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Malfona F, Testi AM, Chiaretti S, Moleti ML. Refractory Burkitt Lymphoma: Diagnosis and Interventional Strategies. Blood Lymphat Cancer 2024; 14:1-15. [PMID: 38510818 PMCID: PMC10949171 DOI: 10.2147/blctt.s407804] [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: 11/29/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
Despite excellent results in frontline therapy, particularly in pediatric age, refractory Burkitt lymphoma still remains a therapeutic challenge, with dismal outcome. The prognosis is very poor, ranging from less than 10% to 30-40%, with longer survival only in transplanted patients. On account of the paucity of data, mostly reporting on small series of patients, with heterogeneous characteristics and salvage treatments, at present it is impossible to draw definitive conclusions on the treatment of choice for this difficult to treat subset of patients. New insights into Burkitt lymphoma/leukemia cell biology have led to the development of new drugs, currently being tested, directed at different specific targets. Herein, we describe the results so far reported in refractory Burkitt lymphoma/leukemia, with standard treatments and hematopoietic stem cell transplant, and we review the new targeted drugs currently under evaluation.
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Affiliation(s)
- Francesco Malfona
- Department of Translational and Precision Medicine, ‘Sapienza’ University, Rome, Italy
| | - Anna Maria Testi
- Department of Translational and Precision Medicine, ‘Sapienza’ University, Rome, Italy
| | - Sabina Chiaretti
- Department of Translational and Precision Medicine, ‘Sapienza’ University, Rome, Italy
| | - Maria Luisa Moleti
- Department of Translational and Precision Medicine, ‘Sapienza’ University, Rome, Italy
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Semary SF, Abdel Rahman H, Elkinaai N, Zaky I, Nagy N, Salem S, Hamoda A. Prognostic Factors and Treatment Outcome of Relapsing and Refractory Pediatric Mature B-cell Non-Hodgkin Lymphoma, Children's Cancer Hospital Egypt Experience. J Pediatr Hematol Oncol 2023; 45:e757-e763. [PMID: 37494612 DOI: 10.1097/mph.0000000000002699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/06/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Relapsed non-Hodgkin lymphoma treated by chemotherapy and hematopoietic stem cell transplantation (HSCT) has a dismal prognosis. PATIENTS It is a retrospective study, including pediatric patients diagnosed as mature B-cell non-Hodgkin lymphoma who were primarily refractory or relapsed over 8 years at CCHE. The aim of the study was to analyze the prognostic factors and outcomes of this group of patients. Our result is, 53 of 750 (7%) patients were included. Thirty-four (64.2%) patients had Burkitt lymphoma. Forty-eight (90.6%) patients received LMB 96 protocol initially. The median delay of duration between chemotherapy cycles in first-line treatment was 37 days. Thirty-five (66%) patients relapsed, 23 (65.7%) of them relapsed early, whereas 18 (34%) had tumor progression. Thirty-one (58.5%) patients presented with stage IV at the time of relapse. rituximab, ifosfamide, carboplatin, etoposide was the second line of treatment in 42 (79.24%) patients, and complete second remission was achieved only in 13 (24.3%) patients. Allogeneic HSCT was done for 4 (7.5%) patients, and auto HSCT was done for 3 (5.7%) patients. Three years of overall survival for relapsed and progressed patients were 35.3% and 11.1%, respectively, with a P-value of 0.009. Three years overall survival for patients who underwent HSCT was 85.7% compared with 18.1% for no HSCT with a P-value of 0.007. CONCLUSIONS The relapse rate is higher than literatures because of the delay of duration between chemotherapy cycles in first-line treatment and more advanced stage at time of relapse. Progression of the disease had a worse outcome than relapse. HSCT in patients with the second remission markedly improved the outcome.
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Affiliation(s)
- Samah F Semary
- Department of Clinical Oncology, Beni-Suef University, Beni-Suef, Egypt
- Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
| | - Hany Abdel Rahman
- Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Naglaa Elkinaai
- Department of Pathology, Children Cancer Hospital Egypt, Cairo, Egypt
- Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Iman Zaky
- Department of Radiodiagnosis, Children Cancer Hospital Egypt, Cairo, Egypt
- Department of Radiodiagnosis, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Nouran Nagy
- Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt
| | - Sherine Salem
- Department of Clinical Pathology, Children Cancer Hospital Egypt, Cairo, Egypt
- Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Asmaa Hamoda
- Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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López C, Burkhardt B, Chan JKC, Leoncini L, Mbulaiteye SM, Ogwang MD, Orem J, Rochford R, Roschewski M, Siebert R. Burkitt lymphoma. Nat Rev Dis Primers 2022; 8:78. [PMID: 36522349 DOI: 10.1038/s41572-022-00404-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2022] [Indexed: 12/16/2022]
Abstract
Burkitt lymphoma (BL) is an aggressive form of B cell lymphoma that can affect children and adults. The study of BL led to the identification of the first recurrent chromosomal aberration in lymphoma, t(8;14)(q24;q32), and subsequent discovery of the central role of MYC and Epstein-Barr virus (EBV) in tumorigenesis. Most patients with BL are cured with chemotherapy but those with relapsed or refractory disease usually die of lymphoma. Historically, endemic BL, non-endemic sporadic BL and the immunodeficiency-associated BL have been recognized, but differentiation of these epidemiological variants is confounded by the frequency of EBV positivity. Subtyping into EBV+ and EBV- BL might better describe the biological heterogeneity of the disease. Phenotypically resembling germinal centre B cells, all types of BL are characterized by dysregulation of MYC due to enhancer activation via juxtaposition with one of the three immunoglobulin loci. Additional molecular changes commonly affect B cell receptor and sphingosine-1-phosphate signalling, proliferation, survival and SWI-SNF chromatin remodelling. BL is diagnosed on the basis of morphology and high expression of MYC. BL can be effectively treated in children and adolescents with short durations of high dose-intensity multiagent chemotherapy regimens. Adults are more susceptible to toxic effects but are effectively treated with chemotherapy, including modified versions of paediatric regimens. The outcomes in patients with BL are good in high-income countries with low mortality and few late effects, but in low-income and middle-income countries, BL is diagnosed late and is usually treated with less-effective regimens affecting the overall good outcomes in patients with this lymphoma.
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Affiliation(s)
- Cristina López
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany
| | - Birgit Burkhardt
- Non-Hodgkin's Lymphoma Berlin-Frankfurt-Münster (NHL-BFM) Study Center and Paediatric Hematology, Oncology and BMT, University Hospital Muenster, Muenster, Germany
| | - John K C Chan
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, China
| | - Lorenzo Leoncini
- Section of Pathology, Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | | | | | - Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Mark Roschewski
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Reiner Siebert
- Institute of Human Genetics, Ulm University and Ulm University Medical Center, Ulm, Germany.
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Khalili-Tanha G, Moghbeli M. Long non-coding RNAs as the critical regulators of doxorubicin resistance in tumor cells. Cell Mol Biol Lett 2021; 26:39. [PMID: 34425750 PMCID: PMC8381522 DOI: 10.1186/s11658-021-00282-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022] Open
Abstract
Resistance against conventional chemotherapeutic agents is one of the main reasons for tumor relapse and poor clinical outcomes in cancer patients. Various mechanisms are associated with drug resistance, including drug efflux, cell cycle, DNA repair and apoptosis. Doxorubicin (DOX) is a widely used first-line anti-cancer drug that functions as a DNA topoisomerase II inhibitor. However, DOX resistance has emerged as a large hurdle in efficient tumor therapy. Furthermore, despite its wide clinical application, DOX is a double-edged sword: it can damage normal tissues and affect the quality of patients’ lives during and after treatment. It is essential to clarify the molecular basis of DOX resistance to support the development of novel therapeutic modalities with fewer and/or lower-impact side effects in cancer patients. Long non-coding RNAs (lncRNAs) have critical roles in the drug resistance of various tumors. In this review, we summarize the state of knowledge on all the lncRNAs associated with DOX resistance. The majority are involved in promoting DOX resistance. This review paves the way to introducing an lncRNA panel marker for the prediction of the DOX response and clinical outcomes for cancer patients.
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Affiliation(s)
- Ghazaleh Khalili-Tanha
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Meysam Moghbeli
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Treatment and Outcome Analysis of 639 Relapsed Non-Hodgkin Lymphomas in Children and Adolescents and Resulting Treatment Recommendations. Cancers (Basel) 2021; 13:cancers13092075. [PMID: 33923026 PMCID: PMC8123268 DOI: 10.3390/cancers13092075] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/18/2021] [Accepted: 04/22/2021] [Indexed: 12/23/2022] Open
Abstract
Simple Summary Despite very poor survival, controversies remain in the treatment for refractory or relapsed non-Hodgkin lymphoma (r/r NHL) in children and adolescents. The current project identifies and reports international experience on re-induction treatment of r/r NHL, hematopoietic stem cell transplantation, risk factors associated with outcome, and suggests treatment recommendations. Abstract Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r/r NHL). The current project aimed to collect international experience on the re-induction treatment of r/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recommendations. Inclusion criteria were (i) refractory disease, disease progression or relapse of any NHL subtype except anaplastic large cell lymphoma, (ii) age < 18 years at initial diagnosis, (iii) diagnosis in/after January 2000. Data from 639 eligible patients were evaluable. The eight-year probability of overall survival was 34 ± 2% with highly significant differences according to NHL subtypes: 28 ± 3% for 254 Burkitt lymphoma/leukemia, 50 ± 6% for 98 diffuse large B-cell lymphomas, 57 ± 8% for 41 primary mediastinal large B-cell lymphomas, 27 ± 3% for 177 T-lymphoblastic lymphomas, 52 ± 10% for 34 precursor-B-cell lymphoblastic lymphomas and 30 ± 9% for 35 patients with rare NHL subtypes. Subtype-specific factors associated with survival and treatment recommendations are suggested. There were no survivors without HSCT, except in few very small subgroups. Conclusions: There is an urgent need to further improve survival in r/r NHL. The current study provides the largest real-world series, which underlines the role of HSCT and suggests treatment recommendations.
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Li X, Zhou M, Qi J, Han Y. Efficacy and Safety of Inotuzumab Ozogamicin (CMC-544) for the Treatment of Relapsed/Refractory Acute Lymphoblastic Leukemia and Non-Hodgkin Lymphoma: A Systematic Review and Meta-Analysis. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 21:e227-e247. [PMID: 33461955 DOI: 10.1016/j.clml.2020.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of inotuzumab ozogamicin (INO) in patients with relapsed/refractory acute lymphocytic leukemia (ALL) and non-Hodgkin lymphoma (NHL). MATERIALS AND METHODS Databases (PubMed, EMBASE, and Cochrane databases) were searched through April 4, 2020. Outcome measures of efficacy covered complete remission (CR) rates and minimal residual disease response rates. Safety was evaluated by hepatic venous obstructive disease/sinus obstructive syndrome and grade ≥ 3 hematologic adverse events. We also evaluated the quality of enrolled studies by the Newcastle-Ottawa Quality Assessment Scale. RESULTS A total of 12 studies involving 644 patients were included. The summary estimates of the CR and minimal residual disease response rates for patients with ALL were 67% (95% confidence interval [CI], 61%-73%) and 45% (95% CI, 37%-53%) of patients with NHL. The pooled CR rate was 28% (95% CI, 15%-47%). Thrombocytopenia and neutropenia were the most common adverse events. In patients receiving INO, venous obstructive disease/sinus obstructive syndrome, grade ≥ 3 thrombocytopenic events, grade ≥ 3 neutropenic events of the pooled estimated incidence were 8% (95% CI, 5%-14%), 29% (95% CI, 20%-39%), and 48% (95% CI, 38%-57%). CONCLUSIONS According to our study, INO was effective in the treatment of relapsed/refractory ALL and NHL with limited adverse effects. High-quality randomized controlled trials and extensive follow-up are pending to confirm and update the results of this analysis in the future.
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Affiliation(s)
- Xueqian Li
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Meng Zhou
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Jiaqian Qi
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Yue Han
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China.
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7
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Zhen Z, Zhu J, Wang J, Lu S, Sun F, Huang J, Sun X. Rituximab is highly effective in children and adolescents with Burkitt lymphoma in Risk Groups R2 to R4. Pediatr Hematol Oncol 2020; 37:489-499. [PMID: 32364412 DOI: 10.1080/08880018.2020.1759741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Data regarding the use of rituximab in children and adolescents with Burkitt's lymphoma (BL) is limited. This study retrospectively analyzed the effect of rituximab on children and adolescents with BL in risk group (R) 2 to R4. Patients underwent chemotherapy according to the revised NHL-BFM-95 protocol. Rituximab was administered at the dose of 375 mg/m2 on day 0 of each cycle. A total of 106 patients were included. Stratified by the number of doses of rituximab, there were 49, 16, and 41 patients in group 1 (no rituximab), group 2 (1-3 doses of rituximab) and group 3 (≥4 doses of rituximab), respectively. The 3-year event-free survival (EFS) rates were 83.2% (95% CI = 72.6%-93.8%), 81.2% (95% CI = 52.3%-93.5%) and 96.8% (95% CI = 78.8%-99.6%) in group 1, group 2 and group 3, respectively (p = 0.077). In R2/R3, the relapse rates were 0 in patients treated with rituximab and 11.8% in those treated without rituximab (p = 0.516). In R4, the relapse rates were 18.8%, 21.4% and 3.0% in group 1, group 2 and group 3, respectively (p = 0.048). Rituximab is highly effective in children and adolescents with BL in R2 to R4. The optimal number of doses was 4-6 in patients with BL in R4.
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Affiliation(s)
- Zijun Zhen
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Jia Zhu
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Juan Wang
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Suying Lu
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Feifei Sun
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Junting Huang
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Xiaofei Sun
- Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.,State Key Laboratory of Oncology in South China, Guangzhou, China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
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Davies K, Barth M, Armenian S, Audino AN, Barnette P, Cuglievan B, Ding H, Ford JB, Galardy PJ, Gardner R, Hanna R, Hayashi R, Kovach AE, Machnitz AJ, Maloney KW, Marks L, Page K, Reilly AF, Weinstein JL, Xavier AC, McMillian NR, Freedman-Cass DA. Pediatric Aggressive Mature B-Cell Lymphomas, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:1105-1123. [PMID: 32755986 DOI: 10.6004/jnccn.2020.0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pediatric aggressive mature B-cell lymphomas are the most common types of non-Hodgkin lymphoma in children, and they include Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL). These diseases are highly aggressive but curable, the treatment is complex, and patients may have many complicated supportive care issues. The NCCN Guidelines for Pediatric Aggressive Mature B-Cell Lymphomas provide guidance regarding pathology and diagnosis, staging, initial treatment, disease reassessment, surveillance, therapy for relapsed/refractory disease, and supportive care for clinicians who treat sporadic pediatric BL and DLBCL.
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Affiliation(s)
- Kimberly Davies
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center
| | | | | | - Anthony N Audino
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | - Hilda Ding
- UCSD Rady Children's Hospital/UC San Diego Moores Cancer Center
| | | | | | - Rebecca Gardner
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - Rabi Hanna
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Robert Hayashi
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Kelly W Maloney
- Children's Hospital of Colorado/University of Colorado Cancer Center
| | | | | | - Anne F Reilly
- Abramson Cancer Center at the University of Pennsylvania
| | | | - Ana C Xavier
- Children's of Alabama/O'Neal Comprehensive Cancer Center at UAB; and
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9
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Guo C, Gong M, Li Z. Knockdown of lncRNA MCM3AP-AS1 Attenuates Chemoresistance of Burkitt Lymphoma to Doxorubicin Treatment via Targeting the miR-15a/EIF4E Axis. Cancer Manag Res 2020; 12:5845-5855. [PMID: 32765087 PMCID: PMC7371474 DOI: 10.2147/cmar.s248698] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/28/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose The long-noncoding RNA MCM3AP-AS1 has been shown to participate in the tumorigenesis and growth of several types of cancer, but little is known about the role of MCM3AP-AS1 in the chemoresistance of lymphoma. Methods A series of patients with Burkitt lymphoma were enrolled for clinical analysis. Daudi and Namalwa cells were used for further experiments. CCK-8 and apoptosis assays were used to assess the response to doxorubicin. Mitochondrial membrane potential assays and high-resolution respirometry were used to assess mitochondrial function. Western blotting was used to detect the expression of certain molecules. Luciferase assays and microRNA transfection were used to clarify the regulatory mechanisms of MCM3AP-AS1. An in vivo model using BALB/c nude mice was utilized to investigate the effects of MCM3AP-AS1 on cell proliferation and tumor growth. Results The expression level of MCM3AP-AS1 was increased in tumors compared with normal lymph nodes, which indicated poor prognosis in patients with Burkitt lymphoma. Moreover, compared with siNC transfection, MCM3AP-AS1 knockdown decreased cell viability and increased apoptosis rates upon doxorubicin treatment compared with siNC. Further studies indicated that upregulation of several antiapoptotic factors, downstream of EIF4E, was partially responsible for MCM3AP-AS1-induced chemoresistance. Moreover, miR-15a functioned as a link between MCM3AP-AS1 and EIF4E, and was sponged by MCM3AP-AS1. Finally, we showed that the MCM3AP-AS1/miR-15a/EIF4E axis regulated the chemoresistance of lymphoma cells in vitro and in vivo. Conclusion MCM3AP-AS1/miR-15a/EIF4E axis plays a role in the chemoresistance of Burkitt lymphoma, and it might become a promising target for lymphoma therapeutics.
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Affiliation(s)
- Chao Guo
- Department of Hematology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Ming Gong
- Department of Hematology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Zhenling Li
- Department of Hematology, China-Japan Friendship Hospital, Beijing, People's Republic of China
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10
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Fitzsimmons L, Cartlidge R, Chang C, Sejic N, Galbraith LCA, Suraweera CD, Croom-Carter D, Dewson G, Tierney RJ, Bell AI, Shannon-Lowe C, Herold MJ, Rickinson AB, Colman PM, Huang DCS, Strasser A, Kvansakul M, Rowe M, Kelly GL. EBV BCL-2 homologue BHRF1 drives chemoresistance and lymphomagenesis by inhibiting multiple cellular pro-apoptotic proteins. Cell Death Differ 2020; 27:1554-1568. [PMID: 31645677 PMCID: PMC7206097 DOI: 10.1038/s41418-019-0435-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 12/30/2022] Open
Abstract
Epstein-Barr virus (EBV), which is ubiquitous in the adult population, is causally associated with human malignancies. Like many infectious agents, EBV has evolved strategies to block host cell death, including through expression of viral homologues of cellular BCL-2 pro-survival proteins (vBCL-2s), such as BHRF1. Small molecule inhibitors of the cellular pro-survival BCL-2 family proteins, termed 'BH3-mimetics', have entered clinical trials for blood cancers with the BCL-2 inhibitor venetoclax already approved for treatment of therapy refractory chronic lymphocytic leukaemia and acute myeloid leukaemia in the elderly. The generation of BH3-mimetics that could specifically target vBCL-2 proteins may be an attractive therapeutic option for virus-associated cancers, since these drugs would be expected to only kill virally infected cells with only minimal side effects on normal healthy tissues. To achieve this, a better understanding of the contribution of vBCL-2 proteins to tumorigenesis and insights into their biochemical functions is needed. In the context of Burkitt lymphoma (BL), BHRF1 expression conferred strong resistance to diverse apoptotic stimuli. Furthermore, BHRF1 expression in mouse haematopoietic stem and progenitor cells accelerated MYC-induced lymphoma development in a model of BL. BHRF1 interacts with the cellular pro-apoptotic BCL-2 proteins, BIM, BID, PUMA and BAK, but its capability to inhibit apoptosis could not be mapped solely to one of these interactions, suggesting plasticity is a key feature of BHRF1. Site-directed mutagenesis revealed a site in BHRF1 that was critical for its interaction with PUMA and blocking DNA-damage-induced apoptosis, identifying a potentially therapeutically targetable vulnerability in BHRF1.
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Affiliation(s)
- Leah Fitzsimmons
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Rachel Cartlidge
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Catherine Chang
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
| | - Nenad Sejic
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Laura C A Galbraith
- Cancer Research UK Beatson Institute, Glasgow, G61 1BD, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Chathura D Suraweera
- La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Deborah Croom-Carter
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Grant Dewson
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
| | - Rosemary J Tierney
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Andrew I Bell
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Clare Shannon-Lowe
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Marco J Herold
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
| | - Alan B Rickinson
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Peter M Colman
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
| | - David C S Huang
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
| | - Andreas Strasser
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia
| | - Marc Kvansakul
- La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Martin Rowe
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Gemma L Kelly
- The Walter and Eliza Hall Institute for Medical Research, Parkville, Melbourne, VIC, 3052, Australia.
- Department of Medical Biology, The University of Melbourne, Parkville, Melbourne, VIC, 3052, Australia.
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11
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Musekwa E, Chapanduka ZC, Bassa F, Kruger M. An 8-year retrospective study of adult and paediatric Burkitt’s lymphoma at Tygerberg Hospital, South Africa. SOUTH AFRICAN JOURNAL OF ONCOLOGY 2020. [DOI: 10.4102/sajo.v4i0.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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12
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Moleti ML, Testi AM, Foà R. Treatment of relapsed/refractory paediatric aggressive B-cell non-Hodgkin lymphoma. Br J Haematol 2020; 189:826-843. [PMID: 32141616 DOI: 10.1111/bjh.16461] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023]
Abstract
Aggressive B-cell non-Hodgkin lymphoma (B-NHL) accounts for ≈60% of NHL in children/adolescents. In newly diagnosed Burkitt lymphoma and diffuse large B-cell lymphoma, short intensive multiagent chemotherapy is associated with a five-year event-free survival of around 90%. Very few children/adolescents with aggressive B-NHL show a relapsed/refractory (r/r) disease. The outcome is poor, with cure rates <30%, and there is no standard of care. Rituximab-containing salvage regimens may provide a complete/partial response in 60-70% of cases. However, long-term survival is <10% for non-transplanted patients. Autologous or allogeneic haematopoietic stem cell transplant is, nowadays, the best option for responding patients, with survival rates around 50%. The benefit of autologous versus allogeneic HSCT is not clear. Numerous novel therapies for r/r B-NHL are currently being tested in adults, including next-generation monoclonal antibodies, novel cellular therapy strategies and therapies directed against new targets. Some are under investigation also in children/adolescents, with promising preliminary results.
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Affiliation(s)
- Maria L Moleti
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Anna M Testi
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
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13
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Geerlinks A, Keis J, Ngan B, Shammas A, Vali R, Hitzler J. Unusual lymphoid malignancy and treatment response in two children with Down syndrome. Pediatr Blood Cancer 2019; 66:e27822. [PMID: 31136091 DOI: 10.1002/pbc.27822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/07/2019] [Accepted: 05/08/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND Lymphoid malignancies other than acute lymphoblastic leukemia (ALL) are rare in children with Down syndrome (DS). Information about the toxicity of chemotherapy and prognosis is largely derived from the experience of children with DS and ALL or children without DS. PROCEDURE We describe the treatment and outcome of two unusual lymphoid malignancies in children with DS. One patient was diagnosed with Burkitt lymphoma (BL) and the second, after treatment for B precursor ALL, with T-cell EBV-positive proliferative disorder (LPD). RESULTS BL was treated with standard doses of LMB group B therapy subsequently intensified to group C therapy, including high-dose methotrexate (HD-MTX, 3-8 g/m2 ). The patient did not experience excessive toxicity and remains in complete remission 13 months later. Despite presentation with disseminated disease the patient with T-cell EBV-positive LPD after treatment for B precursor ALL responded to dexamethasone and rituximab and remains in complete remission two years later. CONCLUSIONS Upfront reduction of the high treatment intensity, which is associated with excellent survival outcomes in BL, may not be warranted in all children with DS. Response to therapy and prognosis of T-cell EBV-positive LPD in a patient with DS was not predicted by reported experience in the absence of DS.
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Affiliation(s)
- Ashley Geerlinks
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Keis
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Bo Ngan
- Division of Pathology, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amer Shammas
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Reza Vali
- Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Johann Hitzler
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Developmental and Stem Cell Biology, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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14
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Rigaud C, Auperin A, Jourdain A, Haouy S, Couec ML, Aladjidi N, Gandemer V, Lambliotte A, Plat G, Landman-Parker J, Michon J, Leblanc T, Patte C, Minard-Colin V. Outcome of relapse in children and adolescents with B-cell non-Hodgkin lymphoma and mature acute leukemia: A report from the French LMB study. Pediatr Blood Cancer 2019; 66:e27873. [PMID: 31207026 DOI: 10.1002/pbc.27873] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In order to describe relapsed B-cell non-Hodgkin lymphoma and mature acute leukemia in children/adolescents treated with the Lymphomes Malins B (LMB) regimen and their outcome in the rituximab era, relapses in the French LMB2001 study were reviewed. METHODS Between February 2001 and December 2011, 33 patients out of 773 (4.3%) relapsed; 27 had Burkitt lymphoma and six large B-cell histology. Median age at diagnosis was 10.1 years. One patient was initially treated in risk group A, 21 in group B, and 11 in group C. RESULTS Median time to relapse after diagnosis was 4.5 months (range 2.4-13.6). Thirty-two patients received salvage therapy. Twenty-seven received rituximab mainly in addition to high-dose cytarabine and etoposide (n = 18) and/or ifosfamide, carboplatin, and etoposide (n = 7). First-line salvage chemotherapy response rate was 66% with 47% being complete remission (CR). Twenty-one patients received high-dose chemotherapy (HDC) followed by autologous (n = 13) or allogeneic (n = 8) transplant. With a median follow-up of 6.8 years, the 5-year survival rate after relapse was 36.4% (95% confidence interval [CI] 22-53%). Twelve patients were still alive; all but one (group A) received consolidation treatment. Achieving CR before consolidation was significantly associated with better survival, with a 5-year survival rate of 75% (95% CI 46.8-91.1%) for patients in CR before HDC, 33% (95% CI 9.7-70%) for patients in partial remission, and 0% for nonresponders (P = .033). CONCLUSION Survival of children/adolescents with mature B-cell lymphoma/leukemia remains poor after relapse with no apparent improvement with rituximab. Response rates to salvage chemo-immunotherapies are insufficient and new drugs are urgently needed to improve disease control.
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Affiliation(s)
- Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Auperin
- Department of Statistics, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Jourdain
- Department of Pediatric Oncology and Haematology, University Hospital of Tours, Tours, France
| | - Stephanie Haouy
- Department of Pediatric Oncology and Haematology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Laure Couec
- Department of Pediatric Oncology and Haematology, University Hospital of Nantes, Nantes, France
| | - Nathalie Aladjidi
- Department of Pediatric Oncology and Haematology, University Hospital of Bordeaux, Bordeaux, France
| | - Virginie Gandemer
- Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
| | - Anne Lambliotte
- Department of Pediatric Oncology and Haematology, Centre Oscar Lambret, Lille, France
| | - Geneviève Plat
- Department of Pediatric Oncology and Haematology, University Hospital of Toulouse, Toulouse, France
| | - Judith Landman-Parker
- Department of Pediatric Oncology and Haematology, Hospital Armand Trousseau, Paris, France
| | - Jean Michon
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | - Thierry Leblanc
- Department of Pediatric Oncology and Haematology, Hospital Robert Debré, Paris, France
| | - Catherine Patte
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
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15
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Zhang M, Jin L, Yang J, Duan YL, Huang S, Zhou CJ, Zhang YH. [Clinical analysis of a modified LMB89 Group C regimen in the treatment of pediatric high-risk Burkitt lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:633-638. [PMID: 31495128 PMCID: PMC7342876 DOI: 10.3760/cma.j.issn.0253-2727.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Indexed: 12/22/2022]
Abstract
Objective: To analyze the therapeutic effect of a modified LMB89 Group C regimen in the treatment of pediatric high-risk Burkitt lymphoma. Methods: The clinical data of 172 children with newly diagnosed high-risk Burkitt lymphoma from January 2007 to April 2017 were retrospectively analyzed. All the cases were treated with the modified LMB89 Group C regimen. Results: The median age of the patients was 6 (1-14) years. The sex ratio was 5.1∶1, 144 boys (83.7%) and 28 girls (16.3%) . According to St. Jude staging classification, 2 patients (1.2%) were in stage Ⅱ, 54 (31.4%) in stage Ⅲ and 116 (67.4%) in stage Ⅳ. Of them, 46 patients (26.7%) had mature B cell acute lymphoblastic leukemia (B-ALL) , and 52 patients had central nervous system (CNS) involvement. According to risk group, the patients can be divided into group C1 (CNS1, without testicles/ovaries involvement, n=65) , group C2 (CNS2, testicles/ovaries involvement, n=55) and group C3 (CNS3, n=52) . A total of 145 patients received rituximab combined with chemotherapy during the treatment, 10 patients suffered from progressive disease and died, and 5 patients relapsed. Treatment-related mortality was 2.9%. With a median follow-up of 36.0 (0.5-119.0) months, 3-year overall survival (OS) rate was (88.9±2.4) % and event free survival (EFS) rate was (87.9±2.6) % for all patients. 3-year EFS rates were (96.9±2.1) %, (90.9±3.9) % and (73.4±6.5) % for Group C1, C2 and C3 respectively, and that of Group C3 was significantly lower than that of Group C1 (χ(2)=12.939, P=0.001) and Group C2 (χ(2)=6.302, P=0.036) . The 3-year EFS rates were (79.3±6.8) % and (44.4±16.6) % for patients in group C3 treated with chemotherapy combined with rituximab and chemotherapy alone (χ(2)=5.972, P=0.015) . Multivariable Cox regression analysis showed that Stage Ⅳ (including B-ALL) , residual diseases in mid-term evaluation were independent unfavorable prognostic factors[HR=4.241 (95%CI 1.163-27.332) , P=0.026; HR=32.184 (95%CI 11.441-99.996) , P<0.001]. Conclusions: The modified LMB89 Group C regimen has ideal effect for the children with high-risk Burkitt lymphoma.
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Affiliation(s)
- M Zhang
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
| | - L Jin
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
| | - J Yang
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
| | - Y L Duan
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
| | - S Huang
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
| | - C J Zhou
- Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Y H Zhang
- Beijing Key Laboratory of Pediatric Hematology Oncology; National Discipline of Pediatrics, Ministry of Education; MOE Key Laboratory of Major Diseases in Children; Hematology Oncology Center, Beijing 100045, China
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16
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Suh JK, Gao YJ, Tang JY, Jou ST, Lin DT, Takahashi Y, Kojima S, Jin L, Zhang Y, Seo JJ. Clinical Characteristics and Treatment Outcomes of Pediatric Patients with Non-Hodgkin Lymphoma in East Asia. Cancer Res Treat 2019; 52:359-368. [PMID: 31352772 PMCID: PMC7176969 DOI: 10.4143/crt.2019.219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose The presentations and geographic incidence of pediatric non-Hodgkin lymphoma (NHL) differ from those of adults. This study delineated the characteristics and outcomes of pediatric NHL in East Asia. Materials and Methods Medical records of 749 pediatric patients with NHL treated at participating institutions in mainland China, Japan, Korea, and Taiwan from January 2008 to December 2013 were reviewed. Demographic and clinical features, survival outcomes, and putative prognostic factors were analyzed. Results Five hundred thirty patients (71%) were male. The most common pathologic subtypes were Burkitt lymphoma (BL) (36%). Six hundred seven patients (81%) had advanced diseases at diagnosis. The 5-year overall survival and event-free survival (EFS) rates were 89% and 84%. The 5-year EFS rates of BL, lymphoblastic lymphoma, and diffuse large B-cell lymphoma were 88%, 88%, and 89%, and those of anaplastic large cell lymphoma (ALCL) and peripheral T-cell lymphoma (PTCL) were 71% and 56% (p < 0.001). Central nervous system involvement, high lactate dehydrogenase level (> 250 IU/mL), and advanced disease at diagnosis (≥ stage III) were associated with poor outcomes (p < 0.05). ALCL and PTCL relapsed more frequently than other pathologic subtypes (p < 0.001). Conclusion In East Asia, PTCL was more frequent than in Western countries, and bone marrow involvement did not affect treatment outcome. This international study should motivate future collaborative study on NHL in East Asia.
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Affiliation(s)
- Jin Kyung Suh
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Yi-Jin Gao
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai, China
| | - Jing-Yan Tang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai, China
| | - Shiann-Tarng Jou
- Department of Pediatrics Hematology/Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Dong-Tsamn Lin
- Department of Pediatrics Hematology/Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Seiji Kojima
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ling Jin
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yonghong Zhang
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Jong Jin Seo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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17
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Kalisz K, Alessandrino F, Beck R, Smith D, Kikano E, Ramaiya NH, Tirumani SH. An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence. Insights Imaging 2019; 10:56. [PMID: 31115699 PMCID: PMC6529494 DOI: 10.1186/s13244-019-0733-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 03/13/2019] [Indexed: 12/12/2022] Open
Abstract
Burkitt lymphoma (BL) is a highly aggressive, rapidly growing B cell non-Hodgkin lymphoma, which manifests in several subtypes including sporadic, endemic, and immunodeficiency-associated forms. Pathologically, BL is classically characterized by translocations of chromosomes 8 and 14 resulting in upregulation of the c-myc protein transcription factor with upregulation of cell proliferation. BL affects nearly every organ system, most commonly the abdomen and pelvis in the sporadic form. Imaging using a multimodality approach plays a crucial role in the management of BL from diagnosis, staging, and evaluation of treatment response to therapy-related complications with ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography playing roles. In this article, we review the pathobiology and classification of BL, illustrate a multimodality imaging approach in evaluating common and uncommon sites of involvement within the trunk and head and neck, and review common therapies and treatment-related complications.
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Affiliation(s)
- Kevin Kalisz
- Department of Radiology, Duke University, Durham, NC, USA
| | - Francesco Alessandrino
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA. .,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Rose Beck
- Department of Pathology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Daniel Smith
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Elias Kikano
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Nikhil H Ramaiya
- Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sree Harsha Tirumani
- Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Radiology, UH Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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18
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Fujita N, Kobayashi R, Atsuta Y, Iwasaki F, Suzumiya J, Sasahara Y, Inoue M, Koh K, Hori T, Goto H, Ichinohe T, Hashii Y, Kato K, Suzuki R, Mitsui T. Hematopoietic stem cell transplantation in children and adolescents with relapsed or refractory B-cell non-Hodgkin lymphoma. Int J Hematol 2019; 109:483-490. [PMID: 30701466 DOI: 10.1007/s12185-019-02608-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/19/2019] [Accepted: 01/23/2019] [Indexed: 01/03/2023]
Abstract
We undertook a retrospective study using the national registry data of hematopoietic stem cell transplantation (HSCT) in Japan to investigate the effect of graft source, particularly autologous or allogeneic tissue, on the treatment outcome in patients aged less than 18 years with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Survival analysis was conducted on 31 autologous HSCT (auto-HSCT) and 48 allogeneic HSCT (allo-HSCT) recipients between 1990 and 2013. The 5-year survival rates were significantly lower for allo-HSCT compared to auto-HSCT recipients (32% vs. 55%; P = 0.036). Multivariate analysis of survival rates identified allogeneic graft, Burkitt histology, and lack of response to chemotherapy as poor prognostic factors for survival. The cumulative incidence of treatment-related mortality (TRM) was significantly higher in allo-HSCT compared to auto-HSCT recipients (P = 0.017), explaining the difference in survival rates. In patients with Burkitt lymphoma (BL), overall survival was significantly inferior in the group of patients undergoing HSCT within 12 months from the initial diagnosis (P = 0.039). These data indicate that treatment outcomes for HSCT in children and adolescents with B-NHL were better in autograft recipients, suggesting that greater attention should be paid to the risk of TRM, especially after allografts, for patients with BL.
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Affiliation(s)
- Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-Machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fuminori Iwasaki
- Department of Hematology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Junji Suzumiya
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Tsukasa Hori
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroaki Goto
- Division of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Hashii
- Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koji Kato
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital Cancer Center, Izumo, Japan
| | - Tetsuo Mitsui
- Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan
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19
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Radiation Therapy in Burkitt Lymphoma. Radiat Oncol 2018. [DOI: 10.1007/978-3-319-52619-5_25-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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20
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Short NJ, Kantarjian HM, Ko H, Khoury JD, Ravandi F, Thomas DA, Garcia-Manero G, Khouri M, Cortes JE, Wierda WG, Verstovsek S, Estrov Z, Ferrajoli A, Thompson PA, Pierce S, O'Brien SM, Jabbour E. Outcomes of adults with relapsed or refractory Burkitt and high-grade B-cell leukemia/lymphoma. Am J Hematol 2017; 92:E114-E117. [PMID: 28295472 DOI: 10.1002/ajh.24720] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/06/2017] [Accepted: 03/13/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Nicholas J. Short
- Division of Cancer Medicine; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Hagop M. Kantarjian
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Heidi Ko
- Department of Internal Medicine; The University of Texas Health Science Center; Houston Texas USA
| | - Joseph D. Khoury
- Department of Hematopathology; The University of Texas Health Science Center; Houston Texas USA
| | - Farhad Ravandi
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Deborah A. Thomas
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Guillermo Garcia-Manero
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Maria Khouri
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Jorge E. Cortes
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - William G. Wierda
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Srdan Verstovsek
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Zeev Estrov
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Alessandra Ferrajoli
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Philip A. Thompson
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Sherry Pierce
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
| | - Susan M. O'Brien
- Chao Family Comprehensive Cancer Center, University of California Irvine; Orange California USA
| | - Elias Jabbour
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas USA
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21
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Kieslich A, Ruf P, Lindhofer H, Buhmann R, Eggert A, Hundsdoerfer P. Immunotherapy with the trifunctional anti-CD20 × anti-CD3 antibody FBTA05 in a patient with relapsed t(8;14)-positive post-transplant lymphoproliferative disease. Leuk Lymphoma 2017; 58:1989-1992. [PMID: 28093004 DOI: 10.1080/10428194.2016.1272687] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Anna Kieslich
- a Department of Pediatrics, Division of Oncology and Hematology , Charité University Medicine , Berlin , Germany
| | - Peter Ruf
- b TRION Research GmbH , Munich , Germany
| | | | - Raynold Buhmann
- c Department of Medicine III and Transfusion Medicine , University Hospital Grosshadern, LMU , Munich , Germany
| | - Angelika Eggert
- a Department of Pediatrics, Division of Oncology and Hematology , Charité University Medicine , Berlin , Germany
| | - Patrick Hundsdoerfer
- a Department of Pediatrics, Division of Oncology and Hematology , Charité University Medicine , Berlin , Germany
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Dozzo M, Carobolante F, Donisi PM, Scattolin A, Maino E, Sancetta R, Viero P, Bassan R. Burkitt lymphoma in adolescents and young adults: management challenges. Adolesc Health Med Ther 2017; 8:11-29. [PMID: 28096698 PMCID: PMC5207020 DOI: 10.2147/ahmt.s94170] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
About one-half of all Burkitt lymphoma (BL) patients are younger than 40 years, and one-third belong to the adolescent and young adult (AYA) subset, defined by an age between 15 and 25-40 years, based on selection criteria used in different reports. BL is an aggressive B-cell neoplasm displaying highly characteristic clinico-diagnostic features, the biologic hallmark of which is a translocation involving immunoglobulin and c-MYC genes. It presents as sporadic, endemic, or epidemic disease. Endemicity is pathogenetically linked to an imbalance of the immune system which occurs in African children infected by malaria parasites and Epstein-Barr virus, while the epidemic form strictly follows the pattern of infection by HIV. BL shows propensity to extranodal involvement of abdominal organs, bone marrow, and central nervous system, and can cause severe metabolic and renal impairment. Nevertheless, BL is highly responsive to specifically designed short-intensive, rotational multiagent chemotherapy programs, empowered by the anti-CD20 monoclonal antibody rituximab. When carefully applied with appropriate supportive measures, these modern programs achieve a cure rate of approximately 90% in the average AYA patient, irrespective of clinical stage, which is the best result achievable in any aggressive lymphoid malignancy to date. The challenges ahead concern the following: optimization of management in underdeveloped countries, with reduction of diagnostic and referral-for-care intervals, and the applicability of currently curative regimens; the development of lower intensity but equally effective treatments for frail or immunocompromised patients at risk of death by complications; the identification of very high-risk patients through positron-emission tomography and minimal residual disease assays; and the assessment in these and the few refractory/relapsed ones of new monoclonals (ofatumumab, blinatumomab, inotuzumab ozogamicin) and new molecules targeting c-MYC and key proliferative steps of B-cell malignancies.
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Affiliation(s)
- Massimo Dozzo
- Complex Operative Unit of Hematology, Ospedale dell’Angelo
| | | | - Pietro Maria Donisi
- Simple Departmental Operative Unit of Anatomic Pathology, Ospedale Ss. Giovanni e Paolo, Venice, Italy
| | | | - Elena Maino
- Complex Operative Unit of Hematology, Ospedale dell’Angelo
| | | | - Piera Viero
- Complex Operative Unit of Hematology, Ospedale dell’Angelo
| | - Renato Bassan
- Complex Operative Unit of Hematology, Ospedale dell’Angelo
- Correspondence: Renato Bassan, Complex Operative Unit of Hematology, Ospedale dell’Angelo, Via Paccagnella 11, 30174 Mestre-Venice, Italy, Tel +39 41 965 7362, Fax +39 41 965 7361, Email
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Sun M, Wang J, Lu Q, Xia G, Zhang Y, Song L, Fang Y. Novel synthesizing method of pH-dependent doxorubicin-loaded anti-CD22-labelled drug delivery nanosystem. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:5123-33. [PMID: 26379425 PMCID: PMC4567241 DOI: 10.2147/dddt.s86764] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The objective of this study was to investigate the anticancer efficacy of dimercaptosuccinic acid-modified iron oxide magnetic nanoparticles coloaded with anti-CD22 antibodies and doxorubicin (anti-CD22-MNPs-DOX) on non-Hodgkin’s lymphoma cells. The physical properties of anti-CD22-MNPs-DOX were studied and its antitumor effect on Raji cells in vitro was evaluated using the Cell Counting Kit-8 assay. Furthermore, cell apoptosis and intracellular accumulation of doxorubicin were determined by flow cytometry. The results revealed that anti-CD22-MNPs-DOX inhibited the proliferation of Raji cells, significantly increased the uptake of doxorubicin, and induced apoptosis. Therefore, it was concluded that a coloaded antibody and chemotherapeutic drug with magnetic nanoparticles might be an efficient targeted treatment strategy for non-Hodgkin’s lymphoma.
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Affiliation(s)
- Mengjiao Sun
- Department of Hematology/Oncology, Nanjing Children's Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jun Wang
- Department of Hematology/Oncology, Nanjing Children's Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Qin Lu
- Department of Hematology/Oncology, Nanjing Children's Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guohua Xia
- Department of Hematology, Zhongda Hospital, Medical School, Southeast University, Nanjing, People's Republic of China
| | - Yu Zhang
- State Key Laboratory of Bioelectronics, Southeast University, Nanjing, People's Republic of China
| | - Lina Song
- State Key Laboratory of Bioelectronics, Southeast University, Nanjing, People's Republic of China
| | - Yongjun Fang
- Department of Hematology/Oncology, Nanjing Children's Hospital, Nanjing Medical University, Nanjing, People's Republic of China
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Jourdain A, Auperin A, Minard-Colin V, Aladjidi N, Zsiros J, Coze C, Gandemer V, Bertrand Y, Leverger G, Bergeron C, Michon J, Patte C. Outcome of and prognostic factors for relapse in children and adolescents with mature B-cell lymphoma and leukemia treated in three consecutive prospective "Lymphomes Malins B" protocols. A Société Française des Cancers de l'Enfant study. Haematologica 2015; 100:810-7. [PMID: 25724577 DOI: 10.3324/haematol.2014.121434] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/25/2015] [Indexed: 11/09/2022] Open
Abstract
To describe relapsed B-cell lymphoma or leukemia in children/adolescents treated with a "Lymphomes Malins B" regimen and their outcome and to identify prognostic factors for survival, we studied relapses in the LMB89, 96 and 2001 studies of the Société Française d'Oncologie Pédiatrique (Société Française des Cancers de l'Enfant). Therapeutic guidelines at relapse were to obtain a second complete remission and to consolidate the remission with high-dose chemotherapy followed by autologous stem-cell transplantation. Between July 1989 and March 2007, 67 patients of 1322 (5%) relapsed: 57 had Burkitt lymphoma and 10 had large-cell histology. Three patients were initially treated in risk group A, 41 in group B and 23 in group C. Thirty-three patients had a relapse in one site (15 in the central nervous system) and 34 at multiple sites. Sixty-five patients received salvage chemotherapy and 33 achieved complete remission. Forty-one patients also received high-dose chemotherapy followed by autologous (n=33) or allogeneic (n=8) transplantation. With a median follow-up of 6.4 years, the 5-year survival rate was 29.9%. Nineteen patients were still alive, all but one (group A) received consolidation treatment. Multivariate analysis showed the following factors to be significantly associated with better survival: relapse at one site (P=0.0006), large-cell histology (P=0.012), initial prognostic group A or B with lactate dehydrogenase level below twice the normal value (P=0.005), and time to relapse more than 6 months (P=0.04).
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Affiliation(s)
- Anne Jourdain
- Paediatric Onco-Hematology Unit, Hopital de Clocheville, Tours, France
| | - Anne Auperin
- Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France
| | | | - Nathalie Aladjidi
- Pediatric Onco-Hematology Unit, Bordeaux University Hospital, France
| | - Josef Zsiros
- Department of Pediatric Oncology, Emma Children's Hospital Academic Medical Centre, Amsterdam, The Netherlands
| | - Carole Coze
- Pediatric Hematology Oncology Unit, Aix-Marseille University and APHM, Hôpital d'Enfants de La Timone, Marseille, France
| | - Virginie Gandemer
- Pediatric Onco-Hematology Unit, Rennes University Hospital, Rennes, France
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology, Lyon, France
| | - Guy Leverger
- Pediatric Onco-Hematology Unit, AP-HP, Armand Trousseau Hospital, UPMC Univ Paris 06, France
| | | | - Jean Michon
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | - Catherine Patte
- Department of Pediatric Oncology, Gustave Roussy, Villejuif, France
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