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Villasenor-Park J, Chung J, Kim EJ. Cutaneous B-Cell Lymphomas. Hematol Oncol Clin North Am 2024:S0889-8588(24)00066-2. [PMID: 39048407 DOI: 10.1016/j.hoc.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Primary cutaneous B-cell lymphomas represent a type of non-Hodgkin's lymphoma of the skin without evidence of extracutaneous involvement at the time of diagnosis. According to the 2018 World Health Organization-the European Organization for Research and Treatment of Cancer classification, primary cutaneous B-cell lymphomas include primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, primary cutaneous diffuse large B-cell lymphoma, leg type, intravascular large B-cell lymphoma, and Epstein-Barr virus+ mucocutaneous ulcer (provisional). Herein, we provide a comprehensive review of the updated literature on these entities, including clinical presentation, histopathology, immunophenotype, molecular genetics, prognosis, and treatment.
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Affiliation(s)
- Jennifer Villasenor-Park
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Jina Chung
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, 2 Maloney Building, 3600 Spruce Street, Philadelphia, PA 19104, USA
| | - Ellen J Kim
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Room 721, 7th floor, Philadelphia, PA 19104, USA.
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2
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Quaglino P, Pimpinelli N, Zinzani PL, Paulli M, Pileri S, Berti E, Cerroni L, Guitart J, Kim YH, Rupoli S, Santucci M, Simontacchi G, Vermeer M, Hoppe R, Pro B, Swerdlow SH, Barosi G. Identifying and addressing unmet clinical needs in primary cutaneous B-cell lymphoma: A consensus-based paper from an ad-hoc international panel. Hematol Oncol 2024; 42:e3215. [PMID: 37649350 DOI: 10.1002/hon.3215] [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: 06/03/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) are lymphoproliferative disorders that appear on the skin without evidence of extracutaneous manifestations at the time of diagnosis. There is a lack of evidence-based guidelines for their clinical management due to the availability of very few large scale studies and controlled clinical trials. Here we present and discuss a series of major unmet clinical needs (UCNs) in the management of PCBCLs by a panel of 16 experts involved in research and clinical practice of PCBCL. The Panel produced recommendations on the appropriateness of the clinical decisions concerning the identified clinical needs and proposed research for improving the knowledge needed to solve them. Recommendations and proposals were achieved by multiple-step formalized procedures to reach a consensus after a comprehensive analysis of the scientific literature. Recommendations and proposals lay in the domain of classification uncertainties of PCBCL, optimization of diagnosis, optimization of prognosis, optimization of staging and critical issues on therapeutic strategies with particular focus on new treatments. These recommendations are intended for use not only by experts but above all by dermatologists and hematologists with limited experience in the field of PCBCLs as well as general practitioners.
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Affiliation(s)
- Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Torino, Italy
| | - Nicola Pimpinelli
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna. Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale. Università di Bologna, Bologna, Italy
- Istituto di Ematologia "Seràgnoli", Azienda Ospedaliero-Universitaria di Bologna - IRCCS, Bologna, Italy
| | - Marco Paulli
- Pathology Section, Department of Molecular Medicine, University of Pavia and Fondazione I.R.C.C.S. Policlinico "S.Matteo", Pavia, Italy
| | - Stefano Pileri
- IEO - European Institute of Oncology IRCCS (Milan) & Bologna University School of Medicine, Milano, Italy
| | - Emilio Berti
- Dermatology Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Lorenzo Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Youn H Kim
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Serena Rupoli
- Clinica di Ematologia, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Marco Santucci
- Pathology Unit, Careggi University Hospital, Florence, Italy
- Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - Gabriele Simontacchi
- Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Maarten Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Richard Hoppe
- Department of Radiation Oncology, Stanford University, Stanford, California, USA
| | - Barbara Pro
- Northwestern University, Chicago, Illinois, USA
| | - Steven H Swerdlow
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Giovanni Barosi
- Center for the Study of Myelofibrosis, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
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3
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Hou Y, Zi J, Liu S, Ge Q, Ge Z. Mutational profiling of circulating tumor DNA and clinical characteristics in lymphoma: Based on next generation sequencing. Mol Carcinog 2023; 62:200-209. [PMID: 36300887 DOI: 10.1002/mc.23476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/10/2022] [Accepted: 09/30/2022] [Indexed: 01/21/2023]
Abstract
Liquid biopsy has been experimented with to identify the mutation of lymphoma based on next-generation sequencing (NGS). We applied NGS analysis to circulating tumor DNA (ctDNA) in 20 lymphoma patients. Then, we compared treatment outcomes, and clinical characteristics among these patients, then investigated mutational profiling. Two independent cohorts of 241 patients with mature B cell lymphoma in Mature B-cell malignancies data set (MBN) data set and 50 diffuse large B-cell lymphoma (DLBCL) patients in DLBCL data set, were used to examine the association between gene mutations and prognosis. We found ctDNA positive group had significantly more relapsed/PD (7/12, 58.3%) and less CR/PR patients (1/12, 8.3%) compared to negative group (0, 0%) (5/8, 62.5%) (p < 0.001). Somatic alterations were identified in 12 of 20 patients and the total 11 mutations were: Ataxia telangiectasia mutated (ATM), TP53, BCL2, BTG2, CD28, EP300, IDH2, IRF8, JAK3, NOTCH1, and NRAS. ATM (S2168L) was found in SLL and TLBL for the first time. BTG2 (c.292_293del), CD28 (P119T), IRF8 (E74D) and NOTCH1 (c.4348 G > A) were newly detected in DLBCL, angioimmunoblastic T-cell lymphoma, primary central nervous system lymphoma, and BCL for the first time respectively. We also disclosed an unreported mutation EP300 (c.1058_1059insC) in DLBCL. Our cases implied ctDNA detection consistent with the FISH of tissue samples to some extent, speculating new molecular subtypes of DLBCL, finding some potential drug-resistant mutations, and suggesting disease recurrence. Moreover, in MBN and DLBCL datasets, patients with TP53 mutation had a significantly shorter OS (all p < 0.05) in both circulating free DNA and tumor tissue. The mutations (no SNP) of NOTCH1 (all p < 0.05) significantly contributed to worse OS in the two cohorts.
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Affiliation(s)
- Yue Hou
- Department of Hematology, School of Medicine, Zhongda Hospital, Institute of Hematology Southeast University, Southeast University, Nanjing, China
| | - Jie Zi
- Department of Hematology, School of Medicine, Zhongda Hospital, Institute of Hematology Southeast University, Southeast University, Nanjing, China
| | - Shuo Liu
- Department of Hematology, School of Medicine, Zhongda Hospital, Institute of Hematology Southeast University, Southeast University, Nanjing, China
| | - Qinyu Ge
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Zheng Ge
- Department of Hematology, School of Medicine, Zhongda Hospital, Institute of Hematology Southeast University, Southeast University, Nanjing, China
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4
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Zhang Y, LeWitt TM, Louissaint A, Guitart J, Zhou XA, Choi J. Disease-Defining Molecular Features of Primary Cutaneous B-Cell Lymphomas: Implications for Classification and Treatment. J Invest Dermatol 2023; 143:189-196. [PMID: 36163302 PMCID: PMC10260375 DOI: 10.1016/j.jid.2022.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/25/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023]
Abstract
Primary cutaneous B-cell lymphoma-primary cutaneous follicle center lymphoma; primary cutaneous marginal zone lymphoma; and primary cutaneous diffuse large B-cell, leg type-is a heterogeneous group with a variety of clinical and histological presentations. Until recently, the molecular bases of these disease subtypes have been unclear. We and others have identified the specific genetic characteristics that distinguish these subtypes from their respective systemic counterparts. These molecular features can improve diagnoses, determine the likelihood of concurrent or future systemic disease, and enable the rational design of novel clinical trials.
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Affiliation(s)
- Yue Zhang
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA; Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA
| | - Tessa M LeWitt
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA
| | - Abner Louissaint
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA
| | - Xiaolong Alan Zhou
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA
| | - Jaehyuk Choi
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA; Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, Ilinois, USA.
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5
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Prochazkova-Carlotti M, Gros A, Richard E, Cherrier F, Laharanne E, Idrissi Y, Baron C, Poglio S, Ducharme O, Menguy S, Pham-Ledard A, Beylot-Barry M, Merlio JP, Bresson-Bepoldin L. Patient-Derived Xenograft and Cell Line Models of Human Primary Cutaneous Diffuse Large B-Cell Lymphoma-Leg Type. J Invest Dermatol 2023; 143:340-344.e6. [PMID: 36084691 DOI: 10.1016/j.jid.2022.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 01/25/2023]
Affiliation(s)
| | - Audrey Gros
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Bordeaux, France
| | - Elodie Richard
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 11, University of Bordeaux, Bordeaux, France
| | - Floriane Cherrier
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France
| | - Elodie Laharanne
- Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Bordeaux, France
| | - Yamina Idrissi
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France
| | - Camille Baron
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France
| | - Sandrine Poglio
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France
| | - Océane Ducharme
- Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Sarah Menguy
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; Pathology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Anne Pham-Ledard
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Marie Beylot-Barry
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; Dermatology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Jean-Philippe Merlio
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Bordeaux, France
| | - Laurence Bresson-Bepoldin
- BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, University of Bordeaux, Bordeaux, France; BRIC (BoRdeaux Institute of onCology), INSERM UMR1312, Team 5, CNRS, Université de Bordeaux, Bordeaux, France.
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6
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Krenitsky A, Klager S, Hatch L, Sarriera-Lazaro C, Chen PL, Seminario-Vidal L. Update in Diagnosis and Management of Primary Cutaneous B-Cell Lymphomas. Am J Clin Dermatol 2022; 23:689-706. [PMID: 35854102 DOI: 10.1007/s40257-022-00704-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
Primary cutaneous lymphomas are a rare group of diseases, with an estimated incidence of 0.5-1 case per 100,000 people per year. Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. There are three main subtypes of pCBCL: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. To date, treatment recommendations for cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. Recently, the pharmacotherapeutic landscape has expanded to include drugs that may modify the underlying disease pathology of pCBCLs, representing new therapeutic modalities for this rare group of diseases. Novel therapies used for other systemic B-cell lymphomas show promise for the treatment of pCBCLs and are being increasingly considered. These new therapies are divided into five main groups: monoclonal antibodies, immune checkpoint inhibitors, small-molecule inhibitors, bispecific T-cell engaging, and chimeric antigen receptor T cell. In this review, we discuss the clinical, histopathological, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management. These emerging treatment strategies for B-cell lymphomas and cutaneous B-cell lymphomas may represent novel first-line options for the management of these rare diseases.
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Affiliation(s)
- Amanda Krenitsky
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA.
| | - Skylar Klager
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
| | - Leigh Hatch
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Pei Ling Chen
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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7
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He MY, Kridel R. Treatment resistance in diffuse large B-cell lymphoma. Leukemia 2021; 35:2151-2165. [PMID: 34017074 DOI: 10.1038/s41375-021-01285-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/21/2021] [Accepted: 05/05/2021] [Indexed: 01/29/2023]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a highly heterogeneous disease and represents the most common subtype of lymphoma. Although 60-70% of all patients can be cured by the current standard of care in the frontline setting, the majority of the remaining patients will experience treatment resistance and have a poor clinical outcome. Numerous efforts have been made to improve the efficacy of the standard regimen by, for example, dose intensification or adding novel agents. However, these results generally failed to demonstrate significant clinical benefits. Hence, understanding treatment resistance is a pressing need to optimize the outcome of those patients. In this Review, we first describe the conceptual sources of treatment resistance in DLBCL and then provide detailed and up-to-date molecular insight into the mechanisms of resistance to the current treatment options in DLBCL. We lastly highlight the potential strategies for rationally managing treatment resistance from both the preventive and interventional perspectives.
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Affiliation(s)
- Michael Y He
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Robert Kridel
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. .,Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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8
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Onaindia A, Santiago-Quispe N, Iglesias-Martinez E, Romero-Abrio C. Molecular Update and Evolving Classification of Large B-Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13133352. [PMID: 34283060 PMCID: PMC8269067 DOI: 10.3390/cancers13133352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The development of high-throughput technologies in recent years has increased our understanding of the molecular complexity of lymphomas, providing new insights into the pathogenesis of large B-cell neoplasms and identifying different molecular biomarkers with prognostic impact, that lead to the revision of the World Health Organization consensus classification of lymphomas. This review addresses the main histopathological and molecular features of large B-cells lymphomas, providing an overview of the main recent novelties introduced by the last update of the consensus classification. Abstract Diffuse large B-cell lymphomas (DLBCLs) are aggressive B-cell neoplasms with considerable clinical, biologic, and pathologic diversity. The application of high throughput technologies to the study of lymphomas has yielded abundant molecular data leading to the identification of distinct molecular identities and novel pathogenetic pathways. In light of this new information, newly refined diagnostic criteria have been established in the fourth edition of the World Health Organization (WHO) consensus classification of lymphomas, which was revised in 2016. This article reviews the histopathological and molecular features of the various aggressive B-cell lymphoma subtypes included in the updated classification.
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Affiliation(s)
- Arantza Onaindia
- Bioaraba Health Research Institute, Oncohaematology Research Group, 01070 Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
- Correspondence: ; Tel.: +34-699-639-645
| | - Nancy Santiago-Quispe
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
| | - Erika Iglesias-Martinez
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
| | - Cristina Romero-Abrio
- Osakidetza Basque Health Service, Araba University Hospital, Pathology Department, 01070 Vitoria-Gasteiz, Spain; (N.S.-Q.); (E.I.-M.); (C.R.-A.)
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Caeser R, Walker I, Gao J, Shah N, Rasso-Barnett L, Anand S, Martin JE, Hodson DJ. Acquired CARD11 mutation promotes BCR independence in Diffuse Large B Cell Lymphoma. JCO Precis Oncol 2021; 5:145-152. [PMID: 33542970 PMCID: PMC7116686 DOI: 10.1200/po.20.00360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Rebecca Caeser
- Department of Haematology, University of Cambridge.,Wellcome-MRC Cambridge Stem Cell Institute, Puddicombe Way CB2 2AW
| | - Ieuan Walker
- Department of Haematology, University of Cambridge.,Wellcome-MRC Cambridge Stem Cell Institute, Puddicombe Way CB2 2AW.,Department of Haematology, Cambridge University Hospitals, Cambridge CB2 2QQ
| | - Jie Gao
- Department of Haematology, University of Cambridge.,Wellcome-MRC Cambridge Stem Cell Institute, Puddicombe Way CB2 2AW
| | - Nimish Shah
- Department of Haematology, Norfolk and Norwich University Hospital, Norwich
| | - Livia Rasso-Barnett
- Haematopathology and Oncology Diagnostic Service, Cambridge University Hospitals, Cambridge CB2 2QQ
| | - Shubha Anand
- Cancer Molecular Diagnostic Laboratory, Department of Oncology, University of Cambridge, CB2 0AH
| | - Jose-Ezequiel Martin
- Cancer Molecular Diagnostic Laboratory, Department of Oncology, University of Cambridge, CB2 0AH
| | - Daniel J Hodson
- Department of Haematology, University of Cambridge.,Wellcome-MRC Cambridge Stem Cell Institute, Puddicombe Way CB2 2AW.,Department of Haematology, Cambridge University Hospitals, Cambridge CB2 2QQ
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10
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Lang CCV, Ramelyte E, Dummer R. Innovative Therapeutic Approaches in Primary Cutaneous B Cell Lymphoma. Front Oncol 2020; 10:1163. [PMID: 32850331 PMCID: PMC7426470 DOI: 10.3389/fonc.2020.01163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/09/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Primary cutaneous B-cell lymphomas (pCBCL) include an infrequent group of non-Hodgkin lymphomas that are limited to skin sites at the time of diagnosis. They comprise roughly 20–25% of all cutaneous lymphomas and are subdivided into primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle center lymphoma (PCFCL), and primary cutaneous diffuse large cell B cell lymphoma, leg type (PCDLCBCL, LT). The first two show a rather indolent course while PCDLCBCL, LT carries a worse prognosis. Intravascular large cell B-cell lymphoma is the most infrequent subtype, and its therapy is not covered in this review. Topical Therapy: For solitary, single-site PCMZL and PCFCL, several topical treatment options exist. They include, but are not limited to, excision, radiotherapy, and intralesional therapies, discussed in this review. However, in selected cases, even “watchful waiting” is reasonable. Systemic Therapy: Indolent types of pCBCL rarely require systemic treatment. However, in extended cases and more importantly DLCBCL, LT, systemic treatment is the first choice. Monoclonal anti-CD20-antibody rituximab is often used as monotherapy in PCMZL and PCFCL or combined with chemotherapy in PCDLBCL, LT. Newer options are monoclonal anti-CD40 antibody dacetuzumab, anti-PD-1 and anti-PD-L1 checkpoint inhibitors, and Bruton tyrosine kinase inhibitors. Conclusion: Indolent pCBCL are treated with a risk-adapted strategy using intralesional steroids, RT, and interferon-α as first-line treatments. Relapsing cases may profit from rituximab. In aggressive PCDLCBCL, LT, rituximab with polychemotherapy is recommended. Innovative therapies include intralesional oncolytic virotherapy, systemic monoclonal antibodies, and small molecules.
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Affiliation(s)
- Claudia C V Lang
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Egle Ramelyte
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Medical Faculty, University of Zurich, Zurich, Switzerland
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11
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Niu J, Ma Z, Nuerlan A, Li S, Cui W, Gao H, Abulajiang G, Zhang W, Li X. Prognostic value of MYD88 L265P mutation in diffuse large B cell lymphoma via droplet digital PCR. Mol Med Rep 2020; 22:1243-1256. [PMID: 32468019 PMCID: PMC7339516 DOI: 10.3892/mmr.2020.11186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 05/05/2020] [Indexed: 12/30/2022] Open
Abstract
To assess the prevalence and prognostic value of myeloid differentiation factor 88 (MYD88) expression and mutational status in diffuse large B cell lymphoma (DLBCL), a total cohort of 100 patients with DLBCL were studied using immunohistochemistry (IHC) and droplet digital polymerase chain reaction (DDPCR), and the association between MYD88 expression and clinicopathological parameters was analyzed. Overall, the positive expression rate of MYD88 protein was 38% and the gene mutation rate was 29%. The positive expression and mutation rates were the highest in the primary central nervous system lymphomas (58.33 and 66.67%, respectively). The coincidence rate of the results of MYD88 expression between IHC and DDPCR results was 73% (73/100). Univariate survival analysis showed that age (≥60 years old), high neutrophil/lymphocyte count ratio, low lymphocyte count, c-Myc ≥40%, positive MYD88 protein expression, and gene mutation were associated with poorer prognosis rates. Multivariate survival analysis revealed that MYD88 expression was an independent prognostic factor affecting overall survival. In conclusion, the results of this study demonstrated that MYD88 mutation was a valuable index to evaluate the prognosis of DLBCL. DDPCR can be used as a method for detecting MYD88 mutations, although it was not completely consistent with the results of IHC.
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Affiliation(s)
- Jing Niu
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Zhiping Ma
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Aijiang Nuerlan
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Sijing Li
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Wenli Cui
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Haixia Gao
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Gulinaer Abulajiang
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Wei Zhang
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
| | - Xinxia Li
- Department of Pathology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830054, P.R. China
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Nfkbie-deficiency leads to increased susceptibility to develop B-cell lymphoproliferative disorders in aged mice. Blood Cancer J 2020; 10:38. [PMID: 32170099 PMCID: PMC7070037 DOI: 10.1038/s41408-020-0305-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/17/2020] [Accepted: 02/26/2020] [Indexed: 12/12/2022] Open
Abstract
Aberrant NF-κB activation is a hallmark of most B-cell malignancies. Recurrent inactivating somatic mutations in the NFKBIE gene, which encodes IκBε, an inhibitor of NF-κB-inducible activity, are reported in several B-cell malignancies with highest frequencies in chronic lymphocytic leukemia and primary mediastinal B-cell lymphoma, and account for a fraction of NF-κB pathway activation. The impact of NFKBIE deficiency on B-cell development and function remains, however, largely unknown. Here, we show that Nfkbie-deficient mice exhibit an amplification of marginal zone B cells and an expansion of B1 B-cell subsets. In germinal center (GC)-dependent immune response, Nfkbie deficiency triggers expansion of GC B-cells through increasing cell proliferation in a B-cell autonomous manner. We also show that Nfkbie deficiency results in hyperproliferation of a B1 B-cell subset and leads to increased NF-κB activation in these cells upon Toll-like receptor stimulation. Nfkbie deficiency cooperates with mutant MYD88 signaling and enhances B-cell proliferation in vitro. In aged mice, Nfkbie absence drives the development of an oligoclonal indolent B-cell lymphoproliferative disorders, resembling monoclonal B-cell lymphocytosis. Collectively, these findings shed light on an essential role of IκBε in finely tuning B-cell development and function.
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Walter HS, Trethewey CS, Ahearne MJ, Jackson R, Jayne S, Wagner SD, Saldanha G, Dyer MJ. Successful Treatment of Primary Cutaneous Diffuse Large B-Cell Lymphoma Leg Type With Single-Agent Venetoclax. JCO Precis Oncol 2019; 3:1-5. [DOI: 10.1200/po.19.00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Harriet S. Walter
- University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | | | - Matthew J. Ahearne
- University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Ross Jackson
- University of Leicester, Leicester, United Kingdom
| | | | - Simon D. Wagner
- University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Gerald Saldanha
- University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Martin J.S. Dyer
- University of Leicester, Leicester, United Kingdom
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Tadiotto Cicogna G, Ferranti M, Lazzarotto A, Alaibac M. Biological Approaches to Aggressive Cutaneous B-Cell Lymphomas. Front Oncol 2019; 9:1238. [PMID: 31799195 PMCID: PMC6864397 DOI: 10.3389/fonc.2019.01238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/28/2019] [Indexed: 01/06/2023] Open
Affiliation(s)
| | | | | | - Mauro Alaibac
- Unit of Dermatology, University of Padua, Padua, Italy
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15
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Ducharme O, Beylot-Barry M, Pham-Ledard A, Bohers E, Viailly PJ, Bandres T, Faur N, Frison E, Vergier B, Jardin F, Merlio JP, Gros A. Mutations of the B-Cell Receptor Pathway Confer Chemoresistance in Primary Cutaneous Diffuse Large B-Cell Lymphoma Leg Type. J Invest Dermatol 2019; 139:2334-2342.e8. [PMID: 31150604 DOI: 10.1016/j.jid.2019.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/16/2019] [Accepted: 05/10/2019] [Indexed: 11/25/2022]
Abstract
Primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL-LT) preferentially involves the lower limb in elderly subjects. A combination of polychemotherapy and rituximab has improved prognosis. However, about 50% of patients will experience progression or relapse without any predictive biologic marker of therapeutic response. The mutational profile of PCLBCL-LT has highlighted mutations contributing to constitutive NF-κB and B-cell receptor (BCR) signaling pathways but has not demonstrated clinical utility. Therefore, the mutational status of 32 patients with PCLBCL-LT (14 patients with complete durable response and 18 patients with relapsing or refractory disease) was determined with a dedicated lymphopanel. Tumor pairs at diagnosis and relapse or progression were analyzed in 14 relapsing or refractory patients. Patients with PCLBCL-LT harboring one mutation that targets one of the BCR signaling genes, CD79A/B or CARD11, displayed a reduced progression-free survival and specific survival (median 18 months, P = 0.002 and 51 months, P = 0.03, respectively, whereas median duration in the wild-type group was not reached) and were associated with therapeutic resistance (P = 0.0006). Longitudinal analyses revealed that MYD88 and CD79B were the earliest and among the most mutated genes. Our data suggest that evaluating BCR mutations in patients with PCLBCL-LT may help to predict first-line therapeutic response and to select targeted therapies.
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Affiliation(s)
- Océane Ducharme
- Service de Dermatologie, CHU de Bordeaux, Bordeaux, France; INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux
| | - Marie Beylot-Barry
- Service de Dermatologie, CHU de Bordeaux, Bordeaux, France; INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux
| | - Anne Pham-Ledard
- Service de Dermatologie, CHU de Bordeaux, Bordeaux, France; INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux
| | - Elodie Bohers
- INSERM U1245 and Centre Henri Becquerel, Rouen, France
| | | | - Thomas Bandres
- Service de Biologie des tumeurs, CHU de Bordeaux, Pessac, France
| | - Nicolas Faur
- Service de Biologie des tumeurs, CHU de Bordeaux, Pessac, France
| | - Eric Frison
- Service d'information médicale, CHU Bordeaux, Bordeaux, France
| | - Béatrice Vergier
- INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux; Service d'Anatomie pathologique, CHU de Bordeaux, Pessac, France
| | | | - Jean-Philippe Merlio
- INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux; Service de Biologie des tumeurs, CHU de Bordeaux, Pessac, France
| | - Audrey Gros
- INSERM U1053, Equipe Oncogenèse des lymphomes cutanés, Université de Bordeaux; Service de Biologie des tumeurs, CHU de Bordeaux, Pessac, France.
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Liu Y, Barta SK. Diffuse large B-cell lymphoma: 2019 update on diagnosis, risk stratification, and treatment. Am J Hematol 2019; 94:604-616. [PMID: 30859597 DOI: 10.1002/ajh.25460] [Citation(s) in RCA: 268] [Impact Index Per Article: 53.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/13/2022]
Abstract
DISEASE OVERVIEW Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma originating from the germinal center, and it represents a heterogeneous group of diseases with variable outcomes that are differentially characterized by clinical features, cell of origin (COO), molecular features, and most recently, frequently recurring mutations. DIAGNOSIS DLBCL is ideally diagnosed from an excisional biopsy of a suspicious lymph node, which shows sheets of large cells that disrupt the underlying structural integrity of the follicle center and stain positive for pan-B-cell antigens, such as CD20 and CD79a. COO is determined by immunohistochemical stains, while molecular features such as double-hit or triple-hit disease are determined by fluorescent in situ hybridization analysis. Commercial tests for frequently recurring mutations are currently not routinely used to inform treatment. RISK STRATIFICATION Clinical prognostic systems for DLBCL, including the rituximab International Prognostic Index, age-adjusted IPI, and NCCN-IPI, use clinical factors for the risk stratification of patients, although this does not affect the treatment approach. Furthermore, DLBCL patients with non-germinal center B-cell (GCB)-like DLBCL (activated B-cell like and unclassifiable) have a poorer response to up-front chemoimmunotherapy (CI) compared to patients with GCB-like DLBCL. Those with c-MYC-altered disease alone and in combination with translocations in BCL2 and/or BCL6 (particularly when the MYC translocation partner is immunoglobulin) respond poorly to up-front CI and salvage autologous stem cell transplant at relapse. RISK-ADAPTED THERAPY This review will focus on differential treatment of DLBCL up-front and at the time of relapse by COO and molecular features.
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Affiliation(s)
- Yang Liu
- Fox Chase Cancer Center, Department of Hematology and Oncology Philadelphia Pennsylvania
| | - Stefan Klaus Barta
- Perelman Center for Advanced Medicine, University of Pennsylvania, Division Philadelphia Pennsylvania
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