico Caligaris-Cappio
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy Department of Onco-Hematology, San Raffaele Hospital, Milano, Italy Università Vita-Salute San Raffaele, Milano, Italy
| | - Maurilio Ponzoni
- Department of Onco-Hematology, San Raffaele Hospital, Milano, Italy
| | | | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, UK
| | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla and Instituto de Formación e Investigación Marqués de Valdecilla, Santander, Spain
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, UK
| | - Paolo Ghia
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy Department of Onco-Hematology, San Raffaele Hospital, Milano, Italy Università Vita-Salute San Raffaele, Milano, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre For Research and Technology Hellas, Thessaloniki, Greece Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - Marta Muzio
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy
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12
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Li Z, Li F, Yi S, Gu Z, Yu Z, Xu Y, Feng X, Liu W, Zou D, Qi J, Zhan F, Qiu L. Superior efficacy of rituximab-based chemoimmunotherapy as an initial therapy in newly diagnosed patients with B cell indolent lymphomas: long-term results from a single center in China. BMC Cancer 2015. [PMID: 26219471 PMCID: PMC4517647 DOI: 10.1186/s12885-015-1534-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Rituximab has been confirmed to improve the survival of patients with B cell indolent non-Hodgkin lymphomas (B-iNHLs) in Western world as previously reported, however, it is rarely reported in Chinese cohort. This study is to investigate the efficacy and safety of rituximab-based chemoimmunotherapy and select subpopulations most sensitive to the regimen in Chinese B-iNHL patients. Methods 334 B-iNHL patients from our center were retrospectively assessed. Results Patients received R-based chemoimmunotherapy showed significantly higher rates of overall response (OR) (93.0 % vs. 53.4 %, P < 0.001) and complete response (CR) (63.3 % vs. 16.0 %, P < 0.001) compared with the patients received other therapies. Survival analysis showed that rituximab-based chemoimmunotherapy could obviously improve the progression-free survival (PFS) (110 vs. 49 months, P = 0.001) and overall survival (OS) (120 vs. 72 months, P < 0.001) in patients with B-iNHLs. Interestingly, in chronic lymphocytic leukemia (CLL) patients, we found that the patients with β2-microglobulin (β2-MG) < 3.5 mg/L, lactate dehydrogenase (LDH) < 220 U/L, zeta-chain-associated protein kinase 70 (ZAP-70) negative, and non high-risk genetic abnormality could achieve more benefits from R-based regimens with higher CR rate (P = 0.003, 0.029, 0.013 and 0.038, respectively). Meanwhile, more CLL patients achieved minimal residual disease (MRD) negative after rituximab-based treatment (46.5 % vs. 10.3 %, P < 0.001). Moreover, CLL patients with MRD < 1 %, LDH < 220 U/L, complete remission (CR) or partial remission (PR), β2-MG < 3.5 mg/L and non high-risk cytogenetic abnormality showed superior outcome compared to the controls (P = 0.001, 0.000, 0.000, 0.001 and 0.013, respectively). No other side-effects increased in chemoimmunotherapy group except the elevation of grade 3–4 neutropenia. Conclusions Our results demonstrate the superior efficacy of rituximab–based chemoimmunotherapy as an initial therapy in Chinese cohort with newly diagnosed B-iNHLs and further identify subpopulations that are more sensitive to R-based chemoimmunotherapy in CLL group.
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Affiliation(s)
- Zengjun Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Fei Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China. .,Department of Hematology, The First Affiliated Hospital of Nanchang University, NanChang, 330006, China.
| | - Shuhua Yi
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Zhimin Gu
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52246, USA.
| | - Zhen Yu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Yan Xu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Xiaoyan Feng
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Dehui Zou
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Junyuan Qi
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China.
| | - Fenghuang Zhan
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52246, USA.
| | - Lugui Qiu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Heping District, Tianjin, 300020, China. .,Umbilical Cord Blood Bank of Tianjin, Tianjin, 300020, China.
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13
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Iannitto E, Luminari S, Tripodo C, Mancuso S, Cesaretti M, Marcheselli L, Merli F, Stelitano C, Carella AM, Fragasso A, Montechiarello E, Ricciuti G, Pulsoni A, Paulli M, Franco V, Federico M. Rituximab with cyclophosphamide, vincristine, non-pegylated liposomal doxorubicin and prednisone as first-line treatment for splenic marginal zone lymphoma: a Fondazione Italiana Linfomi phase II study. Leuk Lymphoma 2015; 56:3281-7. [DOI: 10.3109/10428194.2015.1029925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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14
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Polati R, Brandi J, Dalai I, Zamò A, Cecconi D. Tissue proteomics of splenic marginal zone lymphoma. Electrophoresis 2015; 36:1612-21. [PMID: 25873066 DOI: 10.1002/elps.201400329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 03/27/2015] [Accepted: 04/02/2015] [Indexed: 12/20/2022]
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare chronic B lymphoproliferative disease, whose molecular pathogenesis has still not been well established. For the first time, a proteomic approach was undertaken to analyse the protein profiles of SMZL tissue. 1D and 2D Western blot, immunohistochemical analysis, and functional data mining were also performed in order to validate results, investigate protein species specific regulation, classify proteins, and explore their potential relationships. We demonstrated that SMZL is characterized by modulation of protein species related to energetic metabolism and apoptosis pathways. We also reported specific protein species (such as biliverdin reductase A, manganese superoxide dismutase, beta-2 microglobulin, growth factor receptor-bound protein 2, acidic leucine-rich nuclear phosphoprotein 32 family member A, and Set nuclear oncogene) directly involved in NF-kB and BCR pathways, as well as in chromatin remodelling and cytoskeleton. Our findings shed new light on SMZL pathogenesis and provide a basis for the future development of novel biomarkers. The mass spectrometry proteomics data have been deposited to the ProteomeXchange Consortium with the dataset identifier PXD001124.
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Affiliation(s)
- Rita Polati
- Proteomics and Mass Spectrometry Laboratory, Department of Biotechnology, University of Verona, Verona, Italy
| | - Jessica Brandi
- Proteomics and Mass Spectrometry Laboratory, Department of Biotechnology, University of Verona, Verona, Italy
| | - Irene Dalai
- Department of Pathology and Diagnostics, Pathological Anatomy, University of Verona, Verona, Italy
| | - Alberto Zamò
- Department of Pathology and Diagnostics, Pathological Anatomy, University of Verona, Verona, Italy
| | - Daniela Cecconi
- Proteomics and Mass Spectrometry Laboratory, Department of Biotechnology, University of Verona, Verona, Italy
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15
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Lara-Jiménez MA, Ruiz-Rivera L, Magro-Checa C. Acquired angioedema with C1 inhibitor deficiency secondary to splenic marginal zone B-cell lymphoma. Rev Clin Esp 2014; 214:e107-9. [PMID: 24970460 DOI: 10.1016/j.rce.2014.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
Affiliation(s)
- M A Lara-Jiménez
- Unidad de Alergología, Unidad de Gestión Clínica Medicina Interna, Hospital Universitario San Cecilio, Granada, España.
| | - L Ruiz-Rivera
- Unidad de Gestión Clínica Medicina Interna, Hospital Universitario San Cecilio, Granada, España
| | - C Magro-Checa
- Departamento de Reumatología, Hospital Universitario San Cecilio, Granada, España
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