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Ozcelik F, Aslan K, Gok V, Ari MB, Ozcan A, Eken A, Ünal E, Ozkul Y, Dundar M. A case of autoimmune lymphoproliferative syndrome with a novel de novo FAS variant. Pediatr Hematol Oncol 2024; 41:301-309. [PMID: 38047450 DOI: 10.1080/08880018.2023.2286967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 11/18/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Firat Ozcelik
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Kubra Aslan
- Department of Medical Biology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Betul-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Veysel Gok
- Division of Pediatric Hematology, Oncology and HSCT Center, Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | | | - Alper Ozcan
- Division of Pediatric Hematology, Oncology and HSCT Center, Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | - Ahmet Eken
- Department of Medical Biology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Betul-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Ekrem Ünal
- Betul-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
- Division of Pediatric Hematology, Oncology and HSCT Center, Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey
- Department of Blood Banking and Transfusion Medicine, Health Science Institution, Erciyes University, Kayseri, Turkey
| | - Yusuf Ozkul
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Betul-Ziya Eren Genome and Stem Cell Center (GENKOK), Kayseri, Turkey
| | - Munis Dundar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Giardino G, Lanni V, Mascolo M, Russo D, Cirillo E, Romano R, Cillo F, Grilli L, Prencipe MR, Iuliano A, Uccello G, De Fusco C, Menna G, Scalia G, Portella G, Pignata C. Case report: EBV-related eye orbits and sinuses lymphohistiocytic infiltration responsive to rituximab in a patient with X lymphoproliferative syndrome type 1. Front Immunol 2024; 15:1370991. [PMID: 38633254 PMCID: PMC11021630 DOI: 10.3389/fimmu.2024.1370991] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/07/2024] [Indexed: 04/19/2024] Open
Abstract
Background and aims X lymphoproliferative syndrome type 1 (XLP1) is a rare inborn error of immunity due to mutations of SH2D1A, encoding for slam-associated protein (SAP). The clinical phenotype includes severe mononucleosis, hemophagocytic lymphohistiocytosis (HLH), and B-cell lymphomas. Methods We report the case of a child affected with XLP1 who presented with an incomplete HLH, triggered by Epstein-Barr virus (EBV) and treated with rituximab, involving orbits and paranasal sinuses. Results The lesion was indistinguishable from lymphoma, complicating diagnosis and treatment. In addition, considering the high incidence of lymphoma in patients with XLP1, histology helped define its nature, driving therapeutic choices. Conclusion We described an unusual presentation of incomplete HLH in a patient affected with XLP1: an EBV-driven infiltration of the orbits and paranasal sinuses. This led us to a challenging differential diagnosis of lymphoma-associated hemophagocytic syndrome, which can be frequently observed in patients with XLP1. Considering the extremely poor prognosis of this clinical finding, we sought for a prompt diagnosis and managed to obtain it and to immediately establish the right treatment on the basis of the pathological finding.
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Affiliation(s)
- Giuliana Giardino
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Vittoria Lanni
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Unit, Federico II University of Naples, Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Unit, Federico II University of Naples, Naples, Italy
| | - Emilia Cirillo
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Roberta Romano
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Francesca Cillo
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Laura Grilli
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Maria Rosaria Prencipe
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
| | - Adriana Iuliano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Giovanni Uccello
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Carmela De Fusco
- Pediatric Hematology and Oncology, Pausilipon Hospital, Naples, Italy
| | - Giuseppe Menna
- Pediatric Hematology and Oncology, Pausilipon Hospital, Naples, Italy
| | - Giulia Scalia
- Clinical and Experimental Cytometry Unit, Centre for Advanced Biotechnology Franco Salvatore, CEINGE, Naples, Italy
| | - Giuseppe Portella
- Department of Translational Medical Sciences, Virology Section, Federico II University of Naples, Naples, Italy
| | - Claudio Pignata
- Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy
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Wagenpfeil J, Hoß K, Henkel A, Kütting D, Luetkens JA, Feldmann G, Brossart P, Attenberger UI, Pieper CC. Interventional treatment of refractory non-traumatic chylous effusions in patients with lymphoproliferative disorders. Clin Exp Med 2024; 24:63. [PMID: 38554229 PMCID: PMC10981590 DOI: 10.1007/s10238-024-01312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024]
Abstract
To report results of interventional treatment of refractory non-traumatic abdomino-thoracic chylous effusions in patients with lymphoproliferative disorders. 17 patients (10 male; mean age 66.7 years) with lymphoproliferative disorders suffered from non-traumatic chylous effusions (chylothorax n = 11, chylous ascites n = 3, combined abdomino-thoracic effusion n = 3) refractory to chemotherapy and conservative therapy. All underwent x-ray lymphangiography with iodized-oil to evaluate for and at the same time treat lymphatic abnormalities (leakage, chylo-lymphatic reflux with/without obstruction of central drainage). In patients with identifiable active leakage additional lymph-vessel embolization was performed. Resolution of effusions was deemed as clinical success. Lymphangiography showed reflux in 8/17 (47%), leakage in 2/17 (11.8%), combined leakage and reflux in 3/17 (17.6%), lymphatic obstruction in 2/17 (11.8%) and normal findings in 2/17 cases (11.8%). 12/17 patients (70.6%) were treated by lymphangiography alone; 5/17 (29.4%) with leakage received additional embolization (all technically successful). Effusions resolved in 15/17 cases (88.2%); 10/12 (83.3%) resolved after lymphangiography alone and in 5/5 patients (100%) after embolization. Time-to-resolution of leakage was significantly shorter after embolization (within one day in all cases) than lymphangiography (median 9 [range 4-30] days; p = 0.001). There was no recurrence of symptoms or post-interventional complications during follow-up (median 445 [40-1555] days). Interventional-radiological treatment of refractory, non-traumatic lymphoma-induced chylous effusions is safe and effective. Lymphangiography identifies lymphatic abnormalities in the majority of patients and leads to resolution of effusions in > 80% of cases. Active leakage is found in only a third of patients and can be managed by additional embolization.
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Affiliation(s)
- Julia Wagenpfeil
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany.
| | - Katharina Hoß
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
| | - Andreas Henkel
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
| | - Daniel Kütting
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
| | - Julian Alexander Luetkens
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
| | - Georg Feldmann
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
- Department of Internal Medicine III, University Hospital of Bonn, Bonn, Germany
| | - Peter Brossart
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
- Department of Internal Medicine III, University Hospital of Bonn, Bonn, Germany
| | - Ulrike Irmgard Attenberger
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
| | - Claus Christian Pieper
- Division for Minimally-Invasive Lymph Vessel Therapy, Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Bonn, Germany
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Danis HE, Keenan C, Schaber J, Grasso SL. Primary hepatic Castleman disease. BMJ Case Rep 2024; 17:e256819. [PMID: 38479827 PMCID: PMC10941136 DOI: 10.1136/bcr-2023-256819] [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] [Indexed: 03/18/2024] Open
Abstract
Castleman disease (CD) is a rare, benign lymphoproliferative disorder with characteristic histopathological features, but variable aetiology, presentation, treatment and prognosis. It is broadly classified based on its location and histopathological features, with unicentric hyaline vascular disease presenting most commonly. We present a case of primary, unicentric hepatic CD that was incidentally found on imaging and managed with laparoscopic resection.
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Affiliation(s)
| | - Corey Keenan
- General Surgery, William Beaumont Army Medical Center, Ft. Bliss, Texas, USA
| | - John Schaber
- Pathology, William Beaumont Army Medical Center, El Paso, Texas, USA
| | - Samuel L Grasso
- General Surgery, William Beaumont Army Medical Center, Ft. Bliss, Texas, USA
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Bednarska K, Chowdhury R, Tobin JWD, Swain F, Keane C, Boyle S, Khanna R, Gandhi MK. Epstein-Barr virus-associated lymphomas decoded. Br J Haematol 2024; 204:415-433. [PMID: 38155519 DOI: 10.1111/bjh.19255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/15/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023]
Abstract
Epstein-Barr virus (EBV)-associated lymphomas cover a range of histological B- and T-cell non-Hodgkin and Hodgkin lymphoma subtypes. The role of EBV on B-cell malignant pathogenesis and its impact on the tumour microenvironment are intriguing but incompletely understood. Both the International Consensus Classification (ICC) and 5th Edition of the World Health Organization (WHO-HAEM5) proposals give prominence to the distinct clinical, prognostic, genetic and tumour microenvironmental features of EBV in lymphoproliferative disorders. There have been major advances in our biological understanding, in how to harness features of EBV and its host immune response for targeted therapy, and in using EBV as a method to monitor disease response. In this article, we showcase the latest developments and how they may be integrated to stimulate new and innovative approaches for further lines of investigation and therapy.
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Affiliation(s)
- Karolina Bednarska
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Rakin Chowdhury
- Frazer Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Joshua W D Tobin
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Fiona Swain
- Frazer Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Colm Keane
- Frazer Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Stephen Boyle
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rajiv Khanna
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Maher K Gandhi
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Haematology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Becken BA, Lamson DM, Gonzalez G, Patel S, St. George K, Kajon AE. A Fulminant Case of Adenovirus Genotype C108 Infection in a Pediatric Stem Cell Transplant Recipient with x-Linked Lymphoproliferative Syndrome Type 1. Viruses 2024; 16:137. [PMID: 38257837 PMCID: PMC10819400 DOI: 10.3390/v16010137] [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: 01/02/2024] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
A 3-year-old male with X-linked lymphoproliferative syndrome type 1 underwent an unrelated umbilical cord blood transplant (UUCBT). The week prior to transplant the patient tested positive for adenovirus (HAdV) with a viral load of <190 copies/mL and was started on cidofovir. UUCBT proceeded as scheduled, and the patient engrafted on day +19. The patient's HAdV load in serum continued to rise with resulting hepatic dysfunction, despite ongoing therapy with cidofovir and HAdV specific T-cell infusions. The patient died 6 months after transplantation having never cleared the virus. Next generation whole genome sequencing and sequence data analyses identified an intertypic recombinant HAdV-C P1H2F2 closely related (99.6% similarity) to genotype C108 in the isolates from three blood specimens obtained during the last week of life. Incidentally, the de novo assembly strategy enabled the detection of an adeno-associated virus type 2 (AAV2) genome in the DNA purified from the plasma isolates. Proteotyping analysis revealed minor differences in the predicted amino acid sequences for E1A, E1B 19K, E1B 55K, DNA polymerase, penton base, and fiber. None of the mutations previously described for HAdV-C5 variants resistant to cidofovir were identified. In silico restriction enzyme analysis revealed a distinct Sac I profile for the identified virus, supporting its designation as a C108 variant.
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Affiliation(s)
- Bradford A. Becken
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA; (B.A.B.); (S.P.)
| | - Daryl M. Lamson
- Wadsworth Center, New York State Department of Health, Albany, NY 12208, USA; (D.M.L.); (K.S.G.)
| | - Gabriel Gonzalez
- UCD National Virus Reference Laboratory, Dublin, Ireland;
- Japan Initiative for World-Leading Vaccine Research and Development Centers, Institute for Vaccine Research and Development, Hokkaido University, Hokkaido, Japan
| | - Sachit Patel
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA; (B.A.B.); (S.P.)
| | - Kirsten St. George
- Wadsworth Center, New York State Department of Health, Albany, NY 12208, USA; (D.M.L.); (K.S.G.)
| | - Adriana E. Kajon
- Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA
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7
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Rivalta B, Attardi E, Cifaldi C, Rosti V, Pacillo L, Hajrullaj H, Di Cesare S, Amodio D, Algeri M, Luciani M, Barzaghi F, Finocchi A, Di Matteo G, Aiuti A, Locatelli F, Voso MT, Palumbo G, Cancrini C. Natural history of Ras-associated autoimmune leukoproliferative disorder: A 20-year follow-up of a NRAS-mutated patient excluding a malignant progression. Br J Haematol 2024; 204:e6-e10. [PMID: 37921255 DOI: 10.1111/bjh.19150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023]
Affiliation(s)
- B Rivalta
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - E Attardi
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - C Cifaldi
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
| | - V Rosti
- Center for the Study of Myelofibrosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - L Pacillo
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - H Hajrullaj
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - S Di Cesare
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - D Amodio
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Algeri
- Department of Pediatric Hemato-Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
| | - M Luciani
- Department of Pediatric Hemato-Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
| | - F Barzaghi
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Finocchi
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Di Matteo
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - A Aiuti
- Pediatric Immunohematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F Locatelli
- Department of Pediatric Hemato-Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - M T Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - G Palumbo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Pediatric Hemato-Oncology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
| | - C Cancrini
- Research Unit of Primary Immunodeficiencies, Academic Department of Pediatrics, Bambino Gesù Children's Hospital, Scientific Institute for Research and Healthcare (IRCCS), Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Cury-Martins J, Giannotti MA, Miyashiro D, Pereira J, Sanches JA. A unique case of a lymphoproliferative disorder affecting the skin and uterine cervix on a male transgender. An Bras Dermatol 2024; 99:135-139. [PMID: 37661464 DOI: 10.1016/j.abd.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Jade Cury-Martins
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | - Denis Miyashiro
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana Pereira
- Department of Hematology, Universidade de São Paulo, São Paulo, SP, Brazil
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9
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Gao HX, Duan YL, Zhou CJ, Zhang NN, Jin L, Yang J, Huang S, Zhang M, Zhang YH. [Other iatrogenic immunodeficiency associated lymphoproliferative diseases in children with lymphoma: a case report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:1045-1048. [PMID: 38503532 PMCID: PMC10834865 DOI: 10.3760/cma.j.issn.0253-2727.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Indexed: 03/21/2024]
Affiliation(s)
- H X Gao
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y L Duan
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - C J Zhou
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - N N Zhang
- Department of Imaging, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - L Jin
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - J Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - S Huang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - M Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y H Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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10
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Ford M, Orlando E, Amengual JE. EBV Reactivation and Lymphomagenesis: More Questions than Answers. Curr Hematol Malig Rep 2023; 18:226-233. [PMID: 37566338 DOI: 10.1007/s11899-023-00708-5] [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] [Accepted: 07/11/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE OF REVIEW Epstein-Barr Virus (EBV) is a ubiquitous herpesvirus that affects almost all humans and establishes lifelong infections by infecting B-lymphocytes leading to their immortalization. EBV has a discrete life cycle with latency and lytic reactivation phases. EBV can reactivate and cause lymphoproliferation in both immunocompetent and immunocompromised individuals. There is sparse literature on monitoring protocols for EBV reactivation and no standardized treatment protocols to treat EBV-driven lymphoproliferation. RECENT FINDINGS While there are no FDA-approved therapies to treat EBV, there are several strategies to inhibit EBV replication. These include immunosuppression reduction, nucleoside analogs, HDAC inhibitors, EBV-specific cytotoxic T-lymphocytes (CTLs), and monoclonal antibodies, such as rituximab. There is currently an open clinic trial combining the use of a HDAC inhibitor, nanatinostat, and ganciclovir to treat refractory/relapsed EBV lymphomas. Another novel therapy includes tabelecleucel, which is an allogenic EBV-directed T-cell immunotherapy that was approved by the European Medicines Agency, but is currently only available in the US for limited use in relapsed or refractory EBV-positive PTLD. Further research is needed to establish EBV monitoring protocols in high-risk populations, such as those with autoimmune disease, cancer, HIV, or receiving immunosuppressive therapy. Additionally, standardized treatments for both the prevention of EBV reactivation in high-risk populations and treatment of EBV reactivation and lymphoproliferation need to be established.
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Affiliation(s)
- Maegan Ford
- Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Evelyn Orlando
- Division of Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Jennifer Effie Amengual
- Division of Hematology and Oncology, Columbia University Irving Medical Center, New York, NY, 10032, USA.
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11
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Zhang C, Chang L, Yang X, Khan R, Liu D. Severe atypical hydroa vacciniforme-like lymphoproliferative disorder in a patient with hyper IgE syndromes due to DOCK8 gene mutation. Indian J Dermatol Venereol Leprol 2023; 89:874-877. [PMID: 37317769 DOI: 10.25259/ijdvl_409_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 01/01/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Chaoyin Zhang
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Chang
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xue Yang
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Raqib Khan
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Donghua Liu
- Department of Dermatology and Venereology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
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12
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Kurita D, Shiba N, Ohya T, Murase A, Shimosato Y, Yoshitomi M, Hattori S, Sasaki K, Nishimura K, Tsujimoto SI, Takeuchi M, Tanoshima R, Kanegane H, Kitagawa N, Ito S. Severe RAS-Associated Lymphoproliferative Disease Case with Increasing αβ Double-Negative T Cells with Atypical Features. J Clin Immunol 2023; 43:1992-1996. [PMID: 37644277 DOI: 10.1007/s10875-023-01566-9] [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: 05/31/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
Autoimmune lymphoproliferative syndrome (ALPS) is a disease of lymphocyte homeostasis caused by FAS-mediated apoptotic pathway dysfunction and is characterized by non-malignant lymphoproliferation with an increased number of TCRαβ+CD4-CD8- double-negative T cells (αβDNTs). Conversely, RAS-associated leukoproliferative disease (RALD), which is caused by gain-of-functional somatic variants in KRAS or NRAS, is considered a group of diseases with a similar course. Herein, we present a 7-year-old Japanese female of RALD harboring NRAS variant that aggressively progressed to juvenile myelomonocytic leukemia (JMML) with increased αβDNTs. She eventually underwent hematopoietic cell transplantation due to acute respiratory distress which was caused by pulmonary infiltration of JMML blasts. In general, αβDNTs have been remarkably increased in ALPS; however, FAS pathway gene abnormalities were not observed in this case. This case with RALD had repeated shock/pre-shock episodes as the condition progressed. This shock was thought to be caused by the presence of a high number of αβDNTs. The αβDNTs observed in this case revealed high CCR4, CCR6, and CD45RO expressions, which were similar to Th17. These increased Th17-like αβDNTs have triggered the inflammation, resulting in the pathogenesis of shock, because Th17 secretes pro-inflammatory cytokines such as interleukin (IL)-17A and granulocyte-macrophage colony-stimulating factor. The presence of IL-17A-secreting αβDNTs has been reported in systemic lupus erythematosus (SLE) and Sjögren's syndrome. The present case is complicated with SLE, suggesting the involvement of Th17-like αβDNTs in the disease pathogenesis. Examining the characteristics of αβDNTs in RALD, JMML, and ALPS may reveal the pathologies in these cases.
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Affiliation(s)
- Daisuke Kurita
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Norio Shiba
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
| | - Takashi Ohya
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Ayako Murase
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Yuko Shimosato
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Masahiro Yoshitomi
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Seira Hattori
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Koji Sasaki
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Shin-Ichi Tsujimoto
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Masanobu Takeuchi
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Reo Tanoshima
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Norihiko Kitagawa
- Department of Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan
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13
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Fukatsu M, Hamazaki Y, Sato Y, Koyama D, Ikezoe T. A case of cold agglutinin syndrome associated with chronic lymphocytic leukaemia harbouring mutations in CARD11 and KMT2D. Int J Hematol 2023; 118:472-476. [PMID: 37133636 DOI: 10.1007/s12185-023-03608-9] [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: 12/03/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/04/2023]
Abstract
Cold agglutinin disease (CAD) is a rare cold autoimmune haemolytic anaemia (cAIHA) caused by IgM antibodies recognizing I antigens on erythrocytes. cAIHA is now mainly classified into two types: primary CAD and cold agglutinin syndrome (CAS). CAS develops in association with the underlying disease, which is most commonly malignant lymphoma. Recent studies have identified gene mutations in CARD11 and KMT2D in a high proportion of patients with CAD, which has led to recognition of CAD as an indolent lymphoproliferative disorder. We herein report a case of cAIHA without lymphocytosis or lymphadenopathy in whom bone marrow was infiltrated by a small population of clonal lymphocytes (6.8%) expressing cell surface markers consistent with chronic lymphocytic leukaemia (CLL). Whole-exome sequencing of bone marrow mononuclear cells revealed mutations in the CARD11 and KMT2D genes. This patient also had somatic hypermutation with overrepresentation of IGHV4-34, which is prevalent in CLL harbouring the KMT2D mutation. These observations suggest that CAS caused by early-phase CLL could be misinterpreted as primary CAD.
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Affiliation(s)
- Masahiko Fukatsu
- Department of Hematology, Fukushima Medical University, Fukushima City, Fukushima, 960-1295, Japan
| | - Yoichi Hamazaki
- Department of Hematology, Iwaki City Medical Center, Iwaki, 973-8555, Japan
| | - Yuki Sato
- Department of Hematology, Fukushima Medical University, Fukushima City, Fukushima, 960-1295, Japan
| | - Daisuke Koyama
- Department of Hematology, Fukushima Medical University, Fukushima City, Fukushima, 960-1295, Japan
| | - Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University, Fukushima City, Fukushima, 960-1295, Japan.
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14
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Ogawa K, Honjo M, Sakamoto K, Funamizu N, Tamura K, Shine M, Nishi Y, Nagaoka T, Ito C, Iwata M, Uraoka M, Sakamoto A, Takada Y, Kitazawa R. Epstein-Barr Virus-Associated Latent Malignant Lymphoma With Acute Exacerbation After Living Donor Liver Transplantation: Case Report. Transplant Proc 2023; 55:1959-1963. [PMID: 37543481 DOI: 10.1016/j.transproceed.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/19/2023] [Indexed: 08/07/2023]
Abstract
Concomitant malignant lymphoma at the time of transplantation is usually considered a contraindication to liver transplantation (LT). We report a case of Epstein-Barr virus (EBV)-associated malignant lymphoma that was latent preoperatively and rapidly became aggravated after LT. A 69-year-old man was referred to our hospital with an exacerbation of abdominal distension due to polycystic liver. As cystic infection, ascites, and deteriorated liver reserve function occurred after hepatic artery embolization, he underwent living-donor LT with his daughter as the donor. His respiratory condition worsened, and he was moved to the intensive care unit on postoperative day 34. Histopathologic examination of the excised liver returned around the same time revealed findings suggestive of EBV-associated malignant lymphoma in lymph nodes near the gallbladder. Subsequent computed tomography scans showed apparent neoplastic lesions in the abdominal cavity and worsening pleural effusion and ascites. Numerous atypical lymphocytes were observed in the pleural effusion and ascites, and the patient was diagnosed with exacerbation of EBV-associated malignant lymphoma. He was treated unsuccessfully with rituximab and died 66 days after LT. Caution should be exercised in elderly immunocompromised transplant candidates who may have comorbid EBV-associated lymphoproliferative disease.
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Affiliation(s)
- Kohei Ogawa
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan.
| | - Masahiko Honjo
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Katsunori Sakamoto
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Naotake Funamizu
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Kei Tamura
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Mikiya Shine
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Yusuke Nishi
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Tomoyuki Nagaoka
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Chihiro Ito
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Miku Iwata
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Mio Uraoka
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Akimasa Sakamoto
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Yasutsugu Takada
- Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Riko Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan
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15
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Puello Yocum B, Mesa H, Maratt JK, Ermel AC, Manchanda N, Popnikolov N. EBV-Gastritis Preceded the Development of Nasopharyngeal EBV (+) Diffuse Large B Cell Lymphoma in a Patient With Ruxolitinib-Induced Immunosuppression. Int J Surg Pathol 2023; 31:1340-1346. [PMID: 36734083 DOI: 10.1177/10668969221137525] [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] [Indexed: 02/04/2023]
Abstract
Epstein-Barr virus (EBV) is acquired early in life as asymptomatic or symptomatic infectious mononucleosis (IM) and remains latent in a few B cells in most individuals. Pathologic EBV-reactivation affects immunosuppressed individuals and manifests as IM-like syndromes, polyclonal lymphoproliferative disorders, EBV-related lymphomas, and carcinomas. EBV-associated gastritis is an underrecognized and very rarely reported entity. We report a case of a 65-year-old woman with ruxolitinib-treated polycythemia vera, who developed EBV viremia and EBV gastritis. The patient improved after the ruxolitinib dose reduction and administration of antiviral therapy. A few months after discontinuation of the antiviral therapy the gastric symptoms recurred, numerous gastric ulcers were identified, and a nasopharyngeal mass was detected. A biopsy of the nasopharynx showed an EBV (+) diffuse large B cell lymphoma. Ruxolitinib was discontinued and the patient was started on rituximab monotherapy with a resolution of symptoms and pathologic improvement. Our case supports earlier reports of an association of ruxolitinib therapy with EBV complications. An early diagnosis of EBV gastritis in immunocompromised patients is important since the gastric infection may precede or co-exist with a developing EBV-associated malignancy. Our case and existing literature suggest that EBV gastritis in symptomatic patients with iatrogenic immunosuppression requires discontinuation of immunosuppressive therapy if feasible, treatment with antivirals, and close surveillance for possible evolving/concurrent EBV (+) malignancy.
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Affiliation(s)
- Bianca Puello Yocum
- Department of Laboratory Medicine & Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Hector Mesa
- Department of Laboratory Medicine & Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jennifer K Maratt
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Aaron C Ermel
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Naveen Manchanda
- Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nikolay Popnikolov
- Department of Laboratory Medicine & Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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16
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Mesbah-Oskui L, Alabkal J, Alduaij W, Dhawan PS. A unique case of a fulminant clonal CD8-positive T-cell lymphoproliferative disorder with CNS involvement. BMC Neurol 2023; 23:329. [PMID: 37715128 PMCID: PMC10503065 DOI: 10.1186/s12883-023-03371-8] [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: 05/14/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND This is a unique case that describes the presentation, investigations, and disease trajectory of a fatal, clonal CD8-positive T-cell lymphoproliferative disorder in an otherwise healthy and immunocompetent patient with Epstein-Barr virus seronegative status. Central nervous system involving T-cell lymphoproliferative disorders are rare and typically encountered in the setting of immunocompromise. These disorders are often associated with aggressive cytomorphological features and characteristic magnetic resonance imaging patterns, which were not seen in this case. CASE PRESENTATION Here we describe a case of a 65 year-old male presenting with neuropsychiatric symptoms, truncal ataxia, and falls who's bone marrow, cerebrospinal fluid, and brain biopsy were consistent with a clonal CD8-positive T-cell lymphoproliferative disorder that did not meet existing World Health Organization criteria for classification as T-cell lymphoma. The patient was treated with intrathecal methotrexate resulting in transient improvement of his symptoms followed by disease progression and death related to aspiration. CONCLUSIONS This case highlights the importance of urgent and comprehensive work-up in patients with clinical features suggestive of lymphoma with central nervous system involvement, despite atypical imaging features and lack of cytomorphological features satisfying current World Health Organization classification criteria.
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Affiliation(s)
- Lia Mesbah-Oskui
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Jarrah Alabkal
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Waleed Alduaij
- Division of Medical Oncology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Lymphoid Cancer, British Columbia Cancer, Vancouver, BC, Canada
| | - Priya S Dhawan
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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17
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Di Napoli A, Soma L, Quintanilla-Martinez L, de Leval L, Leoncini L, Zamò A, Ng SB, Ondrejka SL, Climent F, Wotherspoon A, Dirnhofer S. Cavity-based lymphomas: challenges and novel concepts. A report of the 2022 EA4HP/SH lymphoma workshop. Virchows Arch 2023; 483:299-316. [PMID: 37555981 PMCID: PMC10542738 DOI: 10.1007/s00428-023-03599-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/16/2023] [Accepted: 07/07/2023] [Indexed: 08/10/2023]
Abstract
The 2022 European Association for Haematopathology/Society for Hematopathology lymphoma workshop session on cavity-based lymphomas included sixty-eight cases in seven sections. The disease entities discussed include primary effusion lymphomas (PEL), extracavitary primary effusion lymphomas and confounding entities (ECPEL), HHV8-negative B-lineage lymphomas-effusion based (EBV-negative, EBV-positive, and plasmablastic types), diffuse large B-cell lymphoma associated with chronic inflammation, fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL), breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and other lymphomas presenting as an effusion. All entities above are discussed; however, three are delved into greater detail given the challenges with classification: ECPEL, HHV8-negative effusion-based lymphomas, and FA-DLBCL. Cases exemplifying the diagnostic difficulty in differentiating ECPEL from HHV8-positive diffuse large B-cell lymphoma and germinotropic lymphoproliferative disorder were discussed. The more recently recognized effusion-based HHV8-negative large B-cell lymphoma is explored, with several cases submitted raising the question if this subset should be carved out as a specific entity, and if so, what should be the refining diagnostic criteria. Case submissions to the FA-DLBCL section yielded one of the largest case series to date, including classic cases, cases furthering the discussion on disease sites and prognosis, as well as novel concepts to be considered in this entity. The 2022 EA4HP/SH workshop cases allowed for further confirmation of the characteristics of some of the more historically accepted cavity-based lymphomas, as well as further inquiry and debate on relatively new or evolving entities.
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Affiliation(s)
- Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy.
| | - Lori Soma
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Laurence de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Lorenzo Leoncini
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Alberto Zamò
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Siok-Bian Ng
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sarah L Ondrejka
- Pathology, and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Fina Climent
- Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet De Llobregat, Barcelona, Spain
| | | | - Stefan Dirnhofer
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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18
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Chen JH, Arceri T, Datta R, Sullivan KE. Delayed post-COVID-19 hemophagocytic lymphohistiocytosis in patient with XIAP deficiency. Pediatr Allergy Immunol 2023; 34:e14028. [PMID: 37747746 DOI: 10.1111/pai.14028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Jonathan H Chen
- Department of Internal Medicine, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Talia Arceri
- Division of Allergy and Immunology, Department of Pediatrics, Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rahul Datta
- Division of Allergy and Immunology, Department of Pediatrics, Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathleen E Sullivan
- Division of Allergy and Immunology, Department of Pediatrics, Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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19
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Guenther A, Tierens A, Malecka A, Delabie J. The Histopathology of Cold Agglutinin Disease-Associated B-Cell Lymphoproliferative Disease. Am J Clin Pathol 2023; 160:229-237. [PMID: 37253147 DOI: 10.1093/ajcp/aqad048] [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: 01/11/2023] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVES Primary cold agglutinin disease is a type of autoimmune hemolytic anemia caused by circulating antibodies against I antigen, a carbohydrate expressed on most cells, including red blood cells. The underlying disease has been characterized in recent years as a distinct B-cell lymphoproliferative disease of the bone marrow, occurring mostly in the elderly. The disease has been now been included as a separate entity in the most recent classifications of mature B-cell neoplasms. METHODS A review of the characteristics of cold agglutinin disease is provided, with an emphasis on the pathology features. RESULTS A detailed description of the histopathology, immunophenotype, and genetics of cold agglutinin disease is provided and compared to other B-cell lymphoproliferative diseases in the bone marrow with similar features. CONCLUSIONS Recognition of the pathology features of cold agglutinin disease allows to distinguish it from other diseases, especially lymphoplasmacytic lymphoma and marginal zone lymphoma.
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Affiliation(s)
- Angela Guenther
- Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, Canada
| | - Anne Tierens
- Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, Canada
| | | | - Jan Delabie
- Laboratory Medicine Program, University Health Network and University of Toronto, Toronto, Canada
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20
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Sugimoto A, Watanabe T, Matsuoka K, Okuno Y, Yanagi Y, Narita Y, Mabuchi S, Nobusue H, Sugihara E, Hirayama M, Ide T, Onouchi T, Sato Y, Kanda T, Saya H, Iwatani Y, Kimura H, Murata T. Growth Transformation of B Cells by Epstein-Barr Virus Requires IMPDH2 Induction and Nucleolar Hypertrophy. Microbiol Spectr 2023; 11:e0044023. [PMID: 37409959 PMCID: PMC10433962 DOI: 10.1128/spectrum.00440-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
The in vitro growth transformation of primary B cells by Epstein-Barr virus (EBV) is the initial step in the development of posttransplant lymphoproliferative disorder (PTLD). We performed electron microscopic analysis and immunostaining of primary B cells infected with wild-type EBV. Interestingly, the nucleolar size was increased by two days after infection. A recent study found that nucleolar hypertrophy, which is caused by the induction of the IMPDH2 gene, is required for the efficient promotion of growth in cancers. In the present study, RNA-seq revealed that the IMPDH2 gene was significantly induced by EBV and that its level peaked at day 2. Even without EBV infection, the activation of primary B cells by the CD40 ligand and interleukin-4 increased IMPDH2 expression and nucleolar hypertrophy. Using EBNA2 or LMP1 knockout viruses, we found that EBNA2 and MYC, but not LMP1, induced the IMPDH2 gene during primary infections. IMPDH2 inhibition by mycophenolic acid (MPA) blocked the growth transformation of primary B cells by EBV, leading to smaller nucleoli, nuclei, and cells. Mycophenolate mofetil (MMF), which is a prodrug of MPA that is approved for use as an immunosuppressant, was tested in a mouse xenograft model. Oral MMF significantly improved the survival of mice and reduced splenomegaly. Taken together, these results indicate that EBV induces IMPDH2 expression through EBNA2-dependent and MYC-dependent mechanisms, leading to the hypertrophy of the nucleoli, nuclei, and cells as well as efficient cell proliferation. Our results provide basic evidence that IMPDH2 induction and nucleolar enlargement are crucial for B cell transformation by EBV. In addition, the use of MMF suppresses PTLD. IMPORTANCE EBV infections cause nucleolar enlargement via the induction of IMPDH2, which are essential for B cell growth transformation by EBV. Although the significance of IMPDH2 induction and nuclear hypertrophy in the tumorigenesis of glioblastoma has been reported, EBV infection brings about the change quickly by using its transcriptional cofactor, EBNA2, and MYC. Moreover, we present here, for the novel, basic evidence that an IMPDH2 inhibitor, namely, MPA or MMF, can be used for EBV-positive posttransplant lymphoproliferative disorder (PTLD).
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Affiliation(s)
- Atsuko Sugimoto
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Japan
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahiro Watanabe
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Matsuoka
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yusuke Okuno
- Department of Virology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yusuke Yanagi
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohei Narita
- Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Seiyo Mabuchi
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Hiroyuki Nobusue
- Division of Gene Regulation, Cancer Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
| | - Eiji Sugihara
- Division of Gene Regulation, Cancer Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
- Open Facility Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
| | - Masaya Hirayama
- Department of Morphology and Diagnostic Pathology, School of Medical Sciences, Fujita Health University, Toyoake, Japan
- Department of Biomedical Molecular Sciences, Graduate School of Medicine, Fujita Health University, Toyoake, Japan
| | - Tomihiko Ide
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Japan
- Open Facility Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
| | - Takanori Onouchi
- Open Facility Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
| | - Yoshitaka Sato
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Teru Kanda
- Department of Microbiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideyuki Saya
- Division of Gene Regulation, Cancer Center, Research Promotion Headquarters, Fujita Health University, Toyoake, Japan
| | - Yasumasa Iwatani
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroshi Kimura
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takayuki Murata
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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21
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Yamada M, Macedo C, Louis K, Shi T, Landsittel D, Nguyen C, Shinjoh M, Michaels MG, Feingold B, Mazariegos GV, Green M, Metes D. Distinct association between chronic Epstein-Barr virus infection and T cell compartments from pediatric heart, kidney, and liver transplant recipients. Am J Transplant 2023; 23:1145-1158. [PMID: 37187296 DOI: 10.1016/j.ajt.2023.05.007] [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: 11/22/2022] [Revised: 04/23/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
Chronic Epstein-Barr virus (EBV) infection after pediatric organ transplantation (Tx) accounts for significant morbidity and mortality. The risk of complications, such as posttransplant lymphoproliferative disorders, in high viral load (HVL) carriers is the highest in heart Tx recipients. However, the immunologic signatures of such a risk have been insufficiently defined. Here, we assessed the phenotypic, functional, and transcriptomic profiles of peripheral blood CD8+/CD4+ T cells, including EBV-specific T cells, in 77 pediatric heart, kidney, and liver Tx recipients and established the relationship between memory differentiation and progression toward exhaustion. Unlike kidney and liver HVL carriers, heart HVL carriers displayed distinct CD8+ T cells with (1) up-regulation of interleukin-21R, (2) decreased naive phenotype and altered memory differentiation, (3) accumulation of terminally exhausted (TEX PD-1+T-bet-Eomes+) and decrease of functional precursors of exhausted (TPEX PD-1intT-bet+) effector subsets, and (4) transcriptomic signatures supporting the phenotypic changes. In addition, CD4+ T cells from heart HVL carriers displayed similar changes in naive and memory subsets, elevated Th1 follicular helper cells, and plasma interleukin-21, suggesting an alternative inflammatory mechanism that governs T cell responses in heart Tx recipients. These results may explain the different incidences of EBV complications and may help improve the risk stratification and clinical management of different types of Tx recipients.
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Affiliation(s)
- Masaki Yamada
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Camila Macedo
- Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kevin Louis
- Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Kidney Transplant Department, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Tiange Shi
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Douglas Landsittel
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Indiana, Pennsylvania, USA
| | - Christina Nguyen
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Marian G Michaels
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian Feingold
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - George V Mazariegos
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Green
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Diana Metes
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA; Thomas E. Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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22
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Waly B, Abdel-Aal MT, El-Etreby S, Saleh LM, El Baz A, Abdel-Ghaffar H. B-cell Clonality in HCV-Induced Patients Treated with Oral Direct-Acting Antiviral Agents. Asian Pac J Cancer Prev 2023; 24:2187-2193. [PMID: 37378951 PMCID: PMC10505897 DOI: 10.31557/apjcp.2023.24.6.2187] [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: 02/10/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) is a worldwide' health problem as Egypt has a very high prevalence (14.7%) that may affect the B-Lymphocytes, and in some cases leading to an expansion of monoclonal B-cell detected by immunoglobulin heavy chain (IgH) gene rearrangement. Therefore, we aimed to assess the occurrence of IgH gene rearrangement in Egyptian chronic HCV patients and studying the effect of oral direct-acting antiviral (DAAs) therapy on regression of the clonality markers. METHODS 78 Egyptian patients with chronic HCV infection were included in this study and polymerase chain reaction (PCR) analysis was used to detect IgH rearrangement based on standardized PCR protocols of the BIOMED-2 international guidelines study. RESULTS Clonal IgH showed a significant increase of HCV-RNA expression and correlated with increased alanine transaminase (ALT) in all patients, while a significant increase of kappa and lambda free light chain observed only in clonal IgH with lymphoproliferative disorders (LPD) patients. A total of 37.17% (29/78) IgH clonality was detected in all patients (7.69% with LPD and 29.48% without LPD). 37% of these IgH clonality disappeared with HCV eradication after DAAs regimen. CONCLUSIONS we concluded that different DAAs regimen with or without RBV is safe and effective for the treatment of Egyptian patients, but its effect is partially and not completely in the eradication of IgH clonality. Also, using IgH rearrangement in patients with chronic HCV is helpful as indicator in patients at high risk for prediction of LPD.
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Affiliation(s)
- Basma Waly
- Specialized Medical hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | | | - Shahira El-Etreby
- Specialized Medical hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Layla M Saleh
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Ayman El Baz
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Hasan Abdel-Ghaffar
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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23
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Yamada M, Fukuda A, Ogura M, Shimizu S, Uchida H, Yanagi Y, Ishikawa Y, Sakamoto S, Kasahara M, Imadome KI. Early Detection of Epstein-Barr Virus as a Risk Factor for Chronic High Epstein-Barr Viral Load Carriage at a Living-donor-dominant Pediatric Liver Transplantation Center. Transplantation 2023; 107:1322-1329. [PMID: 36476718 DOI: 10.1097/tp.0000000000004429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Epstein-Barr virus (EBV) infection and posttransplant lymphoproliferative disorders (PTLDs) after pediatric liver transplantation (LT) account for significant morbidity and mortality. Knowledge of EBV kinetics, epidemiology, and outcomes among pediatric living-donor LT cases is largely lacking. This study aims to provide clinical information related to EBV infection, chronic high EBV load (CHL) carriage, and PTLD at a living-donor-dominant pediatric LT center. METHODS A total of 5827 EBV load measurements from 394 LT recipients fulfilling inclusion criteria and their clinical data were analyzed. EBV loads >1000 copies/μg DNA (742 IU/μg DNA) were considered "high," and CHL was defined by persistence >6 mo. RESULTS The highlighted results were as follows: (1) 94% of recipients underwent living-donor LT; (2) 80% of EBV seronegative recipients developed first EBV infection <2 y post-LT, and their EBV loads were consistently higher than those of seropositive recipients within <3 y post-LT but did not differ thereafter; (3) 61 (15%) recipients met CHL criteria, but none developed PTLD; (4) age <5 y, cytomegalovirus seronegative donors, and early development of EBV DNAemia <6 mo post-LT were independent risk factors for CHL; (5) the incidence of rejections after 1-y post-LT was comparably low among CHL carriers whose immunosuppression was minimized. CONCLUSIONS Early detection of EBV following LT and CMV seronegative donors would facilitate risk stratification to prevent PTLD while titrating immunosuppression among pediatric LT recipients.
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Affiliation(s)
- Masaki Yamada
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
- Department of Medical Subspecialties, Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, University of Pittsburgh, School of Medicine and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Akinari Fukuda
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miyuki Ogura
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Seiichi Shimizu
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hajime Uchida
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yusuke Yanagi
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yuriko Ishikawa
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Seisuke Sakamoto
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mureo Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ken-Ichi Imadome
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
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24
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Tomomasa D, Yamashita M, Kamiya T, Morio T, Kanegane H. Maternal Gonosomal Mosaicism Causes XIAP Deficiency. J Clin Immunol 2023; 43:525-527. [PMID: 36441290 DOI: 10.1007/s10875-022-01414-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Dan Tomomasa
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motoi Yamashita
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Laboratory for Transcriptional Regulation, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Takahiro Kamiya
- Clinical Research Center, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hirokazu Kanegane
- Deparment of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
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25
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Carlsen ED, Davis AR, Cook JR, Swerdlow SH. The Distinctive Nature of Thyroid MALT Lymphomas Including IRTA1 Expression. Am J Surg Pathol 2023; 47:370-378. [PMID: 36729757 DOI: 10.1097/pas.0000000000002005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas often express IgM and IRTA1 with only a minority demonstrating plasmacytic differentiation. However, like primary cutaneous marginal zone lymphoproliferative disorders (PCMZLPD), thyroid MALT lymphomas (T-MALT-L) frequently show plasmacytic differentiation and IgG positivity. Whether T-MALT-L share other features with PCMZLPD, including frequent IgG4 positivity and infrequent IRTA1 expression, and how IRTA1 staining compares to that in Hashimoto thyroiditis (HT) are unknown. Therefore, the clinicopathologic features of 18 T-MALT-L were assessed, and their IRTA1 expression compared with that in 5 HT cases. All T-MALT-L cases included a B-lymphoid component. Plasmacytic differentiation was present in 15 cases and was extensive in 12. Fourteen cases were IgG+ including 2 IgG4+ (12 κ+, 2 κ-/λ-). One case was IgAλ+. Plasmacytic cells were uniformly CD19+/CD56- but CD138- in 7/15 cases. IRTA1+ cells were present in 16/16 cases, ranging from scattered cells to >50%. They were often concentrated in "MALT ball"-type lymphoepithelial lesions, perifollicular regions, and sometimes in germinal centers. IRTA1 positivity was also present in all HT cases, although it was never very extensive and often had a perifollicular distribution, occasionally with sparse aggregates and positive cells within rare thyroid follicles. Thus, T-MALT-L share some features with PCMZLPD but are more similar to noncutaneous MALT lymphomas, with prominent lymphoepithelial lesions, ubiquitous although variable IRTA1 positivity, and infrequent IgG4 positivity. Plasmacytic differentiation is also common although CD138 loss is frequent and light chain staining may be absent. IRTA1 staining may help in the differential diagnosis with HT, although there is some overlap in staining patterns.
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Affiliation(s)
- Eric D Carlsen
- Department of Pathology, Duke University Medical Center, Durham, NC
| | | | - James R Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Steven H Swerdlow
- Department of Pathology, UPMC
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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26
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Kobushi H, Umeda K, Hiejima E, Kato K, Sugimoto M, Kanegane H, Takita J. Alemtuzumab-based reduced-intensity conditioning for XIAP deficiency. Pediatr Int 2023; 65:e15576. [PMID: 37534620 DOI: 10.1111/ped.15576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Hirokazu Kobushi
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsutsugu Umeda
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eitaro Hiejima
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kentaro Kato
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mayumi Sugimoto
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Kyoto, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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27
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Huang WY, Zeng L, Liao SS, Zhang W, Liu FR, Li LX, Huang YH. [Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract with the whole wall involvement: report of a case]. Zhonghua Bing Li Xue Za Zhi 2022; 51:1051-1053. [PMID: 36207926 DOI: 10.3760/cma.j.cn112151-20220314-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- W Y Huang
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Zeng
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - S S Liao
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - W Zhang
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - F R Liu
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L X Li
- Department of Pathology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y H Huang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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28
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Miyazawa H, Wada T. Immune-mediated inflammatory diseases with chronic excess of serum interleukin-18. Front Immunol 2022; 13:930141. [PMID: 35958573 PMCID: PMC9358977 DOI: 10.3389/fimmu.2022.930141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022] Open
Abstract
Review: Interleukin-18 (IL-18) is a proinflammatory cytokine that promotes various innate immune processes related to infection, inflammation, and autoimmunity. Patients with systemic juvenile idiopathic arthritis and adult-onset Still’s disease exhibit chronic excess of serum IL-18, which is associated with a high incidence of macrophage activation syndrome (MAS), although the mechanisms of IL-18 regulation in such diseases remain largely unknown. Similar elevation of serum IL-18 and susceptibility to MAS/hemophagocytic lymphohistiocytosis (HLH) have been reported in monogenic diseases such as X-linked inhibitor of apoptosis deficiency (i.e., X-linked lymphoproliferative syndrome type 2) and NLRC4-associated autoinflammatory disease. Recent advances in molecular and cellular biology allow the identification of other genetic defects such as defects in CDC42, PSTPIP1, and WDR1 that result in high serum IL-18 levels and hyperinflammation. Among these diseases, chronic excess of serum IL-18 appears to be linked with severe hyperinflammation and/or predisposition to MAS/HLH. In this review, we focus on recent findings in inflammatory diseases associated with and probably attributable to chronic excess of serum IL-18 and describe the clinical and therapeutical relevance of understanding the pathology of this group of diseases.
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29
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Shameli A, Roshan TM. CD200 expression on Sezary cells: A valuable tool for flow cytometric assessment of peripheral blood T-cell neoplasms. Cytometry B Clin Cytom 2022; 102:303-311. [PMID: 35661398 DOI: 10.1002/cyto.b.22080] [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] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/01/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND CD200 (OX-2) is a valuable marker in the diagnosis of B-cell neoplasms and is commonly used in the screening panels for assessment of peripheral blood B-cell lymphoproliferative disorders. However, there is limited understanding about CD200 expression in T-cell neoplasms. A previous study has shown that CD200 is expressed on the neoplastic cells of angioimmunoblastic T-cell lymphoma (AITL) by immunohistochemistry, but no study has evaluated CD200 expression in T-cell neoplasms by flow cytometry. METHODS We assessed CD200 expression in peripheral blood T-cell lymphoproliferative disorders by retrospective analysis of our institutional flow cytometry screening database over a 6-year period. RESULTS In addition to AITL, we identified CD200 expression in a significant number of mycosis fungoides/Sezary syndrome cases (58%, 19 of 33 samples), while most other T-cell neoplasms were negative for CD200. These findings were confirmed by CD200 immunohistochemical staining of tissue specimens from our patient cohort. CONCLUSIONS CD200 is commonly expressed on circulating Sezary cells, a feature that can potentially improve the diagnostic value of flow cytometry for assessment of T-cell neoplasms.
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Affiliation(s)
- Afshin Shameli
- Division of Hematopathology, Alberta Precision Laboratories, South Zone and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tariq M Roshan
- Division of Hematopathology, Alberta Precision Laboratories, South Zone and Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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30
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Fang H, Khoury JD, Torres-Cabala CA, Ng SB, Xu J, El Hussein S, Hu S, Vega F, Li S, Tang Z, Tang G, Medeiros LJ, Wang W. Expression pattern and diagnostic utility of BCL11B in mature T- and NK-cell neoplasms. Pathology 2022; 54:893-899. [PMID: 35864006 DOI: 10.1016/j.pathol.2022.04.012] [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: 01/05/2022] [Revised: 04/15/2022] [Accepted: 04/29/2022] [Indexed: 11/18/2022]
Abstract
BCL11B is an essential transcription factor for T-cell lineage commitment and differentiation, and its dysregulation has been shown to be associated with T-cell tumourigenesis. In this study, we investigated BCL11B expression by immunohistochemical analysis in 120 cases of mature T-cell lymphoma, 34 B-cell lymphomas, 11 NK-cell neoplasms and 17 reactive cutaneous conditions. All cases of mycosis fungoides (n=23), primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (n=8) and T-prolymphocytic leukaemia (n=6) were positive for BCL11B and the staining intensity was higher than that of reactive T-cells. Fourteen of 15 (93%) cases of angioimmunoblastic T-cell lymphoma, 10 of 12 (83%) T-large granular lymphocytic leukaemia and 14 of 20 (70%) peripheral T-cell lymphoma, not otherwise specified, were also positive for BCL11B with an intensity comparable to reactive T-cells. Other T-cell neoplasms were uncommonly positive including one of three (33%) cases of primary cutaneous gamma delta T-cell lymphoma, one of four (25%) cases of subcutaneous panniculitis-like T-cell lymphoma, one of four (25%) cases of hepatosplenic T-cell lymphoma, and one of 20 (5%) cases of anaplastic large cell lymphoma (8 ALK-positive, 12 ALK-negative). T-cells in reactive cutaneous infiltrates were also positive for BCL11B, but staining intensity was much weaker than in mycosis fungoides. All NK-cell (n=11) and B-cell neoplasms (n=34) were negative for BCL11B. In conclusion, BCL11B shows a distinct expression pattern in various T-cell neoplasms. BCL11B appears to have utility as another T-cell marker and may be useful in the differential diagnosis of lymphoid neoplasms.
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Affiliation(s)
- Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siok Bian Ng
- Cancer Science Institute of Singapore, Singapore; Department of Pathology, National University of Singapore, Singapore
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- 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.
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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31
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Moshe Y, Ram R. Cardiac Disorders Associated with Cellular Therapy and Novel Agents for Acute Leukemia. Isr Med Assoc J 2022; 24:170-174. [PMID: 35347930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Several novel strategies have emerged in the last decade as potential therapies for patients with chemorefractory lymphoproliferative diseases and acute leukemia. While these treatments include exciting drugs that dramatically change the landscape of treatment, the organ-toxicity profile associated with these therapies may be significant. This article focuses on cardiac disorders associated with chimeric antigen receptor T-cell (CAR-T) therapy, as well as with novel regimens for acute leukemia.
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Affiliation(s)
- Yakir Moshe
- Bone Marrow Transplantation Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Ram
- Bone Marrow Transplantation Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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32
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Huo YJ, Zhang DD, Zhou L, Li CF, Wang GN, Zhao WG, Zhang YP, Jian XY, Huang HF, Li WC. [Clinicopathological characteristics of natural killer cell enteropathy: report of two cases and review of literature]. Zhonghua Bing Li Xue Za Zhi 2022; 51:108-113. [PMID: 35152628 DOI: 10.3760/cma.j.cn112151-20210703-00481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To study the clinicopathological and genetic features of natural killer (NK)-cell enteropathy for better understanding of this rare disease and prevention of its misdiagnosis. Methods: Two cases of NK-cell enteropathy were diagnosed in the First Affiliated Hospital of Zhengzhou University, China from October 2017 to February 2021. The clinical characteristics, morphology, immunohistochemistry, Epstein-Barr virus-encoded RNA (EBER) in situ hybridization and T cell receptor gene rearrangement were analyzed. The patients were followed up by a telephone interview. Results: The patients were both male, aged 40 and 28 years, respectively. Both patients were admitted to the hospital for an annual checkup without obvious gastrointestinal symptoms. The endoscopy showed that the gastric body of case 1 had a mucosal bulge, small area of congestion and erosion, while the rectum of case 2 had congestion and erosion. Microscopically, the lesions of the 2 cases were relatively limited. Many lymphoid cells infiltrated within the lamina propria of the mucosa and into the muscularis mucosa in case 2. In case 1, the glands were reduced in the lesion, and the glandular cavity was slightly compressed and deformed. There was no infiltration or destruction of the glands in either case. Lymphoid cells were atypical, with medium-to-large cell sizes. Their cytoplasm was medium-to-slightly abundant and appeared eosinophilic or translucent. In case 2, characteristic eosinophilic granules were seen in the cytoplasm of a few cells. The nuclei in both cases were round, oval and irregular, with fine chromatin, inconspicuous nucleoli, and no mitotic figures were noted. Necrosis was seen in case 1 while both cases had no central growth or destruction of blood vessels. Immunophenotyping showed that CD56, granzyme B and TIA-1 were positive in both cases, part of the cells was CD3-positive, and some cells were weakly CD4-positive in case 2. The CD5, CD8, CD30, ALK and B-lineage markers (CD20, CD79α) were all negative. The Ki-67 proliferation index was about 60% and 30%, respectively. Both cases were EBER negative. TCR gene rearrangement was polyclonal. Follow-up showed that none of the 2 patients had any special treatments and stayed well. Conclusions: NK-cell enteropathy is rare, with biological behaviors similar to benign tumors, and occasional recurrence. Its histology and immunophenotype are easily confused with NK/T cell-derived lymphomas. Combination of its unique endoscopic features, EBER negativity, polyclonal TCR gene rearrangement and good prognosis can confirm the diagnosis and avoid misdiagnosis and overtreatment.
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Affiliation(s)
- Y J Huo
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - D D Zhang
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - L Zhou
- Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C F Li
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - G N Wang
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W G Zhao
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y P Zhang
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - X Y Jian
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H F Huang
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W C Li
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Abstract
A 56-year-old woman with rheumatoid arthritis who had been taking methotrexate (MTX) for six years visited our hospital with dyspnea and dizziness. Abdominal ultrasonography revealed mild splenomegaly. Laboratory examinations showed a marked elevation in soluble interleukin-2 receptor and lactate dehydrogenase levels. These abnormalities revealed a spontaneous regression after MTX discontinuation, however, they worsened again four months later. Skin biopsies revealed a diagnosis of intravascular large B-cell lymphoma (IVLBCL), and we diagnosed MTX-associated IVLBCL (MTX-IVLBCL) based on its characteristic course. Despite the recurrence of IVLBCL, it showed a good response to chemotherapy. MTX-IVLBCL should therefore be treated with consideration since it has different characteristics from that of de novo IVLBCL.
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Affiliation(s)
| | - Hirosaka Inoue
- Department of Hematology, Imakiire General Hospital, Japan
| | - Kosuke Obama
- Department of Hematology, Imakiire General Hospital, Japan
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Skrypnyk RІ, Maslova GS, Skrypnyk IN. THE EFFECT OF S-ADEMETIONINE ON PLASMA CITRULLINE LEVEL DURING CHEMOTHERAPY-INDUCED OXIDATIVE STRESS IN PATIENTS WITH CHRONIC LYMPHOPROLIFERATIVE DISORDERS. Wiad Lek 2022; 75:1553-1557. [PMID: 35907233 DOI: 10.36740/wlek202206123] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: To investigate the effect of S-ademetionine on plasma citrulline level in patients with chronic lymphoproliferative disorders (CLPD) during chemotherapy-induced oxidative stress. PATIENTS AND METHODS Materials and methods: 25 patients with CLPD were examined. Examinations were conducted twice: before chemotherapy (CT) and after 3 courses of CT. Several biochemical markers in the blood were determined: the activity of catalase, the level of plasma citrulline, the concentration of N-acetylneuraminic acid (NANA) and the concentration of substances that form a trimethine complex (TBARS) with 2-thiobarbituric acid. Patients were divided into groups: І (n=14) - patients who underwent only CT; ІІ (n=16) - patients who during CT received S-ademetionine, at a dose of 1000 mg/day intravenously for 10 days, then 500 mg twice a day for 20 days. ІІІ (n=20) -the control group of 20 practically healthy individuals. RESULTS Results: Patients in both groups with CLPD had pre-existed mucosal injury that was characterized by 1.25 (p=0.0025) and 1.26 times (р=0.006) higher blood NANA concentration compared to the control group. The conduction of CT was associated with enterocytes dysfunction, which was characterized by 1,66 times (p=0,0002) lower plasma citrulline level in patients of group I compared to the initial examination. The infusion of S-ademetionine attenuated intestinal dysfunction that was associated with 1,23 times (p=0,0005) higher blood citrulline level after the CT as compared to group I. CONCLUSION Conclusions: The infusion of S-ademetionine as adjuvant treatment in patients with CLPD provided effective prophylaxis of intestinal injury that was associated with higher blood citrulline level after the conduction of CT.
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Imamura Y, Kawai H, Mizuno D, Suemori K, Miyauchi S, Iga N, Yoshida R, Uno F, Ishizaki M, Nishi H. [A Case of Malignant Thyroid Lymphoma That Was Difficult to Differentiate from Methotrexate-Associated Lymphoproliferative Disorders(MTX-LPD)]. Gan To Kagaku Ryoho 2021; 48:1837-1839. [PMID: 35046347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A female patient in her 60s was going to get treatment for rheumatoid arthritis(RA). Considering the possibility of using biologics, CT examination was performed for screening of malignant diseases. A mass shadow in the left lobe of the thyroid gland was detected. The patient was followed up, and ultrasonography did not reveal any malignant findings. She was treated with methotrexate(MTX), and 1 year later, the thyroid mass was enlarged on CT. Ultrasonography revealed an enlarged hypoechoic region. Fine needle aspiration cytology revealed malignant lymphoma. Excisional biopsy was performed to determine the treatment plan. The pathological diagnosis was follicular lymphoma, and the possibility of methotrexate- associated lymphoproliferative disorders(MTX-LPD)persisted. It was difficult to discontinue MTX because of the high activity of RA. She was treated with rituximab for malignant lymphoma and concurrently with MTX for RA. The thyroid tumor disappeared for 3 months. Four years later, there is no sign of tumor recurrence.
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Iizuka H, Harada S, Iwao N, Koike M, Noguchi M. Primary Skeletal Muscle Peripheral T-cell Lymphoma: An Autopsy Case Report and Review of the Literature. Intern Med 2021; 60:3309-3315. [PMID: 33967141 PMCID: PMC8580759 DOI: 10.2169/internalmedicine.7391-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022] Open
Abstract
Primary skeletal muscle lymphoma is extremely uncommon, and there have only been eight previous case reports on primary skeletal muscle peripheral T-cell lymphoma, not otherwise specified (PSM-PTCL, NOS). We herein report an autopsy case of a 71-year-old woman with PSM-PTCL, NOS, who had a 24-year history of systemic sclerosis treated with immunosuppressive drugs. A post-mortem examination revealed infiltration of lymphoma cells positive for T-cell markers, cytotoxic markers, and p53. This case was considered to be one of other iatrogenic immunodeficiency-associated lymphoproliferative disorder (OIIA-LPD). This is the first case categorized under both PSM-PTCL, NOS, and OIIA-LPD.
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Affiliation(s)
- Hiroko Iizuka
- Department of Hematology, Juntendo University Shizuoka Hospital, Japan
- Department of Hematology, Juntendo University Urayasu Hospital, Japan
| | - Sakiko Harada
- Department of Hematology, Juntendo University Shizuoka Hospital, Japan
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Noriaki Iwao
- Department of Hematology, Juntendo University Shizuoka Hospital, Japan
| | - Michiaki Koike
- Department of Hematology, Juntendo University Shizuoka Hospital, Japan
| | - Masaaki Noguchi
- Department of Hematology, Juntendo University Urayasu Hospital, Japan
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Quirós C, Fonseca A, Alonso-Álvarez S, Moro-García MA, Alonso-Arias R, Morais LR, Álvarez-Menendez FV, Colado E. Development of an algorithm for the identification of leukemic hematolymphoid neoplasms in Primary Care patients. Diagnosis (Berl) 2021; 8:239-247. [PMID: 32284442 DOI: 10.1515/dx-2020-0021] [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: 02/04/2020] [Accepted: 02/26/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Diagnosis of hematolymphoid neoplasm (HLN) requires different technologies which are performed on a patient basis instead of per protocol. We hypothesize that integration of hematimetric and cytological analysis along with multiparametric flow cytometry (MFC) provides a framework to evaluate peripheral blood (PB) samples from Primary Care. METHODS Samples from patients with persistent (>3 months) lymphocytosis (>5 × 109/L) and/or monocytosis (>109/L) or the presence of atypical and/or blast cells upon the smear review were analyzed by MFC concurrent to cytological analysis. MFC studies were carried out following standardized procedures. RESULTS In a 3-year period, smear review and MFC were performed simultaneously in 350 samples, demonstrating HLN in 194 cases (55.4%). In 156 cases, reactive cell populations were found. The combination of age, absolute lymphocyte count (ALC), hemoglobin and platelets provided the best correlation with MFC for the presence of a chronic lymphoproliferative disorder (CLPD) in lymphocytosis [area under the curve (AUC) 0.891, p < 0.05]. A model evaluating the probability of CLPD has been proposed and validated in an independent cohort. CONCLUSIONS A strategy to perform MFC studies following standardized procedures has proven to be useful to evaluate samples from patients in Primary Care centers for HLN diagnosis or reactive conditions, providing a sensitive and rapid clinical orientation and avoiding unnecessary consultations in routine clinical practice. The probability for the presence of CLPD in PB can be calculated and help guide decision-making regarding further testing.
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Affiliation(s)
- Covadonga Quirós
- Clinical Biochemistry Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ariana Fonseca
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Hematology and Haemotherapy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Sara Alonso-Álvarez
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Hematology and Haemotherapy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Rebeca Alonso-Arias
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Immunology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Lucía-Rita Morais
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Hematology and Haemotherapy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Francisco V Álvarez-Menendez
- Clinical Biochemistry Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Enrique Colado
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Hematology and Haemotherapy Department, Hospital Universitario Central de Asturias, Oviedo, Spain
- Laboratory Medicine Department, Hospital Universitario Central de Asturias, Avda. Roma s/n - 33011 Oviedo, Spain; Hematology and Haemotherapy Department, Hospital Universitario Central de Asturias, Avda. Roma s/n - 33011 Oviedo, Spain; and Hematology and Haemotherapy Department, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain, Phone: +34 985 10 80 00, Ext 37138
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Gao R, Zhang Y, Chen G, Bhekharee AK, Du Z, Chu S. Spontaneous regression of central nervous system posttransplant lymphoproliferative disease: A case report. Medicine (Baltimore) 2021; 100:e24713. [PMID: 33578612 PMCID: PMC10545224 DOI: 10.1097/md.0000000000024713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Primary central nervous system (CNS) posttransplant lymphoproliferative disease (PTLD) is a very rare entity. Patients may respond to reduction of immunosuppression or other therapies, but the prognosis is still pessimistic. PATIENT CONCERNS Herein, we report a 40-year-old female with a history of renal transplantation developed brain masses 4 years ago. Although brain biopsy was performed, PTLD was underdiagnosed then. No relevant treatment was administered. However, the lesions resolved spontaneously. After 4 years, new lesion appeared in a different brain region. DIAGNOSES The history of renal transplantation raised the suspicion of PTLD. Reexamination of previous brain sections confirmed the diagnosis of polymorphic PTLD (P-PTLD). A second biopsy of the new lesion also demonstrated P-PTLD. INTERVENTIONS She was referred to hematology department to receive rituximab. OUTCOMES After 4 rounds of treatment, the lesion resolved satisfactorily. LESSONS This case demonstrates the natural history of primary CNS P-PTLD. Although self-remission and recurrence is possible, aggressive measures should be taken to this condition.
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Affiliation(s)
- Rupan Gao
- Department of Hematology, Zhongshan Hospital
| | | | - Gong Chen
- Department of Neurosurgery, Huashan Hospital
| | | | - Zunguo Du
- Department of Pathology, Huashan Hospital, Fudan University
| | - Shuguang Chu
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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39
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Liu LY, Zeng YY, Qian XW, Wang WJ, Wang Y, Lin L, Sun JQ, Zhai XW, Wang XC. [Cerebral vasculitis in X-linked lymphoproliferative disease in a Chinese patient]. Zhonghua Er Ke Za Zhi 2021; 59:142-144. [PMID: 33548964 DOI: 10.3760/cma.j.cn112140-20200710-00715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- L Y Liu
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Y Y Zeng
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - X W Qian
- Department of Hematology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - W J Wang
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Y Wang
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - L Lin
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - J Q Sun
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - X W Zhai
- Department of Hematology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - X C Wang
- Department of Clinical Immunology, Children's Hospital of Fudan University, Shanghai 201102, China
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40
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Hart A, Ahn YS, Watson C, Skeans M, Barlev A, Thompson B, Dharnidharka VR. Cost burden of post-transplant lymphoproliferative disease following kidney transplants in Medicare-eligible patients by survival status. J Med Econ 2021; 24:620-627. [PMID: 33851571 DOI: 10.1080/13696998.2021.1915793] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS AND OBJECTIVES Patients diagnosed with post-transplant lymphoproliferative disease (PTLD) experience high mortality within the first 2 years of diagnosis; however, few data exist on the economic burden of PTLD in these patients. We determined the healthcare resource utilization (HRU) and cost burden of post-kidney transplant PTLD and evaluated how these differ by survival status. MATERIALS AND METHODS Utilizing data from the United States Renal Data System and the Scientific Registry of Transplant Recipients, we identified 83,818 Medicare-covered kidney transplant recipients between 2007 and 2016, of which 347 had at least one Medicare claim during the first year after diagnosis of PTLD. We tabulated Medicare Part A and Part B and calculated per patient-year (PPY) costs. RESULTS Patients diagnosed with PTLD in the first year post-transplant had Part A + B costs of $222,336 PPY, in contrast with $83,546 PPY in all kidney transplants. Post-transplant costs in the first year of PTLD diagnosis were similar regardless of the year of diagnosis. Cost burden for PTLD patients who died within 2 years of diagnosis was >3.3 times higher than PTLD patients still alive after 2 years. Of those who died within 2 years, the majority died within 6 months and costs were highest for these patients, with almost 7 times higher costs than PTLD patients who were still alive after 2 years. LIMITATIONS Medicare costs were the only costs examined in this study and may not be representative of other costs incurred, nor be generalizable to other insured populations. Patients were only Medicare eligible for 3 years after transplant unless aged ≥62 years, therefore any costs after this cut-off were not included. CONCLUSIONS PTLD represents a considerable HRU and cost burden following kidney transplant, and the burden is most pronounced in patients who die within 6 months.
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Affiliation(s)
- Allyson Hart
- Division of Nephrology, Hennepin Healthcare, Minneapolis, MN, USA
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Yoon Son Ahn
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | | | - Melissa Skeans
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Arie Barlev
- Atara Biotherapeutics, South San Francisco, CA, USA
| | - Bryn Thompson
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Vikas R Dharnidharka
- St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA
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Morimoto S, Shindo T, Iga Y, Morita M, Yurugi K, Masuda K, Hori T, Hishizawa M, Kondo T, Yamashita K, Haga H, Takaori-Kondo A. [Small B-cell neoplasm responding to ibrutinib after 17 years of cold agglutinin disease symptom]. Rinsho Ketsueki 2021; 62:1678-1683. [PMID: 35022336 DOI: 10.11406/rinketsu.62.1678] [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: 06/14/2023]
Abstract
In this study, we report a case of a 77-year-old woman who was presented with anemia in the winter of 2002. She was diagnosed with cold agglutinin disease (CAD) and treated with corticosteroids. Further, her hemoglobin levels were maintained between 7.0 g/dl and 8.0 g/dl. In May 2019, mature peripheral blood lymphocytes increased with exacerbation of hemolytic anemia. The lymphocytes were positive for CD19 and CD20, but negative for CD5, CD10, and CD23. Additionally, they were positive for cell surface IgM-κ. The B-cell neoplasm could not be further subclassified due to the lack of BCL2-IgH and BCL1-IgH rearrangement and morphology. The IgM-κ-type M-protein was found in serum, and the direct Coombs test was negative for IgG but positive for C3b/C3d. These findings suggested that small B-cell neoplasm-associated M-protein was involved in the development of CAD through complement activation. Based on the presence of TP53 deletion, the patient was treated with ibrutinib monotherapy. Although hemolysis rapidly improved with a dramatic decrease in lymphocytes, she died from a cerebral hemorrhage. It is assumed that ibrutinib improved CAD through suppression of small B-cell neoplasm-related M-protein. CAD can precede lymphoproliferative disorders; however, the risk of ibrutinib-associated hemorrhage should be noted.
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Affiliation(s)
| | | | - Yuhei Iga
- Department of Hematology, Kyoto University Hospital
| | - Mari Morita
- Department of Hematology, Kyoto University Hospital
| | - Kimiko Yurugi
- Department of Clinical Laboratory, Kyoto University Hospital
| | - Kenta Masuda
- Department of Clinical Laboratory, Kyoto University Hospital
| | - Toshiyuki Hori
- Department of Hematology, Kyoto University Hospital
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University
| | | | | | | | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital
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42
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Alzghoul BN, Li P, Zaki S, Patel DC. Bronchoalveolar lavage flow cytometry for the diagnosis of pulmonary post-transplant lymphoproliferative disorder. QJM 2020; 113:813-814. [PMID: 32277822 DOI: 10.1093/qjmed/hcaa124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- B N Alzghoul
- From the Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Room M452, PO Box 100225, Gainesville, FL 32610-0225, USA
| | - P Li
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, 1600 SW Archer Road, Room M452, PO Box 100225, Gainesville, FL 32610-0225, USA
| | - S Zaki
- Department of Internal Medicine, Florida State University, 600 W College Ave, Tallahassee, FL 32306, USA
| | - D C Patel
- From the Pulmonary, Critical Care and Sleep Medicine, University of Florida, 1600 SW Archer Road, Room M452, PO Box 100225, Gainesville, FL 32610-0225, USA
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43
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Wang Z, Gong Q, Zhao Y, Xu H, Hu S, Zhang Z. Indolent EBV-positive T-cell lymphoproliferative disorder arising in a chronic pericardial hematoma: the T-cell counterpart of fibrin-associated diffuse large B-cell lymphoma? Haematologica 2020; 105:e437-e439. [PMID: 32414846 PMCID: PMC7395287 DOI: 10.3324/haematol.2020.252007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Zhen Wang
- Department of Pathology, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qixing Gong
- Department of Pathology, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Youcai Zhao
- Department of Pathology, Nanjing First Hospital, Nanjing, China
| | - Hai Xu
- Department of Radiology, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shimin Hu
- Department of Hematopathology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zhihong Zhang
- Department of Pathology, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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44
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García-Romera Á, González-Díaz S, Ramos L. An acute episode of inflammatory bowel disease vs a rare manifestation of an Epstein-Barr virus-positive mucocutaneous ulcer. Case report. Rev Esp Enferm Dig 2020; 112:577-578. [PMID: 32579003 DOI: 10.17235/reed.2020.6737/2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Epstein-Barr virus-positive mucocutaneous ulcer is an entity that has been recently accepted in the literature, included under the lymphoproliferative disorders. Some publications provide information about a limited number of cases describing lesions that mainly involve the oropharynx and skin. However, its rapid onset in the colon, causing a perforation, has not been reported.
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Affiliation(s)
| | | | - Laura Ramos
- Aparato Digestivo, Hospital Universitario de Canarias
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45
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Ott G, Klapper W, Feller AC, Hansmann ML, Möller P, Stein H, Rosenwald A, Fend F. [Revised version of the 4th edition of the WHO classification of malignant lymphomas : What is new?]. Pathologe 2019; 40:157-168. [PMID: 30019203 DOI: 10.1007/s00292-018-0456-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
After 8 years, the WHO has now published the updated version of the 4th edition of the classification of hematopoietic and lymphoid tumors. This update provides a conceptual rewrite of existing entities as well as some new provisional entities and categories, particularly among the aggressive B‑cell lymphomas. Important new diagnostic categories include the high-grade B‑cell lymphomas, the large B‑cell lymphoma with IRF4 rearrangement, and the Burkitt-like lymphoma with 11q aberrations. Of particular importance, new concepts concerning the taxonomy and classification of early lymphoid lesions or precursor lesions are included, such as the in situ follicular neoplasia or the in situ mantle cell neoplasia. In addition, the concept of indolent lymphoproliferations, such as breast-implant-associated anaplastic large cell lymphoma and the indolent T‑cell lymphoproliferative disorder of the gastrointestinal tract, has been strengthened. Finally, diagnostic criteria for existing lymphoma entities have been refined.
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Affiliation(s)
- G Ott
- Abteilung für Klinische Pathologie, Robert-Bosch-Krankenhaus, und Dr. Margarete Fischer-Bosch-Institut für Klinische Pharmakologie, Auerbachstraße 110/112, 70376, Stuttgart, Deutschland.
| | - W Klapper
- Institut für Pathologie, Sektion Hämatopathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - A C Feller
- Hämatopathologie Lübeck, Lübeck, Deutschland
| | - M L Hansmann
- Senckenberg Institut für Pathologie, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - H Stein
- Pathodiagnostik Berlin, Berlin, Deutschland
| | - A Rosenwald
- Pathologisches Institut und Comprehensive Cancer Center Mainfranken, Universität Würzburg, Würzburg, Deutschland
| | - F Fend
- Institut für Pathologie und Neuropathologie, Eberhard-Karls-Universität, Tübingen, Deutschland
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Gui RR, Zu YL, Zhang Y, Han LJ, Zhao HF, Li Z, Yu FK, Wang J, Zhao JJ, Fu YW, Song YP, Zhou J. [Successful treatment of Epstein-Barr virus associated central nervous system diseases after allogeneic hematopoietic stem cell transplantation with intrathecal donor lymphocytes infusion: three cases report and literatures review]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:333-335. [PMID: 31104448 PMCID: PMC7343007 DOI: 10.3760/cma.j.issn.0253-2727.2019.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Indexed: 11/24/2022]
Affiliation(s)
- R R Gui
- Department of Hematology Affiliated Cancer Hospital Zhengzhou University, Henan Tumor Hospital, Institute of Hematology, Zhengzhou 450008, China
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Vollero L, Annibali O, Schena E, Tomarchio V, Cimino G, Cenfra N, Avvisati G. An integrated system for the monitoring of therapy and drug's side effects in Lymphoproliferative disorders. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:2672-2675. [PMID: 29060449 DOI: 10.1109/embc.2017.8037407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The wide diffusion of telecommunication systems and the availability of cheap computational devices, such as smart wearable, PDA and smartphones, is multiplying the number of collaborative and remote-monitored applications accessible to a large mass of people. In particular, this scenario makes it possible the implementation of specific systems that improve the control of patients with minimal impact on the quality of their lives. This paper moves in this context and presents a general system for the continuous monitoring at home of therapy and disease symptoms. Indeed, starting from a specific application aiming at monitoring patients with Lymphoproliferative disorders and the side effects related to specific drugs used in treatment of these diseases, in this paper we present a more general framework easy customizable to the requirements of different applications. In particular, the proposed system has been designed to be easily tuned to a larger class of disorders and, in our opinion, it can be applied in almost all the scenarios where patients require a strict monitoring of their conditions in their home environment. The paper presents the model, the architecture and the implementation of the system.
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Yang X, Nishida N, Zhao X, Kanegane H. Advances in Understanding the Pathogenesis of Epstein-Barr Virus-Associated Lymphoproliferative Disorders. Iran J Allergy Asthma Immunol 2015; 14:462-471. [PMID: 26742434] [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] [Accepted: 10/15/2015] [Indexed: 06/05/2023]
Abstract
Epstein-Barr virus (EBV) was discovered 50 years ago from an african Burkitt lymphoma cell line. EBV-associated lymphoproliferative disorders (LPDs) are life- threatening diseases, especially in children. In this article, we review EBV-associated LPDs, especially in the area of primary immunodeficiency disease (PID). We searched PubMed for publications with key words including EBV infection, lymphoma, LPDs and PID, and selected the manuscripts written in English that we judged to be relevant to the topic of this review.On the basis of the data in the literature, we grouped the EBV-associated LPDs into four categories: nonmalignant disease, malignant disease, acquired immunodeficiency disease and PID. Each category has its own risk factor for LPD development. EBV-associated LPD is a complex disease, creating new challenges for diagnosis and treatment.
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Affiliation(s)
- Xi Yang
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan AND Division of Immunology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Naonori Nishida
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Xiaodong Zhao
- Division of Immunology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hirokazu Kanegane
- Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan AND Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Current world literature. Lymphoid biology and diseases. Curr Opin Hematol 2013; 20:395-401. [PMID: 23885359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Zhou KS, Yu Z, Yi SH, Li ZJ, An G, Wang YY, Zou DH, Qi JY, Zhao YZ, Song YP, Qiu LG. [Expression of microRNA-223 and its clinical value in B lymphoproliferative disorders]. Zhonghua Yi Xue Za Zhi 2011; 91:2384-2387. [PMID: 22321781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To detect the expression of microRNA-223 and analyze its clinical value in B lymphoproliferative disorders. METHODS Peripheral blood samples (n = 78) and bone marrow samples (n = 9) were collected from patients with chronic lymphocytic leukemia (CLL, n = 53), mantle cell lymphoma (MCL, n = 13), splenic marginal zone lymphoma (SMZL, n = 9) and healthy donors (n = 12) at our hospital from 2003 to 2010. Mononuclear cells were isolated and B cells purified with a CD19(+) magnetic-bead system. Total RNA was extracted from purified CD19(+) cells and the expression of microRNA-223 measured by TaqMan microRNA quantitative polymerase chain reaction (PCR). The clinical data of these patients were collected and their outcomes analyzed with SPSS 16.0 software. RESULTS (1) The levels of microRNA-223 in CLL, MCL and SMZL were 4.58 ± 0.62, 4.03 ± 0.54 and 4.63 ± 0.57 respectively. And they were significantly lower than that in normal B cells (5.69 ± 0.60, P < 0.01). The expression of microRNA-223 decreased significantly in MCL versus CLL and SMZL (P < 0.05). There was no statistical difference between CLL and SMZL (P > 0.05). (2) The down-regulation of microRNA-223 was associated with disease aggressiveness in CLL. Patients with unmutated immunoglobulin heavy chain variable region (IgVH) expressed significantly a lower level of microRNA-223 (4.05 ± 0.69 vs 4.67 ± 0.51, P = 0.003). In 13q-negative patients, the expression of microRNA-223 decreased more significantly than that in 13q-positive patients (4.25 ± 0.67 vs 4.76 ± 0.45, P = 0.044). (3) Using receiver operating characteristic (ROC) curve analysis, the microRNA-223 cutoffs were defined according to the IgVH mutational status. The patients were divided into the positive and negative subgroups. The median progression-free survival (PFS) of microRNA-223 positive patient subgroup was 48 months. It was significantly longer than the negative subgroup (P = 0.001). In the microRNA-223 positive subgroup, no patient died at the end of follow-up. CONCLUSIONS MicroRNA-223 may play an important role in the pathogenesis of B lymphoproliferative disorders. The down-regulation of microRNA-223 is associated with disease aggressiveness and poor prognostic factors in CLL. It may become a new reliable prognostic predictor.
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Affiliation(s)
- Ke-Shu Zhou
- Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC,State Key Laboratory of Experimental Hematology, Tianjin 300020, China
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