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Emmanouilidou E, Kosmara D, Papadaki E, Mastorodemos V, Constantoulakis P, Repa A, Christopoulou G, Kalpadakis C, Avgoustidis N, Thomas K, Boumpas D, Sidiropoulos P, Bertsias G. Progressive Multifocal Leukoencephalopathy in Systemic Lupus Erythematosus: A Consequence of Patient-Intrinsic or -Extrinsic Factors? J Clin Med 2023; 12:6945. [PMID: 37959410 PMCID: PMC10647998 DOI: 10.3390/jcm12216945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system (CNS) caused by reactivation of the polyomavirus JC (JCV) typically in immunocompromised individuals. The risk of PML among rheumatic diseases may be higher for systemic lupus erythematosus (SLE), without, however, a clear association with the type and intensity of background therapy. We present the development and outcome of PML in a 32-year-old female lupus patient under mild immunosuppressive treatment, yet with marked B-cell lymphopenia in the peripheral blood and bone marrow (<1% of total lymphocytes). Despite treatment with the immune checkpoint inhibitor pembrolizumab, the patient showed progressive neurological and brain imaging deterioration and eventually died 15 months after PML diagnosis. To unveil possible underlying genetic liabilities, whole exome sequencing was performed which identified deleterious variants in GATA2 and CDH7 genes, which both have been linked to defective T- and/or B-lymphocyte production. These findings reiterate the possible role of disease-/patient-intrinsic factors, rather than that of drug-induced immunosuppression, in driving immune dysregulation and susceptibility to PML in certain patients with SLE.
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Affiliation(s)
- Evgenia Emmanouilidou
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
| | - Despoina Kosmara
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology—Hellas, 71110 Heraklion, Greece
| | - Efrosini Papadaki
- Department of Radiology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology—Hellas, 71110 Heraklion, Greece
| | | | | | - Argyro Repa
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
| | | | - Christina Kalpadakis
- Department of Laboratory Hematology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece
| | - Nestor Avgoustidis
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
| | - Konstantinos Thomas
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Attikon University General Hospital, 12462 Chaidari, Greece
| | - Dimitrios Boumpas
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, Attikon University General Hospital, 12462 Chaidari, Greece
- Laboratory of Autoimmunity and Inflammation, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, 11527 Athens, Greece
| | - Prodromos Sidiropoulos
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology—Hellas, 71110 Heraklion, Greece
| | - George Bertsias
- Rheumatology and Clinical Immunology, University Hospital of Heraklion and University of Crete Medical School, 71500 Heraklion, Greece; (E.E.); (D.K.)
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology—Hellas, 71110 Heraklion, Greece
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Vassilakopoulos TP, Piperidou A, Mellios Z, Verigou E, Katodritou E, Kalpadakis C, Papageorgiou SG, Chatzidimitriou C, Prassopoulos V, Siakantaris MP, Giatra H, Karantanis D, Papathanasiou N, Ligdi L, Kopsaftopoulou A, Leonidopoulou T, Xanthopoulos V, Karakatsanis S, Vrakidou E, Chatziioannou S, Drougkas D, Hatzimichael E, Gainaru G, Palassopoulou M, Tsirogianni M, Kotsopoulou M, Tsourouflis G, Skoura E, Mainta C, Terpos E, Poziopoulos C, Triantafyllou T, Zikos P, Koumarianou A, Liapi D, Pappa V, Verrou E, Tsirigotis P, Labropoulou V, Papadaki H, Datseris I, Symeonidis A, Bouzani M, Bakiri M, Karmiris T, Angelopoulou MK, Rondogianni P. PET for Response Assessment to R-da-EPOCH in Primary Mediastinal Large B-cell lymphoma: Who Is Worthy to be Irradiated? Hemasphere 2023; 7:e965. [PMID: 38027423 PMCID: PMC10631617 DOI: 10.1097/hs9.0000000000000965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/28/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Theodoros P. Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | - Alexia Piperidou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | - Zois Mellios
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Evgenia Verigou
- Department of Internal Medicine, Hematology Division, University of Patras, Rion, Greece
| | - Eirini Katodritou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | | | - Sotirios G. Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, National and Kapodistrian University of Athens, University General Hospital “Attikon,” Greece
| | - Chrysovalantou Chatzidimitriou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | | | - Marina P. Siakantaris
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | - Hara Giatra
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | | | | | - Loukia Ligdi
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Anastasia Kopsaftopoulou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | | | | | - Stamatios Karakatsanis
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | | | - Sophia Chatziioannou
- Department of Nuclear Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Greece
| | - Dimitrios Drougkas
- Department of Nuclear Medicine and PET/CT, Vioiatriki, Thessaloniki, Greece
| | | | | | | | - Maria Tsirogianni
- Department of Hematology, Saint Savvas Anticancer Hospital, Athens, Greece
| | - Maria Kotsopoulou
- Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece
| | - Gerassimos Tsourouflis
- Second Department of Surgery, Propedeutic, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | - Evangelia Skoura
- Department of Nuclear Medicine and PET/CT, Vioiatriki, Athens, Greece
| | - Catherine Mainta
- Department of Nuclear Medicine and PET/CT, Athens Medical Center, Greece
| | - Evangelos Terpos
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Greece
| | | | | | - Panayiotis Zikos
- Haematology Unit, General Hospital of Patras “Agios Andreas,” Greece
| | - Argyro Koumarianou
- First Department of Hematology, Metropolitan General Hospital, Athens, Greece
| | - Dimitra Liapi
- Department of Hematology, Venizelion Hospital, Iraklion, Crete, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, National and Kapodistrian University of Athens, University General Hospital “Attikon,” Greece
| | - Evgenia Verrou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Panayiotis Tsirigotis
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, National and Kapodistrian University of Athens, University General Hospital “Attikon,” Greece
| | - Vassiliki Labropoulou
- Department of Internal Medicine, Hematology Division, University of Patras, Rion, Greece
| | - Helen Papadaki
- Department of Hematology, University of Crete, Iraklion, Greece
| | - Ioannis Datseris
- Department of Nuclear Medicine and PET/CT, Evangelismos General Hospital, Athens, Greece
| | - Argiris Symeonidis
- Department of Internal Medicine, Hematology Division, University of Patras, Rion, Greece
| | - Maria Bouzani
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Maria Bakiri
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Themis Karmiris
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Maria K. Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Greece
| | - Phivi Rondogianni
- Department of Nuclear Medicine and PET/CT, Evangelismos General Hospital, Athens, Greece
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Vassilakopoulos TP, Panitsas F, Mellios Z, Apostolidis J, Michael M, Gurion R, Ferhanoglu B, Hatzimichael E, Karakatsanis S, Dimou M, Kalpadakis C, Katodritou E, Leonidopoulou T, Kotsianidis I, Giatra H, Kanellias N, Sayyed A, Tadmor T, Akay OM, Angelopoulou MK, Horowitz N, Bakiri M, Pangalis GA, Panayiotidis P, Papageorgiou SG. Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B-cell lymphoma in the rituximab era. Hematol Oncol 2023; 41:97-107. [PMID: 36314897 DOI: 10.1002/hon.3096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/15/2022] [Accepted: 10/22/2022] [Indexed: 11/04/2022]
Abstract
Central nervous system (CNS) involvement is rare in primary mediastinal large B-cell lymphoma (PMLBCL). We aimed to evaluate the incidence of CNS relapse as first treatment failure event and the effect of the induction chemotherapy regimen, central nervous system - international prognostic index (CNS-IPI) and other clinical and laboratory variables on the risk of CNS relapse in 564 PMLBCL patients treated with immunochemotherapy. Only 17 patients (3.0%) received CNS prophylaxis. During a 55-month median follow-up only 8 patients experienced CNS relapse as first event, always isolated. The 2-year cumulative incidence of CNS relapse (CI-CNSR) was 1.47% and remained unchanged thereafter. The CI-CNSR was not affected by the chemotherapy regimen (R-CHOP or R-da-EPOCH). None of the established International Prognostic Index factors for aggressive lymphomas predicted CNS relapse in PMLBCL. The 2-year CI-CNSR in patients with versus without kidney involvement was 13.3% versus 0.96% (p < 0.001); 14.3% versus 1.13% with versus without adrenal involvement (p < 0.001); and 10.2% versus 0.97% with versus without either kidney or adrenal involvement. CNS-IPI was also predictive (2-year CI-CNSR in high-risk vs. intermediate/low-risk: 10.37% vs. 0.84%, p < 0.001). However, this association may be driven mainly by kidney and/or adrenal involvement. In conclusion, in PMLBCL, CNS relapse is rare and appears to be strongly associated with kidney and/or adrenal involvement.
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Affiliation(s)
- Theodoros P Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Fotios Panitsas
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Zois Mellios
- Department of Haematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - John Apostolidis
- Department of Adult Hematology & Stem Cell Transplantation, Lymphoma Program, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Michalis Michael
- Department of Haematology, Nicosia General Hospital, Nicosia, Cyprus
| | - Ronit Gurion
- Rabin Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Burhan Ferhanoglu
- Hematology Department, Koç University, School of Medicine, Istanbul, Turkey
| | - Eleftheria Hatzimichael
- Department of Haematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Stamatios Karakatsanis
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Maria Dimou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Eirini Katodritou
- Department of Haematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | | | - Ioannis Kotsianidis
- Department of Haematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Hara Giatra
- Department of Haematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Nick Kanellias
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Ayman Sayyed
- Department of Adult Hematology & Stem Cell Transplantation, Lymphoma Program, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | | | - Olga Meltem Akay
- Hematology Department, Koç University, School of Medicine, Istanbul, Turkey
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Maria Bakiri
- Department of Haematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Gerassimos A Pangalis
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.,Department of Haematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Panayiotis Panayiotidis
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Sotirios G Papageorgiou
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
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4
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Karakatsanis SJ, Bouzani M, Symeonidis A, Angelopoulou MK, Papageorgiou SG, Michail M, Gainaru G, Kourti G, Sachanas S, Kalpadakis C, Katodritou E, Leonidopoulou T, Kotsianidis I, Hatzimichael E, Kotsopoulou M, Dimou M, Variamis E, Boutsis D, Kanellias N, Dimopoulou MN, Michali E, Karianakis G, Tsirkinidis P, Vadikolia C, Poziopoulos C, Pigaditou A, Vrakidou E, Economopoulos T, Kyriazopoulou L, Siakantaris MP, Kyrtsonis MC, Anargyrou K, Papaioannou M, Hatjiharissi E, Vervessou E, Tsirogianni M, Palassopoulou M, Stefanoudaki E, Zikos P, Tsirigotis P, Tsourouflis G, Assimakopoulou T, Verrou E, Papadaki H, Lampropoulou P, Dimopoulos MA, Pappa V, Konstantopoulos K, Karmiris T, Roussou P, Panayiotidis P, Pangalis GA, Vassilakopoulos TP. Real-life Experience With Rituximab-CHOP Every 21 or 14 Days in Primary Mediastinal Large B-cell Lymphoma. In Vivo 2022; 36:1302-1315. [PMID: 35478115 DOI: 10.21873/invivo.12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Primary mediastinal large B-cell lymphoma (PMLBCL) is an aggressive B-cell non-Hodgkin lymphoma (NHL), whose prognosis has greatly improved since the incorporation of the anti-CD20 monoclonal antibody rituximab into current therapeutic regimens. Evidence, however, on the optimal time interval between consecutive chemoimmunotherapy (CIT) cycles is still scarce. This study aimed to evaluate the efficacy outcomes of the more commonly administered 3-weekly regimens to the biweekly ones in a PMLBCL patients' population, who were mostly treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone every 21 days (R-CHOP-21) or R-CHOP-14. PATIENTS AND METHODS We retrospectively studied our cohort of consecutively treated PMLBCL patients, focusing on their treatment density, in order to determine possible differences in treatment outcomes. RESULTS CIT, in the form of both R-CHOP-21 as well as R-CHOP-14 (or similar regimens), is highly active in PMLBCL, with low rates of early treatment failure. In our cohort of patients, R-CHOP-14 did not result in a meaningful improvement of freedom from progression (FFP) or overall survival (OS). CONCLUSION Both R-CHOP-14 and R-CHOP-21 are probably equally effective in PMLBCL, yet further, prospective, randomized studies are warranted to clarify whether dose-dense regimens can be associated with better disease control and long-term results.
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Affiliation(s)
- Stamatis J Karakatsanis
- Third Department of Internal Medicine and Laboratory, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Maria Bouzani
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Argyris Symeonidis
- Hematology Division, Department of Internal Medicine, University of Patras, Patras, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | - Sotirios G Papageorgiou
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Chaidari, Greece
| | - Michail Michail
- Department of Hematology, Nicosia General Hospital, Nicosia, Cyprus
| | | | - Georgia Kourti
- Third Department of Internal Medicine and Laboratory, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece.,Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | | | | | - Eirini Katodritou
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | | | - Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Maria Kotsopoulou
- Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece
| | - Maria Dimou
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | - Eleni Variamis
- First Department of Internal Medicine,Laikon General Hospital, Athens, Greece
| | | | - Nick Kanellias
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Maria N Dimopoulou
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | - Evridiki Michali
- Department of Clinical Hematology, G.Gennimatas Athens General Hospital, Athens, Greece
| | | | | | | | | | - Anna Pigaditou
- Department of Hematology, Athens Medical Center, Marousi, Greece
| | | | | | - Lydia Kyriazopoulou
- Department of Hematology, University of Ioannina, Medical School, Ioannina, Greece
| | - Marina P Siakantaris
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | | | | | - Maria Papaioannou
- Hematology Unit, 1 Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdoxia Hatjiharissi
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece.,Hematology Unit, 1 Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Tsirogianni
- Department of Hematology, Aghios Savvas Anticancer Hospital, Athens, Greece
| | | | | | | | - Panayiotis Tsirigotis
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Chaidari, Greece
| | | | | | - Evgenia Verrou
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | - Helen Papadaki
- Department of Hematology,University Hospital of Heraklion, Heraklion, Greece
| | | | | | - Vassiliki Pappa
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Chaidari, Greece
| | - Kostas Konstantopoulos
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | - Themis Karmiris
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Paraskevi Roussou
- Third Department of Internal Medicine and Laboratory, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Panayiotis Panayiotidis
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece
| | - Gerassimos A Pangalis
- Department of Haematology and Bone Marrow Transplantation,Laikon General Hospital, Athens, Greece.,Department of Hematology, Athens Medical Center, Psychikon, Greece
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Papafragkos I, Markaki E, Kalpadakis C, Verginis P. Decoding the Myeloid-Derived Suppressor Cells in Lymphoid Malignancies. J Clin Med 2021; 10:jcm10163462. [PMID: 34441758 PMCID: PMC8397155 DOI: 10.3390/jcm10163462] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 12/12/2022] Open
Abstract
Myeloid-derived suppressor cells (MDSCs) are immature myeloid precursors which emerged as a potent regulator of the immune system, exerting suppressive properties in diverse disease settings. In regards to cancer, MDSCs have an established role in solid tumors; however, their contribution to immune regulation during hematologic malignancies and particularly in lymphomas remains ill-defined. Herein focused on lymphoma, we discuss the literature on MDSC cells in all histologic types, and we also refer to lessons learned by animal models of lymphoma. Furthermore, we elaborate on future directions and unmet needs and challenges in the MDSC field related to lymphoma malignancies which may shed light on the complex nature of the immune system in malignancies.
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Affiliation(s)
- Iosif Papafragkos
- Laboratory of Immune Regulation and Tolerance, Division of Basic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece; (I.P.); (E.M.)
| | - Efrosyni Markaki
- Laboratory of Immune Regulation and Tolerance, Division of Basic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece; (I.P.); (E.M.)
| | - Christina Kalpadakis
- Laboratory of Haematology, Division of Laboratory Medicine, Medical School, University of Crete, 71003 Heraklion, Greece
- Department of Laboratory Haematology, University Hospital of Heraklion, 71500 Heraklion, Greece
- Correspondence: (C.K.); (P.V.); Tel.: +30-69-4458-2738 (C.K.); +30-28-1039-4553 (P.V.)
| | - Panayotis Verginis
- Laboratory of Immune Regulation and Tolerance, Division of Basic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece; (I.P.); (E.M.)
- Department of Laboratory Haematology, University Hospital of Heraklion, 71500 Heraklion, Greece
- Correspondence: (C.K.); (P.V.); Tel.: +30-69-4458-2738 (C.K.); +30-28-1039-4553 (P.V.)
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6
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Vassilakopoulos TP, Michail M, Papageorgiou S, Kourti G, Angelopoulou MK, Panitsas F, Sachanas S, Kalpadakis C, Katodritou E, Leonidopoulou T, Kotsianidis I, Hatzimichael E, Kotsopoulou M, Dimou M, Variamis E, Boutsis D, Terpos E, Dimopoulou MN, Karakatsanis S, Michalis E, Karianakis G, Tsirkinidis P, Vadikolia C, Poziopoulos C, Pigaditou A, Vrakidou E, Economopoulos T, Kyriazopoulou L, Siakantaris MP, Kyrtsonis MC, Symeonidis A, Anargyrou K, Papaioannou M, Hatjiharissi E, Vervessou E, Tsirogianni M, Palassopoulou M, Gainaru G, Stefanoudaki E, Zikos P, Tsirigotis P, Tsourouflis G, Assimakopoulou T, Konstantinidou P, A Papadaki H, Megalakaki K, Dimopoulos MA, Pappa V, Karmiris T, Roussou P, Panayiotidis P, Konstantopoulos K, Pangalis GA. Identification of Very Low-Risk Subgroups of Patients with Primary Mediastinal Large B-Cell Lymphoma Treated with R-CHOP. Oncologist 2021; 26:597-609. [PMID: 33870594 DOI: 10.1002/onco.13789] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 04/02/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND R-CHOP can cure approximately 75% of patients with primary mediastinal large B-cell lymphoma (PMLBCL), but prognostic factors have not been sufficiently evaluated yet. R-da- EPOCH is potentially more effective but also more toxic than R-CHOP. Reliable prognostic classification is needed to guide treatment decisions. MATERIALS AND METHODS We analyzed the impact of clinical prognostic factors on the outcome of 332 PMLBCL patients ≤65 years treated with R-CHOP ± radiotherapy in a multicenter setting in Greece and Cyprus. RESULTS With a median follow-up of 69 months, 5-year freedom from progression (FFP) was 78% and 5-year lymphoma specific survival (LSS) was 89%. On multivariate analysis, extranodal involvement (E/IV) and lactate dehydrogenase (LDH) ≥2 times upper limit of normal (model A) were significantly associated with FFP; E/IV and bulky disease (model B) were associated with LSS. Both models performed better than the International Prognostic Index (IPI) and the age-adjusted IPI by Harrel's C rank parameter and Akaike information criterion. Both models A and B defined high-risk subgroups (13%-27% of patients [pts]) with approximately 19%-23% lymphoma-related mortality. They also defined subgroups composing approximately one-fourth or one-half of the patients, with 11% risk of failure and only 1% or 4% 5-year lymphoma-related mortality. CONCLUSION The combination of E/IV with either bulky disease or LDH ≥2 times upper limit of normal defined high-risk but not very-high-risk subgroups. More importantly, their absence defined subgroups comprising approximately one-fourth or one-half of the pts, with 11% risk of failure and minimal lymphoma-related mortality, who may not need more intensive treatment such as R-da-EPOCH. IMPLICATIONS FOR PRACTICE By analyzing the impact of baseline clinical characteristics on outcomes of a large cohort of patients with primary mediastinal large B-cell lymphoma homogeneously treated with R-CHOP with or without radiotherapy, we developed novel prognostic indices which can aid in deciding which patients can be adequately treated with R-CHOP and do not need more intensive regimens such as R-da-EPOCH. The new indices consist of objectively determined characteristics (extranodal disease or stage IV, bulky disease, and markedly elevated serum lactate dehydrogenase), which are readily available from standard initial staging procedures and offer better discrimination compared with established risk scores (International Prognostic Index [IPI] and age-adjusted IPI).
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Affiliation(s)
- Theodoros P Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Michail Michail
- Department of Hematology, Nicosia General Hospital, Nicosia, Cyprus
| | - Sotirios Papageorgiou
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Georgia Kourti
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece.,Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Maria K Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Fotios Panitsas
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Sotirios Sachanas
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | | | - Eirini Katodritou
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | | | - Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Maria Kotsopoulou
- Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece
| | - Maria Dimou
- First Propedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Eleni Variamis
- First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Evangelos Terpos
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Maria N Dimopoulou
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Stamatios Karakatsanis
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Eurydiki Michalis
- Department of Clinical Hematology, "G.Gennimatas" Athens General Hospital, Athens, Greece
| | | | | | | | | | - Anna Pigaditou
- Department of Hematology, Athens Medical Center, Amaroussion Branch, Athens, Greece
| | | | | | | | - Marina P Siakantaris
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Marie-Christine Kyrtsonis
- First Propedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Argyris Symeonidis
- Hematology Division, Dept of Internal Medicine, University of Patras, Patras, Greece
| | | | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdoxia Hatjiharissi
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece.,Hematology Unit, 1st Dept of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Tsirogianni
- Department of Hematology, Aghios Savvas Anticancer Hospital, Athens, Greece
| | | | | | | | | | - Panayiotis Tsirigotis
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Gerasimos Tsourouflis
- Second Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | | | - Helen A Papadaki
- Department of Hematology, University of Crete, Iraklion, Crete, Greece
| | | | | | - Vassiliki Pappa
- Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Themis Karmiris
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Paraskevi Roussou
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Panayiotis Panayiotidis
- First Propedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Kostas Konstantopoulos
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Gerassimos A Pangalis
- Department of Hematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.,Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
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7
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Vassilakopoulos T, Ferhanoglu B, Horowitz N, Mellios Z, Kaynar L, Zektser M, Symeonidis A, Piperidou A, Kalpadakis C, Akay OM, Atalar AC, Katodritou E, Leonidopoulou T, Papageorgiou S, Tadmor T, Gutwein O, Karakatsanis S, Ganzel C, Karianakis G, Isenberg G, Gainaru G, Vrakidou E, Palassopoulou M, Ozgur M, Siakantaris M, Paydas S, Tsirigotis P, Tsirogianni M, Hatzimichael E, Tuglular T, Chatzidimitriou C, Megalakaki E, Kanellias N, Zikos P, Koumarianou A, Gafter‐Gvili A, Angelopoulou M, Karmiris T, Gurion R. RITUXIMAB‐DOSE‐ADJUSTED EPOCH (R‐DA‐EPOCH) IN PRIMARY MEDIASTINAL LARGE B‐CELL LYMPHOMA (PMLBCL): REAL‐LIFE EXPERIENCE ON 190 PATIENTS FROM 3 MEDITERRANEAN COUNTRIES. Hematol Oncol 2021. [DOI: 10.1002/hon.76_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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8
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Dimou M, Papageorgiou SG, Stavroyianni N, Katodritou E, Tsirogianni M, Kalpadakis C, Banti A, Arapaki M, Iliakis T, Bouzani M, Verrou E, Spanoudakis E, Giannouli S, Marinakis T, Mandala E, Mparmparousi D, Sachanas S, Dalekou-Tsolakou M, Hatzimichael E, Vadikolia C, Violaki V, Poziopoulos C, Tsirkinidis P, Chatzileontiadou S, Vervessou E, Ximeri M, Sioni A, Konstantinidou P, Kyrtsonis MC, Siakantaris MP, Angelopoulou MK, Pappa V, Konstantopoulos K, Panayiotidis P, Vassilakopoulos TP. Real-life experience with the combination of polatuzumab vedotin, rituximab, and bendamustine in aggressive B-cell lymphomas. Hematol Oncol 2021; 39:336-348. [PMID: 33583077 DOI: 10.1002/hon.2842] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/13/2022]
Abstract
Transplant-ineligible relapsed/refractory (rr) diffuse large B-cell lymphoma (DLBCL) patients represent an unmet medical need. Polatuzumab vedotin (Pola), an anti-CD79b antibody-drug-conjugate (ADG), with bendamustine- rituximab(BR) has recently gained approval for these patients, both in the USA and Europe, based on the GO29365 phase IIb trial. Real-life data with Pola are extremely limited. We report the outcomes of 61 Greek patients, who received Pola-(B)R mainly within a compassionate use program. Treatment was given for up to six 21-day cycles. Bendamustine was omitted in three cases due to previous short-lived responses. Fourty-nine rrDLBCL(efficacy cohort-EC) and 58 rr aggressive B-NHL (safety cohort-SC) patients received at least 1 Pola-BR cycle. Twenty-one (43%) patients of the EC responded with 12/49 (25%) CR and 9/49 (18%) PR as best response. Median progression-free survival, overall survival and duration of response were 4.0, 8.5, and 8.5 months respectively, while 55% of patients experienced a grade ≥3 adverse event, mainly hematologic. Treatment discontinuations and death during treatment were mainly due to disease progression. Twenty-two (41%) patients received further treatment; 11/22 are still alive, including one after CAR-T cells, and two after stem cell transplantation. Our data confirm that Pola-BR is a promising treatment for rrDLBCL patients, inducing an adequate response rate with acceptable toxicity. Pola-BR could be used as bridging therapy before further consolidative treatments.
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Affiliation(s)
- Maria Dimou
- First Department of Internal Medicine, Propaedeutic, Haematology Clinical Trial Unit, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Niki Stavroyianni
- Department of Hematology, Papanikolaou Hospital, Thessaloniki, Greece
| | - Eirini Katodritou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - Maria Tsirogianni
- Department of Hematology, Aghios Savvas Anticancer Hospital, Athens, Greece
| | | | - Anastasia Banti
- Hematology Department, Papageorgiou Hospital, Thessaloniki, Greece
| | - Maria Arapaki
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Iliakis
- First Department of Internal Medicine, Propaedeutic, Haematology Clinical Trial Unit, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Bouzani
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Eugenia Verrou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | | | - Stavroula Giannouli
- Second Department of Internal Medicine, Ippokrateion General Hospital, Athens, Greece
| | - Theodoros Marinakis
- Department of Clinical Hematology, "G. Gennimatas" General Hospital, Athens, Greece
| | - Evdokia Mandala
- Forth Department of Medicine, Faculty of Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Despoina Mparmparousi
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | | | | | - Eleftheria Hatzimichael
- Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Vasiliki Violaki
- Department of Hematology, Chania General Hospital, Chania, Greece
| | | | | | - Sofia Chatzileontiadou
- Hematology Unit, 1st Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | | | - Maria Ximeri
- Department of Hematology, University of Crete, Iraklion, Crete, Greece
| | - Anastasia Sioni
- Department of Hematology, Aghios Savvas Anticancer Hospital, Athens, Greece
| | | | - Marie-Christine Kyrtsonis
- First Department of Internal Medicine, Propaedeutic, Haematology Clinical Trial Unit, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marina P Siakantaris
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Konstantopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Panayiotidis
- First Department of Internal Medicine, Propaedeutic, Haematology Clinical Trial Unit, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros P Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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9
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Vassilakopoulos TP, Papageorgiou SG, Angelopoulou MK, Chatziioannou S, Prassopoulos V, Karakatsanis S, Arapaki M, Mellios Z, Sachanas S, Kalpadakis C, Katodritou E, Leonidopoulou T, Kotsianidis I, Hatzimichael E, Kotsopoulou M, Dimou M, Variamis E, Boutsis D, Terpos E, Michali E, Karianakis G, Tsirkinidis P, Vadikolia C, Poziopoulos C, Pigaditou A, Vrakidou E, Siakantaris MP, Kyrtsonis MC, Symeonidis A, Anargyrou K, Papaioannou M, Chatziharissi E, Vervessou E, Tsirogianni M, Palassopoulou M, Gainaru G, Mainta C, Tsirigotis P, Assimakopoulou T, Konstantinidou P, Papadaki H, Dimopoulos MA, Pappa V, Karmiris T, Roussou P, Datseris I, Panayiotidis P, Konstantopoulos K, Pangalis GA, Rondogianni P. Positron emission tomography after response to rituximab-CHOP in primary mediastinal large B-cell lymphoma: impact on outcomes and radiotherapy strategies. Ann Hematol 2021; 100:2279-2292. [PMID: 33523289 DOI: 10.1007/s00277-021-04421-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 01/22/2023]
Abstract
End-of-treatment (EoT) PET/CT is used as a guide to omit radiotherapy (RT) patients with primary mediastinal large B-cell lymphoma (PMBCL). We present the mature and extended results of a retrospective study evaluating the prognostic significance of EoT-PET/CT after adequate response to R-CHOP. Among 231 consecutive PMLBCL patients, 182 underwent EoT-PET/CT and were evaluated according to the Deauville 5-point scale (D5PS) criteria. Freedom from progression (FFP) was measured from the time of PET/CT examination. Among 182 patients, 72 (40%) had D5PS score 1 (D5PSS-1), 33 (18%) had 2, 28 (15%) had 3, 29 (16%) had 4, and 20 (11%) had 5. The 5-year FFP was 97, 94, 92, 82, and 44% for D5PSS-1, D5PSS-2, D5PSS-3, D5PSS-4, and D5PSS-5, respectively. Among 105 patients with unequivocally negative PET/CT (D5PSS-1/D5PSS-2), 49 (47%) received RT (median dose 3420 cGy) and 56 (53%) did not with relapses in 0/49 vs. 4/56 patients (2 mediastinum and 2 isolated CNS relapses).The 5-year FFP for those who received RT or not was 100% versus 96%, when isolated CNS relapses were censored (p = 0.159). Among D5PSS-3 patients (27/28 irradiated-median dose 3600 cGy), the 5-year FFP was 92%. The 5-year FFP for D5PSS-4 and D5PSS-5 was 82 and 44%; 44/49 patients received RT (median dose 4000 and 4400 cGy for D5PSS-4 and D5PSS-5). Our study supports the omission of RT in a sizeable fraction of PET/CT-negative patients and definitely discourages salvage chemotherapy and ASCT in patients with PMLBCL who conventionally respond to R-CHOP, solely based on PET/CT positivity in the absence of documented progressive or multifocal disease. The persistence of positive PET/CT with D5PSS < 5 after consolidative RT should not trigger the initiation of further salvage chemotherapy in the absence of conventionally defined PD.
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Affiliation(s)
- Theodoros P Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece.
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece
| | - Sophia Chatziioannou
- Department of Nuclear Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | | | - Stamatios Karakatsanis
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Maria Arapaki
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece
| | - Zois Mellios
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Sotirios Sachanas
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | | | - Eirini Katodritou
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | | | - Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Maria Kotsopoulou
- Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece
| | - Maria Dimou
- First Propedeutic Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Variamis
- First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evangelos Terpos
- Department of Therapeutics, National and Kapodistrian University of Athens, Alexandra Hospital, Athens, Greece
| | - Evridiki Michali
- Department of Clinical Hematology, "G.Gennimatas" Athens General Hospital, Athens, Greece
| | | | | | | | | | - Anna Pigaditou
- Department of Hematology, Athens Medical Center, Amaroussion Branch, Athens, Greece
| | | | - Marina P Siakantaris
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece
| | - Marie-Christine Kyrtsonis
- First Propedeutic Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Argyris Symeonidis
- Hematology Division, Department of Internal Medicine, University of Patras, Patras, Greece
| | | | - Maria Papaioannou
- Hematology Unit, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdoxia Chatziharissi
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece.,Hematology Unit, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Tsirogianni
- Department of Hematology, Aghios Savvas Anticancer Hospital, Athens, Greece
| | | | | | - Catherine Mainta
- Department of Nuclear Medicine and PET/CT, Athens Medical Center, Athens, Greece
| | - Panagiotis Tsirigotis
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Helen Papadaki
- Department of Hematology, University of Crete, Iraklion, Crete, Greece
| | | | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit, University General Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Themis Karmiris
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Paraskevi Roussou
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | - Ioannis Datseris
- Department of Nuclear Medicine and PET/CT, Evangelismos General Hospital, Athens, Greece
| | - Panayiotis Panayiotidis
- First Propedeutic Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Konstantopoulos
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece
| | - Gerassimos A Pangalis
- Department of Haematology and Bone Marrow Transplantation, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, 11527, Athens, Greece.,Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Phivi Rondogianni
- Department of Nuclear Medicine and PET/CT, Evangelismos General Hospital, Athens, Greece
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10
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Vassilakopoulos TP, Piperidou A, Hadjiharissi E, Panteliadou AK, Panitsas F, Vassilopoulos I, Variamis E, Boutsis D, Michail M, Papageorgiou S, Tsourouflis G, Dimou M, Karakatsanis S, Kalpadakis C, Stavroyianni N, Katodritou E, Kotsopoulou M, Kotsianidis I, Verigou E, Hatzimichael E, Leonidopoulou T, Xanthopoulos V, Panayiotidis P, Konstantopoulos K, Dimopoulos MA, Karmiris T, Batsis I, Papaioannou M, Pangalis GA, Angelopoulou MK. Development of Classic Hodgkin Lymphoma after successful treatment of primary mediastinal large b-cell lymphoma: results from a well-defined database. Leuk Res 2020; 100:106479. [PMID: 33285316 DOI: 10.1016/j.leukres.2020.106479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Theodoros P Vassilakopoulos
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece.
| | - Alexia Piperidou
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece
| | - Evdoxia Hadjiharissi
- Hematology Unit, First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Fotios Panitsas
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece
| | - Ioannis Vassilopoulos
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece; Department of Hematology, Athens Navy Hospital, Athens, Greece
| | - Eleni Variamis
- First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Michail Michail
- Department of Hematology, Nicosia General Hospital, Nicosia, Cyprus
| | - Sotirios Papageorgiou
- Second Propedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece
| | - Gerassimos Tsourouflis
- Second Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Maria Dimou
- First Propedeutic Department of Internal Medicine, Laikon General Hospital, Athens, Greece
| | - Stamatis Karakatsanis
- Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece
| | | | - Niki Stavroyianni
- Department of Hematology, Papanikolaou Hospital, Thessaloniki, Greece
| | - Eirini Katodritou
- Department of Hematology, Theagenion Anticancer General Hospital, Thessaloniki, Greece
| | - Maria Kotsopoulou
- Department of Hematology, Metaxa Anticancer Hospital, Piraeus, Greece
| | - Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evgenia Verigou
- Hematology Division, Department of Internal Medicine, University of Patras, Patras, Greece
| | | | | | | | | | - Kostas Konstantopoulos
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece
| | | | - Themistoklis Karmiris
- Department of Hematology and Lymphoma, Evangelismos General Hospital, Athens, Greece
| | - Ioannis Batsis
- Department of Hematology, Papanikolaou Hospital, Thessaloniki, Greece
| | - Maria Papaioannou
- Hematology Unit, First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Gerassimos A Pangalis
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece; Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Maria K Angelopoulou
- Department of Hematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens, Greece
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11
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Kalpadakis C, Pangalis GA. Extranodal Marginal-Zone Lymphomas: An Entity with Significant Heterogeneity at Different Anatomic Sites. Acta Haematol 2019; 142:59-60. [PMID: 31207602 DOI: 10.1159/000496380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Kalpadakis
- Department of Hematology, University Hospital, University of Crete, Heraklion, Greece,
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12
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Vassilakopoulos T, Papageorgiou S, Michail M, Angelopoulou M, Kourti G, Kalpadakis C, Kotsopoulou M, Leonidopoulou T, Konstantinidou P, Kotsianidis I, Boutsis D, Michali E, Sachanas S, Terpos E, Karianakis G, Poziopoulos C, Vadikolia C, Pigaditou A, Vrakidou E, Anargyrou K, Symeonidis A, Stefanoudaki E, Hadjiharissi E, Papaioannou M, Gainaru G, Tsirogianni M, Katodritou E, Karmiris T, Variami E, Pappa V, Dimopoulos M, Roussou P, Panayitidis P, Konstantopoulos K, Pangalis G. PROGNOSTIC FACTORS (PFs) IN PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMA (PMLBCL) TREATED WITH RITUXIMAB-CHOP (RCHOP) ± RADIOTHERAPY (RT). Hematol Oncol 2019. [DOI: 10.1002/hon.76_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- T.P. Vassilakopoulos
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - S.G. Papageorgiou
- 2nd Department of Internal Medicine and Research Institute; University General Hospital "Attikon"; Haidari Greece
| | - M. Michail
- Hematology; General Hospital of Nicosia; Nicosia Cyprus
| | - M.K. Angelopoulou
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - G. Kourti
- 3rd Dept of Internal Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - C. Kalpadakis
- Dept of Haematology; University of Crete; Heraclion Crete Greece
| | - M. Kotsopoulou
- Dept of Haematology; Metaxa Anticancer Hospital; Piraeus Greece
| | | | - P. Konstantinidou
- Dept of Haematology; Theagenion Anticancer Hospital; Thessaloniki Greece
| | - I. Kotsianidis
- Dept of Haematology; Democritus University of Thrace; Alexandroupolis Greece
| | - D. Boutsis
- Dept of Haematology; Navy Hospital Athens; Athens Greece
| | - E. Michali
- Dept of Haematology; Athens General Hospital, “Gennimatas; Athens Greece
| | - S. Sachanas
- Dept of Haematology; Athens Medical Center, Psychikon Branch; Athens Greece
| | - E. Terpos
- Dept of Therapeutics; National and Kapodistrian University of Athens; Athens Greece
| | | | - C. Poziopoulos
- Dept of Haematology; Metropolitan Hospital; Piraeus Greece
| | - C. Vadikolia
- Dept of Haematology; 424 Army Hospital; Thessaloniki Greece
| | - A. Pigaditou
- Dept of Haematology; Athens Medical Center; Marousi Greece
| | - E. Vrakidou
- Dept of Haematology; HyGEIA Hospital; Athens Greece
| | - K. Anargyrou
- Dept of Haematology; 251 Air Force Hospital; Athens Greece
| | - A. Symeonidis
- Dept of Haematology; University of Patras; Patras Greece
| | | | - E. Hadjiharissi
- 1st Dept of Internal Medicine; AHEPA University Hospital; Thessaloniki Greece
| | - M. Papaioannou
- 1st Dept of Internal Medicine; AHEPA University Hospital; Thessaloniki Greece
| | - G. Gainaru
- Dept of Haematology; HYGEIA Hospital; Athens Greece
| | - M. Tsirogianni
- Dept of Haematology; AGIOS SAVVAS Anticancer Hospital; Athens Greece
| | - E. Katodritou
- Dept of Haematology; Theagenion Anticancer Hospital; Thessaloniki Greece
| | - T. Karmiris
- Dept of Haematology; Evangelismos Hospital; Athens Greece
| | - E. Variami
- 1st Dept of Internal Medicine; National & Kapodistrian University of Athens; Athens Greece
| | - V. Pappa
- 2nd Department of Internal Medicine and Research Institute; University General Hospital "Attikon"; Haidari Greece
| | - M. Dimopoulos
- Dept of Therapeutics; National and Kapodistrian University of Athens; Athens Greece
| | - P. Roussou
- 3rd Dept of Internal Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - P. Panayitidis
- 1st Propedeutic Dept of Internal Medicine; National & Kapodistrian University of Athens; Athens Greece
| | - K. Konstantopoulos
- Dept of Haematology; National & Kapodistrian University of Athens; Athens Greece
| | - G.A. Pangalis
- Dept of Haematology; Athens Medical Center, Psychikon Branch; Athens Greece
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13
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Kalpadakis C, Pangalis G, Konstantinou E, Vassilakopoulos T, Telonis V, Sachanas S, Tsirkinidis P, Moschogiannis M, Yiakoumis X, Siakantaris M, Tsaftaridis P, Iliakis T, Befani M, Kyrtsonis M, Dimitrakopoulou A, Boutsikas G, Korkolopoulou P, Kontopidou F, Koulieris E, Pontikoglou C, Ximeri M, Psylaki M, Roumelioti M, Rontogiannis D, Papadaki H, Panagiotidis P, Angelopoulou M. CLONAL B-CELL LYMPHOCYTOSIS OF MARGINAL ZONE ORIGIN (CBL-MZ): DESCRIPTION OF MAIN CLINICAL FEATURES, DISEASE EVOLUTION AND OUTCOME IN A SERIES OF 100 PATIENTS. Hematol Oncol 2019. [DOI: 10.1002/hon.38_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C. Kalpadakis
- Department of Haematology; University Hospital, University of Crete; Heraklion Crete Greece
| | - G.A. Pangalis
- Department of Haematology; Athens Medical Center; Athens Greece
| | - E. Konstantinou
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - T.P. Vassilakopoulos
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - V. Telonis
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - S. Sachanas
- Department of Haematology; Athens Medical Center; Athens Greece
| | - P. Tsirkinidis
- Department of Haematology; Athens Medical Center; Athens Greece
| | | | - X. Yiakoumis
- Department of Haematology; Athens Medical Center; Athens Greece
| | - M. Siakantaris
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - P. Tsaftaridis
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - T. Iliakis
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - M. Befani
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - M. Kyrtsonis
- 1st Department of Propedeutics; University of Athens, Laikon General Hospital; Athens Greece
| | - A. Dimitrakopoulou
- Immunology Laboratory; University of Athens, Laikon General Hospital; Athens Greece
| | - G. Boutsikas
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
| | - P. Korkolopoulou
- Department of Pathology; University of Athens, Laikon General Hospital; Athens Greece
| | - F. Kontopidou
- Second Department of Internal Medicine; Hippokrateio General Hospital, University of Athens; Athens Greece
| | - E. Koulieris
- Department of Haematology; Athens Medical Center; Athens Greece
| | - C. Pontikoglou
- Department of Haematology; University Hospital, University of Crete; Heraklion Crete Greece
| | - M. Ximeri
- Department of Haematology; University Hospital, University of Crete; Heraklion Crete Greece
| | - M. Psylaki
- Department of Haematology; University Hospital, University of Crete; Heraklion Crete Greece
| | - M. Roumelioti
- 1st Department of Propedeutics; University of Athens, Laikon General Hospital; Athens Greece
| | - D. Rontogiannis
- Department of Anatomic Pathology; Evangelismos General Hospital; Athens Greece
| | - H. Papadaki
- Department of Haematology; University Hospital, University of Crete; Heraklion Crete Greece
| | - P. Panagiotidis
- 1st Department of Propedeutics; University of Athens, Laikon General Hospital; Athens Greece
| | - M.K. Angelopoulou
- Department of Haematology; University of Athens, Laikon General Hospital; Athens Greece
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14
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Sachanas S, Pangalis GA, Fink AM, Bahlo J, Fischer K, Levidou G, Kyrtsonis MC, Bartzi V, Vassilakopoulos TP, Kalpadakis C, Koulieris E, Moschogiannis M, Yiakoumis X, Tsirkinidis P, Angelopoulou MK, Eichhorst B, Hallek M. Small Lymphocytic Lymphoma: Analysis of Two Cohorts Including Patients in Clinical Trials of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG) or in "Real-Life" Outside of Clinical Trials. Anticancer Res 2019; 39:2591-2598. [PMID: 31092457 DOI: 10.21873/anticanres.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Only few studies have focused exclusively on patients with small lymphocytic lymphoma (SLL). PATIENTS AND METHODS In the present report, 103 SLL patients were analyzed from both, clinical trials of the German Chronic Lymphocytic Leukemia Study Group and Greek centers, and emphasis was placed on the therapeutic strategy. The impact of lymph node characteristics, such as the presence of proliferation centers (PCs) on response and survival was also assessed. RESULTS SLL patients included in clinical trials were treated mostly with fludarabine-based regimens while those in "real-life" were staged and treated mostly as patients with low-grade lymphomas. Our analysis showed a trend for better survival for patients with SLL without detectable PCs. CONCLUSION Patients with SLL outside of clinical trials are usually treated as cases of lymphoma. In addition, this analysis supports published data regarding the adverse prognostic value of the presence of PCs in lymphoid nodes in SLL.
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Affiliation(s)
- Sotirios Sachanas
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | | | - Anna-Maria Fink
- Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany
| | - Jasmin Bahlo
- Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany
| | - Kirsten Fischer
- Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany
| | - Georgia Levidou
- Pathology Department, University of Athens, Athens, Greece.,Pathology Department, Humanpathologie GmbH, Erlangen, Germany
| | | | - Vassiliki Bartzi
- Department of Haematology, General Hospital of Karditsa, Karditsa, Greece
| | | | - Christina Kalpadakis
- Department of Haematology, University Hospital, University of Crete, Heraklion, Greece
| | - Efstathios Koulieris
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Maria Moschogiannis
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Xanthi Yiakoumis
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Pantelis Tsirkinidis
- Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece
| | - Maria K Angelopoulou
- Department of Haematology, University of Athens, Laikon General Hospital, Athens, Greece
| | - Barbara Eichhorst
- Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany
| | - Michael Hallek
- Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany
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15
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Xochelli A, Bikos V, Polychronidou E, Galigalidou C, Agathangelidis A, Charlotte F, Moschonas P, Davis Z, Colombo M, Roumelioti M, Sutton LA, Groenen P, van den Brand M, Boudjoghra M, Algara P, Traverse-Glehen A, Ferrer A, Stalika E, Karypidou M, Kanellis G, Kalpadakis C, Mollejo M, Pangalis G, Vlamos P, Amini RM, Pospisilova S, Gonzalez D, Ponzoni M, Anagnostopoulos A, Giudicelli V, Lefranc MP, Espinet B, Panagiotidis P, Piris MA, Du MQ, Rosenquist R, Papadaki T, Belessi C, Ferrarini M, Oscier D, Tzovaras D, Ghia P, Davi F, Hadzidimitriou A, Stamatopoulos K. Disease-biased and shared characteristics of the immunoglobulin gene repertoires in marginal zone B cell lymphoproliferations. J Pathol 2019; 247:416-421. [PMID: 30484876 DOI: 10.1002/path.5209] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 11/12/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
The B cell receptor immunoglobulin (Ig) gene repertoires of marginal zone (MZ) lymphoproliferations were analyzed in order to obtain insight into their ontogenetic relationships. Our cohort included cases with MZ lymphomas (n = 488), i.e. splenic (SMZL), nodal (NMZL) and extranodal (ENMZL), as well as provisional entities (n = 76), according to the WHO classification. The most striking Ig gene repertoire skewing was observed in SMZL. However, restrictions were also identified in all other MZ lymphomas studied, particularly ENMZL, with significantly different Ig gene distributions depending on the primary site of involvement. Cross-entity comparisons of the MZ Ig sequence dataset with a large dataset of Ig sequences (MZ-related or not; n = 65 837) revealed four major clusters of cases sharing homologous ('public') heavy variable complementarity-determining region 3. These clusters included rearrangements from SMZL, ENMZL (gastric, salivary gland, ocular adnexa), chronic lymphocytic leukemia, but also rheumatoid factors and non-malignant splenic MZ cells. In conclusion, different MZ lymphomas display biased immunogenetic signatures indicating distinct antigen exposure histories. The existence of rare public stereotypes raises the intriguing possibility that common, pathogen-triggered, immune-mediated mechanisms may result in diverse B lymphoproliferations due to targeting versatile progenitor B cells and/or operating in particular microenvironments. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Vasilis Bikos
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Eleftheria Polychronidou
- Information Technologies Institute, CERTH, Thessaloniki, Greece
- Department of Informatics, Ionian University, Corfu, Greece
| | | | - Andreas Agathangelidis
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frédéric Charlotte
- Department of Pathology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Monica Colombo
- Molecular Pathology, Ospedale Policlinico SanMartino, Genoa, Italy
| | - Maria Roumelioti
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Lesley-Ann Sutton
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Patricia Groenen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michiel van den Brand
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Myriam Boudjoghra
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | | | | | - Ana Ferrer
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | - Maria Karypidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - George Kanellis
- Hematopathology Department, Evangelismos Hospital, Athens, Greece
| | | | | | | | | | - Rose-Marie Amini
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - David Gonzalez
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | | | | | - Véronique Giudicelli
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Marie-Paule Lefranc
- IMGT®, the international ImMunoGeneTics Information System®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UMR CNRS UM, Montpellier, France
| | - Blanca Espinet
- Laboratori de Citologia Hematològica i Citogenètica Molecular, Servei de Patologia, Hospital del Mar, Barcelona, Spain
| | | | | | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Manlio Ferrarini
- Direzione Scientifica, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliera Universitaria (AOU) San Martino-IST, Genoa, Italy
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | | | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute and Università Vita-Salute San Raffaele, Milan, Italy
| | - Frederic Davi
- Department of Hematology, Hopital Pitie-Salpetriere and Sorbonne University, Paris, France
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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16
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Pontikoglou C, Kalyva A, Kalpadakis C, Velegraki M, Bizymi N, Alpantaki K, Kontakis G, Pangalis GA, Papadaki HA. Bone marrow-derived mesenchymal stem/stromal cells from patients with splenic marginal zone lymphoma are intrinsically impaired and influence the malignant B-cells. Leuk Lymphoma 2018; 60:538-540. [PMID: 29966468 DOI: 10.1080/10428194.2018.1474526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Charalampos Pontikoglou
- a Hemopoiesis Research Laboratory, School of Medicine , University of Crete , Heraklion , Greece.,b Department of Hematology, School of Medicine , University of Crete , Heraklion, Greece
| | - Athanasia Kalyva
- a Hemopoiesis Research Laboratory, School of Medicine , University of Crete , Heraklion , Greece
| | - Christina Kalpadakis
- b Department of Hematology, School of Medicine , University of Crete , Heraklion, Greece
| | - Maria Velegraki
- a Hemopoiesis Research Laboratory, School of Medicine , University of Crete , Heraklion , Greece.,b Department of Hematology, School of Medicine , University of Crete , Heraklion, Greece
| | - Nikoletta Bizymi
- a Hemopoiesis Research Laboratory, School of Medicine , University of Crete , Heraklion , Greece
| | - Kalliopi Alpantaki
- c Department of Orthopedics, School of Medicine , University of Crete , Heraklion, Crete , Greece
| | - George Kontakis
- c Department of Orthopedics, School of Medicine , University of Crete , Heraklion, Crete , Greece
| | | | - Helen A Papadaki
- a Hemopoiesis Research Laboratory, School of Medicine , University of Crete , Heraklion , Greece.,b Department of Hematology, School of Medicine , University of Crete , Heraklion, Greece
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17
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Tsirkinidis P, Terpos E, Boutsikas G, Papatheodorou A, Anargyrou K, Lalou E, Dimitrakopoulou A, Kalpadakis C, Konstantopoulos K, Siakantaris M, Panayiotidis P, Pangalis G, Kyrtsonis MC, Vassilakopoulos T, Angelopoulou MK. Bone metabolism markers and angiogenic cytokines as regulators of human hematopoietic stem cell mobilization. J Bone Miner Metab 2018; 36:399-409. [PMID: 28660376 DOI: 10.1007/s00774-017-0853-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/06/2017] [Indexed: 10/19/2022]
Abstract
Hematopoietic stem cell (HSC) mobilization involves cleavage of ligands between HSC and niche components. However, there are scarce data regarding the role of bone cells in human HSC mobilization. We studied biochemical markers of bone metabolism and angiogenic cytokines during HSC mobilization in 46 patients' sera with lymphoma and multiple myeloma, by ELISA. Significant changes between pre-mobilization and collection samples were found: (1) Bone alkaline phosphatase (BALP) increased, indicating augmentation of bone formation; (2) Receptor activator of Nf-κB ligand/osteoprotegerin ratio (RANKL/OPG) increased, showing osteoclastic differentiation and survival; however, there was no evidence of increased osteoclastic activity; and (3) Angiopoietin-1/Angiopoietin-2 ratio (ANGP-1/ANGP-2) decreased, consistent with vessel destabilization. Poor mobilizers had significantly higher carboxy-terminal telopeptide of collagen type I (CTX) and lower ANGP-1 at pre-mobilization samples, compared to good ones. CTX, amino-terminal telopeptide of collagen type I (NTX) and ANGP-1 pre-mobilization levels correlated significantly with circulating CD34+ peak cell counts. Our results indicate that bone formation and vessel destabilization are the two major events during human HSC mobilization. Osteoblasts seem to be the orchestrating cells, while osteoclasts are stimulated but not fully active. Moreover, ANGP-1, CTX and NTX may serve as predictors of poor mobilization.
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Affiliation(s)
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Boutsikas
- Department of Hematology, 251 General Air Force Hospital, Athens, Greece
| | | | | | - Eleni Lalou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Aglaia Dimitrakopoulou
- Department of Immunology Research and Flow Cytometry, 'Laiko' General Hospital of Athens, Athens, Greece
| | - Christina Kalpadakis
- Department of Hematology, School of Medicine, University of Crete, Herakleion, Greece
| | - Konstantinos Konstantopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Marina Siakantaris
- 1st Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Panayiotidis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerassimos Pangalis
- Department of Hematology, Psychicon Branch, Athens Medical Center, Athens, Greece
| | - Marie-Christine Kyrtsonis
- 1st Propedeutic Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros Vassilakopoulos
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece
| | - Maria K Angelopoulou
- Department of Hematology and Bone Marrow Transplantation, School of Medicine, National and Kapodistrian University of Athens, 17, Agiou Thoma Street, 11527, Athens, Greece.
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18
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Tsirigotis P, Vassilakopoulos T, Batsis I, Bousiou Z, Gkirkas K, Sakellari I, Kaloyannidis P, Roussou P, Pangalis GA, Moschogiannis M, Vassilopoulos G, Repousis P, Megalakaki A, Michalis E, Kalpadakis C, Papadaki HA, Kotsianidis I, Hatzimichael E, Spyridonidis A, Anargyrou K, Poulakidas E, Giannoullia P, Apostolidis I, Stamouli M, Konstantopoulos K, Pappa V, Panayiotidis P, Harhalakis N, Anagnostopoulos A, Angelopoulou M. Positive impact of brentuximab vedotin on overall survival of patients with classical Hodgkin lymphoma who relapse or progress after autologous stem cell transplantation: A nationwide analysis. Hematol Oncol 2018; 36:645-650. [PMID: 29882363 DOI: 10.1002/hon.2521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 11/12/2022]
Abstract
The outcome of patients with relapsed/refractory classical Hodgkin lymphoma (R/R cHL) after autologous stem cell transplantation (auto-SCT) is poor. Recently, the anti-CD30 monoclonal antibody-drug conjugate, brentuximab vedotin (BV), has shown remarkable activity in the setting of R/R cHL. In the pivotal phase II study, BV produced an overall response rate of 75% and a median progression-free survival of 6.7 months. Although these results have been reproduced by large registry studies, the impact of BV on the overall survival (OS) of patients with R/R cHL has not been addressed so far. The aim of this study was to examine the impact of BV on OS in the setting of post auto-SCT R/R cHL. Analysis was performed in a group of patients with R/R cHL after a previous auto-SCT reported in the Greek registry during the last 2 decades. By using a multivariate model and censoring patients at the time of subsequent allo-SCT or treatment with immune checkpoint inhibitors, we showed that treatment with BV in the posttransplant relapse setting has a positive impact on the outcome and results in significant improvement of OS. To our knowledge, this the first published study, addressing the impact of BV on the OS in the setting of posttransplant relapse.
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Affiliation(s)
- Panagiotis Tsirigotis
- Second Dept of Internal Medicine Propaedeutic, ATTIKO General University Hospital, Athens, Greece
| | | | - Ioannis Batsis
- Dept of Hematology and BMT, PAPANIKOLAOU Hospital, Thessaloniki, Greece
| | - Zoi Bousiou
- Dept of Hematology and BMT, PAPANIKOLAOU Hospital, Thessaloniki, Greece
| | - Konstantinos Gkirkas
- Second Dept of Internal Medicine Propaedeutic, ATTIKO General University Hospital, Athens, Greece
| | - Ioanna Sakellari
- Dept of Hematology and BMT, PAPANIKOLAOU Hospital, Thessaloniki, Greece
| | | | | | | | | | | | | | | | | | | | - Helen A Papadaki
- Dept of Hematology, University Hospital of Crete, Heraklion, Greece
| | | | | | | | | | - Elias Poulakidas
- Dept of Hematology, 401 Military Hospital of Athens, Athens, Greece
| | | | | | - Maria Stamouli
- Second Dept of Internal Medicine Propaedeutic, ATTIKO General University Hospital, Athens, Greece
| | | | - Vassiliki Pappa
- Second Dept of Internal Medicine Propaedeutic, ATTIKO General University Hospital, Athens, Greece
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Vassilakopoulos TP. Should rituximab replace splenectomy in the management of splenic marginal zone lymphoma? Best Pract Res Clin Haematol 2018; 31:65-72. [DOI: 10.1016/j.beha.2017.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 10/27/2017] [Accepted: 10/31/2017] [Indexed: 02/07/2023]
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20
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Angelopoulou MK, Vassilakopoulos TP, Batsis I, Sakellari I, Gkirkas K, Pappa V, Giannoulia P, Apostolidis I, Apostolopoulos C, Roussou P, Panayiotidis P, Dimou M, Kyrtsonis M, Palassopoulou M, Vassilopoulos G, Moschogiannis M, Kalpadakis C, Margaritis D, Spyridonidis A, Michalis E, Anargyrou K, Repousis P, Hatzimichael E, Bousiou Z, Poulakidas E, Grentzelias D, Harhalakis N, Pangalis GA, Anagnostopoulos A, Tsirigotis P. Brentuximab vedotin in relapsed/refractory Hodgkin lymphoma. The Hellenic experience. Hematol Oncol 2018; 36:174-181. [PMID: 28219112 PMCID: PMC5836920 DOI: 10.1002/hon.2383] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/02/2016] [Accepted: 12/09/2016] [Indexed: 01/24/2023]
Abstract
This retrospective study aimed to describe the Hellenic experience on the use of brentuximab vedotin (BV) in relapsed/refractory (R/R) Hodgkin lymphoma (HL) given within its indication. From June 2011 to April 2015, ninety-five patients with R/R HL, who received BV in 20 centers from Greece, were analyzed. Their median age was 33 years, and 62% were males. Sixty-seven patients received BV after autologous stem cell transplantation failure, whereas 28 patients were treated with BV without a prior autologous stem cell transplantation, due to advanced age/comorbidities or chemorefractory disease. The median number of prior treatments was 4 and 44% of the patients were refractory to their most recent therapy. The median number of BV cycles was 8 (range, 2-16), and the median time to best response was the fourth cycle. Fifty-seven patients achieved an objective response: twenty-two (23%), a complete response (CR), and 35 patients (37%), a partial, for an overall response rate of 60%. Twelve patients (13%) had stable disease, and the remaining twenty-six (27%) had progressive disease as their best response. At a median follow-up of 11.5 months, median progression-free survival and overall survival were 8 and 26.5 months, respectively. Multivariate analysis showed that chemosensitivity to treatment administered before BV was associated with a significantly increased probability of achieving response to BV (P = .005). Bulky disease (P = .01) and response to BV (P <.001) were significant for progression-free survival, while refractoriness to most recent treatment (P = .04), bulky disease (P = .005), and B-symptoms (P = .001) were unfavorable factors for overall survival. Among the 22 CRs, 5 remain in CR with no further treatment after BV at a median follow-up of 13 months. In conclusion, our data indicate that BV is an effective treatment for R/R HL patients even outside clinical trials. Whether BV can cure a fraction of patients remains to be seen.
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Affiliation(s)
- Maria K. Angelopoulou
- Department of Hematology, Laikon General HospitalNational and Kapodistrian University of AthensAthensGreece
| | | | - Ioannis Batsis
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Ioanna Sakellari
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Konstantinos Gkirkas
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Vasiliki Pappa
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | | | | | - Christos Apostolopoulos
- Third Department of Medicine, “Sotiria” General Hospital of Thoracic Diseases, Hematology UnitNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Paraskevi Roussou
- Third Department of Medicine, “Sotiria” General Hospital of Thoracic Diseases, Hematology UnitNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Panayiotis Panayiotidis
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Maria Dimou
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Marie‐Christine Kyrtsonis
- 1st Department of Propedeutic Internal Medicine, Laikon General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
| | - Maria Palassopoulou
- Department of Hematology, Larissa University HospitalUniversity of ThessaliaLarissaGreece
| | - Georgios Vassilopoulos
- Department of Hematology, Larissa University HospitalUniversity of ThessaliaLarissaGreece
| | | | - Christina Kalpadakis
- Department of Hematology, Heraklion University HospitalUniversity of CreteHeraklionGreece
| | - Dimitrios Margaritis
- Department of HematologyDemocritus University of Thrace Medical SchoolAlexandroupolisGreece
| | | | - Eurydiki Michalis
- Department of Clinical Hematology“G.Gennimatas” Athens General HospitalAthensGreece
| | | | | | | | - Zoi Bousiou
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Elias Poulakidas
- Department of Hematology401 Military Hospital of AthensAthensGreece
| | | | | | - Gerassimos A. Pangalis
- Department of HematologyDemocritus University of Thrace Medical SchoolAlexandroupolisGreece
| | - Achilles Anagnostopoulos
- Hematology and Bone Marrow Transplantation DepartmentGeneral Hospital of Thessaloniki PapanikolaouThessalonikiGreece
| | - Panagiotis Tsirigotis
- 2nd Department of Internal Medicine, Faculty of Medicine, ATTIKON General University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
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Sachanas S, Pangalis GA, Moschogiannis M, Yiakoumis X, Koulieris E, Tsirkinidis P, Kalpadakis C, Rontogianni D. Hodgkin Lymphoma Transformation of Chronic Lymphocytic Leukemia Under Ibrutinib Therapy: Chance Association or Therapy-related? Anticancer Res 2017; 37:3277-3280. [PMID: 28551676 DOI: 10.21873/anticanres.11692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/10/2022]
Abstract
The established treatment algorithms for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) are currently challenged by novel classes of drugs, with ibrutinib being one of the most effective. Published data suggest that patients with early progression under ibrutinib often emerge as having Richter's transformation (RT) with a rapidly fatal prognosis, mostly developing diffuse large B-cell lymphoma (DLBCL). In this respect, it is known that RT to large DLBCL occurs in about 5% of patients with CLL during the disease course and less frequently to Hodgkin lymphoma (HL). Here, we report a patient with CLL who presented with HL transformation while still receiving therapy with ibrutinib stressing the need for clinical vigilance in any case with persisting or enlarging lymph nodes during treatment with this agent, as prompt modification of therapy is most important.
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Affiliation(s)
- Sotirios Sachanas
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | | | - Maria Moschogiannis
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Xanthi Yiakoumis
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Efstathios Koulieris
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Pantelis Tsirkinidis
- Department of Hematology, Athens Medical Center, Psychikon Branch, Athens, Greece
| | - Christina Kalpadakis
- Department of Hematology, Heraklion University Hospital, University of Crete, Heraklion, Greece
| | - Dimitra Rontogianni
- Department of Anatomic Pathology, Evangelismos General Hospital, University of Athens, Athens, Greece
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22
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Vassilakopoulos TP. Treatment of splenic marginal zone lymphoma. Best Pract Res Clin Haematol 2016; 30:139-148. [PMID: 28288709 DOI: 10.1016/j.beha.2016.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/06/2023]
Abstract
Splenic marginal zone lymphoma (SMZL) is a distinct lymphoma entity characterized by an indolent clinical course and prolonged survival. Treatment is not standardized, since there are no prospective randomized trials in large series of SMZL patients. Splenectomy and rituximab represent the most effective treatment strategies used so far. The addition of chemotherapy to rituximab has not further improved the outcome, although this issue requires further investigation. Rituximab monotherapy has been associated with high response rates (∼90%), with approximately half of these responses being complete, even at the molecular level. More importantly, many of these responses are long-lasting, with a reported 7-year progression-free survival (PFS) at the rate of 69%. Maintenance rituximab treatment has been associated with further improvement of the quality of response as well as longer response duration in studies derived from one group of investigators. Based on its high efficacy and the good safety profile, rituximab represent one of the best treatment options for SMZL patients. Moreover, rituximab retains its efficacy in the relapse setting in most cases. Splenectomy is a meaningful alternative to rituximab in patients with bulky splenomegaly and cytopenias, without extensive bone marrow infiltration, who are fit for surgery. However splenectomy cannot completely eradicate the disease and it is also associated with greater morbidity or even mortality compared to rituximab. The choice of one of these two treatment approaches (rituximab or splenectomy) should mainly be based on patient's characteristics and on the disease burden. Novel agents are currently testing in low grade lymphomas including a small number of SMZL patients with promising results.
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Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, Heraklion University Hospital, 71001, University of Crete, Heraklion, Crete, Greece.
| | - Gerassimos A Pangalis
- Department of Haematology, Athens Medical Center-Psychikon Branch, 11525, Athens, Greece.
| | - Maria K Angelopoulou
- Department of Haematology, National and Kapodistrian University, Laikon General Hospital, Athens, Greece.
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23
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Kalpadakis C, Pangalis GA, Vassilakopoulos TP, Roumelioti M, Sachanas S, Korkolopoulou P, Koulieris E, Moschogiannis M, Yiakoumis X, Tsirkinidis P, Pontikoglou C, Rondoyianni D, Papadaki HA, Panayiotidis P, Angelopoulou MK. Detection of L265P MYD-88
mutation in a series of clonal B-cell lymphocytosis of marginal zone origin (CBL-MZ). Hematol Oncol 2016; 35:542-547. [DOI: 10.1002/hon.2361] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/01/2016] [Accepted: 09/06/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Maria Roumelioti
- 1st Department of Propedeutics; Laikon General Hospital; University of Athens; Athens Greece
| | - Sotirios Sachanas
- Department of Haematology; Athens Medical Center Psychikon Branch; Athens Greece
| | | | - Efstathios Koulieris
- Department of Haematology; Athens Medical Center Psychikon Branch; Athens Greece
| | - Maria Moschogiannis
- Department of Haematology; Athens Medical Center Psychikon Branch; Athens Greece
| | - Xanthi Yiakoumis
- Department of Haematology; Athens Medical Center Psychikon Branch; Athens Greece
| | - Pantelis Tsirkinidis
- Department of Haematology; Athens Medical Center Psychikon Branch; Athens Greece
| | | | - Dimitra Rondoyianni
- Department of Anatomic Pathology; Evangelismos Hospital of Athens; Athens Greece
| | - Helen A. Papadaki
- Department of Haematology; University of Crete; Heraklion Crete Greece
| | | | - Maria K. Angelopoulou
- Department of Haematology; Laikon General Hospital; University of Athens; Athens Greece
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24
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Vassilakopoulos TP. Current and emerging treatment approaches for splenic marginal zone lymphoma. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1198255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, Heraklion University Hospital, University of Crete, Heraklion, Crete, Greece
| | | | - Maria K. Angelopoulou
- Department of Haematology, National and Kapodistrian University, Laikon General Hospital, Athens, Greece
| | - Sotirios Sachanas
- Department of Haematology, Athens Medical Center- Psychikon Branch, Athens, Greece
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25
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Kalpadakis C, Pangalis GA, Sachanas S, Rontogianni D, Korkolopoulou P, Milionis V, Vassilakopoulos TP, Papadaki HA, Angelopoulou MK. No evidence of splenic disease in patients with splenic marginal zone lymphoma undergoing splenectomy for autoimmune hemolytic anemia after monotherapy with rituximab. Leuk Lymphoma 2016; 57:2705-8. [DOI: 10.3109/10428194.2016.1157877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lakiotaki E, Levidou G, Angelopoulou MK, Adamopoulos C, Pangalis G, Rassidakis G, Vassilakopoulos T, Gainaru G, Flevari P, Sachanas S, Saetta AA, Sepsa A, Moschogiannis M, Kalpadakis C, Tsesmetzis N, Milionis V, Chatziandreou I, Thymara I, Panayiotidis P, Dimopoulou M, Plata E, Konstantopoulos K, Patsouris E, Piperi C, Korkolopoulou P. Potential role of AKT/mTOR signalling proteins in hairy cell leukaemia: association with BRAF/ERK activation and clinical outcome. Sci Rep 2016; 6:21252. [PMID: 26893254 PMCID: PMC4759548 DOI: 10.1038/srep21252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/20/2016] [Indexed: 01/04/2023] Open
Abstract
The potential role of AKT/mTOR signalling proteins and its association with the Raf-MEK-ERK pathway was investigated in hairy cell leukaemia (HCL). BRAFV600E expression and activated forms of AKT, mTOR, ERK1/2, p70S6k and 4E-BP1 were immunohistochemically assessed in 77 BM biopsies of HCL patients and correlated with clinicopathological and BM microvascular characteristics, as well as with c-Caspase-3 levels in hairy cells. Additionally, we tested rapamycin treatment response of BONNA-12 wild-type cells or transfected with BRAFV600E. Most HCL cases expressed p-p70S6K and p-4E-BP1 but not p-mTOR, being accompanied by p-ERK1/2 and p-AKT. AKT/mTOR activation was evident in BONNA-12 cells irrespective of the presence of BRAFV600E mutation and was implicated in cell proliferation enhancement. In multivariate analysis p-AKT/p-mTOR/p-4E-BP1 overexpression was an adverse prognostic factor for time to next treatment conferring earlier relapse. When p-AKT, p-mTOR and p-4E-BP1 were examined separately only p-4E-BP1 remained significant. Our findings indicate that in HCL, critical proteins up- and downstream of mTOR are activated. Moreover, the strong associations with Raf-MEK-ERK signalling imply a possible biologic interaction between these pathways. Most importantly, expression of p-4E-BP1 alone or combined with p-AKT and p-mTOR is of prognostic value in patients with HCL.
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Affiliation(s)
| | - Georgia Levidou
- Department of Pathology, University of Athens, Medical School, Greece
| | - Maria K Angelopoulou
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Christos Adamopoulos
- Department of Biological Chemistry, University of Athens, Medical School, Greece
| | | | - George Rassidakis
- Department of Pathology, University of Athens, Medical School, Greece.,Department of Oncology-Pathology, Cancer Centrum Karolinska, Karolinska Institutet, Stockholm, Sweden
| | - Theodoros Vassilakopoulos
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Gabriella Gainaru
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Pagona Flevari
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Sotirios Sachanas
- Department of Haematology, Athens Medical Centre, Psychikon Branch, Greece
| | - Angelica A Saetta
- Department of Pathology, University of Athens, Medical School, Greece
| | - Athanasia Sepsa
- Department of Pathology, University of Athens, Medical School, Greece
| | | | | | - Nikolaos Tsesmetzis
- Department of Oncology-Pathology, Cancer Centrum Karolinska, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Irene Thymara
- Department of Pathology, University of Athens, Medical School, Greece
| | - Panayiotis Panayiotidis
- 1st Department of Propaedeutic Internal Medicine, University of Athens, Medical School, Greece
| | - Maria Dimopoulou
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | - Eleni Plata
- Department of Haematology and Bone Marrow Transplantation, University of Athens, Medical School, Greece
| | | | | | - Christina Piperi
- Department of Biological Chemistry, University of Athens, Medical School, Greece
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Jackson AE, Mian M, Kalpadakis C, Pangalis GA, Stathis A, Porro E, Conconi A, Cortelazzo S, Gaidano G, Lopez Guillermo A, Johnson PW, Martelli M, Martinelli G, Thieblemont C, McPhail ED, Copie-Bergman C, Pileri SA, Jack A, Campo E, Mazzucchelli L, Ristow K, Habermann TM, Cavalli F, Nowakowski GS, Zucca E. Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Salivary Glands: A Multicenter, International Experience of 248 Patients (IELSG 41). Oncologist 2015; 20:1149-53. [PMID: 26268740 DOI: 10.1634/theoncologist.2015-0180] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/09/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The salivary gland is one of the most common sites involved by nongastric, extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT). A large series of patients with long-term follow-up has not been documented. This multicenter, international study sought to characterize the clinical characteristics, treatment, and natural history of salivary gland MALT lymphoma. METHODS Patients with biopsy-confirmed salivary gland MALT lymphoma were identified from multiple international sites. Risk factors, treatment, and long-term outcomes were evaluated. RESULTS A total of 247 patients were evaluated; 76% presented with limited-stage disease. There was a history of autoimmune disorder in 41%, with Sjögren disease being the most common (83%). Fifty-seven percent of patients were initially treated with local therapy with surgery, radiation, or both; 37 of patients were treated with systemic therapy initially, with 47% of those receiving rituximab; and 6% of patients were observed. The median overall survival (OS) was 18.3 years. The median progression-free survival (PFS) following primary therapy was 9.3 years. There was no difference in the outcomes between patients receiving local or systemic therapy in first-line management. On multivariate analysis, age <60 years and low to intermediate international prognostic index were associated with improved OS and PFS; Sjögren disease was associated with improved OS. CONCLUSION Salivary gland MALT lymphoma has an excellent prognosis regardless of initial treatment, and patients with Sjögren disease have improved survival. Risks for long-term complications must be weighed when determining initial therapy.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chemotherapy, Adjuvant
- Disease-Free Survival
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/mortality
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Prognosis
- Rituximab/therapeutic use
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/pathology
- Salivary Gland Neoplasms/therapy
- Sjogren's Syndrome/complications
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Amie E Jackson
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Michael Mian
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Christina Kalpadakis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Gerassimos A Pangalis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Anastasios Stathis
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Elena Porro
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Annarita Conconi
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Sergio Cortelazzo
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Gianluca Gaidano
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | | | - Peter W Johnson
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Maurizio Martelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Giovanni Martinelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Catherine Thieblemont
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Ellen D McPhail
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Christiane Copie-Bergman
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Stefano A Pileri
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Andrew Jack
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Elias Campo
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Luca Mazzucchelli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Kay Ristow
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Thomas M Habermann
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Franco Cavalli
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Grzegorz S Nowakowski
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
| | - Emanuele Zucca
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota USA; Hospital of Bolzano, Department of Hematology & Center of Bone Marrow Transplantation, Bolzano, Italy; Department of Hematology and Oncology, University Hospital Innsbruck, Innsbruck, Austria; University Hospital of Crete, Heraklion, Greece; Athens Medical Center-Psychikon Branch, Athens, Greece; Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Hematology Unit, Department of Internal Medicine, Ospedale degli Infermi, Biella, Italy; Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Hospital Clínic, Hematology, Barcelona, Spain; Cancer Research UK Centre, Southampton, United Kingdom; Dipartimento Biotecnologie Cellulari ed Ematologia, Universitá La Sapienza, Rome, Italy; European Institute of Oncology, Division of Clinical Haemato-Oncology, Milan, Italy; APHP, Saint-Louis Hospital, Hemato-Oncology, and Diderot University-Sorbonne Paris Cité, Paris, France; Département de Pathologie, Groupe Henri Mondor-Albert Chenevier, AP-HP, Creteil, France; Diagnostic Haematopathology, European Institute of Oncology, Milan, Bologna University School of Medicine, Bologna, Italy; St. James's University Hospital, Leeds, United Kingdom; Hospital Clinic, Anatomia Patologica, IDIBAPS, Barcelona, Spain; ICP Locarno, Locarno, Switzerland
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Kyritsi EMA, Yiakoumis X, Pangalis GA, Pontikoglou C, Pyrovolaki K, Kalpadakis C, Mavroudi I, Koutala H, Mastrodemou S, Vassilakopoulos TP, Vaiopoulos G, Diamanti-Kandarakis E, Papadaki HA, Angelopoulou MK. High Frequency of Thyroid Disorders in Patients Presenting With Neutropenia to an Outpatient Hematology Clinic STROBE-Compliant Article. Medicine (Baltimore) 2015; 94:e886. [PMID: 26061308 PMCID: PMC4616464 DOI: 10.1097/md.0000000000000886] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Granulopoiesis abnormalities have been described in association with thyroid disorders (TD). However, data regarding systematic evaluation of adult neutropenia and concurrent or prior TD are scarce. To investigate the frequency of TD among patients presenting with neutropenia, and the immunophenotypic and immunologic profile of neutropenic patients with concomitant thyroidopathy. Two hundred eighteen consecutive neutropenic patients were prospectively evaluated in our outpatient Hematology Clinic, with a detailed laboratory screen, including thyroid function tests, antineutrophil antibodies, blood lymphocytes immunophenotyping, and detection of T-cell clonality by PCR. Among 218 patients with neutropenia, 95 (43.6%) had TD, 65 chronic immunologic neutropenia, 20 clonal proliferation of T-large granular lymphocytes (T-LGL), 5 autoimmune disorders, and 33 other diagnoses. TD-patients had an increased frequency of recurrent infections compared with other patients (P = 0.045). The following correlations were found: negative correlation between FT3 and absolute neutrophil count (ANC) (r² = -0.274, P = 0.007), negative correlation between TPO-Abs/TG-Abs and C4 (r² = -0.16, P = 0.045; r² = -0.266, P = 0.001), and CD4⁺ counts were inversely correlated to T4 and positively to TSH (r² = -0.274, P = 0.024; r² = 0.16, P = 0.045). In addition, TD-patients had significantly higher percentages of CD4⁺ lymphocytes (P = 0.003). Among TD-patients, 23.4% had Hashimoto thyroiditis (HT), 4.1%, Graves disease (GD), 8.2% nontoxic multinodular goiter (NTMG), 5% subclinical hypothyroidism, and 2.8% had undergone total thyroidectomy associated with nodules (TTM). Thirteen TD-patients displayed T-LGL. Patients with autoimmune thyroidopathy had an increased frequency of concomitant autoimmune manifestations (P = 0.03). Significant differences between the different thyroidopathies included: HT-patients had higher percentages of B-lymphocytes, while the opposite was evident for the TTM-subgroup (P = 0.009, 0.02); GD-patients showed an increase of the proportion of NK cells and a decrease in the percentage of TCRγδ+ lymphocytes (P = 0.001, 0.045); and NTMG-patients had significantly higher ANC (P = 0.004) compared to other thyroidopathies. Antineutrophil antibodies were found in 37.2% of TD-patients tested. Anti-TPO titers were significantly higher in patients with positive antineutrophil antibodies (P = 0.04). The frequency of TD among neutropenic patients may be higher than previously reported. The existence of antineutrophil antibodies, as well as the different distribution of lymphocyte subsets among patients with different TD, suggests both humoral and cellular mechanisms in the pathophysiology of thyroid disease-associated neutropenia.
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Affiliation(s)
- Eleni Magdalini A Kyritsi
- From the Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens, University of Athens Medical School, "Aghia Sophia" Children's Hospital, (EMK); Hematology Clinic, Athens Medical Center, Psychiko Branch, Athens (XY, GAP); Department of Hematology, University of Crete School of Medicine, Heraklion, Crete (CP, KP, CK, IM, HK, SM, HAP); Department of Hematology and BMT, National and Kapodistrian University of Athens, Laikon General Hospital (TPV, MKA); First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital (GV); and Third Department of Internal Medicine, Medical School, University of Athens, Sotiria General Hospital, Athens, Greece (ED-K)
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Sachanas S, Pangalis GA, Kalpadakis C, Levidou G, Yiakoumis X, Moschogiannis M, Kyrtsonis MC, Vassilakopoulos TP, Tsirkinidis P, Siakantaris M, Spiliadi C, Karagianni E, Korkolopoulou P, Rontogianni D, Papadaki H, Panayiotidis P, Angelopoulou M. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) with concurrent high grade component at diagnosis: clinico-pathologic features and treatment strategy. Leuk Lymphoma 2015; 56:3230-2. [PMID: 25827212 DOI: 10.3109/10428194.2015.1034698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sotirios Sachanas
- a Department of Haematology , Athens Medical Center-Psychikon Branch , Athens , Greece
| | - Gerassimos A Pangalis
- a Department of Haematology , Athens Medical Center-Psychikon Branch , Athens , Greece
| | - Christina Kalpadakis
- b Department of Haematology , Heraklion University Hospital of Crete , Heraklion, Crete , Greece
| | - Georgia Levidou
- c Department of Pathology , University of Athens , Athens , Greece
| | - Xanthi Yiakoumis
- a Department of Haematology , Athens Medical Center-Psychikon Branch , Athens , Greece
| | - Maria Moschogiannis
- a Department of Haematology , Athens Medical Center-Psychikon Branch , Athens , Greece
| | | | | | - Pantelis Tsirkinidis
- a Department of Haematology , Athens Medical Center-Psychikon Branch , Athens , Greece
| | - Marina Siakantaris
- e First Department of Internal Medicine , University of Athens, Laikon General Hospital , Athens , Greece
| | | | | | | | | | - Helen Papadaki
- b Department of Haematology , Heraklion University Hospital of Crete , Heraklion, Crete , Greece
| | - Panayiotis Panayiotidis
- d Department of Haematology , University of Athens, Laikon General Hospital , Athens , Greece
| | - Maria Angelopoulou
- d Department of Haematology , University of Athens, Laikon General Hospital , Athens , Greece
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Parry M, Rose-Zerilli MJ, Ljungström V, Gibson J, Wang J, Walewska R, Parker H, Parker A, Davis Z, Gardiner A, McIver-Brown N, Kalpadakis C, Xochelli A, Anagnostopoulos A, Fazi C, de Castro DG, Dearden C, Pratt G, Rosenquist R, Ashton-Key M, Forconi F, Collins A, Ghia P, Matutes E, Pangalis G, Stamatopoulos K, Oscier D, Strefford JC. Genetics and Prognostication in Splenic Marginal Zone Lymphoma: Revelations from Deep Sequencing. Clin Cancer Res 2015; 21:4174-4183. [PMID: 25779943 DOI: 10.1158/1078-0432.ccr-14-2759] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/03/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Mounting evidence supports the clinical significance of gene mutations and immunogenetic features in common mature B-cell malignancies. EXPERIMENTAL DESIGN We undertook a detailed characterization of the genetic background of splenic marginal zone lymphoma (SMZL), using targeted resequencing and explored potential clinical implications in a multinational cohort of 175 patients with SMZL. RESULTS We identified recurrent mutations in TP53 (16%), KLF2 (12%), NOTCH2 (10%), TNFAIP3 (7%), MLL2 (11%), MYD88 (7%), and ARID1A (6%), all genes known to be targeted by somatic mutation in SMZL. KLF2 mutations were early, clonal events, enriched in patients with del(7q) and IGHV1-2*04 B-cell receptor immunoglobulins, and were associated with a short median time to first treatment (0.12 vs. 1.11 years; P = 0.01). In multivariate analysis, mutations in NOTCH2 [HR, 2.12; 95% confidence interval (CI), 1.02-4.4; P = 0.044] and 100% germline IGHV gene identity (HR, 2.19; 95% CI, 1.05-4.55; P = 0.036) were independent markers of short time to first treatment, whereas TP53 mutations were an independent marker of short overall survival (HR, 2.36; 95 % CI, 1.08-5.2; P = 0.03). CONCLUSIONS We identify key associations between gene mutations and clinical outcome, demonstrating for the first time that NOTCH2 and TP53 gene mutations are independent markers of reduced treatment-free and overall survival, respectively.
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Affiliation(s)
- Marina Parry
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Viktor Ljungström
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Jane Gibson
- Centre for Biological Sciences, University of Southampton, Southampton, UK
| | - Jun Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Renata Walewska
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Helen Parker
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anton Parker
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Zadie Davis
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Anne Gardiner
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Neil McIver-Brown
- Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Christina Kalpadakis
- Department of Hematology, School of Medicine, University of Crete, Heraklion, Greece
| | - Aliki Xochelli
- Institute of Applied Biosciences, Center for Research and Technology, Thessaloniki, Greece
| | | | - Claudia Fazi
- Division of Molecular Oncology, Department of Onco-Haematology, IRCCS Istituto Scientifico San Raffaele, Fondazione Centro San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - David Gonzalez de Castro
- Heamato-oncology Unit, Division of Molecular Pathology, Institute for Cancer Research, Sutton, UK
| | - Claire Dearden
- Heamato-oncology Unit, Division of Molecular Pathology, Institute for Cancer Research, Sutton, UK
| | - Guy Pratt
- School of Cancer Studies, University of Birmingham, Birmingham, UK; Department of Haematology, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Margaret Ashton-Key
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Francesco Forconi
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andrew Collins
- Genetic Epidemiology and Bioinformatics, Faculty of Medicine, University of Southampton, UK
| | - Paolo Ghia
- Division of Molecular Oncology, Department of Onco-Haematology, IRCCS Istituto Scientifico San Raffaele, Fondazione Centro San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Estella Matutes
- Haematopathology Unit, Hospital Clinic, Barcelona University, Villarroel, Barcelona, Spain
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology, Thessaloniki, Greece.,Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - David Oscier
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Jonathan C Strefford
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Sachanas S, Pangalis G, Kalpadakis C, Yiakoumis X, Moschogiannis M, Kyrtsonis MC, Vassilakopoulos T, Tsirkinidis P, Kontopidou F, Kokoris S, Siakantaris M, Viniou NA, Korkolopoulou P, Papadaki H, Panayiotidis P, Angelopoulou M. Composite Lymphomas: A Challenging Entity. CCTR 2014. [DOI: 10.2174/157339471002141124121738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Kontopidou F, Moschogiannis M, Ximeri M, Tsirkinidis P, Yiakoumis X, Papadaki HA, Vassilakopoulos TP. Validation of the simplified prognostic score for splenic marginal zone lymphoma of the Splenic Marginal Zone Lymphoma Working Group. Leuk Lymphoma 2014; 55:2640-2. [DOI: 10.3109/10428194.2014.897703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Christina Kalpadakis
- Department of Hematology, Heraklion University Hospital, University of Crete,
Heraklion, Greece
| | | | - Maria K. Angelopoulou
- Department of Hematology, University of Athens, Laikon General Hospital,
Athens, Greece
| | - Sotirios Sachanas
- Department of Hematology, Athens Medical Center – Psychikon Branch,
Athens, Greece
| | - Flora Kontopidou
- Department of Hematology, Ippokrateion General Hospital,
Athens, Greece
| | - Maria Moschogiannis
- Department of Hematology, Athens Medical Center – Psychikon Branch,
Athens, Greece
| | - Maria Ximeri
- Department of Hematology, Heraklion University Hospital, University of Crete,
Heraklion, Greece
| | - Pantelis Tsirkinidis
- Department of Hematology, Athens Medical Center – Psychikon Branch,
Athens, Greece
| | - Xanthi Yiakoumis
- Department of Hematology, Athens Medical Center – Psychikon Branch,
Athens, Greece
| | - Helen A. Papadaki
- Department of Hematology, Heraklion University Hospital, University of Crete,
Heraklion, Greece
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Kalpadakis C, Pangalis GA, Vassilakopoulos TP, Sachanas S, Angelopoulou MK. Treatment of splenic marginal zone lymphoma: should splenectomy be abandoned? Leuk Lymphoma 2013; 55:1463-70. [DOI: 10.3109/10428194.2013.845884] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Pangalis GA, Vassilakopoulos TP, Kalpadakis C, Kyrtsonis MC, Kokoris SI, Angelopoulou MK, Panayiotidis P. Treatment of indolent lymphomas from watch and wait to high dose therapy. Hematology 2013; 10 Suppl 1:6-9. [PMID: 16188622 DOI: 10.1080/10245330512331389755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Gerassimos A Pangalis
- First Department of Internal Medicine and Department of Haematology, National and Kapodistrian University of Athens School of Medicine, Laikon University Hospital, Athens, Greece
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Sachanas S, Levidou G, Angelopoulou MK, Moschogiannis M, Yiakoumis X, Kalpadakis C, Vassilakopoulos TP, Kontopidou F, Tsirkinidis P, Dimitrakopoulou A, Kokoris S, Dimitriadou E, Kyrtsonis MC, Panayiotidis P, Papadaki H, Patsouris E, Korkolopoulou P, Pangalis GA. Apoptotic and proliferative characteristics of proliferation centers in lymph node sections of patients with chronic lymphocytic leukemia. Leuk Lymphoma 2013; 55:571-82. [PMID: 23697878 DOI: 10.3109/10428194.2013.806802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We have analyzed the immunohistochemical expression of a wide range of molecules along with the proliferation rate separately in the proliferation centers (PCs) and in the rest of the tumor area, in lymph node or spleen sections of patients with chronic lymphocytic leukemia (CLL). Fas, FasL and c-FLIP were observed both within and outside the PCs in all cases. However, only the difference in FasL expression between the PCs and the non-PC areas attained statistical significance. Median survivin expression in the PCs was higher compared to the non-PC areas. Cleaved caspase 3 was expressed at very low levels both within and outside PCs, while BCL-2 protein was expressed at high levels in all cases in both tumor compartments. Multivariate analysis demonstrated that concurrent overexpression of Fas/FasL/c-FLIP in the PCs was correlated with worse outcome for progression-free survival as well as for overall survival.
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Pontikoglou C, Kastrinaki MC, Klaus M, Kalpadakis C, Katonis P, Alpantaki K, Pangalis GA, Papadaki HA. Study of the quantitative, functional, cytogenetic, and immunoregulatory properties of bone marrow mesenchymal stem cells in patients with B-cell chronic lymphocytic leukemia. Stem Cells Dev 2013; 22:1329-41. [PMID: 23249221 DOI: 10.1089/scd.2012.0255] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The bone marrow (BM) microenvironment has clearly been implicated in the pathogenesis of B-cell chronic lymphocytic leukemia (B-CLL). However, the potential involvement of BM stromal progenitors, the mesenchymal stem cells (MSCs), in the pathophysiology of the disease has not been extensively investigated. We expanded in vitro BM-MSCs from B-CLL patients (n=11) and healthy individuals (n=16) and comparatively assessed their reserves, proliferative potential, differentiation capacity, and immunoregulatory effects on T- and B-cells. We also evaluated the anti-apoptotic effect of patient-derived MSCs on leukemic cells and studied their cytogenetic characteristics in comparison to BM hematopoietic cells. B-CLL-derived BM MSCs exhibit a similar phenotype, differentiation potential, and ability to suppress T-cell proliferative responses as compared with MSCs from normal controls. Furthermore, they do not carry the cytogenetic abnormalities of the leukemic clone, and they exert a similar anti-apoptotic effect on leukemic cells and healthy donor-derived B-cells, as their normal counterparts. On the other hand, MSCs from B-CLL patients significantly promote normal B-cell proliferation and IgG production, in contrast to healthy-donor-derived MSCs. Furthermore, they have impaired reserves, defective cellular growth due to increased apoptotic cell death and exhibit aberrant production of stromal cell-derived factor 1, B-cell activating factor, a proliferation inducing ligand, and transforming growth factor β1, cytokines that are crucial for the survival/nourishing of the leukemic cells. We conclude that ex vivo expanded B-CLL-derived MSCs harbor intrinsic qualitative and quantitative abnormalities that may be implicated in disease development and/or progression.
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Kalpadakis C, Pangalis GA, Angelopoulou MK, Sachanas S, Kontopidou FN, Yiakoumis X, Kokoris SI, Dimitriadou EM, Dimopoulou MN, Moschogiannis M, Korkolopoulou P, Kyrtsonis MC, Siakantaris MP, Papadaki T, Tsaftaridis P, Plata E, Papadaki HE, Vassilakopoulos TP. Treatment of splenic marginal zone lymphoma with rituximab monotherapy: progress report and comparison with splenectomy. Oncologist 2013; 18:190-7. [PMID: 23345547 DOI: 10.1634/theoncologist.2012-0251] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Treatment of splenic marginal zone lymphoma (SMZL) patients is not standardized. Recent data suggest that rituximab is highly effective and could be considered as initial therapy. AIM To assess the efficacy of rituximab monotherapy in a large series of patients with SMZL and compare these results with splenectomy results. METHODS The studied population included 85 patients. Fifty-eight received rituximab at a dose of 375 mg/m2 per week for 6 weeks as induction followed by maintenance at the same dose every 2 months for 1-2 years, whereas 27 patients were treated using splenectomy only. RESULTS The overall response rate to rituximab 2 months after the end of induction was 95% (complete response [CR], 45%; unconfirmed CR, 26%; partial response, 24%). The median times to hematologic and clinical response were 2 weeks and 3 weeks, respectively. Forty-three of 55 patients already completed the maintenance phase: 28 sustained their initial response, 14 improved their response, and one progressed. Eighty-five percent of splenectomized patients responded, and two were treated with rituximab as consolidation after splenectomy and achieved a CR. The 5-year overall and progression-free survival (PFS) rates for rituximab-treated and splenectomized patients were 92% and 77% (p = .09) and 73% and 58% (p = .06), respectively. Furthermore, maintenance therapy with rituximab resulted in a longer duration of response (at 5 years, PFS was 84% for patients receiving maintenance and 36% for patients without maintenance, p <.0001). CONCLUSIONS Rituximab is a very effective and well-tolerated therapy and may be substituted for splenectomy as the first-line treatment of choice for patients with SMZL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/adverse effects
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Disease-Free Survival
- Female
- Humans
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Male
- Middle Aged
- Retrospective Studies
- Rituximab
- Splenectomy/adverse effects
- Splenectomy/methods
- Splenic Neoplasms/drug therapy
- Splenic Neoplasms/pathology
- Splenic Neoplasms/surgery
- Treatment Outcome
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Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, University Hospital of Heraklion, P.O. Box 1352, Heraklion, Crete, Greece.
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Kyrtsonis MC, Koulieris E, Maltezas D, Tzenou T, Harding S, Kastritis E, Kafassi N, Bartzis V, Efthymiou A, Bitsanis K, Gavriatopoulou M, Terpos E, Kalpadakis C, K. Angelopoulou M, P. Vassilakopoulos T, R. Bradwell A, Beris P, A. Pangalis G, Panayiotidis P, A. Dimopoulos M. Prognostic Contribution of the New Immunoglobulin (Ig) Biomarkers (Freelite™ and Hevylite™) in Waldenstrom’s Macroglobulinemia (WM). ACTA ACUST UNITED AC 2012. [DOI: 10.5923/j.ajmms.20120206.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Papageorgiou SG, Diamantopoulos P, Levidou G, Angelopoulou MK, Economopoulou P, Efthimiou A, Constantinou N, Katsigiannis A, Korkolopoulou P, Pappa V, Economopoulou C, Georgiou G, Dimou M, Tsirigotis P, Kyrtsonis MC, Kotsianidis I, Kalpadakis C, Dimopoulos MA, Beris P, Meletis J, Pangalis GA, Dervenoulas J, Panayiotidis P, Vassilakopoulos TP. Isolated central nervous system relapses in primary mediastinal large B-cell lymphoma after CHOP-like chemotherapy with or without Rituximab. Hematol Oncol 2012; 31:10-7. [DOI: 10.1002/hon.2012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 02/06/2012] [Accepted: 03/01/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Sotirios G. Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - Panayiotis Diamantopoulos
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Georgia Levidou
- Department of Pathology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Maria K. Angelopoulou
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Panagiota Economopoulou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - Anna Efthimiou
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | | | - Andreas Katsigiannis
- Third Department of Internal Medicine; National and Kapodistrian University of Athens, Medical School, ‘Sotiria’ Hospital; Athens; Greece
| | - Penelope Korkolopoulou
- Department of Pathology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - Christina Economopoulou
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - George Georgiou
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Maria Dimou
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Panagiotis Tsirigotis
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - Marie-Christine Kyrtsonis
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - Ioannis Kotsianidis
- Department of Haematology; Democritus University of Thrace; Alexandroupolis; Greece
| | | | - Meletios-Athanassios Dimopoulos
- Department of Therapeutics; National and Kapodistrian University of Athens, Medical School, ‘Alexandra’ Hospital; Athens; Greece
| | - Photis Beris
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | - John Meletis
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
| | | | - John Dervenoulas
- Second Department of Internal Medicine, Propaedeutic, Hematology Unit; National and Kapodistrian University of Athens, Medical School, University General Hospital ‘Attikon’; Haidari; Greece
| | - Panayiotis Panayiotidis
- Department of Haematology; University of Athens, Medical School, ‘Laikon’ General Hospital; Athens; Greece
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Dimou M, Angelopoulou MK, Pangalis GA, Georgiou G, Kalpadakis C, Pappi V, Tsopra O, Koutsoukos K, Zografos E, Boutsikas G, Moschogianni M, Vardounioti I, Petevi K, Karali V, Kanellopoulos A, Ntalageorgos T, Yiakoumis X, Bartzis V, Bitsani A, Pessach E, Efthimiou A, Korkolopoulou P, Rassidakis G, Kyrtsonis MC, Patsouris E, Meletis J, Panayiotidis P, Vassilakopoulos TP. Autoimmune hemolytic anemia and autoimmune thrombocytopenia at diagnosis and during follow-up of Hodgkin lymphoma. Leuk Lymphoma 2012; 53:1481-7. [DOI: 10.3109/10428194.2012.660628] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Vassilakopoulos TP, Pangalis GA, Katsigiannis A, Papageorgiou SG, Constantinou N, Terpos E, Zorbala A, Vrakidou E, Repoussis P, Poziopoulos C, Galani Z, Dimopoulou MN, Kokoris SI, Sachanas S, Kalpadakis C, Dimitriadou EM, Siakantaris MP, Kyrtsonis MC, Dervenoulas J, Dimopoulos MA, Meletis J, Roussou P, Panayiotidis P, Beris P, Angelopoulou MK. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone with or without radiotherapy in primary mediastinal large B-cell lymphoma: the emerging standard of care. Oncologist 2012; 17:239-49. [PMID: 22282906 PMCID: PMC3286173 DOI: 10.1634/theoncologist.2011-0275] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 11/02/2011] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED More aggressive treatment approaches (methotrexate, cytarabine, cyclophosphamide, vincristine, prednisone, and bleomycin [the MACOP-B regimen] or consolidation with high-dose therapy and autologous stem cell transplantation) have been considered to be superior to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with primary mediastinal large B-cell lymphoma (PMLBCL). Rituximab-CHOP (R-CHOP) is the standard of care for diffuse large B-cell lymphoma, whereas efficacy in PMLBCL has not been adequately confirmed. PATIENT AND METHODS Seventy-six consecutive PMLBCL patients who received R-CHOP with or without radiotherapy (RT) were compared with 45 consecutive historical controls treated with CHOP with or without RT. Baseline characteristics of the two groups were balanced. RESULTS The rate of early treatment failure was much lower with R-CHOP with or without RT (9% versus 30%; p = .004). The 5-year freedom from progression rate after R-CHOP with or without RT was 81%, versus 48% for CHOP with or without RT (p < .0001). The 5-year event-free survival rates were 80% and 47% (p < .0001) and the 5-year overall and lymphoma-specific survival rates were 89% and 69% (p = .003) and 91% and 69% (p = .001), respectively, with only seven of 76 lymphoma-related deaths. Among R-CHOP responders, 52 of 68 received RT. CONCLUSIONS Based on these results, most patients with PMLBCL appear to be cured by R-CHOP in 21-day cycles with or without RT, which could be the current standard of care. Therefore, the need for more aggressive treatment strategies is questionable unless high-risk patients are adequately defined. Further studies are required to establish the precise role of RT.
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Affiliation(s)
- Theodoros P Vassilakopoulos
- Department of Haematology, National and Kapodistrian University of Athens, School of Medicine, Laikon General Hospital, Athens 11527, Greece.
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Pontikoglou C, Kalpadakis C, Papadaki HA. Pathophysiologic mechanisms and management of neutropenia associated with large granular lymphocytic leukemia. Expert Rev Hematol 2011; 4:317-28. [PMID: 21668396 DOI: 10.1586/ehm.11.26] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Large granular lymphocyte (LGL) syndrome includes a spectrum of clonal T cell and natural killer cell chronic lymphoproliferative disorders. These conditions are thought to arise from chronic antigenic stimulation, while the long-term survival of the abnormal LGLs appears to be sustained by resistance to apoptosis and/or impaired survival signaling. T-cell LGL (T-LGL) leukemia is the most common LGL disorder in the Western world. Despite its indolent course, the disease is often associated with neutropenia, the pathogenesis of which is multifactorial, comprising both humoral and cytotoxic mechanisms. This article addresses the pathogenesis of T-LGL leukemia and natural killer cell chronic lymphoproliferative disorder, as well as that of T-LGL leukemia-associated neutropenia. Furthermore, as symptomatic neutropenia represents an indication for initiating treatment, available therapeutic options are also discussed.
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Mavroudi I, Pyrovolaki K, Pavlaki K, Kozana A, Psyllaki M, Kalpadakis C, Pontikoglou C, Papadaki HA. Effect of the nonpeptide thrombopoietin receptor agonist eltrombopag on megakaryopoiesis of patients with lower risk myelodysplastic syndrome. Leuk Res 2011; 35:323-8. [DOI: 10.1016/j.leukres.2010.06.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Revised: 06/28/2010] [Accepted: 06/29/2010] [Indexed: 12/24/2022]
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Klaus M, Psaraki A, Mastrodemou S, Pyrovolaki K, Mavroudi I, Kalpadakis C, Papadaki HA. Evaluation of TET2 deletions in myeloid disorders: A fluorescence in situ hybridization analysis of 109 cases. Leuk Res 2011; 35:413-5. [DOI: 10.1016/j.leukres.2010.10.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/01/2010] [Accepted: 10/23/2010] [Indexed: 11/28/2022]
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Kyrtsonis MC, Levidou G, Korkolopoulou P, Koulieris E, Bartzi V, Maltezas D, Pangalis GA, Kalpadakis C, Dimou M, Georgiou G, Vassilakopoulos TP, Angelopoulou MK, Salpeas V, Tsaftaridis P, Patsouris E, Panayiotidis P, Tzenou TK. CD138 Expression Helps Distinguishing Waldenström's Macroglobulinemia (WM) From Splenic Marginal Zone Lymphoma (SMZL). Clinical Lymphoma Myeloma and Leukemia 2011; 11:99-102. [DOI: 10.3816/clml.2011.n.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sachanas S, Pangalis GA, Vassilakopoulos TP, Korkolopoulou P, Kontopidou FN, Athanasoulia M, Yiakoumis X, Kalpadakis C, Georgiou G, Masouridis S, Moschogiannis M, Tsirkinidis P, Pappis V, Kokoris SI, Siakantaris MP, Panayiotidis P, Angelopoulou MK. Combination of rituximab with chlorambucil as first line treatment in patients with mantle cell lymphoma: a highly effective regimen. Leuk Lymphoma 2010; 52:387-93. [DOI: 10.3109/10428194.2010.534518] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yiakoumis X, Pangalis GA, Kyrtsonis MC, Vassilakopoulos TP, Kontopidou FN, Kalpadakis C, Korkolopoulou P, Levidou G, Androulaki A, Siakantaris MP, Sachanas S, Andreopoulos A. Primary effusion lymphoma in two HIV-negative patients successfully treated with pleurodesis as first-line therapy. Anticancer Res 2010; 30:271-276. [PMID: 20150647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Primary effusion lymphoma (PEL) is a rare non-Hodgkin's lymphoma (NHL) mostly occurring in HIV-positive patients. It is characterized by the development of effusion in one or more body cavities, with no tumor masses and a positive human herpes virus-8 (HHV8) status. It has a poor survival profile and no optimal treatment is yet defined. We report two HIV-negative, HHV8-positive patients with PEL of the pleural cavity who achieved a durable remission after pleurodesis with bleomycin and no systemic therapy. We also perform a review of the relevant literature regarding the clinical data, treatment, and survival of PEL in HIV-negative patients.
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Affiliation(s)
- X Yiakoumis
- Department of Haematology, Iatriko Athinon, Psychicon Branch, 1st Kyriakidou Str, P. Psychikon, 15452 Athens, Greece
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Kalpadakis C, Pangalis GA, Vassilakopoulos TP, Kyrtsonis MC, Siakantaris MP, Kontopidou FN, Korkolopoulou P, Bobotsis P, Sahanas S, Tzenou T, Anagnostou D, Dimitriadou E, Yiakoumis X, Patsouris E, Roussou P, Panayiotidis P, Papadaki E, Angelopoulou MK. Non-gastric extra-nodal marginal zone lymphomas–a single centre experience on 76 patients. Leuk Lymphoma 2009; 49:2308-15. [DOI: 10.1080/10428190802510331] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Kalpadakis C, Pangalis GA, Dimitriadou E, Angelopoulou MK, Siakantaris MP, Kyrtsonis MC, Ximeris M, Tzenou T, Sahanas S, Yiakoumis X, Papadaki EA, Panayiotidis P, Vassilakopoulos T. Mutation analysis of IgVH genes in splenic marginal zone lymphomas: correlation with clinical characteristics and outcome. Anticancer Res 2009; 29:1811-1816. [PMID: 19443409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND To determine the immunoglobulin variable heavy chain (IgVH) gene usage and somatic mutation patterns in a series of SMZL patients and to correlate these findings with the clinical features and outcome. PATIENTS AND METHODS IgVH genes were amplified and sequenced from 22 SMZL cases. Clinical and laboratory data of these patients were recorded. RESULTS A biased usage of IgVH gene was found with overrepresentation of VH3 in 16/22 cases. A total of 13/22 (59%) of cases were found to have mutated IgVH genes, whereas 9/22 (41%) were unmutated. Positive antigen selection process was identified in two cases. Treatment was different between the cases with mutation and those without. No differences in clinical and laboratory characteristics, or survival were found between the mutated and unmutated cases. CONCLUSION SMZL are characterized by marked molecular heterogeneity. A biased usage of certain sequences suggests antigen selection. Prognostic significance of mutational status was not confirmed in this study. However further studies are needed in order to confirm these results.
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Affiliation(s)
- Christina Kalpadakis
- Department of Haematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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