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Moustafa MA, Ramdial JL, Tsalatsanis A, Khimani F, Dholaria B, Bojanini L, Brooks T, Zain J, Bennani NN, Braunstein Z, Brammer JE, Beitinjaneh A, Jagadeesh D, Weng WK, Kumar A, Kharfan-Dabaja MA, Ahmed S, Murthy HS. A US Multicenter Collaborative Study on Outcomes of Hematopoietic Cell Transplantation in Hepatosplenic T-Cell Lymphoma. Transplant Cell Ther 2024; 30:516.e1-516.e10. [PMID: 38431075 DOI: 10.1016/j.jtct.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare and aggressive type of peripheral T-cell lymphoma with median overall survival (OS) of approximately 1 year. Data on the effectiveness of hematopoietic cell transplantation (HCT) is limited, as is the choice between autologous HCT (auto-HCT) and allogeneic HCT (allo-HCT) in the treatment of this disease. To evaluate the outcome of patients with HSTCL who underwent either auto-HCT or allo-HCT, we performed a multi-institutional retrospective cohort study to assess outcomes of HCT in HSTCL patients. Fifty-three patients with HSTCL were included in the study. Thirty-six patients received an allo-HCT and 17 received an auto-HCT. Thirty-five (66%) were males. Median age at diagnosis was 38 (range 2 to 64) years. Median follow-up for survivors was 75 months (range 8 to 204). The median number of prior lines of therapy was 1 (range 1 to 4). Median OS and progression-free survival (PFS) for the entire cohort were 78.5 months (95% CI: 25 to 79) and 54 months (95% CI: 18 to 75), respectively. There were no significant differences in OS (HR: 0.63, 95% CI: 0.28 to 1.45, P = .245) or PFS (HR: 0.7, 95% CI: 0.32 to 1.57, P = .365) between the allo-HCT and auto-HCT groups, respectively. In the allo-HCT group, the 3-year cumulative incidence of relapse was 35% (95% CI: 21 to 57), while 3-year cumulative incidence of NRM was 16% (95% CI: 7 to 35). In the auto-HCT group, the 3-year cumulative incidence of relapse and NRM were 43% (95% CI: 23 to 78) and 14% (95% CI: 4 to 52), respectively. Both Auto-HCT and Allo-HCT are effective consolidative strategies in patients with HSTCL, and patients should be promptly referred for HCT evaluation.
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Affiliation(s)
| | - Jeremy L Ramdial
- Department of Lymphoma/Myeloma and Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Athanasios Tsalatsanis
- Department of Internal Medicine, Research Methodology and Biostatistics Core, Office of Research, University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Farhad Khimani
- Blood and Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Bhagirathbhai Dholaria
- Medicine, Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Leyla Bojanini
- Stanford University School of Medicine, Palo Alto, California
| | - Taylor Brooks
- Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Jasmine Zain
- Hematology/Hematopoietic Cell Transplant, City of Hope National Medical Center, Duarte, California
| | | | - Zachary Braunstein
- Department of Internal Medicine, Ohio State University Wexner Medical Columbus, Columbus, Ohio
| | - Jonathan E Brammer
- Division of Hematology, Department of Internal Medicine, James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Amer Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami, Miami, Florida
| | - Deepa Jagadeesh
- Hematology and Medical Oncology, Cleveland Clinic, Cleveland, Ohio
| | - Wen Kai Weng
- Division of BMT and Cellular Therapy, Stanford University School of Medicine, Stanford, California
| | - Ambuj Kumar
- Department of Internal Medicine, Research Methodology and Biostatistics Core, Office of Research, University of South Florida Morsani College of Medicine, Tampa, Florida
| | | | - Sairah Ahmed
- Department of Lymphoma/Myeloma and Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hemant S Murthy
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida.
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Gabra A, Polanco J, Thapa S, Sawhney S, Glazyrin A. Hepatosplenic Alpha-Beta T-Cell Lymphoma: A Challenging Diagnostic Entity. J Hematol 2024; 13:29-33. [PMID: 38644989 PMCID: PMC11027770 DOI: 10.14740/jh1203] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/08/2024] [Indexed: 04/23/2024] Open
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is rare and clinically very aggressive T-cell lymphoma. The majority of cases harbor γδ T-cell receptors (TCRs); however, in some even rarer cases, tumor cells harbor αβ TCR. Recent studies suggest that αβ cases may have distinct morphological characteristics and demonstrate an even more aggressive course. In this case report, we demonstrated that in line with previous findings, αβ case of HSTCL had hemolytic presentation, demonstrated a very aggressive clinical course, and was unrelated to immunosuppression. Morphologically, tumor cells demonstrated diffuse growth pattern, blastoid morphology, and were CD8+ positive on the background of CD4+ small to medium reactive T cells. Additionally, the liver tumor cells demonstrated periportal localization, and in bone marrow, evidence of emperipolesis was noted. The latter finding may significantly contribute to pancytopenia characteristic, all types of HSTCL. Those unusual morphologic and clinical characteristics make diagnosis of this rare subtype of rare disease very challenging. More case analysis is required to establish whether αβ/γδ HSTCL are prognostically or morphologically significantly distinct entities.
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Affiliation(s)
- Abanoub Gabra
- Department of Pathology, HCA East Florida, Fort Lauderdale, FL, USA
| | - Joanna Polanco
- Department of Internal Medicine, HCA East Florida, Fort Lauderdale, FL, USA
| | - Shrija Thapa
- Department of Internal Medicine, HCA East Florida, Fort Lauderdale, FL, USA
| | - Sumit Sawhney
- Department of Internal Medicine, HCA East Florida, Fort Lauderdale, FL, USA
| | - Alexey Glazyrin
- Department of Pathology, HCA East Florida, Fort Lauderdale, FL, USA
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Saito A, Nara M, Fujishima T, Kuroki W, Yamashita T, Kobayashi T, Ikeda S, Kitadate A, Kameoka Y, Takahashi N. [Successful cord blood transplantation for refractory gamma-delta hepatosplenic T-cell lymphoma developed during treatment of Crohn's disease]. Rinsho Ketsueki 2024; 65:41-46. [PMID: 38311388 DOI: 10.11406/rinketsu.65.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
The patient was a 21-year-old man who had been diagnosed with Crohn's disease and received infliximab and azathioprine six years earlier. He was admitted with fever and fatigue. Peripheral blood examination showed LDH 2,473 U/l and thrombocytopenia, and contrast-enhanced computed tomography (CT) showed hepatosplenomegaly. Bone marrow biopsy and liver biopsy showed CD4+CD56+TCRγδ+CD8- atypical cells, leading to a diagnosis of hepatosplenic T-cell lymphoma (HSTCL). The patient was refractory to CHOP and DA-EPOCH, and therefore received cord blood transplantation with myeloablative conditioning. CT showed reduced in hepatosplenomegaly and peripheral blood examination showed LDH 165 U/l and plt 180,000/µl, so the patient was discharged on day117. HSTCL is a tumor of immature γδT cells with a Vδ1 mutation in the spleen, and immunodeficiency has been implicated in its pathogenesis. Patients with inflammatory bowel disease treated with azathioprine are known to have an increased risk of lymphoproliferative disease. In this case, use of immunosuppressive drugs for Crohn's disease may have caused malignant transformation of γδ cells in the intestinal epithelium. Although the patient was refractory to chemotherapy, he was able to achieve remission with early cord blood transplantation and long-term survival is expected.
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Affiliation(s)
- Akihito Saito
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Miho Nara
- Center for Transfusion Cell Therapy, Transplantation and Regenerative Medicine, Akita University Hospital
| | - Takashi Fujishima
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Wataru Kuroki
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Takaya Yamashita
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Takahiro Kobayashi
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Sho Ikeda
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Akihiro Kitadate
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Yoshihiro Kameoka
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
| | - Naoto Takahashi
- Department of Hematology, Nephrology, Rheumatology, Akita University Graduate School of Medicine
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Song W, Zhang H, Yang F, Nakahira K, Wang C, Shi K, Zhang R. Single cell profiling of γδ hepatosplenic T-cell lymphoma unravels tumor cell heterogeneity associated with disease progression. Cell Oncol (Dordr) 2023; 46:211-226. [PMID: 36417130 PMCID: PMC9947078 DOI: 10.1007/s13402-022-00745-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Hepatosplenic T-cell lymphoma (HSTCL), mostly derived from γδ T cells, is a rare but very aggressive lymphoma with poor outcomes. In this study, we generated the first single cell landscape for this rare disease and characterized the molecular pathogenesis underlying the disease progression. METHODS We performed paired single cell RNA-seq and T cell receptor (TCR) sequencing on biopsies from a HSTCL patient pre- and post- chemotherapy treatments. Following by a series of bioinformatics analysis, we investigated the gene expression profile of γδ HSTCS as well as its tumor microenvironment (TME). RESULTS We characterized the unique gene expressing signatures of malignant γδ T cells with a set of marker genes were newly identified in HSTCL (AREG, PLEKHA5, VCAM1 etc.). Although the malignant γδ T cells were expanded from a single TCR clonotype, they evolved into two transcriptionally distinct tumor subtypes during the disease progression. The Tumor_1 subtype was dominant in pre-treatment samples with highly aggressive phenotypes. While the Tumor_2 had relative mild cancer hallmark signatures but expressed genes associated with tumor survival signal and drug resistance (IL32, TOX2, AIF1, AKAP12, CD38 etc.), and eventually became the main tumor subtype post-treatment. We further dissected the tumor microenvironment and discovered the dynamically rewiring cell-cell interaction networks during the treatment. The tumor cells had reduced communications with the microenvironment post-treatment. CONCLUSIONS Our study reveals heterogenous and dynamic tumor and microenvironment underlying pathogenesis of HSTCL and may contribute to identify novel targets for diagnosis and treatment of HSTCL in the future.
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Affiliation(s)
- Wei Song
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500 Yunnan People’s Republic of China ,School of Medicine, Kunming University of Science and Technology, Kunming, 650500 Yunnan People’s Republic of China ,Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, 650032 Yunnan People’s Republic of China
| | - Haixi Zhang
- Department of Hematology, The First People’s Hospital of Yunnan Province, Kunming, 650032 Yunnan People’s Republic of China ,Yunnan Province Clinical Center for Hematologic Disease, Kunming, 650032 Yunnan People’s Republic of China ,Yunnan Province Clinical Research Center for Hematologic Disease, Kunming, 650032 Yunnan People’s Republic of China
| | - Fan Yang
- School of Medicine, Kunming University of Science and Technology, Kunming, 650500 Yunnan People’s Republic of China
| | - Kiichi Nakahira
- Department of Pharmacology, Nara Medical University, Kashihara, Nara, 634-8521 Japan ,Division of Pulmonary and Critical Care Medicine, Weill Department of Medicine, Joan and Sanford I, Weill Cornell Medicine, New York, NY 10065 USA
| | - Cheng Wang
- Innovec Biotherapeutics, Inc., Beijing, 100193 People’s Republic of China
| | - Keqian Shi
- Department of Hematology, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan, People's Republic of China. .,Yunnan Province Clinical Center for Hematologic Disease, Kunming, 650032, Yunnan, People's Republic of China. .,Yunnan Province Clinical Research Center for Hematologic Disease, Kunming, 650032, Yunnan, People's Republic of China.
| | - Ruoyu Zhang
- Innovec Biotherapeutics, Inc., Beijing, 100193, People's Republic of China.
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Honda T, Yamaoka M, Terao YM, Hasegawa D, Kumamoto T, Takagi M, Yoshida K, Ogawa S, Goto H, Akiyama M. Successful treatment of hepatosplenic T-cell lymphoma with fludarabine, high-dose cytarabine and subsequent unrelated umbilical cord blood transplantation. Int J Hematol 2022; 115:140-145. [PMID: 34591292 DOI: 10.1007/s12185-021-03229-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare subtype of peripheral T-cell lymphoma that occurs most often in adolescents and young adults and is rare in children. Because of the aggressive clinical course, resistance to conventional chemotherapy and poor prognosis of HSTCL, an effective treatment has not been established. We report the case of a 3-year-old girl with HSTCL presenting with trilineage myelodysplasia. Although the HSTCL was refractory to conventional chemotherapy, remission was achieved with salvage chemotherapy that included fludarabine and cytarabine, which were shown to be effective in the drug sensitivity assay. After undergoing umbilical cord blood transplantation with a conditioning regimen consisting of etoposide, cyclophosphamide and total body irradiation, the patient has remained in complete remission for 8 years. Single-nucleotide polymorphism array analysis revealed heterozygous deletions of PAX5 (9p), ETV6 (12p) and homozygous deletions of CDKN2A (9p). Exome analysis showed a heterozygous nonsense c.2961C>G (p.Tyr987Ter) variant of the KMT2C gene. To improve the poor prognosis of HSTCL, the chemotherapeutic regimen can be selected for each patient on the basis of drug sensitivity and molecular genetic characteristics.
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Affiliation(s)
- Takaya Honda
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masayoshi Yamaoka
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoko Mikami Terao
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Tadashi Kumamoto
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for the Advanced Study of Human Biology, Kyoto University, Kyoto, Japan
- Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masaharu Akiyama
- Department of Pediatrics, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
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Wang Q, Jiang Y, Zhu Q, Duan Y, Chen X, Xu T, Jin Z, Li C, Wu D, Huang H. Clinical features and treatment outcomes of 14 patients with hepatosplenic γ δ T-cell lymphoma. J Cancer Res Clin Oncol 2021. [PMID: 33856526 DOI: 10.1007/s00432-021-03587-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hepatosplenic γ δ T-cell lymphoma (HSTCL) is a rare subtype of peripheral T-cell lymphoma (PTCL) with aggressive clinical behavior. To date, no standard therapy for HSTCL has been established. This study analyzed the clinical features, treatment, and prognosis for patients with HSTCL to determine the best therapeutic approach. METHODS We reviewed the clinical characteristics, treatments, and responses to treatment of patients in our center between January 2001 and June 2021, and also reviewed related literature. RESULTS Median patient age was 38 years (range 16-60 years) and the patients included eight males and six females. HSTCL in these patients typically presented with B symptoms (71.4%), splenomegaly (100%), and hepatomegaly (50.0%), but lymphadenopathy was extremely rare. In these patients, routine laboratory testing showed elevated lactate dehydrogenase (71.4%), liver dysfunction (42.9%), and decreased fibrinogen (35.7%). In the induction phase, five of the 14 patients received chemotherapy regimens containing anthracycline (CHOP, or CHOP plus bortezomib or Chidamide), and six were treated with non-CHOP chemotherapy. Seven patients responded to induction treatment, four of whom received allogeneic hematopoietic cell transplantation and then achieved a complete response in the consolidation phase. survival time of patients who received alloHCT range from 10 to 27 months. CONCLUSION Hepatosplenic γ δ T-cell lacks a standard therapy and is often refractory to conventional chemotherapy regimens. Intensive induction chemotherapy followed by hematopoietic cell transplantation may improve the prognosis of HSTCL.
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Jansson-Knodell CL, Walker MJ, Fischer M. Pancytopenia in a Young Male Patient With Inflammatory Bowel Disease. Gastroenterology 2021; 160:1483-1485. [PMID: 32777287 DOI: 10.1053/j.gastro.2020.07.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/02/2022]
Affiliation(s)
| | - Megan J Walker
- Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana
| | - Monika Fischer
- Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana
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Wang XT, Guo W, Sun M, Han W, Du ZH, Wang XX, Du BB, Bai O. Effect of chidamide on treating hepatosplenic T-cell lymphoma: A case report. World J Clin Cases 2020; 8:3122-3129. [PMID: 32775395 PMCID: PMC7385602 DOI: 10.12998/wjcc.v8.i14.3122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/26/2020] [Accepted: 07/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatosplenic T-cell lymphoma (HSTCL) is a rare subtype of non-Hodgkin’s lymphoma, which has an aggressive clinical course and an extremely poor prognosis. Chidamide is a novel, orally active, benzamide-type histone deacetylase (HDAC) inhibitor that has been used for peripheral T-cell lymphoma (PTCL) treatment. However, to date, there has been no report of the treatment and effect of the HDAC inhibitor chidamide in HSTCL, which is a special subtype of PTCL.
CASE SUMMARY A 45-year-old male patient was admitted with splenomegaly and slight bicytopenia. He was diagnosed with HSTCL via splenectomy. The patient was treated with fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine regiment as inductive therapy. Unfortunately, the disease progressed rapidly during chemotherapy before a suitable allogeneic gene transplant donor was found. The chidamide-combined chemotherapy regimen and single-drug oral maintenance regimen achieved complete remission, duration of response of 9 mo, and overall survival of 15 mo.
CONCLUSION The novel agent chidamide can be used in HSTCL to achieve deep remission and improve the duration of response and overall survival.
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Affiliation(s)
- Xing-Tong Wang
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Wei Guo
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Mo Sun
- Department of Pathology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Wei Han
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Zhong-Hua Du
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Xiu-Xiu Wang
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Bei-Bei Du
- Department of Cardiology, The Third Hospital of Jilin University, Changchun, Jilin Province 130031, China
| | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
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Klebaner D, Koura D, Tzachanis D, Ball ED, Horwitz S, Goodman AM. Intensive Induction Therapy Compared With CHOP for Hepatosplenic T-cell Lymphoma. Clin Lymphoma Myeloma Leuk 2020; 20:431-437.e2. [PMID: 32284297 DOI: 10.1016/j.clml.2019.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hepatosplenic T-cell lymphoma (HSTCL) is a rare peripheral T-cell lymphoma that disproportionately affects individuals with a clinical history of immunosuppression. It carries a poor prognosis, and, owing to its rarity, there is no single or well-established treatment. PATIENTS AND METHODS We conducted the largest-to-date individual-level meta-analysis based on literature searches to determine the best induction therapy for HSTCL. We compared response rates and survival among patients who received "non-CHOP-based" induction with regimens containing cytarabine, etoposide, and/or platinum-based treatment to those receiving treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or CHOP-like therapy. We also review additional regimens including alemtuzumab and pentostatin, and assessed the role of consolidation with hematopoietic stem-cell transplantation (HSCT). RESULTS We identified 166 patients with HSTCL, 118 of whom had sufficient information on induction treatment and survival. Eighty-four patients received non-CHOP-based (N = 34) or CHOP/CHOP-like (N = 50) induction treatment. Non-CHOP-based induction was associated with a complete/partial response rate of 82% compared with 52% (P = .006) with CHOP/CHOP-like and increased median overall survival (P = .00014). Our data showed that maximum survival among patients with HSTCL was achieved with non-CHOP-based induction followed by consolidation with HSCT. CONCLUSIONS Non-CHOP-based induction appears superior to CHOP/CHOP-like induction in both achieving complete/partial response and durable survival. Induction therapy of HSTCL should be intensified with non-CHOP-based regimens and followed by consolidation with HSCT in eligible patients.
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Affiliation(s)
- Daniella Klebaner
- School of Medicine, University of California San Diego, La Jolla, CA.
| | - Divya Koura
- Department of Medicine, Division of Blood and Marrow Transplantation, University of California San Diego, La Jolla, CA
| | - Dimitrios Tzachanis
- Department of Medicine, Division of Blood and Marrow Transplantation, University of California San Diego, La Jolla, CA
| | - Edward D Ball
- Department of Medicine, Division of Blood and Marrow Transplantation, University of California San Diego, La Jolla, CA
| | - Steven Horwitz
- Hematology Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Aaron M Goodman
- Department of Medicine, Division of Blood and Marrow Transplantation, University of California San Diego, La Jolla, CA
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Rastogi P, Nada R. How Does It Look in an Autopsy? Hepatosplenic T-Cell Lymphoma in a Patient with Crohn’s Disease on Azathioprine. Turk J Haematol 2020; 37:205-206. [PMID: 32270949 PMCID: PMC7463212 DOI: 10.4274/tjh.galenos.2020.2020.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Pulkit Rastogi
- Postgraduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Ritambhra Nada
- Postgraduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
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Yamamoto K, Yakushijin K, Okuni-Watanabe M, Hashimoto A, Matsuoka H, Minami H. Tetrasomy 8 and isochromosome 7q in CD5-positive hepatosplenic T-cell lymphoma with leukemic presentation. Int J Hematol 2019; 110:521-523. [PMID: 31342408 DOI: 10.1007/s12185-019-02708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/14/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Marika Okuni-Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akiko Hashimoto
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Abstract
Hepatosplenic T-cell lymphoma (HSTL) is a rare variant of extranodal peripheral T-cell lymphomas (PTCL), associated with aggressive disease course and a relentless track record for lethal outcomes. HSTL presents commonly in young men in their third or fourth decade. Of the known causes, immune dysregulation and immunosuppression are the key players in the pathogenesis of HSTL. Clinical manifestation includes hepatosplenomegaly, fevers, and weakness. Bone marrow involvement or organomegaly can cause cytopenias. Anthracycline-based regimens provide modest responses with most individuals dying within a year of diagnosis. Hematopoietic stem cell transplant (HSCT) can be offered to fit and eligible patients to prolong remissions. Disease relapse post chemotherapy has an aggressive phenotype, with limited salvage options available in the setting of declining performance status. Understanding the disease biology further to identify mechanistic-driven drug discovery could overcome the current limitations of existing therapeutic armamentarium.
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13
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Carvão J, Magno Pereira V, Jacinto F, Sousa Andrade C, Jasmins L. Hepatosplenic T-Cell Lymphoma: A Rare Complication of Monotherapy with Thiopurines in Crohn's Disease. GE Port J Gastroenterol 2018; 26:279-284. [PMID: 31328143 DOI: 10.1159/000493350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/27/2018] [Indexed: 12/18/2022]
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is an extremely rare and aggressive form of non-Hodgkin lymphoma associated with poor response to treatment and high mortality. There is an increased incidence among patients with inflammatory bowel disease, especially young male patients under 35 years old and on combination therapy (thiopurine and anti-TNF-α). We describe a case of HSTCL in a young male patient with stenosing ileal Crohn's disease on azathioprine monotherapy for 4.8 years admitted to our hospital with intra- abdominal sepsis. Despite chemotherapy, the patient eventually died 1 month after the diagnosis. Through a literature review, we identified 18 additional cases of HSTCL in Crohn's disease patients that had only been treated with thiopurine monotherapy. The authors intend to highlight the rarity of this diagnosis especially with azathioprine monotherapy and the diagnostic challenge in a case that presented with intra-abdominal sepsis.
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Affiliation(s)
- Joana Carvão
- Gastroenterology Department, Hospital Central do Funchal, Funchal, Portugal
| | | | - Fernando Jacinto
- Hemato-Oncology Department, Hospital Central do Funchal, Funchal, Portugal
| | | | - Luís Jasmins
- Gastroenterology Department, Hospital Central do Funchal, Funchal, Portugal
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14
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Jain H, Shetty D, Jain H, Sengar M, Khattry N, Subramanian PG. A rare case of hepatosplenic γδ T-cell lymphoma expressing CD19 with ring chromosome 7 and trisomy 8. Cancer Genet 2018; 228-229:17-20. [PMID: 30553467 DOI: 10.1016/j.cancergen.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Hepatosplenic T-cell lymphoma (HSTL) is a rare subtype of peripheral T-cell lymphoma predominantly seen in young males. This disease presents with isolated hepatosplenomegaly and thrombocytopenia with sinusoidal infiltration of liver and sinusal infiltration of spleen. Immunophenotype shows positivity for CD3, CD7, TCRγδ or TCRαβ, CD38 and double negative for CD4, CD8, TdT, CD5, and CD56. Isochromosome 7q with or without trisomy 8 is seen in HSTL. Recently, ring chromosome 7 has also been identified as a new abnormality. We describe the clinical, immunophenotypic and cytogenetic analysis in a 24-year-old woman. We present an unusual case of TCRγδ positive T-cell lymphoma with aberrant expression of CD19, which is a B-cell lymphoid marker, with amplification of 7q region and subsequent formation of ring chromosome 7 and trisomy 8. This is the second case of HSTL, positive for CD19 and first case presenting with ring chromosome 7 and trisomy 8 in a CD19 positive HSTL which is a rare finding in T-cell lymphoma and needs to be explored further.
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Affiliation(s)
- Hemani Jain
- Cancer Cytogenetic Department, Tata Memorial Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Sector-22, Room No. 6, CCE building, Kharghar, Navi Mumbai 410210, India.
| | - Dhanlaxmi Shetty
- Cancer Cytogenetic Department, Tata Memorial Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Sector-22, Room No. 6, CCE building, Kharghar, Navi Mumbai 410210, India
| | - Hasmukh Jain
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai 400012, India
| | - Navin Khattry
- Department of Medical Oncology, Tata Memorial Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Sector-22, Kharghar, Navi Mumbai 410210, India
| | - P G Subramanian
- Hematopathology Department, Tata Memorial Centre, Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Sector-22, Kharghar, CCE building, Navi Mumbai 410210, India
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15
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Yabe M, Miranda RN, Medeiros LJ. Hepatosplenic T-cell Lymphoma: a review of clinicopathologic features, pathogenesis, and prognostic factors. Hum Pathol 2018; 74:5-16. [PMID: 29337025 DOI: 10.1016/j.humpath.2018.01.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 12/31/2022]
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare and clinically aggressive type of T-cell lymphoma that arises most often in adolescents and young adults. Patients with HSTCL commonly present with B-symptoms and cytopenias, which may suggest a diagnosis of acute leukemia initially. Patients present with extranodal disease involving the spleen, liver and bone marrow; lymphadenopathy is usually absent. The lymphoma cells can show a spectrum of cell sizes and are of T-cell lineage, often negative for CD4 and CD8 and positive for T-cell receptor γδ or, less often, αβ. Recent studies have identified gene mutations in oncogenic pathways that are likely involved in pathogenesis and may be targets for therapy. Mutations in STAT3 or STAT5B lead to activation of the JAK/STAT pathway, and mutations involving SETD2, IN080 and ARID1 are involved in chromatin modification. Currently, there is no consensus standard of care for HSTCL patients, although several studies support a role for allogeneic hematopoietic stem cell transplant. Although patients with HSTCL are best treated in the context of clinical trials, the rarity of these neoplasms likely necessitates a multi-institutional approach. In this review, we focus on the clinicopathologic and genetic characteristics of HSTCL. We also discuss the differential diagnosis and therapeutic approaches.
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Affiliation(s)
- Mariko Yabe
- Hematopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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16
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van de Meeberg MM, Derikx LAAP, Sinnige HAM, Nooijen P, Schipper DL, Nissen LHC. Hepatosplenic T-cell lymphoma in a 47-year-old Crohn’s disease patient on thiopurine monotherapy. World J Gastroenterol 2016; 22:10465-10470. [PMID: 28058028 PMCID: PMC5175260 DOI: 10.3748/wjg.v22.i47.10465] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 09/01/2016] [Accepted: 09/28/2016] [Indexed: 02/06/2023] Open
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare non-Hodgkin lymphoma with a high mortality rate. Higher incidence is reported in patients with inflammatory bowel disease, specifically in male patients that are younger than 35 years, and have been treated with thiopurine and tumor necrosis factor (TNF)-α inhibitor combination therapy for over 2 years. In this case report we describe a 47-year-old patient with Crohn’s disease (CD) who developed HSTCL after having been treated with thiopurine monotherapy for 14 years. To our best knowledge, only eleven cases exist of patients with CD who developed HSTCL while on thiopurine monotherapy. We report the first patient with CD, older than 35 years, who developed HSTCL while on thiopurine monotherapy. This emphasizes that HSTCL risk is not limited to young men receiving both thiopurines and TNF-α inhibitors.
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17
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Bhat R, Pai S, Das K, Dixit A. Aggressive Lymphomas Diagnosed in the Bone Marrow: Two Illustrative Cases. Indian J Hematol Blood Transfus 2016; 32:125-9. [PMID: 27408373 DOI: 10.1007/s12288-015-0520-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022] Open
Abstract
Lymphomas with subtle patterns in the marrow can be a diagnostic challenge, unless a high index of suspicion is maintained. We present two patients with aggressive lymphomas who presented with cytopenias and the subsequent bone marrow examinations yielded surprising results. These cases highlight the potential usefulness of a bone marrow examination in the diagnosis of lymphomas in the absence of nodal or other tissue specimens.
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18
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Kawai H, Matsushita H, Ohmachi K, Kojima M, Machida S, Ogawa Y, Kawada H, Nakamura N, Ando K. Four hepatosplenic T-cell lymphoma cases of Japanese patients. Leuk Res Rep 2016; 5:3-6. [PMID: 26870659 DOI: 10.1016/j.lrr.2015.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/04/2015] [Indexed: 11/21/2022] Open
Abstract
Hepatosplenic T-cell lymphoma (HSTCL), a rare type of γδ T-cell lymphoma, is characterized by hepatosplenomegaly and cytopenias. It is associated with immunodeficiency and its age of onset is reportedly between the 20s and 30s. We herein report 4 Japanese HSTCL cases. Three of them, including an elderly case that was 74 years of age, were not at adolescence. No cases had a history of immunodeficiency. All other disease phenotypes were similar to the typical HSTCL cases. These findings suggest that there are a certain proportion of HSTCL patients who presented after middle age. Three out of four HSTCL cases in a Japanese institute were over 59 years of age. None of the patients had previous illness that was related to immunodeficiency. There may be a certain proportion of HSTCL patients who presented after middle age.
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19
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Yabe M, Medeiros LJ, Wang SA, Konoplev S, Ok CY, Loghavi S, Lu G, Flores L, Khoury JD, Cason RC, Young KH, Miranda RN. Clinicopathologic, Immunophenotypic, Cytogenetic, and Molecular Features of γδ T-Cell Large Granular Lymphocytic Leukemia: An Analysis of 14 Patients Suggests Biologic Differences With αβ T-Cell Large Granular Lymphocytic Leukemia. [corrected]. Am J Clin Pathol 2015; 144:607-19. [PMID: 26386082 DOI: 10.1309/ajcpjsa1e1ywszey] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES T-cell large granular lymphocytic (T-LGL) leukemia is a rare disorder in which the neoplastic cells usually express the αβ T-cell receptor (TCR). To determine the significance of γδ TCR expression in this leukemia, we compared the clinicopathologic, immunophenotypic, and genetic features of patients with T-LGL leukemia expressing γδ TCR or αβ TCR. METHODS We used the World Health Organization classification criteria to confirm the diagnosis. All patients were diagnosed and treated at our institution. RESULTS We identified 14 patients with γδ T-LGL leukemia, 11 men and three women; six (43%) patients had a history of rheumatoid arthritis, 10 (71%) had neutropenia, four (29%) had thrombocytopenia, and three (21%) had anemia. Eight (67%) of 12 patients had a CD4-/CD8- phenotype, and four (33%) had a CD4-/CD8+ phenotype. The median overall survival was 62 months. Patients with γδ T-LGL leukemia were more likely to have rheumatoid arthritis (P = .04), lower absolute neutrophil count (P = .04), lower platelet count (P = .004), and a higher frequency of the CD4-/CD8- phenotype (P < .0001). However, there was no significant difference in overall survival between the two groups (P = .64). CONCLUSIONS Although patients with γδ and αβ T-LGL leukemia show some different clinical or phenotypic features, overall survival is similar, suggesting that γδ TCR expression does not carry prognostic significance.
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Affiliation(s)
- Mariko Yabe
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - L. Jeffrey Medeiros
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sa A. Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sergej Konoplev
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Chi Young Ok
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sanam Loghavi
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Gary Lu
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Lauren Flores
- Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Joseph D. Khoury
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - R. Craig Cason
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Ken H. Young
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Roberto N. Miranda
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
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20
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Catania G, Zallio F, Monaco F, Corsetti MT, Trincheri N, Bonello L, Mele L, Dallavalle F, Salvi F, Pini M. Successful HLA haploidentical myeloablative stem cell transplantation for aggressive hepatosplenic alpha/beta (αβ) T-cell lymphoma. Leuk Res Rep 2014; 3:90-3. [PMID: 25429355 PMCID: PMC4242978 DOI: 10.1016/j.lrr.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/27/2014] [Revised: 09/02/2014] [Accepted: 09/15/2014] [Indexed: 12/02/2022] Open
Abstract
Hepatosplenic T cell lymphoma (HSTCL) is a type of hematologic neoplasia with a poor prognosis and a high frequency of refractoriness to conventional chemotherapy. The results obtained by high dose chemotherapy followed by autologous stem cells transplantation seem to be a more effective option but still unsatisfactory. Also the role of allogeneic stem cell transplantation is still unclear, although the few cases reported on the literature would seem to show good results in overall survival rates. In this paper, we reported the patient׳s medical history affected by a αβ variant of hepatosplenic T cell successfully rescued with a haploidentical transplant. Hepatosplenic T-cell lymphoma is associated with a poor prognosis. Allogeneic stem cell transplantation has a role in treatment of refractory lymphoma. The haploidentical SCT may offer a strategy in patients without a matched donor.
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Affiliation(s)
- Gioacchino Catania
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Francesco Zallio
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Federico Monaco
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Maria Teresa Corsetti
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Nicol Trincheri
- Division of Anatomic-Pathology, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Lisa Bonello
- Department of Pathology, Center for Experimental Research and Medical Studies, University of Torino, Turin, Italy
| | - Lia Mele
- Divison of Transfusion Medicine, A.O. SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Franco Dallavalle
- Divison of Transfusion Medicine, A.O. SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Flavia Salvi
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Massimo Pini
- Hematology and Marrow Transplant, A.O. SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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21
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Ashmore P, Patel M, Vaughan J, Wiggill T, Willem P, van den Berg E, Philip V, Lakha A. Hepatosplenic T-cell lymphoma: A case series. Hematol Oncol Stem Cell Ther 2014; 8:78-84. [PMID: 25450840 DOI: 10.1016/j.hemonc.2014.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/29/2014] [Accepted: 09/01/2014] [Indexed: 12/01/2022] Open
Abstract
Hepatosplenic T-cell lymphoma (HSTCL) is a rare type of Non-Hodgkin Lymphoma (NHL), grouped under the mature or peripheral T-cell lymphomas. It is characterised by extranodal infiltration and proliferation of malignant T-cells within the sinusoids of the liver, sinuses and red pulp of the spleen, and the bone marrow. The tumour cells express CD2 and CD3, but are CD4, CD5 and CD8 negative and express a clonally restricted gamma-delta (or less commonly alpha-beta) T-cell receptor. The disease has an aggressive clinical course associated with a poor prognosis. We highlight and report three patients from South Africa with HSTCL, all of whom had hepatosplenomegaly and cytopaenias, and despite being HIV seronegative and immunocompetent, had a poor outcome, with a mean survival of 7.5 months in the two evaluable patients. This rare entity has not previously been reported from South Africa and as yet needs to be adequately characterised in a population where lymphoma is the most common haematological malignancy in adults, and where approximately two thirds of the adult lymphoma population are HIV seropositive.
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Affiliation(s)
- Philippa Ashmore
- Division of Clinical Haematology, Department of Medicine, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Moosa Patel
- Division of Clinical Haematology, Department of Medicine, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Jenifer Vaughan
- Department of Molecular Medicine and Haematology, NHLS (National Health Laboratory Services), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tracey Wiggill
- Department of Molecular Medicine and Haematology, NHLS (National Health Laboratory Services), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pascale Willem
- Department of Molecular Medicine and Haematology, NHLS (National Health Laboratory Services), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Eunice van den Berg
- Department of Anatomical Pathology, NHLS (National Health Laboratory Services), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vinitha Philip
- Division of Clinical Haematology, Department of Medicine, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Atul Lakha
- Division of Clinical Haematology, Department of Medicine, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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22
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Ok CY, Yin CC, Yabe M, Bueso-Ramos CE, Miranda RN, Medeiros LJ, Konoplev SN. Lymphoma with features intermediate between aggressive T-large granular lymphocytic leukemia and hepatosplenic T-cell lymphoma: a diagnostic dilemma? Clin Lymphoma Myeloma Leuk 2014; 14:e95-e100. [PMID: 24524924 DOI: 10.1016/j.clml.2013.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 12/27/2013] [Accepted: 12/27/2013] [Indexed: 02/03/2023]
Affiliation(s)
- Chi Young Ok
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Mariko Yabe
- Department of Pathology, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Sergej N Konoplev
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
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23
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Magro F, Peyrin-Biroulet L, Sokol H, Aldeger X, Costa A, Higgins PD, Joyce JC, Katsanos KH, Lopez A, de Xaxars TM, Toader E, Beaugerie L. Extra-intestinal malignancies in inflammatory bowel disease: results of the 3rd ECCO Pathogenesis Scientific Workshop (III). J Crohns Colitis 2014; 8:31-44. [PMID: 23721759 DOI: 10.1016/j.crohns.2013.04.006] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/05/2013] [Indexed: 12/28/2022]
Abstract
The incidence of lymphoproliferative disorders (LD) is increasing in developed countries. Patients with inflammatory bowel disease (IBD) exposed to thiopurines are at additional risk of three specific forms of LD: Epstein-Barr-Virus-related post-transplant like LD, hepato-splenic T-cell lymphoma and post-mononucleosis lymphoproliferation. The risk of the two latter forms of LD can be reduced when considering specific immunosuppressive strategies in young males. It is still unclear whether the risk of uterine cervix abnormalities is increased in IBD women, irrespective of the use of immunosuppressants. Given the excess risk demonstrated in various other contexts of immunosuppression, it is currently recommended that all women with IBD, particularly those receiving immunosuppressants, strictly adhere to a screening program of cervical surveillance and undergo vaccination against HPV, when appropriate. Patients with IBD receiving immunosuppressants are at increased risk of skin cancers. The risk of non-melanoma skin cancer is notably increased in patients receiving thiopurines. Recent data suggest that the risk of melanoma is mildly increased in patients exposed to anti-TNF therapy. All IBD patients should adhere to a program of sun protection and dermatological surveillance, whose details should take into account the other non-IBD-related risk factors.
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Affiliation(s)
- Fernando Magro
- Gastroenterology Department, Centro Hospitalar S. João, Institute of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Institute for Molecular and Cell Biology, University of Porto, Porto, Portugal
| | - Laurent Peyrin-Biroulet
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France
| | - Harry Sokol
- Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France
| | - Xavier Aldeger
- Department of Gastroenterology of University Hospital Doctor Josep Trueta de Girona, Spain
| | - Antonia Costa
- Department of Gynecology and Obstetrics Department, Centro Hospitalar S. João, Portugal, and Faculty of Medicine, Porto University, Porto, Portugal
| | - Peter D Higgins
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Joel C Joyce
- Department of Dermatology, Medical College of Wisconsin, WI, USA
| | - Konstantinos H Katsanos
- Department of Internal Medicine & Hepato-Gastroenterology Unit, Medical School University of Ioannina, Ioannina, Greece
| | - Anthony Lopez
- Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, and Université Henri Poincaré 1,Vandoeuvre-lès-Nancy, France
| | | | - Elena Toader
- Gastroenterology and Hepatology Center, University Hospital Sf. Spiridon, and University of Medicine and Pharmacy Gr. T. Popa, Iasi, Romania
| | - Laurent Beaugerie
- Department of Gastroenterology, AP-HP, Hôpital Saint-Antoine F-75012 and ERL 1057 INSERM/UMRS 7203, UPMC Univ Paris 06F-75005, Paris, France.
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