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Lemal R, Poulain S, Ledoux‐Pilon A, Veronese L, Tchirkov A, Lebecque B, Tassin T, Bay J, Charlotte F, Nguyen‐Khac F, Berger M, Godfraind C, Ysebaert L, Davi F, Pereira B, Leblond V, Hermine O, Guièze R, Pagès F, Tournilhac O. Mast cell density and its clinical relevance in Waldenström's macroglobulinemia. EJHaem 2022; 3:371-378. [PMID: 35846063 PMCID: PMC9176068 DOI: 10.1002/jha2.378] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 06/15/2023]
Abstract
The presence of numerous mast cells (MCs) mixed with tumor cells in the bone marrow (BM) is a hallmark of the diagnosis of Waldenström's macroglobulinemia (WM). MCs have been shown to support lymphoplasmacytic cell growth, but there is thus far no demonstration of the prognostic impact of BM MC density in WM. We investigated BM MC density by sensitive and specific digital quantification, allowing the analysis of a large area infiltrated by BM tumor cells. A total of 65 WM patients were investigated, including 54 at diagnosis and 11 at relapse. Tryptase and CD20 immunohistochemisty staining was performed on contiguous sections of deparaffinized BM trephine biopsies. After numerization of each section, the BM surface area was manually marked out, excluding the bone framework and adipocytes to limit the analyses to only hematopoietic tissue. MCs were assessed using a digital tool previously used to quantify immune-cell infiltrates on tumor-tissue sections. Deep next-generation sequencing and allele-specific PCR were used to explore the MYD88 and CXCR4 mutational status. MC density was heterogeneous among the WM patients. An optimal MC density threshold (> 56 MC.mm-2) was defined according to ROC curve analysis of overall survival. A higher MC density (> 56 MC.mm-2) was associated with greater BM involvement by WM lymphoplasmacytic cells and less hepatosplenic involvement (p = 0.023). Furthermore, MC density significantly correlated with a higher ISSWM score (p = 0.0003) in symptomatic patients. Patients with a higher MC density showed shorter median OS (56.5 months vs. nonreached, p = 0.0004), even in multivariate analysis after controlling for other predictive variables, such as age, ISSWM score, and CXCR4 mutational status. In conclusion, MC density can be accurately measured in WM patients using a specific digital tool on well-outlined hematopoietic tissue surfaces. High MC density is associated with aggressive features and a poor clinical outcome, emphasizing the need for further investigation of the involvement of MCs in the pathophysiology of WM.
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Affiliation(s)
- Richard Lemal
- Laboratoire d'Histocompatibilité, Centre de Biologie, CHU de Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | - Stéphanie Poulain
- “CANcer HeterogeneityPlasticity and Resistance to THERapies” INSERM 1277‐CNRS 9020 UMRS 12University of LilleLilleFrance
- Service d'Hématologie CellulaireCentre de Biologie PathologieLilleFrance
| | - Albane Ledoux‐Pilon
- Anatomie PathologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Lauren Veronese
- Service de Cytogénétique MédicaleCHU Clermont‐FerrandINSERM U1240 IMOSTUniversité Clermont AuvergneClermont FerrandFrance
| | - Andrei Tchirkov
- Service de Cytogénétique MédicaleCHU Clermont‐FerrandINSERM U1240 IMOSTUniversité Clermont AuvergneClermont FerrandFrance
| | - Benjamin Lebecque
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Thomas Tassin
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Jacques‐Olivier Bay
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | | | - Florence Nguyen‐Khac
- Service d‘Hématologie BiologiqueSorbonne UniversitéHôpital Pitié‐SalpêtrièreCentre de Recherche des CordeliersParisFrance
| | - Marc Berger
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Catherine Godfraind
- Anatomie PathologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | | | - Frédéric Davi
- La Pitié SalpêtrièreAPHPLaboratoire d'HématologieParisFrance
| | - Bruno Pereira
- Direction de la recherche cliniqueUnité BiostatistiqueClermont FerrandFrance
| | | | - Olivier Hermine
- Hématologie CliniqueAPHP, IMAGINE InstituteNecker‐Enfants MaladesParisFrance
| | - Romain Guièze
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | - Franck Pagès
- Immunomonitoring PlateformAPHPHôpital Européen Georges PompidouParisFrance
| | - Olivier Tournilhac
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
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Krzisch D, Guedes N, Boccon‐Gibod C, Baron M, Bravetti C, Davi F, Armand M, Smagghe L, Caron J, Bernard OA, Susin S, Chapiro E, Leblond V, Nguyen‐Khac F, Roos‐Weil D. Cytogenetic and molecular abnormalities in Waldenström's macroglobulinemia patients: Correlations and prognostic impact. Am J Hematol 2021; 96:1569-1579. [PMID: 34462944 DOI: 10.1002/ajh.26339] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 12/17/2022]
Abstract
While Waldenström macroglobulinemia (WM) is characterized by an almost unifying mutation in MYD88, clinical presentation at diagnosis and response to therapy can be widely different among WM patients. Current prognostic tools only partially address this clinical heterogeneity. Limited data compiling both molecular and cytogenetic information have been used in risk prognostication in WM. To investigate the clinical impact of genetic alterations in WM, we evaluated cytogenetic and molecular abnormalities by chromosome banding analyses, FISH and targeted NGS in a retrospective cohort of 239 WM patients, including 187 patients treated by first-line chemotherapy or immunochemotherapy. Most frequent mutations were identified in MYD88 (93%), CXCR4 (29%), MLL2 (11%), ARID1A (8%), TP53 (8%), CD79A/B (6%), TBL1XR1 (4%) and SPI1 (4%). The median number of cytogenetic abnormalities was two (range, 0-22). Main cytogenetic abnormalities were 6q deletion (del6q) (27%), trisomy 4 (tri4) (12%), tri18 (11%), del13q (11%), tri12 (7.5%) and del17p (7%). Complex karyotype (CK) was observed in 15% (n = 31) of cases, including 5% (n = 12) of highly CK (high-CK). TP53 abnormalities (TP53abn) were present in 15% of evaluable patients. TP53abn and del6q were associated with CK/high-CK (p < .05). Fifty-three percent of patients with hyperviscosity harbored CXCR4 mutations. Cytogenetic and molecular abnormalities did not significantly impact time to first treatment and response to therapy. Prognostic factors associated with shorter PFS were del6q (p = .01), TP53abn (p = .002) and high-CK (p = .01). These same factors as well as IPSSWM, tri4, CXCR4 frameshift and SPI1 mutations were significantly associated with lower OS (p < .05). These results argue for integration of both cytogenetic and molecular screening in evaluation of first-line WM patients.
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Affiliation(s)
- Daphné Krzisch
- Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
| | - Nayara Guedes
- Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | | | - Marine Baron
- Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Clotilde Bravetti
- Sorbonne Université, Biologie moléculaire, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Frédéric Davi
- Sorbonne Université, Biologie moléculaire, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Marine Armand
- Sorbonne Université, Biologie moléculaire, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Luce Smagghe
- Sorbonne Université, Unité de Cytogénétique, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Jonathan Caron
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
| | | | - Santos Susin
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
| | - Elise Chapiro
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
- Sorbonne Université, Unité de Cytogénétique, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | | | - Florence Nguyen‐Khac
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
- Sorbonne Université, Unité de Cytogénétique, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Damien Roos‐Weil
- Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
- Centre de Recherche des Cordeliers, INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot Paris France
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Moulin C, Guillemin F, Remen T, Bouclet F, Hergalant S, Quinquenel A, Dartigeas C, Tausch E, Lazarian G, Blanchet O, Lomazzi S, Chapiro E, Schneider C, Nguyen‐Khac F, Davi F, Hunault M, Tomowiak C, Roos‐Weil D, Siebert R, Thieblemont C, Cymbalista F, Laribi K, Béné M, Stilgenbauer S, Guièze R, Feugier P, Broséus J. Clinical, biological, and molecular genetic features of Richter syndrome and prognostic significance: A study of the French Innovative Leukemia Organization. Am J Hematol 2021; 96:E311-E314. [PMID: 34000073 DOI: 10.1002/ajh.26239] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Charline Moulin
- Department of Hematology University Hospital of Nancy Nancy France
- Inserm, CHRU, University of Lorraine, CIC Clinical Epidemiology Nancy France
| | - Francis Guillemin
- Inserm, CHRU, University of Lorraine, CIC Clinical Epidemiology Nancy France
| | - Thomas Remen
- Methodology, Data Management and Statistic Unit, MPI Department University Hospital of Nancy Nancy France
| | - Florian Bouclet
- Hematology Department, Clermont‐Ferrand University Hospital, Clermont Auvergne University Clermont‐Ferrand France
| | - Sébastien Hergalant
- Inserm UMRS1256 Nutrition‐Génétique et Exposition aux Risque Environnementaux (N‐GERE), University of Lorraine Nancy France
| | - Anne Quinquenel
- University Hospital of Reims, Hôpital Robert Debré, Reims Champagne‐Ardenne University, Unité de Formation et de Recherche (UFR) Médecine Reims France
| | | | - Eugen Tausch
- Department of Internal Medicine III Ulm University Ulm Germany
| | - Grégory Lazarian
- Laboratoire d'hématologie, Hôpital Avicenne Assistance Publique‐Hôpitaux de Paris Paris France
| | - Odile Blanchet
- Biological Resource Center of Angers University Hospital of Angers Angers France
| | | | - Elise Chapiro
- Hematology Department Hôpital de la Pitié‐Salpêtrière, AP‐HP Paris France
| | | | | | - Frédéric Davi
- Hematology Department Hôpital de la Pitié‐Salpêtrière, AP‐HP Paris France
| | - Mathilde Hunault
- Department of Hematology University Hospital of Angers Angers France
| | - Cécile Tomowiak
- Department of Hematology CHU Poitiers Poitiers France
- CIC1402 Inserm Poitiers Poitiers France
| | - Damien Roos‐Weil
- Department of Hematology Hôpital de la Pitié‐Salpêtrière, APHP Paris France
| | - Reiner Siebert
- Institute of Human Genetics Ulm University & Ulm University Medical Center Ulm Germany
| | | | - Florence Cymbalista
- Laboratoire d'hématologie, Hôpital Avicenne Assistance Publique‐Hôpitaux de Paris Paris France
| | - Kamel Laribi
- Department of Hematology Centre Hospitalier Le Mans Le Mans France
| | | | | | - Romain Guièze
- Hematology Department, Clermont‐Ferrand University Hospital, Clermont Auvergne University Clermont‐Ferrand France
| | - Pierre Feugier
- Department of Hematology University Hospital of Nancy Nancy France
- Inserm UMRS1256 Nutrition‐Génétique et Exposition aux Risque Environnementaux (N‐GERE), University of Lorraine Nancy France
| | - Julien Broséus
- Inserm UMRS1256 Nutrition‐Génétique et Exposition aux Risque Environnementaux (N‐GERE), University of Lorraine Nancy France
- Université de Lorraine, CHRU‐Nancy, service d'hématologie biologique, pôle laboratoires Nancy France
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4
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Jondreville L, Krzisch D, Chapiro E, Nguyen‐Khac F. The complex karyotype and chronic lymphocytic leukemia: prognostic value and diagnostic recommendations. Am J Hematol 2020; 95:1361-1367. [PMID: 32777106 DOI: 10.1002/ajh.25956] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022]
Abstract
Chromosomal abnormalities are frequently observed in patients with chronic lymphocytic leukemia (CLL) and have prognostic value. Deletions of the short arm of chromosome 17 (and/or mutations TP53) predict resistance to chemoimmunotherapy and shorter progression-free survival after targeted therapies. Although the complex karyotype (CK) is strongly predictive of a poor prognosis in hematologic malignancies such acute myeloid leukemia or myelodysplastic syndrome, its value in CLL is subject to debate. Here, we review the literature on the CK in CLL and examine its prognostic value with different treatments. We also propose a standardized method for defining a CK in all types of hematopoietic neoplasm.
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Affiliation(s)
- Ludovic Jondreville
- INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Centre de Recherche des Cordeliers Paris France
| | - Daphné Krzisch
- INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Centre de Recherche des Cordeliers Paris France
| | - Elise Chapiro
- INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Centre de Recherche des Cordeliers Paris France
- Service dʼHématologie Biologique Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Florence Nguyen‐Khac
- INSERM, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team Centre de Recherche des Cordeliers Paris France
- Service dʼHématologie Biologique Sorbonne Université, Hôpital Pitié‐Salpêtrière, APHP Paris France
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5
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Penther D, Etancelin P, Lusina D, Bidet A, Quilichini B, Gaillard B, Rafdord‐Weiss I, Mozziconacci MJ, Ittel A, Roche‐Lestienne C, Barin C, Soler G, Daudignon A, Nadal N, Chapiro E, Lefebvre C, Godon C, Nadeau G, Mugneret F, Richebourg S, Viailly P, Ferret Y, Nguyen‐Khac F, Eclache V. Isolated isochromosomes i(X)(p10) and idic(X)(q13) are associated with myeloid malignancies and dysplastic features. Am J Hematol 2019; 94:E285-E288. [PMID: 31379011 DOI: 10.1002/ajh.25601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/25/2019] [Accepted: 07/29/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Dominique Penther
- Laboratoire de Génétique OncologiqueCLCC Henri Becquerel & INSERM U1245 Rouen France
| | - Pascaline Etancelin
- Laboratoire de Génétique OncologiqueCLCC Henri Becquerel & INSERM U1245 Rouen France
| | - Daniel Lusina
- Laboratoire d'HématologieCentre Hospitalier Universitaire Avicenne, APHP Bobigny France
| | - Audrey Bidet
- Laboratoire d'HématologieCentre Hospitalier Universitaire Bordeaux France
| | | | - Baptiste Gaillard
- Laboratoire d'HématologieCentre Hospitalier Universitaire Reims France
| | | | | | - Antoine Ittel
- Laboratoire de CytogénétiqueCentre Hospitalier Universitaire Strasbourg France
| | - Catherine Roche‐Lestienne
- Laboratoire de Génétique MédicaleHôpital Jeanne de Flandre, and UMR‐S 1172, Univ. Lille Lille France
| | - Carole Barin
- Laboratoire de CytogénétiqueHôpital Bretonneau Tours France
| | - Gwendoline Soler
- Laboratoire de CytogénétiqueCentre Hospitalier Universitaire Clermont‐Ferrand France
| | - Agnes Daudignon
- Laboratoire de Génétique MédicaleHôpital Jeanne de Flandre, and UMR‐S 1172, Univ. Lille Lille France
| | - Nathalie Nadal
- Service de génétique chromosomique et moléculaire. C.H.U. DIJON Dijon France
| | - Elise Chapiro
- Service d'Hématologie BiologiqueHôpital Pitié‐Salpêtrière, AP‐HP, Sorbonne Université Paris France
| | - Christine Lefebvre
- Laboratoire de CytogénétiqueCentre Hospitalier Universitaire Grenoble France
| | - Catherine Godon
- Laboratoire de CytogénétiqueHôpital Hôtel Dieu Nantes France
| | - Gwenael Nadeau
- Laboratoire de Génétique ChromosomiqueCentre Hospitalier Métropole Savoie Chambéry France
| | - Francine Mugneret
- Service de génétique chromosomique et moléculaire. C.H.U. DIJON Dijon France
| | - Steven Richebourg
- Laboratoire de Cytogénétique onco‐hématologiqueHôpital du Saint Sacrement Québec Canada
| | - Pierre‐Julien Viailly
- Laboratoire de Génétique OncologiqueCLCC Henri Becquerel & INSERM U1245 Rouen France
| | - Yann Ferret
- Laboratoire de cytogénétiqueCHU Amiens Picardie Amiens France
| | - Florence Nguyen‐Khac
- Service d'Hématologie BiologiqueHôpital Pitié‐Salpêtrière, AP‐HP, Sorbonne Université Paris France
| | - Virginie Eclache
- Laboratoire d'HématologieCentre Hospitalier Universitaire Avicenne, APHP Bobigny France
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