Cutaneous lymphomas other than mycosis fungoides: follow-up study of 52 patients.

1991 ◽  
Vol 9 (11) ◽  
pp. 1994-2001 ◽  
Author(s):  
P Joly ◽  
F Charlotte ◽  
M Leibowitch ◽  
C Haioun ◽  
J Wechsler ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Mycosis Fungoides ◽  
Stage Iv ◽  
Disease Stage ◽  
Cell Phenotype ◽  
Low Grade ◽  
Cutaneous Lymphomas ◽  
Radiotherapy Alone

Cutaneous lymphomas other than mycosis fungoides (MF) represent a rare and heterogeneous group of lymphomas. Their clinical behavior remains largely unknown. In this study, the clinical and immunohistologic characteristics and follow-up data of 52 well-documented cases of cutaneous lymphomas other than MF, presenting with initial cutaneous lesions, were reviewed. Twenty-seven patients presented with skin disease alone (stage IE), and 25 patients had concurrent cutaneous and extracutaneous disease (stage IV). The tumors were grouped into high-grade lymphomas (HGLs; 21%), intermediate-grade lymphomas (IGLs; 58%), and low-grade lymphomas (LGLs; 21%). A B-cell phenotype was most often expressed by cutaneous lymphomas (73%), particularly by stage IE lymphomas (85%). Among 13 cases of T-cell lymphomas, loss of one of the pan-T-cell antigens was detected in all cases but one. The clinical course of cutaneous lymphoma was closely dependent on stage and histologic subtype but not on T-cell or B-cell phenotype. Of 20 patients with stage IV HGL or IGL, 13 were treated by polychemotherapy with curative potential. Their median survival was 37 months. Fourteen patients with stage IE HGL or IGL were treated by radiotherapy alone. Nine patients (69%) relapsed within 2 years posttreatment. Seven of them relapsed in the skin outside the initial site involved, suggesting that radiotherapy alone is not an adequate treatment for these patients. Preliminary results concerning seven other patients with stage IE IGL or HGL treated by an initial third-generation polychemotherapy regimen are presented.

scholarly journals The immunologic and clinicopathologic heterogeneity of cutaneous lymphomas other than mycosis fungoides

Blood ◽  
1983 ◽  
Vol 62 (2) ◽  
pp. 464-472 ◽  
Author(s):  
GS Wood ◽  
JS Burke ◽  
S Horning ◽  
RS Doggett ◽  
R Levy ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Mycosis Fungoides ◽  
Survival Data ◽  
Large Cell ◽  
Cell Phenotype ◽  
Time Interval ◽  
Histologic Subtype ◽  
Interval Therapy ◽  
Cutaneous Lymphomas

Abstract Twenty-one cases of non-Hodgkin's lymphoma with cutaneous involvement, other than mycosis fungoides, were evaluated immunologically, histologically, and clinically. Ten patients presented with skin disease alone, seven with concurrent cutaneous and extracutaneous disease, and four with extracutaneous disease only. Twenty of the 21 cases were nonepidermotropic tumors and were equally likely to express B or T phenotypes. None of the cases expressed a true histiocytic phenotype. Almost all cases expressed la and class 1 HLA determinants. Immunophenotypes were stable regardless of time interval, therapy, or body site sampled in seven of eight patients studied serially. In contrast to mycosis fungoides, the T lymphomas exhibited noncerebriform cytology, tumor la expression, lack of mature helper T-cell phenotype, nonepidermotropic histology, a tendency for marrow involvement, and presented as nodules rather than patches or plaques. Since each T lymphoma expressed an abnormal but uniform T-cell phenotype other than mature cytotoxic/suppressor or helper, the neoplastic population could be distinguished from reactive T cells. Reactive elements averaged one- third of the cellular infiltrates and were mainly T cells and macrophages. Langerhans cells were generally normal in number and distribution. Several histopathologic subtypes were identified with diffuse large cell lymphomas, including immunoblastic lymphomas, comprising 71% of cases (15/21). Prediction of the immunophenotype based on cytologic criteria was correct in 67% of cases (14/21). All errors occurred among the 13 high-grade lymphomas. Survival data were consistent with those of prior studies that have indicated that clinical course is dependent on stage and histologic subtype. Non- Hodgkin's cutaneous lymphomas constitute an immunologically, histologically, and clinically heterogeneous group of neoplasms.

scholarly journals Mycosis Fungoides: Case Report and Literature Review

2014 ◽  
Vol 7 ◽  
pp. CCRep.S15724 ◽  
Author(s):  
Akinsegun A. Akinbami ◽  
Bodunrin I. Osikomaiya ◽  
Sarah O. John-Olabode ◽  
Adewumi A. Adediran ◽  
Olajumoke Osinaike ◽  
...  
Keyword(s):  
Case Report ◽  
T Cell ◽  
Literature Review ◽  
B Cell ◽  
Mycosis Fungoides ◽  
Cell Lymphoma ◽  
Cutaneous T Cell Lymphoma ◽  
Cutaneous Lymphomas ◽  
Nigerian Woman ◽  
Topical Glucocorticoids

Mycosis fungoides (MF), also known as Alibert-Bazin syndrome or granuloma fungoides, is the most common form of cutaneous T-cell lymphoma. Cutaneous lymphomas are an uncommon, heterogeneous group of non-Hodgkin lymphomas (NHLs) of T- and B-cell origin where the skin is the primary organ of involvement. This is a case of a 60-year-old Nigerian woman, who was diagnosed and managed as a case of chronic dermatitis but further investigations confirmed a diagnosis of MF; she was thereafter managed with topical glucocorticoids/chemotherapy and improved on these treatments. We make a plea for better awareness of the disease among physicians and pathologists in Africa.

Other Tumours in Primary Cutaneous Lymphomas.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4417-4417
Author(s):  
Serena Rupoli ◽  
G. Goteri ◽  
P. Picardi ◽  
S. Pulini ◽  
A. Tassetti ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Skin Carcinoma ◽  
B Cell Lymphomas ◽  
T Cell Lymphomas ◽  
Cutaneous Lymphomas ◽  
Other Neoplasms

Abstract Patients with primary cutaneous lymphomas (PCLs) are treated with multiple therapeutic regimens, which may increase the risk of subsequent solid and haematological neoplasms. The aim of our study was to assess the incidence of other malignancies in our series of PCLs. From March 1994 to January 2007, 272 patients with PCLs (179 M, 93 F, median age 65 yr, range 14–88) were referred to our center for staging, treatment and follow-up. The clinical charts were reviewed to detect the incidence of malignancies occurred before or after the diagnosis of PCL or concomitantly. The series was composed by 228 patients (150 M, 78 F, median age 66 yrs) with T-cell lymphomas (202 Mycosis Fungoides/MF, 10 Sézary Syndrome/SS, 9 CD30+ PCL, 7 non MF/non CD30+ T cell PCL); 43 patients (28 M, 15 F, median age 60 yrs) with B-cell lymphomas (25 Follicular/FL, 14 marginal/MZL, 3 Leg-type, 1 Lymphoblastic) and one patient with CD4+/CD56+ hematodermic neoplasm. Chemotherapy was administered to 48 patients. During follow-up 12 patients died for the disease and 24 for other causes. A second tumor was observed in 41 patients (15%): 6 of them experienced more than one neoplasms: overall we observed 48 malignancies, 38 solid and 10 haematological. The other neoplasms appeared similarly before (20) and after (21) the diagnosis of PCL; in 7 cases they were diagnosed simultaneously. Solid tumours (17 preceding, 4 concurrent, 17 subsequent) were diagnosed in: skin (11), colon (5), lung (4), breast (3), CNS (3), bladder (2), liver (2), kidney (2), uterus (2), testis (1), prostate (1), stomach (1), thyroid (1). The haematological malignancies (3 preceding, 3 concurrent, 4 subsequent) were: B-cell lymphomas (4), acute myeloid leukemias (3), plasmocytoma (1), T-cell lymphoma (1), Hodgkin’s lymphoma (1). Among the six patients with more than one adjunctive neoplasms one patient had lung and kidney carcinoma preceding PCL; two patients a preceding carcinoma (skin and bladder, respectively) and subsequently a lung carcinoma; other two patients showed both a preceding and a concurrent neoplasm (skin and colon carcinoma, B-cell lymphoma and skin carcinoma, respectively). Finally a patient had a preceding skin carcinoma, a concurrent nodal Hodgkin’s lymphoma and a subsequent nodal B-cell lymphoma. So we have reported 48 other neoplasms in 41 patients within 272 PCLs (15%). The occurrence of the other malignancy was not related to the B/T phenotype of PCLs, as it was observed in 35/228 (15.4%) T-cell lymphomas (32 MF, 2 SS, 1 non MF/non CD30+ T cell lymphoma) and in 6/43 (14%) B-cell lymphomas (3 FL, 3 MZL; χ2 test: P=0.88). The interval of occurrence was longer for tumors preceding (median 60 mo.s, range 8–180) than for tumors following PCL (median 45, range 6–122). The administration of chemotherapy for PCL was not associated with an increased incidence of second neoplasm(χ2 test, P=0.77). Multicentric studies might help in elucidating the role of genetic and immunitary factors in the pathogenesis of multiple neoplasms in patients with PCLs.

scholarly journals The immunologic and clinicopathologic heterogeneity of cutaneous lymphomas other than mycosis fungoides

Blood ◽  
1983 ◽  
Vol 62 (2) ◽  
pp. 464-472 ◽  
Author(s):  
GS Wood ◽  
JS Burke ◽  
S Horning ◽  
RS Doggett ◽  
R Levy ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Mycosis Fungoides ◽  
Survival Data ◽  
Large Cell ◽  
Cell Phenotype ◽  
Time Interval ◽  
Histologic Subtype ◽  
Interval Therapy ◽  
Cutaneous Lymphomas

Twenty-one cases of non-Hodgkin's lymphoma with cutaneous involvement, other than mycosis fungoides, were evaluated immunologically, histologically, and clinically. Ten patients presented with skin disease alone, seven with concurrent cutaneous and extracutaneous disease, and four with extracutaneous disease only. Twenty of the 21 cases were nonepidermotropic tumors and were equally likely to express B or T phenotypes. None of the cases expressed a true histiocytic phenotype. Almost all cases expressed la and class 1 HLA determinants. Immunophenotypes were stable regardless of time interval, therapy, or body site sampled in seven of eight patients studied serially. In contrast to mycosis fungoides, the T lymphomas exhibited noncerebriform cytology, tumor la expression, lack of mature helper T-cell phenotype, nonepidermotropic histology, a tendency for marrow involvement, and presented as nodules rather than patches or plaques. Since each T lymphoma expressed an abnormal but uniform T-cell phenotype other than mature cytotoxic/suppressor or helper, the neoplastic population could be distinguished from reactive T cells. Reactive elements averaged one- third of the cellular infiltrates and were mainly T cells and macrophages. Langerhans cells were generally normal in number and distribution. Several histopathologic subtypes were identified with diffuse large cell lymphomas, including immunoblastic lymphomas, comprising 71% of cases (15/21). Prediction of the immunophenotype based on cytologic criteria was correct in 67% of cases (14/21). All errors occurred among the 13 high-grade lymphomas. Survival data were consistent with those of prior studies that have indicated that clinical course is dependent on stage and histologic subtype. Non- Hodgkin's cutaneous lymphomas constitute an immunologically, histologically, and clinically heterogeneous group of neoplasms.

Efficacy of single-agent chemotherapy in low-grade B-cell mucosa-associated lymphoid tissue lymphoma with prominent gastric expression.

1995 ◽  
Vol 13 (10) ◽  
pp. 2524-2529 ◽  
Author(s):  
P Hammel ◽  
C Haioun ◽  
M T Chaumette ◽  
P Gaulard ◽  
M Divine ◽  
...  
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Lymphoid Tissue ◽  
Alkylating Agent ◽  
Bone Marrow Involvement ◽  
Single Agent ◽  
Stage Iv ◽  
Large Cell ◽  
Disease Stage ◽  
Low Grade

PURPOSE The treatment of low-grade B-cell mucosa-associated lymphoid tissue (MALT) lymphoma with prominent gastric expression is controversial. Total gastrectomy has been proposed, but is associated with significant morbidity. The aim of this monocentric study was to assess the efficacy of continuous oral chemotherapy with a single alkylating agent. PATIENTS AND METHODS Twenty-four consecutive patients, 13 men and 11 women, were studied. Their mean age was 51 years (range, 22 to 79). Low-grade B-cell MALT lymphoma was diagnosed by histologic and immunohistologic examination of endoscopic biopsies. Seventeen patients had stage I disease and seven stage IV disease, with lung and gastric involvement. Two of these seven patients also had bone marrow involvement. The alkylating agent (cyclophosphamide or chlorambucil) was administered orally and daily for periods of 12 to 24 months. RESULTS The median follow-up time was 45 months (range, 14 months to 14 years). Complete remission was obtained in 18 patients (75%) after a median treatment duration of 12 months. Five patients relapsed; two of them were successfully re-treated, and one died of MALT lymphoma that had transformed into large-cell lymphoma. Chemotherapy was stopped after 24 months for six patients who only achieved a partial remission; two of them required further treatment for progressive disease (surgery for a small-bowel localization in one case and cyclophosphamide rechallenge in the other). Nine patients had neutropenia that required a reduced chemotherapy dosage. CONCLUSION In low-grade MALT lymphoma with prominent gastric expression, continuous monochemotherapy may constitute an efficient alternative to gastrectomy, regardless of disease stage.

Bone Involvement in Lymphoma: 36 Cases. An Argentinian Cooperative Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5025-5025
Author(s):  
Marta O Dragosky ◽  
Susana Alcaraz ◽  
Isabel Annetta ◽  
Laura Devotto ◽  
Ariel Corzo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Soft Tissue ◽  
Stage Iv ◽  
Bone Involvement ◽  
Disease Stage ◽  
Clinical Aspects ◽  
Hiv Positive ◽  
Low Grade ◽  
Primary Bone

Abstract Abstract 5025 Background Bone involvement in linfomas is not very frequent, usually reflects progression of the disease and bad prognosis. The WHO recognizes 4 groups of lymphomas involving bone: 1) single primary bone site, 2) multiple bone sites, without visceral involvement, 3) bone lesion with visceral or lymph node involvement, 4) soft tissue lymphoma with bone involvement. Primary bone lymphoma (PBL) constitutes 3-7% of malignant bone tumors and 2-3% of extranodal lymphomas, groups 1 and 2 belong to this type. They are characterized by lytic lesions, predominant in metadiaphysis, with aggressive periosteal reaction and presence of soft tissue mass. The secondary affectation of bone has been described in 15 to 25 % of the linfomas in progression. Radiological studies, Scintigraphy, CT, MRI and PET allow to delimit extension. Objective To make a retrospective study of the clinical aspects, treatment and evolution of patients with lymphoma and bone involvement. Methods In a database from hemato-oncological patientes, 36 patients were studied: 30 Non Hodgkin Lymphoma (NHL):83, 33 % and 6 Hodgkin's Lymphoma (HL): 16, 66 % . Results Bone involment was found in 32 cases at diagnosis and 4 in relapse. Characteristics of the LNH B Lineage: 28 cases, T: 2. High grade 22 cases: 18 large cells B, 2 large cells T, 2 plasmoblastic; low grade: 7 small lymphocytic, 1 lymphoplasmocytic. Bone locations were multiple in 26 cases and localized in 10: 3 femur, 2 humerus, 1 tibia, 4 vertebral column (4 dorsal vertebrae, 1 lumbar). Mean age: 49, 44 (20-86) years. Gender: M/F: 16/14. Stages: I: 26, 6 %, II: 16, 66 %, III: 10 %, IV: 46, 66 %. B symptoms in 25 %. Bone marrow involvement: 13, 88 %. Symptoms: pain 40 %, pain and tumor in 13, 33 %, pain and lymph nodes: 16, 66%, tumor (soft tissue involvement): 33,33%, pathological fracture: 10 %, paraplegia: 6,66%. HIV positive 5 cases, (3 large cells B, 2 plasmoblastic), 2 maxilla, 2 mandible, 1 humerus. Treatment: Chemotherapy (CT) in 28 patients), CHOP in 14, CVP 4, R-CHOP 3, EPOCH 2, ESHAP 2, CNOP, CAVPE, Fludara/CFM 1. 16 patients CT and Radiotherapy (RT), and 2 only RT. Evolution: 17 in complete response (RC), 6 dead, 6 without follow-up, 1 in treatment. Follow-up: 3-133 months, average: 44, 22. Characteristics of the patients with LH 4 nodular sclerosis, 2 mixed cellularity. Mean age: 31, 33 (21-37) years, stage IV in all; 3 bone involvement at diagnosis and 3 at relapse. Treatment: CT: ABVD: 4, BEACOPP 1, ESHAP 1.RT in 4. Autologous bone marrow transplant: 1.Evolution: 2 in RC, 2 dead, 2 in relapse, 1 in treatment. Conclusions Our population shares the criteria described in other series: LNH's predominance, aggressive histologies, predominant symptoms: pain and local tumor, with involvement of soft tissues. Adverse prognostic factors were stage IV and location in maxilla (33, 33% dead). Combined treatment: CT and RT allowed better results. With an average follow- up of 44,22 months, 17 patients with LNH remain in RC, stage I: 87,5 % RC. Patients HIV positive had a bad prognosis, CR only 1, follow up 26 months. Bone involvement in HL was associated with advanced disease (stage IV) and bad prognosis, 33, 3 % RC, follow up: 4-72 months, average: 35, 5. Disclosures No relevant conflicts of interest to declare.

Lack of Survival Improvement in Patients with Large Cell Lymphomas of T-Cell Phenotype: A SEER Analysis Comparing Outcomes According to Phenotype and Year of Diagnosis.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3577-3577
Author(s):  
Daniel Morgensztern ◽  
Gail Walker ◽  
Leonidas Koniaris ◽  
Izidore S. Lossos
Keyword(s):  
T Cell ◽  
B Cell ◽  
Poor Prognosis ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
Large Cell ◽  
Good Prognosis ◽  
Cell Phenotype ◽  
Survival Difference ◽  
Over Time

Abstract Background: The majority of studies suggest that among patients with aggressive non-Hodgkin lymphomas (NHL), T-cell phenotype (TCP) confers a poor prognosis. The worse outcomes in TCP may have become more accentuated since the introduction of rituximab, which has been associated with improved survival in patients with diffuse large B-cell lymphoma (DLBCL). The purpose of our study was to evaluate changes in NHL-survival (NHLS) according to immunophenotype and diagnostic era in a large sample of tumor registry cases. Methods: We analyzed SEER-reported cases aged 19 or older, diagnosed with NHL during the period from 1992 to 2003, and with available information on covariates including gender, race, site of disease, and stage at presentation. Lymphomas with ICD-0-3 codes 9675, 9680, or 684 and B-cell immunophenotype were classified as DLBCL, while TCP cases were identified by codes 9675, 9680, 9684, or 9702 and T-cell immunophenotype. NHLS was analyzed separately for cases diagnosed in 1992–1997 (era 1), and 1998–2003 (era 2), using SAS v9.1. We report 5-year Kaplan-Meier estimates and log rank comparisons, by cell type and era, adjusted for age and SEER summary stage. Since SEER data does not include IPI, we also analyzed two subgroups: patients under age 60 with Ann Arbor stage I/II disease (very good prognosis), and patients with age 60 and older with stage IV (poor prognosis). Results: Based on 7,359 study cases (6,526 DLBCL; 833 TCP) from era 1 and 18,099 (16,858 DLBCL; 1,241 TCP) from era 2, NHLS was significantly better in patients with B-cell v T-cell phenotype (p<0.001 both eras). Five-year rates were 54.4% v 42.9% in era 1, and 61.3% v 42.2% in era 2. Improvement for DLBCL in era 2 compared with era 1 was also significant (p<0.001), while there was no change for TCP (p=0.708). For the subgroup with very good prognosis, outcomes were comparable for DLBCL and TCP in era 1 but significantly different in era 2 (p=0.531 and p<0.001). The outcome for DLBCL patients with good prognosis improved over time (p<0.001) whereas similar benefit was not seen in TCP patients (p=0.273). Five-year NHLS rates were 75.2% v 73.8% in era 1, and 84.7% v 66.6% in era 2. In the poor prognosis subgroup, TCP was associated with worse outcome in both eras (p=0.011 and p=0.001). For these patient population, improvement in NHLS over time was not statistically significant for either DLBCL (p=0.076) or TCP (p=0.858). Five-year rates for DLBCL versus TCP were 30.6% v 22.2% in era 1, and 35.5% v 25.3% in era 2. Conclusions: The survival difference between DLBCL and TCP increased significantly after 1997 and is most likely attributable to widespread use of rituximab for B-cell lymphomas during the period 1998–2003. In DLBCL, the improved outcome was seen mainly in patients with good prognosis. In contrast, there were no significant advances in the treatment of T-cell lymphomas. Novel therapies are urgently needed in patients with TCP.

scholarly journals CD30 Ligand Is Frequently Expressed in Human Hematopoietic Malignancies of Myeloid and Lymphoid Origin

Blood ◽  
1997 ◽  
Vol 89 (6) ◽  
pp. 2048-2059 ◽  
Author(s):  
Valter Gattei ◽  
Massimo Degan ◽  
Annunziata Gloghini ◽  
Angela De Iuliis ◽  
Salvatore Improta ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Tumor Cells ◽  
Hematopoietic Cells ◽  
Cell Phenotype ◽  
Target Cells ◽  
Low Grade ◽  
Cell Leukemia ◽  
Primary Tumors ◽  
Hematopoietic Malignancies

Abstract CD30 ligand (CD30L) is a type-II membrane glycoprotein capable of transducing signals leading to either cell death or proliferation through its specific counterstructure CD30. Although several lines of evidence indicate that CD30L plays a key role as a paracrine- or autocrine-acting surface molecule in the deregulated cytokine cascade of Hodgkin's disease, little is known regarding its distribution and biologic significance in other human hematopoietic malignancies. By analyzing tumor cells from 181 patients with RNA studies and immunostaining by the anti-CD30L monoclonal antibody M80, we were able to show that human hematopoietic malignancies of different lineage and maturation stage display a frequent and broad expression of the ligand. CD30L mRNA and surface protein were detected in 60% of acute myeloid leukemias (AMLs), 54% of B-lineage acute lymphoblastic leukemias (ALLs), and in a consistent fraction (68%) of B-cell lymphoproliferative disorders. In this latter group, hairy cell leukemia and high-grade B-cell non-Hodgkin's lymphoma (B-NHL) expressed a higher surface density of CD30L as compared with B-cell chronic lymphocytic leukemia and low-grade B-NHL. Purified plasmacells from a fraction of multiple myeloma patients also displayed CD30L mRNA and protein. A more restricted expression of CD30L was found in T-cell tumors that was mainly confined to neoplasms with an activated peripheral T-cell phenotype, such as T-cell prolymphocytic leukemia, peripheral T-NHL, and adult T-cell leukemia/lymphoma. In contrast, none of the T-lineage ALLs analyzed expressed the ligand. In AML, a high cellular density of CD30L was detected in French-American-British M3, M4, and M5 phenotypes, which are directly associated with the presence on tumor cells of certain surface structures, including the p55 interleukin-2 receptor α-chain, the αM (CD11b) chain of β2 integrins, and the intercellular adhesion molecule-1 (CD54). Analysis of normal hematopoietic cells evidenced that, in addition to circulating and tonsil B cells, a fraction of bone marrow myeloid precursors, erythroblasts, and subsets of megakaryocytes also express CD30L. Finally, we have shown that native CD30L expressed on primary leukemic cells is functionally active by triggering both mitogenic and antiproliferative signals on CD30+ target cells. As opposed to CD30L, only 10 of 181 primary tumors expressed CD30 mRNA or protein, rendering therefore unlikely a CD30-CD30L autocrine loop in human hematopoietic neoplasms. Taken together, our data indicate that CD30L is widely expressed from early to late stages of human hematopoiesis and suggest a regulatory role for this molecule in the interactions of normal and malignant hematopoietic cells with CD30+ immune effectors and/or microenvironmental accessory cells.

Efficacy and safety of CAR19/22 T-cell “cocktail” therapy in patients with refractory/relapsed B-cell non-Hodgkin lymphoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 2534-2534
Author(s):  
Liang Huang ◽  
Na Wang ◽  
Chunrui Li ◽  
Yi Xiao ◽  
Yang Cao ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Low Grade ◽  
Efficacy And Safety ◽  
T Cell Therapy ◽  
Overall Response ◽  
Non Hodgkin Lymphoma ◽  
The Impact

2534 Background: Antigen escape relapse has emerged as a major challenge for long-term disease control post CD19-directed therapies, to which dual-targeting of CD19 and CD22 has been proposed as a potential solution. Methods: Between Mar 2016 and Jan 2018, we conducted a pilot study (ChiCTR-OPN-16008526) in 38 patients (pts), who had refractory/relapsed B-cell non-Hodgkin lymphoma (B-NHL), to evaluate the efficacy and safety of sequential infusion of anti-CD19 and anti-CD22, two single-specific, third-generation CAR19/22 T-cell “cocktail”. The cutoff date for data collection was Apr 30, 2018. Results: At a minimum follow-up of 3 months (mos), 26 of the 36 evaluable pts achieved an overall response (ORR), including 18 with a complete response (CR) and 8 with a partial response (PR). The ORR at mo 3 was consistent in different subgroups, irrespective of pathologic subtypes, cell of origin, cytogenetic or genomic aberrations. At the data cutoff, 15 of the 18 pts who had a CR at mo 3 maintained their responses, 2 of 8 pts who had a PR within 3 mos continued to have a CR without additional therapies. Collectively, the best ORR was 83.3%, with a best CR rate of 55.5% and a best PR rate of 27.8%. With a median follow-up of 5.3 mos (range, 0.4 to 16.2), the median PFS was 5.8 mos, and the median OS was not reached (NR). Pts received therapy at first relapse had better PFS than those who received therapy at the time with primary refractory diseases or at multiple relapses. Notably, pts who achieved an overall response at mo 3 (R3m) had significantly extended PFS and OS when compared with pts who did not. Repeated biopsy and IHC was conducted in 3 of the 13 pts. However, loss of CD19 or CD22 was not detected. Of the 9 pts with IgH/MYC translocation, with a median follow-up of 10.1 mos, the median PFS and median OS were NR. At data cutoff, 7 pts who had achieved R3m maintained their responses, including all the 4 pts with double-hit lymphoma. However, of the 10 pts with del(17p) or TP53 mutation, with a median follow-up of 5.3 mos (range, 2.7 to 14.5), the median PFS was 3.6 mos and the median OS was 9.9 mos. All pts experienced reversible CRS, with 21.1% were of high-grade. Neurotoxicity developed in 13.2% pts and were all low-grade. Conclusions: Our results indicated that sequential infusion of CAR19/22 T-cell is efficient and safe for pts with B-NHL. Dual antigen targeting is a promising approach to circumvent antigen loss relapse after CAR T-cell therapy. The impact of genetic subtypes and clinical parameters further underscores the critical importance of personalized immunotherapies. Clinical trial information: ChiCTR-OPN-16008526.

scholarly journals Erythrodermic CD4/CD8 Double-Negative Mycosis Fungoides: A Case Report

2021 ◽  
pp. 256-261
Author(s):  
Monira Abdullah Alnasser ◽  
Nour Marwan AlKhawajah ◽  
Nada Ghazi AlQadri ◽  
Asem Mustafa Shadid ◽  
Fahad M. Alsaif
Keyword(s):  
T Cell ◽  
Mycosis Fungoides ◽  
Cell Lymphoma ◽  
Early Stage ◽  
Common Type ◽  
Lymphoproliferative Disorders ◽  
Cell Phenotype ◽  
Double Negative ◽  
Cutaneous T Cell Lymphoma ◽  
Cutaneous Lymphomas

Cutaneous T-cell lymphoma (CTCL) describes a group of lymphoproliferative disorders characterized by localization of neoplastic T lymphocytes to the skin. Mycosis fungoides (MF) represents the most common type of CTCL and accounts for ∼60% of all primary cutaneous lymphomas. Apart from the classic type of MF, many clinical and histopathologic variants have been described. The malignant lymphocytes in MF are usually CD3, CD4 and CD45RO positive and CD8 negative. An unusual immunohistochemical profile of a CD4-negative and CD8-positive mature T-cell phenotype has been reported in a minority of patients; up to 20% of early-stage MF demonstrates a CD8-positive phenotype. There are only a few cases of a double-negative CD4/CD8 MF phenotype reported in the literature. We present the case of a 60-year-old male presenting a double-negative CD4/CD8 MF phenotype.

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