1
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Deng M, Zhang M, Xu-Monette ZY, Pham LV, Tzankov A, Visco C, Fang X, Bhagat G, Zhu F, Dybkaer K, Chiu A, Tam W, Zu Y, Hsi ED, Choi WWL, Huh J, Ponzoni M, Ferreri AJM, Møller MB, Parsons BM, van Krieken JH, Piris MA, Winter JN, Hagemeister F, Alinari L, Li Y, Andreeff M, Xu B, Young KH. XPO1 expression worsens the prognosis of unfavorable DLBCL that can be effectively targeted by selinexor in the absence of mutant p53. J Hematol Oncol 2020; 13:148. [PMID: 33148342 PMCID: PMC7641823 DOI: 10.1186/s13045-020-00982-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
The XPO1 inhibitor selinexor was recently approved in relapsed/refractory DLBCL patients but only demonstrated modest anti-DLBCL efficacy, prompting us to investigate the prognostic effect of XPO1 in DLBCL patients and the rational combination therapies in high-risk DLBCL. High XPO1 expression (XPO1high) showed significant adverse prognostic impact in 544 studied DLBCL patients, especially in those with BCL2 overexpression. Therapeutic study in 30 DLBCL cell lines with various molecular and genetic background found robust cytotoxicity of selinexor, especially in cells with BCL2-rearranged (BCL2-R+) DLBCL or high-grade B-cell lymphoma with MYC/BCL2 double-hit (HGBCL-DH). However, expression of mutant (Mut) p53 significantly reduced the cytotoxicity of selinexor in overall cell lines and the BCL2-R and HGBCL-DH subsets, consistent with the favorable impact of XPO1high observed in Mut-p53-expressing patients. The therapeutic effect of selinexor in HGBCL-DH cells was significantly enhanced when combined with a BET inhibitor INCB057643, overcoming the drug resistance in Mut-p53-expressing cells. Collectively, these data suggest that XPO1 worsens the survival of DLBCL patients with unfavorable prognostic factors such as BCL2 overexpression and double-hit, in line with the higher efficacy of selinexor demonstrated in BCL2-R+ DLBCL and HGBCL-DH cell lines. Expression of Mut-p53 confers resistance to selinexor treatment, which can be overcome by combined INCB057643 treatment in HGBCL-DH cells. This study provides insight into the XPO1 significance and selinexor efficacy in DLBCL, important for developing combination therapy for relapsed/refractory DLBCL and HGBCL-DH.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Cell Line, Tumor
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Hydrazines/therapeutic use
- Karyopherins/antagonists & inhibitors
- Karyopherins/genetics
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Prognosis
- Receptors, Cytoplasmic and Nuclear/antagonists & inhibitors
- Receptors, Cytoplasmic and Nuclear/genetics
- Triazoles/therapeutic use
- Tumor Suppressor Protein p53/genetics
- Exportin 1 Protein
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Affiliation(s)
- Manman Deng
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, School of Medicine, Xiamen, Fujian, China
- Division of Hematopathology, Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zijun Y Xu-Monette
- Division of Hematopathology, Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Lan V Pham
- Phamacyclics, an Abbvie Company, San Francisco, CA, USA
| | - Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Xiaosheng Fang
- Division of Hematopathology, Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Feng Zhu
- Division of Hematopathology, Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | | | | | - Wayne Tam
- Weill Medical College of Cornell University, New York, NY, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, USA
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | | | | | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Miguel A Piris
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Fredrick Hagemeister
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lapo Alinari
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Yong Li
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Michael Andreeff
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bing Xu
- Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, Xiamen University, School of Medicine, Xiamen, Fujian, China.
- Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China.
| | - Ken H Young
- Division of Hematopathology, Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA.
- Duke Cancer Institute, Durham, NC, USA.
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2
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Mak KY, Au CH, Chan TL, Ma ESK, Chow EYD, Lin SY, Choi WWL. Next-generation sequencing panel for diagnosis and management of chronic neutrophilic leukaemia: a case report. Hong Kong Med J 2020; 25:248-250. [PMID: 31182673 DOI: 10.12809/hkmj176959] [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: 11/05/2022] Open
Affiliation(s)
- K Y Mak
- Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong
| | - C H Au
- Department of Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
| | - T L Chan
- Department of Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
| | - E S K Ma
- Department of Pathology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong
| | - E Y D Chow
- Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong
| | - S Y Lin
- Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong
| | - W W L Choi
- Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong
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3
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Panea RI, Love CL, Shingleton JR, Reddy A, Bailey JA, Moormann AM, Otieno JA, Ong'echa JM, Oduor CI, Schroeder KMS, Masalu N, Chao NJ, Agajanian M, Major MB, Fedoriw Y, Richards KL, Rymkiewicz G, Miles RR, Alobeid B, Bhagat G, Flowers CR, Ondrejka SL, Hsi ED, Choi WWL, Au-Yeung RKH, Hartmann W, Lenz G, Meyerson H, Lin YY, Zhuang Y, Luftig MA, Waldrop A, Dave T, Thakkar D, Sahay H, Li G, Palus BC, Seshadri V, Kim SY, Gascoyne RD, Levy S, Mukhopadyay M, Dunson DB, Dave SS. The whole-genome landscape of Burkitt lymphoma subtypes. Blood 2019; 134:1598-1607. [PMID: 31558468 PMCID: PMC6871305 DOI: 10.1182/blood.2019001880] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/28/2019] [Indexed: 01/10/2023] Open
Abstract
Burkitt lymphoma (BL) is an aggressive, MYC-driven lymphoma comprising 3 distinct clinical subtypes: sporadic BLs that occur worldwide, endemic BLs that occur predominantly in sub-Saharan Africa, and immunodeficiency-associated BLs that occur primarily in the setting of HIV. In this study, we comprehensively delineated the genomic basis of BL through whole-genome sequencing (WGS) of 101 tumors representing all 3 subtypes of BL to identify 72 driver genes. These data were additionally informed by CRISPR screens in BL cell lines to functionally annotate the role of oncogenic drivers. Nearly every driver gene was found to have both coding and non-coding mutations, highlighting the importance of WGS for identifying driver events. Our data implicate coding and non-coding mutations in IGLL5, BACH2, SIN3A, and DNMT1. Epstein-Barr virus (EBV) infection was associated with higher mutation load, with type 1 EBV showing a higher mutational burden than type 2 EBV. Although sporadic and immunodeficiency-associated BLs had similar genetic profiles, endemic BLs manifested more frequent mutations in BCL7A and BCL6 and fewer genetic alterations in DNMT1, SNTB2, and CTCF. Silencing mutations in ID3 were a common feature of all 3 subtypes of BL. In vitro, mass spectrometry-based proteomics demonstrated that the ID3 protein binds primarily to TCF3 and TCF4. In vivo knockout of ID3 potentiated the effects of MYC, leading to rapid tumorigenesis and tumor phenotypes consistent with those observed in the human disease.
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Affiliation(s)
- Razvan I Panea
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Cassandra L Love
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Jennifer R Shingleton
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Anupama Reddy
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI
| | - Ann M Moormann
- Department of Medicine, University of Massachusetts, Worcester, MA
| | - Juliana A Otieno
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Ministry of Health, Kisumu, Kenya
| | | | - Cliff I Oduor
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Kristin M S Schroeder
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
- Bugando Medical Center, Mwanza, Tanzania
| | | | - Nelson J Chao
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Megan Agajanian
- Department of Cell Biology and Physiology, Washington University in St. Louis, St. Louis, MO
| | - Michael B Major
- Department of Cell Biology and Physiology, Washington University in St. Louis, St. Louis, MO
| | | | | | - Grzegorz Rymkiewicz
- Poland Flow Cytometry Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, UT
| | - Bachir Alobeid
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | - Govind Bhagat
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | | | - Sarah L Ondrejka
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - Eric D Hsi
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - William W L Choi
- Department of Pathology, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Rex K H Au-Yeung
- The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
- Institute of Human Genetics, Christian-Albrechts-University, Kiel, Germany
| | - Wolfgang Hartmann
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Georg Lenz
- Medical Department A, Hematology, Oncology and Pneumology, University of Münster, Münster, Germany
| | - Howard Meyerson
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | | | | | - Micah A Luftig
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - Alexander Waldrop
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Tushar Dave
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Devang Thakkar
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Harshit Sahay
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Guojie Li
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Brooke C Palus
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Vidya Seshadri
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - So Young Kim
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - Randy D Gascoyne
- Department of Pathology and Experimental Therapeutics, BC Cancer Agency and BC Cancer Research Centre, Vancouver, BC, Canada
| | - Shawn Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL; and
| | | | - David B Dunson
- Department of Statistical Science, Duke University, Durham, NC
| | - Sandeep S Dave
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
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4
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Zhang M, Xu-Monette ZY, Li L, Manyam GC, Visco C, Tzankov A, Wang J, Montes-Moreno S, Dybkaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, Han van Krieken J, Huh J, Ponzoni M, Ferreri AJM, Møller MB, Parsons BM, Winter JN, Piris MA, Medeiros LJ, Pham LV, Young KH. RelA NF-κB subunit activation as a therapeutic target in diffuse large B-cell lymphoma. Aging (Albany NY) 2017; 8:3321-3340. [PMID: 27941215 PMCID: PMC5270671 DOI: 10.18632/aging.101121] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 10/29/2016] [Accepted: 11/11/2016] [Indexed: 12/17/2022]
Abstract
It has been well established that nuclear factor kappa-B (NF-κB) activation is important for tumor cell growth and survival. RelA/p65 and p50 are the most common NF-kB subunits and involved in the classical NF-kB pathway. However, the prognostic and biological significance of RelA/p65 is equivocal in the field. In this study, we assessed RelA/p65 nuclear expression by immunohistochemistry in 487 patients with de novo diffuse large B-cell lymphoma (DLBCL), and studied the effects of molecular and pharmacological inhibition of NF-kB on cell viability. We found RelA/p65 nuclear expression, without associations with other apparent genetic or phenotypic abnormalities, had unfavorable prognostic impact in patients with stage I/II DLBCL. Gene expression profiling analysis suggested immune dysregulation and antiapoptosis may be relevant for the poorer prognosis associated with p65 hyperactivation in germinal center B-cell-like (GCB) DLBCL and in activated B-cell-like (ABC) DLBCL, respectively. We knocked down individual NF-κB subunits in representative DLBCL cells in vitro, and found targeting p65 was more effective than targeting other NF-κB subunits in inhibiting cell growth and survival. In summary, RelA/p65 nuclear overexpression correlates with significant poor survival in early-stage DLBCL patients, and therapeutic targeting RelA/p65 is effective in inhibiting proliferation and survival of DLBCL with NF-κB hyperactivation.
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Affiliation(s)
- Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital Zhengzhou University, Zhengzhou, Henan, China.,Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ling Li
- Department of Oncology, The First Affiliated Hospital Zhengzhou University, Zhengzhou, Henan, China
| | - Ganiraju C Manyam
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, NY 10065, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX 77030, USA
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY 10032, USA
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, NC 27514, USA
| | - Eric D Hsi
- Cleveland Clinic, Cleveland, OH 44195, USA
| | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | | | - Ben M Parsons
- Gundersen Medical Foundation, La Crosse, WI 54601, USA
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lan V Pham
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.,The University of Texas School of Medicine, Graduate School of Biomedical Sciences, Houston, TX 77030, USA
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5
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Reddy A, Zhang J, Davis NS, Moffitt AB, Love CL, Waldrop A, Leppa S, Pasanen A, Meriranta L, Karjalainen-Lindsberg ML, Nørgaard P, Pedersen M, Gang AO, Høgdall E, Heavican TB, Lone W, Iqbal J, Qin Q, Li G, Kim SY, Healy J, Richards KL, Fedoriw Y, Bernal-Mizrachi L, Koff JL, Staton AD, Flowers CR, Paltiel O, Goldschmidt N, Calaminici M, Clear A, Gribben J, Nguyen E, Czader MB, Ondrejka SL, Collie A, Hsi ED, Tse E, Au-Yeung RKH, Kwong YL, Srivastava G, Choi WWL, Evens AM, Pilichowska M, Sengar M, Reddy N, Li S, Chadburn A, Gordon LI, Jaffe ES, Levy S, Rempel R, Tzeng T, Happ LE, Dave T, Rajagopalan D, Datta J, Dunson DB, Dave SS. Genetic and Functional Drivers of Diffuse Large B Cell Lymphoma. Cell 2017; 171:481-494.e15. [PMID: 28985567 DOI: 10.1016/j.cell.2017.09.027] [Citation(s) in RCA: 694] [Impact Index Per Article: 99.1] [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: 07/31/2017] [Revised: 09/05/2017] [Accepted: 09/18/2017] [Indexed: 12/12/2022]
Abstract
Diffuse large B cell lymphoma (DLBCL) is the most common form of blood cancer and is characterized by a striking degree of genetic and clinical heterogeneity. This heterogeneity poses a major barrier to understanding the genetic basis of the disease and its response to therapy. Here, we performed an integrative analysis of whole-exome sequencing and transcriptome sequencing in a cohort of 1,001 DLBCL patients to comprehensively define the landscape of 150 genetic drivers of the disease. We characterized the functional impact of these genes using an unbiased CRISPR screen of DLBCL cell lines to define oncogenes that promote cell growth. A prognostic model comprising these genetic alterations outperformed current established methods: cell of origin, the International Prognostic Index comprising clinical variables, and dual MYC and BCL2 expression. These results comprehensively define the genetic drivers and their functional roles in DLBCL to identify new therapeutic opportunities in the disease.
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Affiliation(s)
- Anupama Reddy
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Jenny Zhang
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Nicholas S Davis
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Andrea B Moffitt
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Cassandra L Love
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Alexander Waldrop
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Sirpa Leppa
- Helsinki University Hospital Cancer Center and University of Helsinki, Helsinki, Finland
| | - Annika Pasanen
- Helsinki University Hospital Cancer Center and University of Helsinki, Helsinki, Finland
| | - Leo Meriranta
- Helsinki University Hospital Cancer Center and University of Helsinki, Helsinki, Finland
| | | | - Peter Nørgaard
- Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Mette Pedersen
- Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Anne O Gang
- Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Estrid Høgdall
- Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
| | - Tayla B Heavican
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Waseem Lone
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Javeed Iqbal
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Qiu Qin
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Guojie Li
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - So Young Kim
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Jane Healy
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Kristy L Richards
- Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Yuri Fedoriw
- Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jean L Koff
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Ashley D Staton
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | - Ora Paltiel
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - Maria Calaminici
- Barts Cancer Institute of Queen Mary University of London, London, UK
| | - Andrew Clear
- Barts Cancer Institute of Queen Mary University of London, London, UK
| | - John Gribben
- Barts Cancer Institute of Queen Mary University of London, London, UK
| | - Evelyn Nguyen
- Pathology, Indiana University, Indianapolis, IN, USA
| | | | - Sarah L Ondrejka
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Angela Collie
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Eric D Hsi
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Eric Tse
- Queen Mary Hospital, University of Hong Kong, Hong Kong
| | | | - Yok-Lam Kwong
- Queen Mary Hospital, University of Hong Kong, Hong Kong
| | | | | | | | | | | | - Nishitha Reddy
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Amy Chadburn
- Columbia-Presbyterian Hospital, New York, NY, USA
| | - Leo I Gordon
- Northwestern University Medical School, Chicago, IL, USA
| | | | - Shawn Levy
- Hudson Alpha Institute for Biotechnology, Huntsville, AL, USA
| | - Rachel Rempel
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Tiffany Tzeng
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Lanie E Happ
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Tushar Dave
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Deepthi Rajagopalan
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Jyotishka Datta
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - David B Dunson
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - Sandeep S Dave
- Duke Cancer Institute and Center for Genomic and Computational Biology, Duke University, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA.
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6
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McKinney M, Moffitt AB, Gaulard P, Travert M, De Leval L, Nicolae A, Raffeld M, Jaffe ES, Pittaluga S, Xi L, Heavican T, Iqbal J, Belhadj K, Delfau-Larue MH, Fataccioli V, Czader MB, Lossos IS, Chapman-Fredricks JR, Richards KL, Fedoriw Y, Ondrejka SL, Hsi ED, Low L, Weisenburger D, Chan WC, Mehta-Shah N, Horwitz S, Bernal-Mizrachi L, Flowers CR, Beaven AW, Parihar M, Baseggio L, Parrens M, Moreau A, Sujobert P, Pilichowska M, Evens AM, Chadburn A, Au-Yeung RKH, Srivastava G, Choi WWL, Goodlad JR, Aurer I, Basic-Kinda S, Gascoyne RD, Davis NS, Li G, Zhang J, Rajagopalan D, Reddy A, Love C, Levy S, Zhuang Y, Datta J, Dunson DB, Davé SS. The Genetic Basis of Hepatosplenic T-cell Lymphoma. Cancer Discov 2017; 7:369-379. [PMID: 28122867 DOI: 10.1158/2159-8290.cd-16-0330] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 01/13/2017] [Accepted: 01/23/2017] [Indexed: 12/18/2022]
Abstract
Hepatosplenic T-cell lymphoma (HSTL) is a rare and lethal lymphoma; the genetic drivers of this disease are unknown. Through whole-exome sequencing of 68 HSTLs, we define recurrently mutated driver genes and copy-number alterations in the disease. Chromatin-modifying genes, including SETD2, INO80, and ARID1B, were commonly mutated in HSTL, affecting 62% of cases. HSTLs manifest frequent mutations in STAT5B (31%), STAT3 (9%), and PIK3CD (9%), for which there currently exist potential targeted therapies. In addition, we noted less frequent events in EZH2, KRAS, and TP53SETD2 was the most frequently silenced gene in HSTL. We experimentally demonstrated that SETD2 acts as a tumor suppressor gene. In addition, we found that mutations in STAT5B and PIK3CD activate critical signaling pathways important to cell survival in HSTL. Our work thus defines the genetic landscape of HSTL and implicates gene mutations linked to HSTL pathogenesis and potential treatment targets.Significance: We report the first systematic application of whole-exome sequencing to define the genetic basis of HSTL, a rare but lethal disease. Our work defines SETD2 as a tumor suppressor gene in HSTL and implicates genes including INO80 and PIK3CD in the disease. Cancer Discov; 7(4); 369-79. ©2017 AACR.See related commentary by Yoshida and Weinstock, p. 352This article is highlighted in the In This Issue feature, p. 339.
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Affiliation(s)
- Matthew McKinney
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Andrea B Moffitt
- Duke Center for Genomics and Computational Biology, Duke University, Durham, North Carolina
| | - Philippe Gaulard
- Hôpital Henri Mondor, Department of Pathology, AP-HP, Créteil, France, INSERM U955, Créteil, France, and University Paris-Est, Créteil, France
| | - Marion Travert
- Hôpital Henri Mondor, Department of Pathology, AP-HP, Créteil, France, INSERM U955, Créteil, France, and University Paris-Est, Créteil, France
| | | | - Alina Nicolae
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mark Raffeld
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Elaine S Jaffe
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Stefania Pittaluga
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Liqiang Xi
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | - Karim Belhadj
- Hôpital Henri Mondor, Department of Pathology, AP-HP, Créteil, France, INSERM U955, Créteil, France, and University Paris-Est, Créteil, France
| | - Marie Helene Delfau-Larue
- Hôpital Henri Mondor, Department of Pathology, AP-HP, Créteil, France, INSERM U955, Créteil, France, and University Paris-Est, Créteil, France
| | - Virginie Fataccioli
- Hôpital Henri Mondor, Department of Pathology, AP-HP, Créteil, France, INSERM U955, Créteil, France, and University Paris-Est, Créteil, France
| | | | | | | | | | - Yuri Fedoriw
- University of North Carolina, Chapel Hill, North Carolina
| | | | | | | | | | - Wing C Chan
- City of Hope Medical Center, Duarte, California
| | | | - Steven Horwitz
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | - Anne W Beaven
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | | | | | | | - Anne Moreau
- Pathology, Hôpital Hôtel-Dieu, Nantes, France
| | - Pierre Sujobert
- Faculté de Médecine Lyon-Sud Charles Mérieux, Université Claude Bernard, Lyon, France
| | | | | | - Amy Chadburn
- Presbyterian Hospital, Pathology and Cell Biology, Cornell University, New York, New York
| | | | | | | | - John R Goodlad
- Department of Pathology, Western General Hospital, Edinburgh, UK
| | - Igor Aurer
- University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Randy D Gascoyne
- British Columbia Cancer Agency, University of British Columbia, Vancouver, Canada
| | - Nicholas S Davis
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Guojie Li
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Jenny Zhang
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Deepthi Rajagopalan
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Anupama Reddy
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Cassandra Love
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Shawn Levy
- Hudson Alpha Institute for Biotechnology, Huntsville, Alabama
| | - Yuan Zhuang
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina
| | - Jyotishka Datta
- Department of Statistical Science, Duke University, Durham, North Carolina
| | - David B Dunson
- Department of Statistical Science, Duke University, Durham, North Carolina
| | - Sandeep S Davé
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina. .,Duke Center for Genomics and Computational Biology, Duke University, Durham, North Carolina
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7
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Li L, Xu-Monette ZY, Ok CY, Tzankov A, Manyam GC, Sun R, Visco C, Zhang M, Montes-Moreno S, Dybkaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ponzoni M, Ferreri AJM, Møller MB, Wang J, Parsons BM, Winter JN, Piris MA, Pham LV, Medeiros LJ, Young KH. Prognostic impact of c-Rel nuclear expression and REL amplification and crosstalk between c-Rel and the p53 pathway in diffuse large B-cell lymphoma. Oncotarget 2016; 6:23157-80. [PMID: 26324762 PMCID: PMC4695110 DOI: 10.18632/oncotarget.4319] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 05/25/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023] Open
Abstract
Dysregulated NF-κB signaling is critical for lymphomagenesis. The regulation, function, and clinical relevance of c-Rel/NF-κB activation in diffuse large B-cell lymphoma (DLBCL) have not been well studied. In this study we analyzed the prognostic significance and gene-expression signature of c-Rel nuclear expression as surrogate of c-Rel activation in 460 patients with de novo DLBCL. Nuclear c-Rel expression, observed in 137 (26.3%) DLBCL patients frequently associated with extranoal origin, did not show significantly prognostic impact in the overall- or germinal center B-like-DLBCL cohort, likely due to decreased pAKT and Myc levels, up-regulation of FOXP3, FOXO3, MEG3 and other tumor suppressors coincided with c-Rel nuclear expression, as well as the complicated relationships between NF-κB members and their overlapping function. However, c-Rel nuclear expression correlated with significantly poorer survival in p63+ and BCL-2− activated B-cell-like-DLBCL, and in DLBCL patients with TP53 mutations. Multivariate analysis indicated that after adjusting clinical parameters, c-Rel positivity was a significantly adverse prognostic factor in DLBCL patients with wild type TP53. Gene expression profiling suggested dysregulations of cell cycle, metabolism, adhesion, and migration associated with c-Rel activation. In contrast, REL amplification did not correlate with c-Rel nuclear expression and patient survival, likely due to co-amplification of genes that negatively regulate NF-κB activation. These insights into the expression, prognostic impact, regulation and function of c-Rel as well as its crosstalk with the p53 pathway underscore the importance of c-Rel and have significant therapeutic implications.
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Affiliation(s)
- Ling Li
- Zhengzhou University, The First Affiliated University Hospital, Zhengzhou, China.,Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chi Young Ok
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ganiraju C Manyam
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ruifang Sun
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Mingzhi Zhang
- Zhengzhou University, The First Affiliated University Hospital, Zhengzhou, China
| | | | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, NY, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, USA
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | | | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | | | | | | | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Lan V Pham
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas School of Medicine, Graduate School of Biomedical Sciences, Houston, Texas, USA
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8
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Chen J, Xu-Monette ZY, Deng L, Shen Q, Manyam GC, Martinez-Lopez A, Zhang L, Montes-Moreno S, Visco C, Tzankov A, Yin L, Dybkaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ponzoni M, Ferreri AJM, Zhao X, Møller MB, Farnen JP, Winter JN, Piris MA, Pham L, Young KH. Dysregulated CXCR4 expression promotes lymphoma cell survival and independently predicts disease progression in germinal center B-cell-like diffuse large B-cell lymphoma. Oncotarget 2016; 6:5597-614. [PMID: 25704881 PMCID: PMC4467389 DOI: 10.18632/oncotarget.3343] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [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: 12/30/2014] [Accepted: 01/04/2015] [Indexed: 12/13/2022] Open
Abstract
Abnormal expression of the chemokine receptor CXCR4 plays an essential role in tumor cell dissemination and disease progression. However, the significance of CXCR4 overexpression in de novo diffuse large B cell lymphoma (DLBCL) is unknown. In 743 patients with de novo diffuse large B cell lymphoma (DLBCL) who received standard Rituximab-CHOP immunochemotherapy, we assessed the expression of CXCR4 and dissected its prognostic significance in various DLBCL subsets. Our results showed that CXCR4+ patients was associated with male, bulky tumor, high Ki-67 index, activated B-cell-like (ABC) subtype, and Myc, Bcl-2 or p53 overexpression. Moreover, CXCR4+ was an independent factor predicting poorer progression-free survival in germinal-center B-cell-like (GCB)-DLBCL, but not in ABC-DLBCL; and in patients with an IPI of ≤2, but not in those with an IPI>2. The lack of prognostic significance of CXCR4 in ABC-DLBCL was likely due to the activation of p53 tumor suppressor attenuating CXCR4 signaling. Furthermore, concurrent CXCR4+ and BCL2 translocation showed dismal outcomes resembling but independent of MYC/BCL2 double-hit DLBCL. Gene expression profiling suggested that alterations in the tumor microenvironment and immune responses, increased tumor proliferation and survival, and the dissemination of CXCR4+ tumor cells to distant organs or tissues were underlying molecular mechanisms responsible for the CXCR4+ associated poor prognosis.
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Affiliation(s)
- Jiayu Chen
- Medical School of Taizhou University, Taizhou, Zhejiang, China.,Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lijuan Deng
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qi Shen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ganiraju C Manyam
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Li Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | - Lihui Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, NY, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, USA
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | | | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | - Xiaoying Zhao
- Zhejiang University School of Medicine, Second University Hospital, Hangzhou, China
| | | | - John P Farnen
- Gundersen Lutheran Health System, La Crosse, WI, USA
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Lan Pham
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas School of Medicine, Graduate School of Biomedical Sciences, Houston, TX, USA
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9
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Xu-Monette ZY, Tu M, Jabbar KJ, Cao X, Tzankov A, Visco C, Nagarajan L, Cai Q, Montes-Moreno S, An Y, Dybkaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ponzoni M, Ferreri AJM, Zhao X, Møller MB, Farnen JP, Winter JN, Piris MA, Miranda RN, Medeiros LJ, Young KH. Clinical and biological significance of de novo CD5+ diffuse large B-cell lymphoma in Western countries. Oncotarget 2016; 6:5615-33. [PMID: 25760242 PMCID: PMC4467390 DOI: 10.18632/oncotarget.3479] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 12/29/2014] [Accepted: 01/02/2015] [Indexed: 12/11/2022] Open
Abstract
CD5 is a pan-T-cell surface marker and is rarely expressed in diffuse large B-cell lymphoma (DLBCL). Large-scale studies of de novo CD5+ DLBCL are lacking in Western countries. In this study by the DLBCL Rituximab-CHOP Consortium, CD5 was expressed in 5.5% of 879 DLBCL patients from Western countries. CD5+ DLBCL was associated with higher frequencies of >1 ECOG performance status, bone marrow involvement, central nervous system relapse, activated B-cell-like subtype, Bcl-2 overexpression, and STAT3 and NF-κB activation, whereas rarely expressed single-stranded DNA-binding protein 2 (SSBP2), CD30 or had MYC mutations. With standard R-CHOP chemotherapy, CD5+ DLBCL patients had significantly worse overall survival (median, 25.3 months vs. not reached, P< .0001) and progression-free survival (median, 21.3 vs. 85.8 months, P< .0001) than CD5- DLBCL patients, which was independent of Bcl-2, STAT3, NF-κB and the International Prognostic Index. Interestingly, SSBP2 expression abolished the prognostic significance of CD5 expression, suggesting a tumor-suppressor role of SSBP2 for CD5 signaling. Gene-expression profiling demonstrated that B-cell receptor signaling dysfunction and microenvironment alterations are the important mechanisms underlying the clinical impact of CD5 expression. This study shows the distinctive clinical and biological features of CD5+ DLBCL patients in Western countries and underscores important pathways with therapeutic implications.
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Affiliation(s)
- Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Meifeng Tu
- Peking University Cancer Hospital and Institute, Beijing, China
| | - Kausar J Jabbar
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xin Cao
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Lalitha Nagarajan
- Department of Genetics and Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qingqing Cai
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Yuji An
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, NY, USA
| | - Youli Zu
- The Methodist Hospital, Houston, TX, USA
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | | | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | - Xiaoying Zhao
- Zhejiang University School of Medicine, Second University Hospital, Hangzhou, China
| | | | - John P Farnen
- Gundersen Lutheran Health System, La Crosse, WI, USA
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas School of Medicine, Graduate School of Biomedical Sciences, Houston, TX, USA
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10
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Xu-Monette ZY, Deng Q, Manyam GC, Tzankov A, Li L, Xia Y, Wang XX, Zou D, Visco C, Dybkær K, Li J, Zhang L, Liang H, Montes-Moreno S, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ponzoni M, Ferreri AJM, Parsons BM, Møller MB, Wang SA, Miranda RN, Piris MA, Winter JN, Medeiros LJ, Li Y, Young KH. Clinical and Biologic Significance of MYC Genetic Mutations in De Novo Diffuse Large B-cell Lymphoma. Clin Cancer Res 2016; 22:3593-605. [PMID: 26927665 DOI: 10.1158/1078-0432.ccr-15-2296] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/09/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE MYC is a critical driver oncogene in many cancers, and its deregulation in the forms of translocation and overexpression has been implicated in lymphomagenesis and progression of diffuse large B-cell lymphoma (DLBCL). The MYC mutational profile and its roles in DLBCL are unknown. This study aims to determine the spectrum of MYC mutations in a large group of patients with DLBCL, and to evaluate the clinical significance of MYC mutations in patients with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) immunochemotherapy. EXPERIMENTAL DESIGN We identified MYC mutations in 750 patients with DLBCL using Sanger sequencing and evaluated the prognostic significance in 602 R-CHOP-treated patients. RESULTS The frequency of MYC mutations was 33.3% at the DNA level (mutations in either the coding sequence or the untranslated regions) and 16.1% at the protein level (nonsynonymous mutations). Most of the nonsynonymous mutations correlated with better survival outcomes; in contrast, T58 and F138 mutations (which were associated with MYC rearrangements), as well as several mutations occurred at the 3' untranslated region, correlated with significantly worse survival outcomes. However, these mutations occurred infrequently (only in approximately 2% of DLBCL). A germline SNP encoding the Myc-N11S variant (observed in 6.5% of the study cohort) was associated with significantly better patient survival, and resulted in reduced tumorigenecity in mouse xenografts. CONCLUSIONS Various types of MYC gene mutations are present in DLBCL and show different impact on Myc function and clinical outcomes. Unlike MYC gene translocations and overexpression, most MYC gene mutations may not have a role in driving lymphomagenesis. Clin Cancer Res; 22(14); 3593-605. ©2016 AACR.
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Affiliation(s)
- Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qipan Deng
- Department of Cancer Biology, Cleveland Clinic, Cleveland, Ohio
| | - Ganiraju C Manyam
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Ling Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yi Xia
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiao-Xiao Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dehui Zou
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | - Jun Li
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Li Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Han Liang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, New York
| | - Youli Zu
- The Methodist Hospital, Houston, Texas
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, New York
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | | | - Ben M Parsons
- Gundersen Lutheran Health System, La Crosse, Wisconsin
| | | | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Miguel A Piris
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yong Li
- Department of Cancer Biology, Cleveland Clinic, Cleveland, Ohio.
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. The University of Texas School of Medicine, Graduate School of Biomedical Sciences, Houston, Texas.
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11
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Xu-Monette ZY, Tu M, Jabbar KJ, Cao X, Tzankov A, Visco C, Nagarajan L, Cai Q, Montes-Moreno S, An Y, Dybkaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ponzoni M, Ferreri AJM, Zhao X, Møller MB, Farnen JP, Winter JN, Piris MA, Miranda RN, Medeiros LJ, Young KH. Erratum: Clinical and biological significance of de novo CD5+ diffuse large B-cell lymphoma in Western countries. Oncotarget 2015; 6:14720. [PMID: 26116824 PMCID: PMC4546500 DOI: 10.18632/oncotarget.4464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Gill H, Man CH, Ip AHW, Choi WWL, Chow HCH, Kwong YL, Leung AYH. Azacitidine as post-remission consolidation for sorafenib-induced remission of Fms-like tyrosine kinase-3 internal tandem duplication positive acute myeloid leukemia. Haematologica 2015; 100:e250-3. [PMID: 25820334 DOI: 10.3324/haematol.2014.123034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Harinder Gill
- Division of Haematology, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, the University of Hong Kong, China
| | - Cheuk-Him Man
- Division of Haematology, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, the University of Hong Kong, China
| | - Alvin H W Ip
- Department of Pathology, the University of Hong Kong, China
| | | | - Howard C H Chow
- Division of Haematology, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, the University of Hong Kong, China
| | - Yok-Lam Kwong
- Division of Haematology, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, the University of Hong Kong, China
| | - Anskar Y H Leung
- Division of Haematology, Medical Oncology and Bone Marrow Transplantation, Department of Medicine, the University of Hong Kong, China
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13
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Ok CY, Chen J, Xu-Monette ZY, Tzankov A, Manyam GC, Li L, Visco C, Montes-Moreno S, Dybkær K, Chiu A, Orazi A, Zu Y, Bhagat G, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Zhao X, Ponzoni M, Ferreri AJM, Bertoni F, Farnen JP, Møller MB, Piris MA, Winter JN, Medeiros LJ, Young KH. Clinical implications of phosphorylated STAT3 expression in De Novo diffuse large B-cell lymphoma. Clin Cancer Res 2014; 20:5113-23. [PMID: 25124685 DOI: 10.1158/1078-0432.ccr-14-0683] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE Activated signal transducer and activator of transcription 3 (STAT3) regulates tumor growth, invasion, cell proliferation, angiogenesis, immune response, and survival. Data regarding expression of phosphorylated (activated) STAT3 in diffuse large B-cell lymphoma (DLBCL) and the impact of phosphorylated STAT3 (pSTAT3) on prognosis are limited. EXPERIMENTAL DESIGN We evaluated expression of pSTAT3 in de novo DLBCL using immunohistochemistry, gene expression profiling (GEP), and gene set enrichment analysis (GSEA). Results were analyzed in correlation with cell-of-origin (COO), critical lymphoma biomarkers, and genetic translocations. RESULTS pSTAT3 expression was observed in 16% of DLBCL and was associated with advanced stage, multiple extranodal sites of involvement, activated B-cell-like (ABC) subtype, MYC expression, and MYC/BCL2 expression. Expression of pSTAT3 predicted inferior overall survival (OS) and progression-free survival (PFS) in patients with de novo DLBCL. When DLBCL cases were stratified according to COO or MYC expression, pSTAT3 expression did not predict inferior outcome, respectively. Multivariate analysis showed that the prognostic predictability of pSTAT3 expression was due to its association with the ABC subtype, MYC expression, and adverse clinical features. GEP demonstrated upregulation of genes, which can potentiate function of STAT3. GSEA showed the JAK-STAT pathway to be enriched in pSTAT3(+) DLBCL. CONCLUSIONS The results of this study provide a rationale for the ongoing successful clinical trials targeting the JAK-STAT pathway in DLBCL.
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Affiliation(s)
- Chi Young Ok
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jiayu Chen
- Medical School of Taizhou University, Taizhou, Zhejiang, China
| | - Zijun Y Xu-Monette
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Ganiraju C Manyam
- Department of Biostatistics and Bioinformatics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ling Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | | | | - April Chiu
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Attilio Orazi
- Weill Medical College of Cornell University, New York, New York
| | - Youli Zu
- Houston Methodist Hospital, Houston, Texas
| | - Govind Bhagat
- Columbia University Medical Center and New York Presbyterian Hospital, New York, New York
| | - Kristy L Richards
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | | | - William W L Choi
- University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China
| | - J Han van Krieken
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Jooryung Huh
- Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Xiaoying Zhao
- Zhejiang University School of Medicine, Second University Hospital, Hangzhou, China
| | | | | | - Francesco Bertoni
- IOR Institute of Oncology Research and IOSI Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - John P Farnen
- Gundersen Lutheran Health System, La Crosse, Wisconsin
| | | | - Miguel A Piris
- Hospital Universitario Marques de Valdecilla, Santander, Spain
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ken H Young
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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He BL, Shi X, Man CH, Ma ACH, Ekker SC, Chow HCH, So CWE, Choi WWL, Zhang W, Zhang Y, Leung AYH. Functions of flt3 in zebrafish hematopoiesis and its relevance to human acute myeloid leukemia. Blood 2014; 123:2518-29. [PMID: 24591202 PMCID: PMC4017313 DOI: 10.1182/blood-2013-02-486688] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 02/18/2014] [Indexed: 12/22/2022] Open
Abstract
FMS-like tyrosine kinase 3 (FLT3) is expressed in human hematopoietic stem and progenitor cells (HSPCs) but its role during embryogenesis is unclear. In acute myeloid leukemia (AML), internal tandem duplication (ITD) of FLT3 at the juxtamembrane (JMD) and tyrosine kinase (TKD) domains (FLT3-ITD(+)) occurs in 30% of patients and is associated with inferior clinical prognosis. TKD mutations (FLT3-TKD(+)) occur in 5% of cases. We made use of zebrafish to examine the role of flt3 in developmental hematopoiesis and model human FLT3-ITD(+) and FLT3-TKD(+) AML. Zebrafish flt3 JMD and TKD were remarkably similar to their mammalian orthologs. Morpholino knockdown significantly reduced the expression of l-plastin (pan-leukocyte), csf1r, and mpeg1 (macrophage) as well as that of c-myb (definitive HSPCs), lck, and rag1 (T-lymphocyte). Expressing human FLT3-ITD in zebrafish embryos resulted in expansion and clustering of myeloid cells (pu.1(+), mpo(+), and cebpα(+)) which were ameliorated by AC220 and associated with stat5, erk1/2, and akt phosphorylation. Human FLT3-TKD (D835Y) induced significant, albeit modest, myeloid expansion resistant to AC220. This study provides novel insight into the role of flt3 during hematopoiesis and establishes a zebrafish model of FLT3-ITD(+) and FLT3-TKD(+) AML that may facilitate high-throughput screening of novel and personalized agents.
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Affiliation(s)
- Bai-Liang He
- Division of Haematology, Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Visco C, Li Y, Xu-Monette ZY, Miranda RN, Green TM, Li Y, Tzankov A, Wen W, Liu WM, Kahl BS, d'Amore ESG, Montes-Moreno S, Dybkær K, Chiu A, Tam W, Orazi A, Zu Y, Bhagat G, Winter JN, Wang HY, O'Neill S, Dunphy CH, Hsi ED, Zhao XF, Go RS, Choi WWL, Zhou F, Czader M, Tong J, Zhao X, van Krieken JH, Huang Q, Ai W, Etzell J, Ponzoni M, Ferreri AJM, Piris MA, Møller MB, Bueso-Ramos CE, Medeiros LJ, Wu L, Young KH. Erratum: Comprehensive gene expression profiling and immunohistochemical studies support application of immunophenotypic algorithm for molecular subtype classification in diffuse large B-cell lymphoma: a report from the International DLBCL Rituximab-CHOP Consortium Program Study. Leukemia 2014. [DOI: 10.1038/leu.2014.24] [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: 11/09/2022]
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Ok CY, Li L, Xu-Monette ZY, Visco C, Tzankov A, Manyam GC, Montes-Moreno S, Dybkaer K, Dybaer K, Chiu A, Orazi A, Zu Y, Bhagat G, Chen J, Richards KL, Hsi ED, Choi WWL, van Krieken JH, Huh J, Ai W, Ponzoni M, Ferreri AJM, Farnen JP, Møller MB, Bueso-Ramos CE, Miranda RN, Winter JN, Piris MA, Medeiros LJ, Young KH. Prevalence and clinical implications of epstein-barr virus infection in de novo diffuse large B-cell lymphoma in Western countries. Clin Cancer Res 2014; 20:2338-49. [PMID: 24583797 DOI: 10.1158/1078-0432.ccr-13-3157] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Epstein-Barr virus-positive (EBV(+)) diffuse large B-cell lymphoma (DLBCL) of the elderly is a variant of DLBCL with worse outcome that occurs most often in East-Asian countries and is uncommon in the Western hemisphere. We studied the largest cohort of EBV(+) DLBCL, independent of age, treated with rituximab combined with CHOP (R-CHOP) in developed Western countries. EXPERIMENTAL DESIGN A large cohort (n = 732) of patients with DLBCL treated with R-CHOP chemotherapy is included from the multicenter consortium. This study group has been studied for expression of different biomarkers by immunohistochemistry, genetic abnormalities by FISH and mutation analysis, genomic information by gene expression profiling (GEP), and gene set enrichment analysis (GSEA). RESULTS Twenty-eight patients (4.0%) were positive for EBV with a median age of 60.5 years. No clinical characteristics distinguished patients with EBV(+) DLBCL from patients with EBV-negative (EBV(-)) DLBCL. Genetic aberrations were rarely seen. NF-κB p50, phosphorylated STAT-3, and CD30 were more commonly expressed in EBV(+) DLBCLs (P < 0.05). Significant differences in survival were not observed in patients with EBV(+) DLBCL versus EBV(-) DLBCL. However, CD30 expression combined with EBV conferred an inferior outcome. GEP showed a unique expression signature in EBV(+) DLBCL. GSEA revealed enhanced activity of the NF-κB and JAK/STAT pathways independent of molecular subtype. CONCLUSIONS The clinical characteristics of patients with EBV(+) versus EBV(-) DLBCL are similar and EBV infection does not predict a worse outcome. EBV(+) DLBCL, however, has a unique genetic signature. CD30 expression is more common in EBV(+) DLBCL and, consistent CD30 and EBV is associated with an adverse outcome. Clin Cancer Res; 20(9); 2338-49. ©2014 AACR.
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Affiliation(s)
- Chi Young Ok
- Authors' Affiliations: Departments of Hematopathology and Biostatistics and Bioinformatics, The University of Texas MD Anderson Cancer Center; The Methodist Hospital, Houston, Texas; Memorial Sloan-Kettering Cancer Center; Weill Medical College of Cornell University; Columbia University Medical Center and New York Presbyterian Hospital, New York, New York; University of North Carolina School of Medicine, Chapel Hill, North Carolina; Cleveland Clinic, Cleveland, Ohio; University of California San Francisco School of Medicine, San Francisco, California; Gundersen Lutheran Health System, La Crosse, Wisconsin; Feinberg School of Medicine, Northwestern University, Chicago, Illinois; San Bartolo Hospital, Vicenza; San Raffaele H. Scientific Institute, Milan, Italy; University Hospital, Basel, Switzerland; Hospital Universitario Marques de Valdecilla, Santander, Spain; Aalborg University Hospital, Aalborg; Odense University Hospital, Odense, Denmark; Medical School of Taizhou University, Taizhou, Zhejiang; University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China; Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; and Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
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Love C, Sun Z, Jima D, Li G, Zhang J, Miles R, Richards KL, Dunphy CH, Choi WWL, Srivastava G, Lugar PL, Rizzieri DA, Lagoo AS, Bernal-Mizrachi L, Mann KP, Flowers CR, Naresh KN, Evens AM, Chadburn A, Gordon LI, Czader MB, Gill JI, Hsi ED, Greenough A, Moffitt AB, McKinney M, Banerjee A, Grubor V, Levy S, Dunson DB, Dave SS. The genetic landscape of mutations in Burkitt lymphoma. Nat Genet 2012; 44:1321-5. [PMID: 23143597 DOI: 10.1038/ng.2468] [Citation(s) in RCA: 431] [Impact Index Per Article: 35.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 10/17/2012] [Indexed: 12/13/2022]
Abstract
Burkitt lymphoma is characterized by deregulation of MYC, but the contribution of other genetic mutations to the disease is largely unknown. Here, we describe the first completely sequenced genome from a Burkitt lymphoma tumor and germline DNA from the same affected individual. We further sequenced the exomes of 59 Burkitt lymphoma tumors and compared them to sequenced exomes from 94 diffuse large B-cell lymphoma (DLBCL) tumors. We identified 70 genes that were recurrently mutated in Burkitt lymphomas, including ID3, GNA13, RET, PIK3R1 and the SWI/SNF genes ARID1A and SMARCA4. Our data implicate a number of genes in cancer for the first time, including CCT6B, SALL3, FTCD and PC. ID3 mutations occurred in 34% of Burkitt lymphomas and not in DLBCLs. We show experimentally that ID3 mutations promote cell cycle progression and proliferation. Our work thus elucidates commonly occurring gene-coding mutations in Burkitt lymphoma and implicates ID3 as a new tumor suppressor gene.
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Affiliation(s)
- Cassandra Love
- Duke Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
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Visco C, Tzankov A, Xu-Monette ZY, Miranda RN, Tai YC, Li Y, Liu WM, d'Amore ESG, Li Y, Montes-Moreno S, Dybkær K, Chiu A, Orazi A, Zu Y, Bhagat G, Wang HY, Dunphy CH, His ED, Zhao XF, Choi WWL, Zhao X, van Krieken JH, Huang Q, Ai W, O'Neill S, Ponzoni M, Ferreri AJM, Kahl BS, Winter JN, Go RS, Dirnhofer S, Piris MA, Møller MB, Wu L, Medeiros LJ, Young KH. Patients with diffuse large B-cell lymphoma of germinal center origin with BCL2 translocations have poor outcome, irrespective of MYC status: a report from an International DLBCL rituximab-CHOP Consortium Program Study. Haematologica 2012; 98:255-63. [PMID: 22929980 DOI: 10.3324/haematol.2012.066209] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Diffuse large B-cell lymphoma can be classified by gene expression profiling into germinal center and activated B-cell subtypes with different prognoses after rituximab-CHOP. The importance of previously recognized prognostic markers, such as Bcl-2 protein expression and BCL2 gene abnormalities, has been questioned in the new therapeutic era. We analyzed Bcl-2 protein expression, and BCL2 and MYC gene abnormalities by interphase fluorescence in situ hybridization in 327 patients with de novo disease treated with rituximab-CHOP. Isolated BCL2 and MYC rearrangements were not predictive of outcome in our patients as a whole, but only in those with the germinal center subtype of lymphoma. The prognostic relevance of isolated MYC rearrangements was weaker than that of BCL2 isolated translocations, but was probably limited by the rarity of the rearrangements. Seven of eight patients with double hit lymphoma had the germinal center subtype with poor outcome. The germinal center subtype patients with isolated BCL2 translocations had significantly worse outcome than the patients without BCL2 rearrangements (P=0.0002), and their outcome was similar to that of patients with the activated B-cell subtype (P=0.30), but not as bad as the outcome of patients with double hit lymphoma (P<0.0001). Bcl-2 protein overexpression was associated with inferior outcome in patients with germinal center subtype lymphoma, but multivariate analysis showed that this was dependent on BCL2 translocations. The gene expression profiling of patients with BCL2 rearrangements was unique, showing activation of pathways that were silent in the negative counterpart. BCL2 translocated germinal center subtype patients have worse prognosis after rituximab-CHOP, irrespective of MYC status, but the presence of combined gene breaks significantly overcomes the prognostic relevance of isolated lesions.
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Affiliation(s)
- Carlo Visco
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Visco C, Li Y, Xu-Monette ZY, Miranda RN, Green TM, Li Y, Tzankov A, Wen W, Liu WM, Kahl BS, d'Amore ESG, Montes-Moreno S, Dybkær K, Chiu A, Tam W, Orazi A, Zu Y, Bhagat G, Winter JN, Wang HY, O'Neill S, Dunphy CH, Hsi ED, Zhao XF, Go RS, Choi WWL, Zhou F, Czader M, Tong J, Zhao X, van Krieken JH, Huang Q, Ai W, Etzell J, Ponzoni M, Ferreri AJM, Piris MA, Møller MB, Bueso-Ramos CE, Medeiros LJ, Wu L, Young KH. Comprehensive gene expression profiling and immunohistochemical studies support application of immunophenotypic algorithm for molecular subtype classification in diffuse large B-cell lymphoma: a report from the International DLBCL Rituximab-CHOP Consortium Program Study. Leukemia 2012; 26:2103-13. [PMID: 22437443 DOI: 10.1038/leu.2012.83] [Citation(s) in RCA: 255] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Gene expression profiling (GEP) has stratified diffuse large B-cell lymphoma (DLBCL) into molecular subgroups that correspond to different stages of lymphocyte development-namely germinal center B-cell like and activated B-cell like. This classification has prognostic significance, but GEP is expensive and not readily applicable into daily practice, which has lead to immunohistochemical algorithms proposed as a surrogate for GEP analysis. We assembled tissue microarrays from 475 de novo DLBCL patients who were treated with rituximab-CHOP chemotherapy. All cases were successfully profiled by GEP on formalin-fixed, paraffin-embedded tissue samples. Sections were stained with antibodies reactive with CD10, GCET1, FOXP1, MUM1 and BCL6 and cases were classified following a rationale of sequential steps of differentiation of B cells. Cutoffs for each marker were obtained using receiver-operating characteristic curves, obviating the need for any arbitrary method. An algorithm based on the expression of CD10, FOXP1 and BCL6 was developed that had a simpler structure than other recently proposed algorithms and 92.6% concordance with GEP. In multivariate analysis, both the International Prognostic Index and our proposed algorithm were significant independent predictors of progression-free and overall survival. In conclusion, this algorithm effectively predicts prognosis of DLBCL patients matching GEP subgroups in the era of rituximab therapy.
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Affiliation(s)
- C Visco
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Perpiñán D, Costa TP, Choi WWL, Caponetti G, Brodersen BW, Armstrong DL. Clinical and pathologic characteristics of T-cell lymphoma with a leukemic phase in a raccoon dog (Nyctereutes procyonoides). J Vet Diagn Invest 2011; 23:817-20. [PMID: 21908331 DOI: 10.1177/1040638711407876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
A 7.5-year-old raccoon dog (Nyctereutes procyonoides) from the Henry Doorly Zoo (Omaha, Nebraska) presented to the veterinary hospital for lethargy and weight loss. On physical examination, splenomegaly and hepatomegaly were noted on palpation and were confirmed by radiographic evaluation. Radiography also demonstrated a mass in the cranial mediastinum. A complete blood cell count revealed marked leukocytosis (115,200 cells/µl), with a predominance of lymphoid cells. The animal was euthanized due to a poor prognosis. Necropsy revealed splenomegaly, hepatomegaly, and a large multiloculated mass in the cranial mediastinum. The histologic and immunohistochemical diagnosis was multicentric T-cell lymphoma with a leukemic phase.
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Choi WWL, Weisenburger DD, Greiner TC, Piris MA, Banham AH, Delabie J, Braziel RM, Geng H, Iqbal J, Lenz G, Vose JM, Hans CP, Fu K, Smith LM, Li M, Liu Z, Gascoyne RD, Rosenwald A, Ott G, Rimsza LM, Campo E, Jaffe ES, Jaye DL, Staudt LM, Chan WC. A new immunostain algorithm classifies diffuse large B-cell lymphoma into molecular subtypes with high accuracy. Clin Cancer Res 2009; 15:5494-502. [PMID: 19706817 DOI: 10.1158/1078-0432.ccr-09-0113] [Citation(s) in RCA: 464] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Hans and coworkers previously developed an immunohistochemical algorithm with approximately 80% concordance with the gene expression profiling (GEP) classification of diffuse large B-cell lymphoma (DLBCL) into the germinal center B-cell-like (GCB) and activated B-cell-like (ABC) subtypes. Since then, new antibodies specific to germinal center B-cells have been developed, which might improve the performance of an immunostain algorithm. EXPERIMENTAL DESIGN We studied 84 cases of cyclophosphamide-doxorubicin-vincristine-prednisone (CHOP)-treated DLBCL (47 GCB, 37 ABC) with GCET1, CD10, BCL6, MUM1, FOXP1, BCL2, MTA3, and cyclin D2 immunostains, and compared different combinations of the immunostaining results with the GEP classification. A perturbation analysis was also applied to eliminate the possible effects of interobserver or intraobserver variations. A separate set of 63 DLBCL cases treated with rituximab plus CHOP (37 GCB, 26 ABC) was used to validate the new algorithm. RESULTS A new algorithm using GCET1, CD10, BCL6, MUM1, and FOXP1 was derived that closely approximated the GEP classification with 93% concordance. Perturbation analysis indicated that the algorithm was robust within the range of observer variance. The new algorithm predicted 3-year overall survival of the validation set [GCB (87%) versus ABC (44%); P < 0.001], simulating the predictive power of the GEP classification. For a group of seven primary mediastinal large B-cell lymphoma, the new algorithm is a better prognostic classifier (all "GCB") than the Hans' algorithm (two GCB, five non-GCB). CONCLUSION Our new algorithm is significantly more accurate than the Hans' algorithm and will facilitate risk stratification of DLBCL patients and future DLBCL research using archival materials.
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Affiliation(s)
- William W L Choi
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198-3135, USA
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Naushad H, Choi WWL, Page CJ, Sanger WG, Weisenburger DD, Aoun P. Mantle cell lymphoma with flow cytometric evidence of clonal plasmacytic differentiation: A case report. Cytometry 2009; 76:218-24. [DOI: 10.1002/cyto.b.20463] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fu K, Weisenburger DD, Choi WWL, Perry KD, Smith LM, Shi X, Hans CP, Greiner TC, Bierman PJ, Bociek RG, Armitage JO, Chan WC, Vose JM. Addition of rituximab to standard chemotherapy improves the survival of both the germinal center B-cell-like and non-germinal center B-cell-like subtypes of diffuse large B-cell lymphoma. J Clin Oncol 2008; 26:4587-94. [PMID: 18662967 DOI: 10.1200/jco.2007.15.9277] [Citation(s) in RCA: 238] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Diffuse large B-cell lymphoma (DLBCL) includes at least two prognostically important subtypes (ie, germinal center B-cell-like [GCB] and activated B-cell-like [ABC] DLBCL), which initially were characterized by gene expression profiling and subsequently were confirmed by immunostaining. However, with the addition of rituximab to standard chemotherapy, the prognostic significance of this subclassification of DLBCL is unclear. PATIENTS AND METHODS We studied 243 patient cases of de novo DLBCL, which included 131 patient cases treated with rituximab plus standard chemotherapy (rituximab group) and 112 patient cases treated with only standard chemotherapy (control group). The cases were assigned to GCB or non-GCB subgroups (the latter of which included both ABC DLBCL and unclassifiable DLBCL) on the basis of immunophenotype by using the Hans method. Clinical characteristics and survival outcomes of the two patient groups were compared. RESULTS The clinical characteristics of the patients in the rituximab and the control groups were similar. Compared with the control group, addition of rituximab improved the 3-year overall survival (OS; 42% v 77%; P < .001) of patients with DLBCL. Rituximab-treated patients in either the GCB or the non-GCB subgroups also had a significantly improved 3-year OS compared with their respective subgroups in the control group (P < .001). In the rituximab group, the GCB subgroup had a significantly better 3-year OS than the non-GCB subgroup (85% v 69%; P = .032). Multivariate analyses confirmed that rituximab treatment was predictive for survival in both the GCB and the non-GCB subgroups. CONCLUSION In this retrospective study, we have shown that the subclassification of DLBCL on the basis of the cell of origin continues to have prognostic importance in the rituximab era.
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Affiliation(s)
- Kai Fu
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198-7680, USA
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Choi WWL, Lewis MM, Lawson D, Yin-Goen Q, Birdsong GG, Cotsonis GA, Cohen C, Young AN. Angiogenic and lymphangiogenic microvessel density in breast carcinoma: correlation with clinicopathologic parameters and VEGF-family gene expression. Mod Pathol 2005; 18:143-52. [PMID: 15297858 DOI: 10.1038/modpathol.3800253] [Citation(s) in RCA: 167] [Impact Index Per Article: 8.8] [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: 12/14/2022]
Abstract
Angiogenesis and lymphangiogenesis are essential for breast cancer progression and are regulated by vascular endothelial growth factors (VEGF). To determine clinical and molecular correlates of these processes, we measured blood and lymphatic vascular microvessel density in 29 invasive carcinomas (22 ductal, six lobular, one papillary), using the vascular marker CD31 and the novel lymphatic marker D2-40. Microvessel density was assessed microscopically and by image cytometry, and was compared with tumor histology, grade, stage, lymph node metastasis, hormone receptors, HER2/neu status, and expression of VEGF, VEGF-C and VEGF-D by immunohistochemistry or quantitative RT-PCR. Strong correlation was observed between visual and image cytometric microvessel density using D2-40 but not CD31 (P=0.016 and 0.1521, respectively). Image cytometric CD31 microvessel density correlated with tumor size, grade, stage and lymph node metastasis (P=0.0001, 0.0107, 0.0035 and 0.0395, respectively). D2-40 microvessel density correlated with tumor stage (P=0.0123 by image cytometry) and lymph node metastasis (P=0.0558 by microscopy). Immunohistochemical VEGF signal in peritumoral blood vessels correlated with image cytometric CD31 and D2-40 microvessel density (P=0.022 and 0.0012, respectively), consistent with the role of VEGF in blood and lymphatic vascular growth. Intratumoral VEGF-C and VEGF-D expression by quantitative RT-PCR correlated with D2-40 (P=0.0291 by image cytometry) but not with CD31 microvessel density, which could suggest a selective role of VEGF-C and VEGF-D in lymphangiogenesis. CD31 and D2-40 microvessel density correlated significantly with several prognostic factors, including lymph node metastasis. Thus, measurements of angiogenesis and lymphangiogenesis may have utility for breast cancer pathology, particularly for estimation of metastatic risk.
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Affiliation(s)
- William W L Choi
- Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30033, USA
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Choi WWL, Lui YH, Lau WH, Crowley P, Khan A, Chan JKC. Adenocarcinoma of the thymus: report of two cases, including a previously undescribed mucinous subtype. Am J Surg Pathol 2003; 27:124-30. [PMID: 12502935 DOI: 10.1097/00000478-200301000-00014] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [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: 12/16/2022]
Abstract
We report two cases of primary thymic adenocarcinoma, a very uncommon neoplasm with limited information in the literature. Both patients were men (age 15 and 39 years). The first case was a mucinous carcinoma, a subtype of adenocarcinoma not previously recognized in the thymus. It comprised islands and strips of mucin-rich tumor cells floating in large pools of extracellular mucin. There was transition of carcinomatous epithelium to the attenuated epithelium of a thymic cyst. Immunostaining for high molecular weight cytokeratin furthermore highlighted in one area negatively stained tumor islands wrapped by positively stained residual thymic medullary epithelium, suggesting in situ origin of the carcinoma from the thymic epithelium. The second case was a papillary carcinoma with high nuclear grade and many psammoma bodies. It showed strong immunoreactivity for CD5 and did not stain for CA-125 as well as thyroid, pulmonary, and mesothelial markers. The findings in this study therefore broaden the morphologic spectrum of thymic adenocarcinomas to include a mucinous subtype. Review of the literature indicates that thymic adenocarcinomas usually arise from thymic cyst or type A thymoma, and the clinical outcome is variable.
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