1
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Fardella E, Zanirato G, Magni M, Caldarelli N, Chiappella A, Dodero A, Ljevar S, Orsucci L, Re A, Usai SV, Stefoni V, Castellino C, Rossi FG, Pinto A, Carniti C, Corradini P. Prognostic impact of pretreatment cell-free DNA concentration in newly diagnosed peripheral T-cell lymphomas. Br J Haematol 2024; 204:1752-1756. [PMID: 38176400 DOI: 10.1111/bjh.19280] [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: 10/03/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024]
Abstract
Peripheral T-cell lymphomas (PTCLs) have a poor prognosis and, to date, there are no reliable predictive biomarkers of response. In this work we explored the prognostic impact of cell-free DNA (cfDNA) concentration in 75 newly diagnosed patients enrolled in a prospective multicenter study. Pre-treatment cfDNA was strongly associated with clinical risk factors and was identified as a superior predictor for shorter progression-free survival in multivariable analysis, outweighing canonical risk parameters. Furthermore, we identified a cfDNA value above which survival worsens. In conclusion, pre-treatment cfDNA concentration represents an easily usable predictive biomarker that is highly associated with survival of PTCL patients.
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MESH Headings
- Humans
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/genetics
- Male
- Female
- Middle Aged
- Aged
- Cell-Free Nucleic Acids/blood
- Prognosis
- Adult
- Biomarkers, Tumor/blood
- Prospective Studies
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
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Affiliation(s)
| | - G Zanirato
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Magni
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - A Chiappella
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Dodero
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Ljevar
- Unit of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - L Orsucci
- Division of Hematology, Azienda Ospedaliera e Universitaria Città della Salute e della Scienza, Turin, Italy
| | - A Re
- Hematology Division, ASST Spedali Civili di Brescia, Brescia, Italy
| | - S V Usai
- Hematology Unit, Ospedale Oncologico Armando Businco, Cagliari, Italy
| | - V Stefoni
- Institute of Hematology Seràgnoli, University of Bologna, Bologna, Italy
| | - C Castellino
- Division of Hematology, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy
| | - F G Rossi
- Division of Hematology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Pinto
- Hematology-Oncology & Stem Cell Transplantation Unit, IRCCS Istituto Nazionale Tumori, Fondazione G. Pascale, Napoli, Italy
| | - C Carniti
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Corradini
- University of Milan, Milan, Italy
- Division of Hematology and Stem Cell Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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2
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Foss FM, Horwitz SM, Civallero M, Bellei M, Marcheselli L, Kim WS, Cabrera ME, Dlouhy I, Nagler A, Advani RH, Pesce EA, Ko YH, Montoto S, Chiattone C, Moskowitz A, Spina M, Cesaretti M, Biasoli I, Federico M. Incidence and outcomes of rare T cell lymphomas from the T Cell Project: hepatosplenic, enteropathy associated and peripheral gamma delta T cell lymphomas. Am J Hematol 2020; 95:151-155. [PMID: 31709579 DOI: 10.1002/ajh.25674] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 12/20/2022]
Abstract
The T Cell Project was the largest prospective trial to explore the incidence, treatment patterns, and outcomes for T cell lymphomas. The rare subtypes of T cell lymphomas, including hepatosplenic T cell lymphoma (HSTCL), enteropathy associated T cell lymphoma (EATL), and peripheral gamma delta T cell lymphomas (PGDTCLs) are poorly represented in most studies and there is little data regarding treatment patterns. We report results from 115 patients with hepatosplenic (n = 31), enteropathy associated (n = 65), and PGDTCLs (n = 19). While anthracycline regimens were most commonly used as first line therapy, response rates ranged from 20%-40% and were suboptimal for all groups. Autologous stem cell transplantation was performed as a consolidation in first remission in a small number of patients (33% of HSTCL, 7% of EATL, and 12% of PGDTCL), and four patients with HSTCL underwent allogeneic stem cell transplantation in first remission. The progression free survival at 3 years ranged from 28%-40% for these rare subtypes, and the overall survival at 3 years was most favorable for PGDTCL (70%). These data highlight the need for novel treatment approaches for rare subtypes of T cell lymphomas and for their inclusion in clinical trials.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Disease-Free Survival
- Enteropathy-Associated T-Cell Lymphoma/blood
- Enteropathy-Associated T-Cell Lymphoma/mortality
- Enteropathy-Associated T-Cell Lymphoma/therapy
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Incidence
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/therapy
- Male
- Middle Aged
- Neoplasm Proteins/blood
- Receptors, Antigen, T-Cell, gamma-delta/blood
- Survival Rate
- Transplantation, Autologous
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Affiliation(s)
| | - Steven M Horwitz
- Department Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Monica Civallero
- CHIMOMO Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Bellei
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Marcheselli
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Won Seog Kim
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | - Maria E Cabrera
- Sección Hematología, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Ivan Dlouhy
- Hematology Department, Hematologia, Hospital Clinic, Villarroel, Spain
| | - Arnon Nagler
- Department of Bone Marrow Transplantation, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Emanuela A Pesce
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Young-Hyeh Ko
- Department of Pathology, Sungkyunkwan University, Seoul, Korea
| | - Silvia Montoto
- Department of Haematology, Barts Health NHS Trust, London, UK
| | - Carlos Chiattone
- Departamento de Clínica Médica, FCM da Santa Casa de São Paulo, and Centro de Linfomas Núcleo de Oncologia Hospital Samaritano, São Paulo, Brazil
| | - Alison Moskowitz
- Department Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Michele Spina
- Medical Oncology A, Aviano National Cancer Institute, Aviano, Italy
| | - Marina Cesaretti
- Fondazione Italiana Linfomi (FIL) onlus, University of Modena and Reggio Emilia, Modena, Italy
| | - Irene Biasoli
- Department of Medicine, University Hospital and School of Medicine, Universida de Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Massimo Federico
- CHIMOMO Department University of Modena and Reggio Emilia, Modena, Italy
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3
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de Pádua Covas Lage LA, Hamasaki DT, Moreira FR, Rocha V, Zerbini MCN, Pereira J. Absolute monocyte count is a predictor of overall survival and progression-free survival in nodal peripheral T cell lymphoma. Ann Hematol 2019; 98:2097-2102. [PMID: 31243570 DOI: 10.1007/s00277-019-03731-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/04/2019] [Accepted: 06/10/2019] [Indexed: 11/25/2022]
Abstract
Nodal peripheral T cell lymphomas (nPTCL) present aggressive clinical course, and its heterogeneous nature and poor prognosis with current therapeutic strategies make it a target for the development of new prognostic markers. Thus, we investigated tumor-associated macrophages (TAM) according to the number of cells expressing CD68 in biopsies and the absolute monocyte count (AMC) in peripheral blood of 87 patients with nPTCL. The median overall survival (OS) was 3 years (95% CI 1.3-8.4 years) and estimate 5 years OS of 43.3% (95% CI 32.5-53.7%). The median progression-free survival (PFS) was 1.5 years (95% CI 0.8-2.6 years) with estimate 5 years PFS of 29.2% (95% CI 19.7-39.3%). The cutoff for AMC was 1.5 × 109/L and the median OS for patients with AMC ≥ 1.5 × 109/L was 0.83 years versus 3.7 years for those with AMC < 1.5 × 109/L (HR 2.32, 95% CI 1.03-5.22, p = 0.035). The median PFS for patients with AMC ≥ 1.5 × 109/L was 0.50 years versus 1.5 years for those with AMC < 1.5 × 109/L (HR 2.25, 95% CI 1.05-4.78, p = 0.031). CD68 was evaluated in 26/87 (29.8%) patients with a median expression of 34% and positivity cutoff of 43%. CD68 expression was not associated with OS or PFS either with AMC values. Our findings suggest that the AMC of ≥ 1.5 × 109/L at diagnosis in peripheral blood is associated with poor prognosis in nPTCL. Further investigations in a larger cohort are required to better validate our results.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD/blood
- Antigens, Differentiation, Myelomonocytic/blood
- Disease-Free Survival
- Female
- Humans
- Leukocyte Count
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Monocytes/metabolism
- Monocytes/pathology
- Neoplasm Proteins/blood
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- Luís Alberto de Pádua Covas Lage
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Débora Toshie Hamasaki
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Frederico Rafael Moreira
- Statistical of Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Vanderson Rocha
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
- Fundação Pró-Sangue, São Paulo, SP, Brazil
- Churchill Hospital, Oxford University, Oxford, UK
| | | | - Juliana Pereira
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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4
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Choi M, Lee JO, Jung J, Lee JY, Lee E, Lee H, Bang SM, Eom HS, Lee JS. Prognostic Value of Platelet Count in Patients with Peripheral T Cell Lymphoma. Acta Haematol 2019; 141:176-186. [PMID: 30814469 DOI: 10.1159/000495337] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 11/08/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Peripheral T cell lymphoma (PTCL) is a heterogeneous entity with poor survival. We evaluated the neutrophil-to-lymphocyte ratio (NLR), absolute lymphocyte count (ALC), and platelet count as new prognostic factors for PTCL. PATIENTS AND METHODS We retrospectively analyzed 77 patients with PTCL initially treated with anthracycline-based chemotherapy. Survival curves were compared between groups with different initial NLR (iNLR), end-point NLR (eNLR), initial ALC, and platelet counts. Cox regression was used to analyze the risk factor for survival. RESULTS Patients with a higher eNLR (≥3), lymphopenia (< 1,000/μL), and thrombocytopenia (< 150 K/μL) had an inferior progression-free survival (PFS) and overall survival (OS) compared to their counterparts, while a higher iNLR (≥3) was predictive of a shorter OS but not PFS. Among these, thrombocytopenia was an independent poor prognostic factor for both PFS and OS, with a hazard ratio of 2.42 (p = 0.012) for PFS and 4.21 (p = 0.006) for OS. The presence of thrombocytopenia further stratified patients with a worse prognosis within overlapping risk-groups by the prognostic index for PTCL. CONCLUSIONS Our study showed that thrombocytopenia at diagnosis was an independent prognostic factor for survival in patients with PTCL.
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Affiliation(s)
- Mihong Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Ok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea,
| | - Jongheon Jung
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Ji Yun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eunyoung Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Hyewon Lee
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Soo-Mee Bang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Seok Eom
- Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Jong Seok Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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5
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Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is a major subtype of peripheral T-cell lymphoma (PTCL). Due to its low incidence, the characteristics of AITL are still not well understood. The prognostic evaluation of this disease has not been established.We retrospectively analyzed 52 patients with newly diagnosed AITL in China between January 2008 and September 2016.Among these patients, the median age at diagnosis was 62 (40-83) and 58% (30/52) of the patients were older than 60 years. Thirty-five patients were male, accounting for 67.3% of the whole. Among these, 90% (47/52) of the diagnoses were estimated at advanced stage. A total of 25 (48%) patients were scored >1 by the ECOG performance status. Systemic B symptoms were described in 34 (65%) patients. When evaluated by International Prognostic Index (IPI), 81% were scored >2, and 77% got >1 score according to the prognostic index for PTCL (PIT) upon diagnosis. The 3-year progression-free survival (PFS) was 44% and the 3-year overall survival (OS) rate was 52%. IPI and PIT scores could not be effectively applied to stratify those AITL patients into subgroups. Our multivariate analysis results found that the elevated serum C-reactive protein (CRP) level was an independent adverse factor to the OS of the AITL patients.Patients with AITL had a poor outcome. The serum level of CRP may be applied as an independent prognostic factor for AITL.
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Affiliation(s)
- Ying Li
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Chunmei Yang
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Liping Mao
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Jinghan Wang
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Chenying Li
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Wenbin Qian
- Department of Hematology, the First Affiliated Hospital of Zhejiang University
- Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
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6
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Sekiguchi Y, Shirane S, Shimada A, Ichikawa K, Wakabayashi M, Sugimoto K, Tomita S, Izumi H, Nakamura N, Sawada T, Ohta Y, Komatsu N, Noguchi M. Peripheral T cell lymphoma, not otherwise specified with myelofibrosis: report of a case with review of the literature. Int J Clin Exp Pathol 2015; 8:4186-4203. [PMID: 26097612 PMCID: PMC4466999] [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] [Received: 02/06/2015] [Accepted: 03/30/2015] [Indexed: 06/04/2023]
Abstract
A 68-year-old man presented to us with pancytopenia, erythroderma, and multiple lymphadenopathies. Lymph node biopsy led to the diagnosis of peripheral T-Cell lymphoma-not otherwise specified (PTCL-NOS). Immunostaining of the lymph node biopsy specimens for cytokines revealed that the tumor cells were positive for plated-derived growth factor (PDGF), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), tumor necrosis factor α (TNF-α), interferon-γ (IFN-γ), interleukin-1β (IL-1β), interleukin-2 (IL-2), and transforming growth factor-β (TGF-β). Bone marrow biopsy revealed infiltration by the PTCL-NOS and myelofibrosis (MF). Bone marrow blood was negative for JAK-2V617F. Bone marrow immunostaining for cytokines showed that the tumor cells were positive for PDGF, b-FGF, VEGF, TNF-α, IFN-γ, IL-1β, IL-2, and TGF-β. The patient was initiated on treatment, and after the first course of CHOP therapy, the bone marrow infiltration by the PTCL-NOS and MF improved. Repeat immunostaining of bone marrow biopsy specimens for cytokines showed that the tumor cells had become negative for PDGF, VEGF, TNF-α and TGF-β. However, after the second course of CHOP therapy, the bone marrow infiltration by the PTCL-NOS and MF worsened. Immunostaining of bone marrow specimens for cytokines again revealed positive staining results of the tumor cells for PDGF, TNF-α, and TGF-β. At the completion of the first course of treatment, the infiltration by the PTCL-NOS improved, but not the pancytopenia.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Biopsy
- Bone Marrow/drug effects
- Bone Marrow/immunology
- Bone Marrow/pathology
- Bone Marrow Examination
- Cyclophosphamide/therapeutic use
- Cytokines/blood
- Doxorubicin/therapeutic use
- Humans
- Immunohistochemistry
- Lymph Nodes/drug effects
- Lymph Nodes/immunology
- Lymph Nodes/pathology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/immunology
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Prednisolone/therapeutic use
- Primary Myelofibrosis/blood
- Primary Myelofibrosis/drug therapy
- Primary Myelofibrosis/immunology
- Primary Myelofibrosis/pathology
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
- Vincristine/therapeutic use
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Affiliation(s)
| | | | - Asami Shimada
- Department of Hematology, Juntendo University Urayasu HospitalJapan
| | | | | | - Keiji Sugimoto
- Department of Hematology, Juntendo University Urayasu HospitalJapan
| | - Shigeki Tomita
- Department of Pathology, Juntendo University Urayasu HospitalJapan
| | - Hiroshi Izumi
- Department of Pathology, Juntendo University Urayasu HospitalJapan
| | - Noriko Nakamura
- Department of Clinical Laboratory, Juntendo University Urayasu HospitalJapan
| | - Tomohiro Sawada
- Department of Clinical Laboratory, Juntendo University Urayasu HospitalJapan
| | - Yasunori Ohta
- Department of Pathology, Research Hospital, Institute of Medical Science, University of TokyoJapan
| | - Norio Komatsu
- Department of Hematology, Juntendo University HospitalJapan
| | - Masaaki Noguchi
- Department of Hematology, Juntendo University Urayasu HospitalJapan
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7
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Mitrovic Z, Perry AM, Suzumiya J, Armitage JO, Au WY, Coiffier B, Holte H, Jaffe ES, Monserrat E, Rajan SK, Savage KJ, Tobinai K, Vose JM, Weisenburger DD. The prognostic significance of lymphopenia in peripheral T-cell and natural killer/T-cell lymphomas: a study of 826 cases from the International Peripheral T-cell Lymphoma Project. Am J Hematol 2012; 87:790-4. [PMID: 22488678 DOI: 10.1002/ajh.23205] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 03/09/2012] [Indexed: 12/25/2022]
Abstract
Lymphopenia is a marker of inferior survival in patients with various malignancies. However, the prognostic significance of lymphopenia in peripheral T-cell lymphoma (PTCL) is unclear. We analyzed the prognostic significance of lymphopenia in 826 patients with different types of PTCL and natural killer/T-cell lymphoma (NKTCL) from the International Peripheral T-cell Lymphoma Project. Lymphopenia was defined as an absolute lymphocyte count of less than 1,000 cells per microliter. The overall frequency of lymphopenia was 35.3%, ranging from 21.1% in ALK(+) anaplastic large cell lymphoma (ALCL) to 47.5% in angioimmunoblastic T-cell lymphoma (AITL). Lymphopenia was independently associated with an inferior overall survival (OS) in patients with the lymphoma type of adult T-cell leukemia/lymphoma (ATLL), with a 2-year OS of 15% versus 40% for those without lymphopenia (P < 0.001). Lymphopenia was also an adverse predictor of survival in PTCL, not otherwise specified, but was associated with other unfavorable prognostic factors. A trend toward inferior survival for lymphopenic patients was also observed in AITL, ALK(-) ALCL and extranasal NKTCL lymphoma, whereas no difference in survival was found in nasal NKTCL, ALK(+) ALCL, or enteropathy-associated T-cell lymphoma. In this study, lymphopenia was identified as a new adverse prognostic factor in the lymphoma type of ATLL.
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Affiliation(s)
- Zdravko Mitrovic
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, 68198-3135, USA
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8
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Ahsanuddin AN, Brynes RK, Li S. Peripheral blood polyclonal plasmacytosis mimicking plasma cell leukemia in patients with angioimmunoblastic T-cell lymphoma: report of 3 cases and review of the literature. Int J Clin Exp Pathol 2011; 4:416-420. [PMID: 21577327 PMCID: PMC3093066] [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] [Received: 03/21/2011] [Accepted: 04/12/2011] [Indexed: 05/30/2023]
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is a unique type of peripheral T-cell lymphoma. Patients with AITL may have occasional reactive plasma cells present in the peripheral circulation. Prominent peripheral blood polyclonal plasmacytosis mimicking plasma cell leukemia, however, is distinctly uncommon. Here we describe 3 such cases from two large tertiary medical centers and discuss the role of ancillary studies in the differential diagnosis of peripheral blood plasmacytosis.
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MESH Headings
- Adult
- Aged
- Blood Cell Count
- Diagnosis, Differential
- Erythrocyte Aggregation
- Female
- Flow Cytometry
- Humans
- Immunoblastic Lymphadenopathy/blood
- Immunoblastic Lymphadenopathy/immunology
- Immunoblastic Lymphadenopathy/pathology
- Immunophenotyping/methods
- Leukemia, Plasma Cell/blood
- Leukemia, Plasma Cell/immunology
- Leukemia, Plasma Cell/pathology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/immunology
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Plasma Cells/immunology
- Plasma Cells/pathology
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Affiliation(s)
- Arshad N Ahsanuddin
- Department of Pathology and Laboratory Medicine, Emory University School of MedicineAtlanta, GA
| | - Russell K Brynes
- Department of Pathology, Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA
| | - Shiyong Li
- Department of Pathology and Laboratory Medicine, Emory University School of MedicineAtlanta, GA
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9
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Abstract
IgG4-related disease is a recently recognized fibroinflammatory disorder characterized by extensive IgG4-positive plasma cell and lymphocyte infiltration of various organs. The pancreatic manifestation of IgG4-related disease is called autoimmune pancreatitis (AIP), in which autoimmune mechanisms are likely involved. On the other hand, some autoimmune and chronic inflammatory disorders, such as Sjögren's syndrome and rheumatoid arthritis, are associated with increased risks of non-Hodgkin lymphoma (NHL). There have been a few reports of cases with IgG4-related disease that had subsequently developed NHL, however, all of them suffered from B-cell lymphoma. We describe the first case of NHL, compatible with a subtype of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), which arose in IgG4-related sclerosing cholangitis. As patients with IgG4-related disease may be at an increased risk of developing NHL, such presentation during the follow-up of IgG4-related disease should be carefully scrutinized to exclude NHL.
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Affiliation(s)
- Goki Kanda
- Department of Internal Medicine, Social Insurance Chuo General Hospital, Japan
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10
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Yi S, An G, Qi J, Zou D, Zhao Y, Zhang P, Chen H, Wang J, Qiu L. The significance of bone marrow involvement in aggressive lymphomas: A retrospective comparison of clinical outcomes between peripheral T cell lymphoma and diffuse large B cell lymphoma in China. Acta Haematol 2010; 124:239-44. [PMID: 21099213 DOI: 10.1159/000321544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 09/21/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Peripheral T cell lymphomas (PTCL) have been demonstrated to have a poorer prognosis than diffuse large B cell lymphoma (DLBCL) due to a high frequency of bone marrow involvement (BMI). However, the clinical characteristics of PTCL with BMI have not been fully described, and the clinical outcomes of PTCL with BMI and DLBCL with BMI have not been well compared. METHODS The clinical characteristics and survival of 25 nodal PTCL cases with BMI and 42 DLBCL cases with BMI were compared. RESULTS Most of the PTCL patients with BMI had lymphadenopathy (88%), B symptoms (76%), an elevated LDH level (68%), anemia (64%), splenomegaly (60%), and a poor performance status (52%). Except for the differences of lymphadenopathy and thrombocytopenia between PTCL with BMI and DLBCL with BMI, similarities in gender, age, hepatomegaly, splenomegaly, a bulky mass, B symptoms, elevated LDH, ≥2 extranodal sites, ECOG scores ≥2, anemia, and international prognostic index (IPI) and age-adjusted IPI scores were observed between the 2 groups. The 2 groups also had similar 3-year overall survival (25.8 vs. 30.0%, p = 0.846) and progressive-free survival (21.3 vs. 25.2%, p = 0.815) rates. CONCLUSIONS PTCL with BMI have a similar aggressive course and poor survival compared to DLBCL with BMI. Thus, the immunophenotype of either T or B lineage may not be a crucial prognostic indicator of survival for these 2 aggressive lymphomas.
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MESH Headings
- Aged
- Body Mass Index
- Bone Marrow/pathology
- Female
- Hemoglobins/metabolism
- Humans
- L-Lactate Dehydrogenase/blood
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/therapy
- Male
- Middle Aged
- Prognosis
- Retrospective Studies
- Survival Rate
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Shuhua Yi
- Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
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11
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Qin Y, Shi YK, He XH, Yang JL, Zhang CG, Zhou SY, Liu XF, Liu P, Yang S, Zhou LQ, Han XH, Yao JR. [Clinical features and prognostic factors of angioimmunoblastic T cell lymphoma]. Zhonghua Zhong Liu Za Zhi 2010; 32:448-451. [PMID: 20819488] [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: 05/29/2023]
Abstract
OBJECTIVE To retrospectively analyze the clinical features and prognostic factors of patients with angioimmunoblastic T-cell lymphoma (AITL). METHODS The clinicopathological and follow-up data of 18 AITL patients undergoing integrated treatment from Feb. 1998 to April 2009 in our department were retrospectively analyzed. All of the patients received CHOP-like regimens as initial chemotherapy, including 4 once treated with radiotherapy and 1 with high dose therapy followed by autologous stem cell transplantation (HDT-ASCT) as upfront consolidation therapy. B-cell, T-cell and NK-cell subgroup proportions in the peripheral blood were tested by flow cytometry in 6 patients. RESULTS The median age of the 18 patients was 55 years, male and female ratio was 2.6:1. Seventy-two percent of the patients were in an advanced stage. 72% of them had B symptoms, 69% hypergammaglobulinemia, 60% elevated LDH and 47% anemia. Forty-four percent achieved CR after initial treatment with CHOP-like regimens. With the median follow-up of 26 months, the overall 2-year survival and disease free survival (DFS) rates were 62.2% and 44.4%, respectively. In the univariate analysis, only age > 30 years and primary refractory disease adversely affected overall survival (OS); age > 30 years, advanced stage, B symptoms and splenomegaly adversely affected DFS. Four patients suffered from severe pneumonia during treatment, 2 of them died of respiratory failure. Flow cytometry of peripheral blood lymphocytes showed that 5 of the 6 tested cases had decreasing proportion of CD3(+)CD4(+) T cells, B cells and NK cells but elevated CD3(+)CD8(+) T cells. Two heavily treated patients achieved partial and complete response by thalidomide therapy, with a progression free survival (PFS) of 2 and 6+ months, respectively. CONCLUSION AITL patients do not response well to CHOP-like regimens chemotherapy. Age < 30 years and sensitive to initial chemotherapy are associated with prolonged OS. Effectiveness of thalidomide in the treatment of AITL deserves further investigation. Peripheral blood lymphocytes test indicates that AITL patients suffered from both natural and acquired immune defects.
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Affiliation(s)
- Yan Qin
- Department of Medical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijng 100021, China
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12
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Shirai T, Takahashi R, Tajima Y, Kohata K, Yamamoto J, Fujii H, Takasawa N, Ishizawa K, Ichinohasama R, Ishii T, Harigae H. Peripheral T cell lymphoma with a high titer of proteinase-3-antineutrophil cytoplasmic antibodies that resembled Wegener's granulomatosis. Intern Med 2009; 48:2041-5. [PMID: 19952489 DOI: 10.2169/internalmedicine.48.2600] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Here, we present a 54-year-old man with proptosis and swelling below the left eyelid. Laboratory findings showed high levels of PR3-ANCA and histological examination of the first biopsy revealed acute inflammation. Together with the findings of MRI, a diagnosis of WG was made. However, the disease progressed rapidly and histological examination of the second biopsy revealed infiltration of neoplastic T lymphocytes with aberrant loss of CD7. A final diagnosis of peripheral T cell lymphoma, not otherwise specified (WHO) was made, and complete remission was achieved by chemotherapy. This is a very rare case of T cell lymphoma with a high titer of PR3-ANCA.
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Affiliation(s)
- Tsuyoshi Shirai
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai
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13
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Suwiwat S, Pradutkanchana J, Ishida T, Mitarnun W. Quantitative analysis of cell-free Epstein-Barr virus DNA in the plasma of patients with peripheral T-cell and NK-cell lymphomas and peripheral T-cell proliferative diseases. J Clin Virol 2007; 40:277-83. [PMID: 17996493 DOI: 10.1016/j.jcv.2007.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [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: 12/11/2006] [Revised: 08/21/2007] [Accepted: 08/21/2007] [Indexed: 11/18/2022]
Abstract
BACKGROUND The level of circulating EBV DNA is a prognostic marker in patients with some EBV-associated malignant diseases. OBJECTIVES To investigate the presence and nature of Epstein-Barr virus (EBV) DNA in the plasma and to evaluate the correlation of plasma concentrations of EBV DNA with the EBV genomic status in peripheral blood T-cells and neoplastic cells and with the clinical outcome of patients with peripheral T-cell and NK-cell lymphomas (PTCL) and peripheral T-cell proliferative diseases (PTPD). STUDY DESIGN EBV DNA in the plasma of 45 patients and 45 controls was measured using real-time PCR. The presence of the EBV genome in the isolated peripheral blood lymphocytes (CD3+ and CD3- cells) was analysed by PCR. Detection of EBV-encoded early RNA (EBER) in corresponding tumor tissues was carried out using in situ hybridization. DNase I digestion was applied to plasma samples to detect naked EBV DNA. RESULTS Cell-free EBV DNA was detected in 32/38 (84%) of PTCL patients and 5/7 (71%) of PTPD patients, but not in the controls. Patients with EBV genome in peripheral blood CD3+ cells and EBV genome (EBER) in the tumor cells, compared to those without these findings, had significantly higher plasma EBV DNA levels. The majority of circulating EBV DNA molecules was naked form. The plasma EBV DNA levels were not related to survival. CONCLUSIONS The concentration of EBV DNA in the plasma was not a prognostic marker in PTCL and PTPD patients.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- CD3 Complex/immunology
- Case-Control Studies
- Child
- Child, Preschool
- DNA, Viral/blood
- Female
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Humans
- In Situ Hybridization/methods
- Killer Cells, Natural/pathology
- Lymphocyte Activation
- Lymphoma, Extranodal NK-T-Cell/blood
- Lymphoma, Extranodal NK-T-Cell/immunology
- Lymphoma, Extranodal NK-T-Cell/pathology
- Lymphoma, Extranodal NK-T-Cell/virology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/immunology
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/virology
- Male
- Middle Aged
- Polymerase Chain Reaction/methods
- T-Lymphocytes/pathology
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Affiliation(s)
- Supaporn Suwiwat
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla 90110, Thailand
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14
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Sekine R, Ohno N, Uchimura K, Oyaizu N, Tojo A. [Severe systemic edema correlated with serum VEGF titer in a patient with angioimmunoblastic T-cell lymphoma]. Rinsho Ketsueki 2007; 48:1498-1502. [PMID: 18080509] [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: 05/25/2023]
Abstract
A 73-year-old woman was admitted with generalized lymphadenopathy, marked protrusion of the abdomen, severe systemic edema, oliguria, and dyspnea. Histological examination of a cervical lymph node specimen showed a typical structure of angioimmunoblastic T-cell lymphoma. CT scan revealed whole paraaortic lymphadenopathy, marked edematous lesions in the subcutaneous tissues and mesenterium, but small amounts of pleural effusion and ascites. This patient achieved complete remission after 5 courses of chemotherapy, a first course of CHOP followed by 4 courses of hyper CVAD plus high-dose MTX/AraC regimen alternatively. Her body weight was 58 kg on the day of admission and decreased to 41kg after 5 courses of chemotherapy, accompanied with symptomatic improvement. We checked the kinetics of serum Vascular endothelial growth factor (VEGF) concentrations during the 5 courses of chemotherapy. Pretreatment serum level of VEGF was high and declined gradually within the normal range. The serum VEGF value was positively correlated with body weight (r = 0.95). Immunohistochemical study of the biopsy specimen revealed that endothelia of the venules and some dendritic cells were positive for VEGF. We speculated that significant edematous changes in this patient were associated with VEGF, which is known as a vascular permeability factor based on its ability to induce vascular leakage.
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Affiliation(s)
- Rieko Sekine
- Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo
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15
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Fujisawa T, Suda T, Matsuura S, Enomoto N, Takeshita K, Ohnishi K, Chida K. Peripheral T-cell lymphoma with diffuse pulmonary infiltration and an increase in serum KL-6 level. Respirology 2007; 12:452-4. [PMID: 17539855 DOI: 10.1111/j.1440-1843.2007.01057.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Peripheral T-cell lymphoma is a subtype of non-Hodgkin's lymphoma. A case of peripheral T-cell lymphoma showing diffuse pulmonary involvement together with a marked increase in the level of serum KL-6 is presented. CXR and CT revealed reticular and ground-glass opacities, which mimicked interstitial pneumonia. Immunopathological findings and an analysis of T-cell receptor gene rearrangements of the lung biopsy specimen led to a definite diagnosis of peripheral T-cell lymphoma. In addition, the extensive proliferation of type II pneumocytes, which stained strongly positive for anti-KL-6 antibody suggested that the pneumocytes were the source of serum KL-6.
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MESH Headings
- Antigens, Neoplasm/blood
- Diagnosis, Differential
- Humans
- Lung/pathology
- Lung Diseases, Interstitial/diagnosis
- Lung Neoplasms/blood
- Lung Neoplasms/diagnosis
- Lung Neoplasms/pathology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Mucin-1
- Mucins/blood
- Neoplasm Invasiveness/pathology
- Receptors, Antigen, T-Cell/genetics
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Affiliation(s)
- Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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16
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Daly RM, Healy CM, Toner ME, Flint SR. Spontaneous regression of non-Hodgkin's lymphoma in the oral cavity after incisional biopsy. Br J Oral Maxillofac Surg 2007; 46:223-225. [PMID: 17478018 DOI: 10.1016/j.bjoms.2007.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2007] [Indexed: 10/23/2022]
Abstract
We report a case of gingival T cell non-Hodgkin's lymphoma that responded initially to chemotherapy, recurred at another site a year later, but regressed spontaneously after incisional biopsy. We are not aware of any other reports about spontaneous regression of T cell lymphomas in the oral cavity.
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Affiliation(s)
- R-M Daly
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - C M Healy
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College Dublin, Dublin 2, Ireland.
| | - M E Toner
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College Dublin, Dublin 2, Ireland
| | - S R Flint
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College Dublin, Dublin 2, Ireland
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17
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Okabe S, Miyazawa K, Iguchi T, Sumi M, Takaku T, Ito Y, Kimura Y, Serizawa H, Mukai K, Ohyashiki K. Peripheral T-cell lymphoma together with myelofibrosis with elevated plasma transforming growth factor-beta1. Leuk Lymphoma 2005; 46:599-602. [PMID: 16019489 DOI: 10.1080/10428190400029809] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 10/25/2022]
Abstract
Myelofibrosis is usually observed in myeloproliferative disorders, such as chronic myeloid leukemia. However, there are only a few reports showing an association between T-cell lymphoma and myelofibrosis. We report a case of peripheral T-cell lymphoma, unspecified (diffuse large cell) type, involving the bone marrow that was associated with severe myelofibrosis. In the present case, the plasma concentration of transforming growth factor-beta1 (TGF-beta1) was increased to 8.95 ng/ml (normal range: 1.56-3.24 ng/ml). No lymphadenopathy or skin lesions were observed during the entire clinical course. Although the mechanism of secondary myelofibrosis is still unclear, elevated plasma TGF-beta1 might be involved in the pathogenesis of bone marrow fibrosis in the present case.
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Affiliation(s)
- Seiichi Okabe
- First Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
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18
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Mori A, Takao S, Pradutkanchana J, Kietthubthew S, Mitarnun W, Ishida T. High tumor necrosis factor-alpha levels in the patients with Epstein-Barr virus-associated peripheral T-cell proliferative disease/lymphoma. Leuk Res 2003; 27:493-8. [PMID: 12648508 DOI: 10.1016/s0145-2126(02)00266-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have attempted to find out any relationships between circulating tumor necrosis factor (TNF)-alpha levels and Epstein-Barr virus (EBV) associated peripheral T-cell and NK-cell proliferative disease/lymphoma (PTPD/L) status. The distribution of TNF-alpha level was significantly higher (P<0.05) in patients than in controls. Patients carrying EBV genome in their peripheral T-cells showed higher TNF-alpha levels than the patients with EBV negative peripheral T-cells (P<0.001). Among patients whose peripheral T-cells were positive for EBV genome, TNF-alpha levels between the wild type LMP-1 gene carriers and the 30-bp deletion type LMP-1 gene carriers were compared and the wild type LMP-1 gene carrier group showed significantly higher TNF-alpha levels (P<0.01). As for the outcome of the patients and TNF-alpha levels, significant differences were observed between dead and alive with disease group (P<0.001), and dead and alive with complete remission group (P<0.01). Since circulating TNF-alpha levels in PTPD/L patients correlate with the disease and EBV infection status, it may be possible that monitoring of the TNF-alpha levels will be a useful prognostic marker.
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MESH Headings
- Case-Control Studies
- DNA, Viral/genetics
- DNA, Viral/metabolism
- Enzyme-Linked Immunosorbent Assay
- Epstein-Barr Virus Infections/blood
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/pathology
- Herpesvirus 4, Human/pathogenicity
- Humans
- Killer Cells, Natural/virology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/etiology
- Lymphoma, T-Cell, Peripheral/pathology
- Polymerase Chain Reaction
- Prognosis
- Remission Induction
- T-Lymphocytes/virology
- Thailand
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/metabolism
- Up-Regulation
- Viral Matrix Proteins/genetics
- Viral Matrix Proteins/metabolism
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Affiliation(s)
- Atsumi Mori
- Department of Biological Sciences, School of Science, University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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19
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Abe Y, Ohshima K, Shiratsuchi M, Honda K, Nishimura J, Nawata H, Muta K. Cytotoxic T-cell lymphoma presenting as secondary myelofibrosis with high levels of PDGF and TGF-β. Eur J Haematol 2001; 66:210-2. [PMID: 11350491 DOI: 10.1034/j.1600-0609.2001.00302.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Immunophenotyping
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/therapy
- Neoplasm Proteins/blood
- Pancytopenia/etiology
- Platelet-Derived Growth Factor/analysis
- Prednisolone/administration & dosage
- Primary Myelofibrosis/etiology
- Remission Induction
- T-Lymphocytes, Cytotoxic/pathology
- Transforming Growth Factor beta/blood
- Transplantation, Homologous
- Vincristine/administration & dosage
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20
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Piekarz RL, Robey R, Sandor V, Bakke S, Wilson WH, Dahmoush L, Kingma DM, Turner ML, Altemus R, Bates SE. Inhibitor of histone deacetylation, depsipeptide (FR901228), in the treatment of peripheral and cutaneous T-cell lymphoma: a case report. Blood 2001; 98:2865-8. [PMID: 11675364 DOI: 10.1182/blood.v98.9.2865] [Citation(s) in RCA: 359] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Depsipeptide, FR901228, has demonstrated potent in vitro and in vivo cytotoxic activity against murine and human tumor cell lines. In the laboratory, it has been shown to be a histone deacetylase (HDAC) inhibitor. In a phase I trial of depsipeptide conducted at the National Cancer Institute, 3 patients with cutaneous T-cell lymphoma had a partial response, and 1 patient with peripheral T-cell lymphoma, unspecified, had a complete response. Sézary cells isolated from patients after treatment had increased histone acetylation. These results suggest that inhibition of HDAC is a novel and potentially effective therapy for patients with T-cell lymphoma.
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MESH Headings
- Acetylation/drug effects
- Aged
- Anti-Bacterial Agents/administration & dosage
- Anti-Bacterial Agents/pharmacology
- Antibiotics, Antineoplastic/administration & dosage
- Antibiotics, Antineoplastic/pharmacology
- Depsipeptides
- Enzyme Inhibitors/pharmacology
- Histone Deacetylase Inhibitors
- Histones/blood
- Histones/metabolism
- Humans
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Peptides, Cyclic
- Remission Induction
- Skin Neoplasms/blood
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- Treatment Outcome
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Affiliation(s)
- R L Piekarz
- Medicine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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21
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Ciaudo M, Chauvenet L, Audouin J, Rossert J, Favier R, Horellou MH, Bernadou A, Samama M. Peripheral-T-cell lymphoma with hemophagocytic histiocytosis localised to the bone marrow associated with inappropriate secretion of antidiuretic hormone. Leuk Lymphoma 1995; 19:511-4. [PMID: 8590855 DOI: 10.3109/10428199509112213] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [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: 01/31/2023]
Abstract
A patient with high fever, loss of weight and profound pancytopenia is reported. Peripheral T-cell lymphoma with hemophagocytosis was diagnosed. Bone marrow was the only localisation of the lymphoma. At presentation there were (i) a coagulopathy consistent with hemophagocytic histiocytosis (ii) the features of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). These different abnormalities disappeared after chemotherapy and reappeared during each of the 2 periods of disease progression. The patient died 6 months after diagnosis without ever achieving complete remission. As far as we are aware this is the first case report of T-cell lymphoma with hemophagocytic syndrome localised to the bone marrow and associated with SIADH.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bleomycin/administration & dosage
- Bone Marrow Diseases/pathology
- Cisplatin/administration & dosage
- Cyclophosphamide/administration & dosage
- Cytarabine/administration & dosage
- Dexamethasone/administration & dosage
- Disease Progression
- Doxorubicin/administration & dosage
- Fatal Outcome
- Female
- Histiocytosis, Non-Langerhans-Cell/etiology
- Histiocytosis, Non-Langerhans-Cell/pathology
- Humans
- Ifosfamide/administration & dosage
- Inappropriate ADH Syndrome/etiology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/pathology
- Methotrexate/administration & dosage
- Mitoguazone/administration & dosage
- Prednisone/administration & dosage
- Teniposide/administration & dosage
- Verapamil/administration & dosage
- Vincristine/administration & dosage
- Vindesine/administration & dosage
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Affiliation(s)
- M Ciaudo
- Laboratoire Central d'Hématologie, Hôpital Hôtel-Dieu, Paris, France
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22
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Nishimura T, Nagumo F, Ueda H, Tajima Y, Sano M, Shimamoto Y, Tadano J. [Peripheral T-cell lymphoma with abundant ATL-like cells in the blood]. Rinsho Ketsueki 1995; 36:487-92. [PMID: 7783355] [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: 01/27/2023]
Abstract
A 69-year-old woman was admitted to our hospital because of leucocytosis and systemic lymphadenopathy. On admission, white blood cell count was 163,000/microliters, most of which consisted of flower-like cells with convoluted nuclei in the peripheral blood. In the abnormal lymphocyte cells surface-marker test by flow cytometry showed that they expressed CD2, CD3, CD4, CD29, CD45RA, and CD38, but not CD8, CD16, and CD25. Serum anti-Human T-lymphotropic virus type-I (HTLV-I) antibody was negative in particle agglutination, enzyme-linked immunosorbent assay (ELISA) and western-blotting assay. HTLV-I proviral DNA in the abnormal lymphocyte cells was not detected by southern blotting hybridization technique. Moreover, HTLV-I provirus was not detected using a polymerase-chain-reaction (PCR). A monoclonal rearrangement of the TCR-beta chain gene was evident by using DNA probe in southern blot hybridization. Because of the rapid progress of the disease, chemotherapy was started immediately after admission. Though, this patient became refractory, and she died about 1 year after admission.
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Affiliation(s)
- T Nishimura
- Department of Laboratory Medicine, Saga Medical School
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23
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Chang CS, Wang CH, Su IJ, Chen YC, Shen MC. Hematophagic histiocytosis: a clinicopathologic analysis of 23 cases with special reference to the association with peripheral T-cell lymphoma. J Formos Med Assoc 1994; 93:421-8. [PMID: 7920083] [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: 01/27/2023]
Abstract
The clinicopathologic features of 23 patients with hematophagic histiocytosis (HH) are described. All of them exhibited increased histiocytes associated with hemophagocytosis in the marrow. The patients usually presented with fever, hepatosplenomegaly, lymphadenopathy, and cytopenia. The underlying illnesses were heterogeneous, including non-Hodgkin's lymphoma in 17, systemic lupus erythematosus in one, diabetes mellitus in one, acute myelomonocytic leukemia in one, myelodysplastic syndrome in one, and unknown cause in two. Among 17 non-Hodgkin's lymphoma, 14 were peripheral T-cell lymphoma, two were B-cell lymphoma, and one was an undefined phenotype. Among 14 patients with peripheral T-cell lymphoma, six of the patients had nasal T-cell lymphoma. Five of these 14 patients initially diagnosed as malignant histiocytosis turned out to be T-lineage lymphoma after immunophenotypic studies. Active infections, most of viral origin, were documented in eight patients, including Epstein-Barr virus in three, cytomegalovirus in three, herpes simplex virus in three, Pseudomonas aeruginosa in one, Bacteroides vulgatus in one, and mycoplasma in one. Some of them had mixed virus and bacteria infection. Sixteen (70%) of our patients died of their acute illness within 10 weeks of the diagnosis of HH. In the past, the clinical and histologic differentiation between hematophagic histiocytosis and true histiocytic neoplasm (histiocytic medullary reticulosis/malignant histiocytosis) has proved difficult, but now these can be distinguished with immunohistologic, immunogenetic, and cytogenetic studies, especially in the cases of peripheral T-cell lymphoma with hemophagocytic syndrome.
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MESH Headings
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Diagnosis, Differential
- Female
- Histiocytosis, Non-Langerhans-Cell/blood
- Histiocytosis, Non-Langerhans-Cell/complications
- Histiocytosis, Non-Langerhans-Cell/pathology
- Histiocytosis, Non-Langerhans-Cell/therapy
- Humans
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/therapy
- Male
- Middle Aged
- Retrospective Studies
- Taiwan
- Treatment Outcome
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Affiliation(s)
- C S Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C
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24
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Abstract
BACKGROUND Cytokines, interleukin (IL)-4, IL-6, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), soluble CD23 (sCD23), and soluble IL-2 receptors (sIL-2R) are mediators of inflammation and immune response. Alterations in immune status of patients with various cancers may result in release of cytokines in circulation. The authors measured the circulating levels of IL-4, IL-6, IFN-gamma, TNF-alpha, sCD23, and sIL-2R from patients with T-cell chronic lymphocytic leukemia (T-CLL), T-cell acute lymphoblastic leukemia (T-ALL) and peripheral T-cell lymphoma (PTCL) to determine their importance in these T-cell disorders. METHODS IL-4, IL-6, IFN-gamma, TNF-alpha, sCD23, and sIL-2R levels were measured from the serum samples by enzyme-linked immunosorbent assay or bioassay methods. RESULTS IL-4 levels were higher only in T-CLL, whereas, IFN-gamma and sIL-2R levels were higher in T-CLL and T-ALL. However, IL-6, TNF-alpha, and sCD23 levels were higher in PTCL. CONCLUSIONS T-cell-derived IL-4 and IFN-gamma in T-CLL may act as an autocrine growth factor for proliferation of neoplastic T-cells. The sIL-2R levels in T-CLL, T-ALL, and PTCL are an indication of the degree of T-cell or immune activation due to concomitant immunologic processes in these disorders. However, IL-6, TNF-alpha, and sCD23 levels may contribute to inflammatory response and provide evidence of monocyte/macrophage, T-cell, or B-cell aberrations in PTCL.
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MESH Headings
- Adolescent
- Aged
- CD3 Complex/blood
- CD4 Antigens/blood
- CD8 Antigens/blood
- Child
- Cytokines/blood
- Female
- Humans
- Interferon-gamma/blood
- Interleukin-4/blood
- Interleukin-6/blood
- Leukemia-Lymphoma, Adult T-Cell/blood
- Lymphoma, T-Cell, Peripheral/blood
- Male
- Middle Aged
- Receptors, Antigen, T-Cell, alpha-beta/analysis
- Receptors, Antigen, T-Cell, gamma-delta/analysis
- Receptors, Cytokine/analysis
- Receptors, IgE/analysis
- Receptors, Interleukin-2/analysis
- Tumor Necrosis Factor-alpha/analysis
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Affiliation(s)
- S Raziuddin
- Department of Clinical Immunology, King Saud University, College of Medicine, Abha, Saudi Arabia
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25
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Shimoyama M, Oyama A, Tajima K, Tobinai K, Minato K, Takenaka T, Konda C, Takeyama K, Kohno A, Narabayashi M. Differences in clinicopathological characteristics and major prognostic factors between B-lymphoma and peripheral T-lymphoma excluding adult T-cell leukemia/lymphoma. Leuk Lymphoma 1993; 10:335-42. [PMID: 8220132 DOI: 10.3109/10428199309148557] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A total of 541 consecutive patients treated between 1975 and 1985, 449 with B-lymphoma and 92 with peripheral T-lymphoma, excluding adult T-cell leukemia/lymphoma (ATL), termed peripheral non-ATL T-lymphoma, were analysed. Clinicopathological features that were predominantly associated with B-lymphoma were low and intermediate grades (defined by the Working Formulation), diffuse large cell type, stage II disease, bulky disease, favourable extranodal sites that are defined as a group of primary tumors such as the eye, Waldeyer's ring, thyroid, and stomach, while other features predominantly associated with peripheral non-ATL T-lymphoma were high grade pathology, diffuse mixed-cell and immunoblastic type, systemic "B" symptoms, poor performance status (PS), generalized lymphadenopathy, involvement of organs such as liver, skin, and nose, leucocytosis, and a high levels of serum alkaline phosphatase. The survival curve for B-lymphoma was better (P < 0.01) than that for peripheral non-ATL T-lymphoma. Multivariate analysis revealed that the major prognostic factors were pathology, stage, and primary site for B-lymphoma, while stage, PS, and total protein levels were important for peripheral non-ATL T-lymphoma. These results indicate that B- and peripheral non-ATL T-lymphomas appear to have different biological characteristics.
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MESH Headings
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/blood
- Combined Modality Therapy
- Female
- Humans
- Immunophenotyping
- Japan/epidemiology
- Life Tables
- Lymphoma, B-Cell/blood
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/therapy
- Male
- Middle Aged
- Neoplasm Proteins/blood
- Neoplasm Staging
- Prognosis
- Proportional Hazards Models
- Survival Analysis
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Affiliation(s)
- M Shimoyama
- Department of Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
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26
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Abstract
BACKGROUND The autologous mixed lymphocyte reaction (AMLR) is an important immunoregulatory phenomenon in human immune disorders. The authors have determined the phenotype and assessed the response of malignant lymph node T-cells, from histologically and immunologically proven cases of peripheral T-cell lymphoma, in AMLR and allogeneic mixed lymphocyte reaction (MLR) and studied the secretion of lymphokines. METHODS The proliferative response, tritiated 3H-thymidine incorporation assay, was used to determine the AMLR and allogeneic MLR of the responding T-cells. An interleukin-2 (IL-2)-dependent T-cell line (CTLL) was used for the production of IL-2 by phytohemagglutinin-stimulated T-cells in a cytotoxic assay. B-cell growth and differentiation factor activity of T-cells was studied by enzyme-linked immunosorbent assay. RESULTS The AMLR of malignant lymph node T-cells was increased characteristically in 12 of the 14 lymphoma cases studied; however, that of the blood T-cells was decreased. The allogeneic MLR of the malignant lymph node T-cells and blood-purified T-cells of the eight cases investigated was decreased. Expression or deficiency of CD2 and CD3 antigens on malignant T-cells did not show any difference in the AMLR assay. CONCLUSIONS This study demonstrates an important tendency of malignant T-cells from patients with peripheral T-cell lymphoma to proliferate in AMLR. The highly augmented AMLR but deficient allogeneic MLR observed in these malignant T-cells indicate that autologous recognitive events may play an important role in the immunopathogenesis of this human disease.
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Affiliation(s)
- A Sheikha
- Department of Clinical and Laboratory Hematology, King Saud University Medical College, Abha, Saudi Arabia
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27
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Zelickson BD, Peters MS, Muller SA, Thibodeau SN, Lust JA, Quam LM, Pittelkow MR. T-cell receptor gene rearrangement analysis: cutaneous T cell lymphoma, peripheral T cell lymphoma, and premalignant and benign cutaneous lymphoproliferative disorders. J Am Acad Dermatol 1991; 25:787-96. [PMID: 1839392 DOI: 10.1016/s0190-9622(08)80970-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.2] [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: 12/29/2022]
Abstract
T-cell receptor gene rearrangement analysis is a useful technique to detect clonality and determine lineage of lymphoid neoplasms. We examined 103 patients with mycosis fungoides, Sézary syndrome, peripheral T cell lymphoma, potentially malignant lymphoproliferative disorders including pre-Sézary syndrome, large plaque parapsoriasis, lymphomatoid papulosis and follicular mucinosis, and various benign inflammatory infiltrates. A clonal rearrangement was detected in skin samples in 20 of 24 patients with mycosis fungoides and in peripheral blood samples in 19 of 21 patients with Sézary syndrome. A clonal population was also detected in seven of eight cases classified as peripheral T cell lymphoma. The potentially malignant dermatoses tended to have clonal rearrangement, with the exception of large plaque parapsoriasis, and further follow-up is needed to correlate clonality with the disease course. These studies demonstrate the value of molecular genetics as an adjunct to morphology in the examination of patients with cutaneous lymphoproliferative disease.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Cloning, Molecular
- DNA/analysis
- Female
- Gene Rearrangement, T-Lymphocyte/genetics
- Humans
- Immunophenotyping
- Lymph Nodes/pathology
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoproliferative Disorders/blood
- Lymphoproliferative Disorders/genetics
- Lymphoproliferative Disorders/pathology
- Male
- Middle Aged
- Mucinosis, Follicular/blood
- Mucinosis, Follicular/genetics
- Mucinosis, Follicular/pathology
- Mycosis Fungoides/blood
- Mycosis Fungoides/genetics
- Mycosis Fungoides/pathology
- Parapsoriasis/blood
- Parapsoriasis/genetics
- Parapsoriasis/pathology
- Precancerous Conditions/blood
- Precancerous Conditions/genetics
- Precancerous Conditions/pathology
- Sezary Syndrome/blood
- Sezary Syndrome/genetics
- Sezary Syndrome/pathology
- Skin/pathology
- Skin Diseases/blood
- Skin Diseases/genetics
- Skin Diseases/pathology
- Skin Neoplasms/blood
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
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Affiliation(s)
- B D Zelickson
- Department of Dermatology, Mayo Clinic, Rochester, MN 55905
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28
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Valemzuela PL, Montalban C, Matorras R, Nieto A, Gonzales A, Perera S. Pregnancy and relapse of peripheral T cell lymphoma. A case report. Gynecol Obstet Invest 1991; 32:59-61. [PMID: 1765321 DOI: 10.1159/000292994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 12/28/2022]
Abstract
A patient was admitted to our hospital, in the 34th week of her pregnancy, who presented a non-Hodgkin lymphoma. The delivery was induced in the 38th week and the newborn baby had no other anomalies than a single umbilical artery and a slight dilation of the cerebral ventricles which receded spontaneously. Peculiar characteristics, not previously described, were a peripheral T cell lymphoma with relapse after 5 years since its remission with chemotherapy.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Cyclophosphamide/administration & dosage
- Daunorubicin/administration & dosage
- Ethinyl Estradiol/administration & dosage
- Ethinyl Estradiol/therapeutic use
- Female
- Humans
- Lymphocyte Subsets/chemistry
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/pathology
- Neoplasm Recurrence, Local
- Prednisone/administration & dosage
- Pregnancy
- Pregnancy Complications, Neoplastic/blood
- Pregnancy Complications, Neoplastic/drug therapy
- Pregnancy Complications, Neoplastic/pathology
- Tonsillar Neoplasms/blood
- Tonsillar Neoplasms/drug therapy
- Tonsillar Neoplasms/pathology
- Vincristine/administration & dosage
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Affiliation(s)
- P L Valemzuela
- Department of Obstetrics and Gynecology, University Hospital, Madrid, Spain
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