1.Role of Immune Microenvironmental Factors for Improving the IPI-related Risk Stratification of Aggressive B Cell Lymphoma.
Yi GONG ; Rui CHEN ; Xi ZHANG ; Zhong Min ZOU ; Xing Hua CHEN
Biomedical and Environmental Sciences 2017;30(7):492-500
<b>OBJECTIVEb>To investigate the risk stratification of aggressive B cell lymphoma using the immune microenvironment and clinical factors.
<b>METHODSb>A total of 127 patients with aggressive B cell lymphoma between 2014 and 2015 were enrolled in this study. CD4, Foxp3, CD8, CD68, CD163, PD-1, and PD-L1 expression levels were evaluated in paraffin-embedded lymphoma tissues to identify their roles in the risk stratification. Eleven factors were identified for further evaluation using analysis of variance, chi-square, and multinomial logistic regression analysis.
<b>RESULTSb>Significant differences in 11 factors (age, Ann Arbor stage, B symptom, ECOG performance status, infiltrating CD8+ T cells, PD-L1 expression, absolute blood monocyte count, serum lactate dehydrogenase, serum iron, serum albumin, and serum β2-microglobulin) were observed among patient groups stratified by at least two risk stratification methods [International Prognostic Index (IPI), revised IPI, and NCCN-IPI models] (P < 0.05). Concordance rates were high (81.4%-100.0%) when these factors were used for the risk stratification. No difference in the risk stratification results was observed with or without the Ann Arbor stage data.
<b>CONCLUSIONb>We developed a convenient and inexpensive tool for use in risk stratification of aggressive B cell lymphomas, although further studies on the role of immune microenvironmental factors are needed.
Adult ; Biomarkers, Tumor ; Gene Expression Regulation, Neoplastic ; immunology ; Humans ; Lymphoma, B-Cell ; classification ; pathology ; Prognosis ; Retrospective Studies ; Survival Analysis
2.Current status and perspectives of chimeric antigen receptor modified T cells for cancer treatment.
Zhenguang WANG ; Yelei GUO ; Weidong HAN
Protein & Cell 2017;8(12):896-925
Chimeric antigen receptor (CAR) is a recombinant immunoreceptor combining an antibody-derived targeting fragment with signaling domains capable of activating cells, which endows T cells with the ability to recognize tumor-associated surface antigens independent of the expression of major histocompatibility complex (MHC) molecules. Recent early-phase clinical trials of CAR-modified T (CAR-T) cells for relapsed or refractory B cell malignancies have demonstrated promising results (that is, anti-CD19 CAR-T in B cell acute lymphoblastic leukemia (B-ALL)). Given this success, broadening the clinical experience of CAR-T cell therapy beyond hematological malignancies has been actively investigated. Here we discuss the basic design of CAR and review the clinical results from the studies of CAR-T cells in B cell leukemia and lymphoma, and several solid tumors. We additionally discuss the major challenges in the further development and strategies for increasing anti-tumor activity and safety, as well as for successful commercial translation.
Animals
;
Humans
;
Immunity, Cellular
;
Immunotherapy
;
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
;
immunology
;
pathology
;
therapy
;
Receptors, Antigen, T-Cell
;
immunology
;
Recombinant Fusion Proteins
;
immunology
;
T-Lymphocytes
;
immunology
;
transplantation
3.The First Case Report of Composite Bone Marrow Involvement by Simultaneously Developed Peripheral T-Cell Lymphoma, Not Otherwise Specified, and Diffuse Large B-Cell Lymphoma.
Hyun Ki KIM ; Chan Jeoung PARK ; Seongsoo JANG ; Young Uk CHO ; Sang Hyuk PARK ; Jene CHOI ; Chan Sik PARK ; Jooryung HUH ; Young Hwa CHUNG ; Jung Hee LEE
Annals of Laboratory Medicine 2015;35(1):152-154
No abstract available.
Antibodies, Monoclonal, Murine-Derived/therapeutic use
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
B-Cell-Specific Activator Protein/metabolism
;
Bone Marrow/metabolism/*pathology
;
Cyclophosphamide/therapeutic use
;
Doxorubicin/therapeutic use
;
Endoscopy, Digestive System
;
Female
;
Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor
;
Genetic Loci
;
Humans
;
Liver/metabolism/pathology
;
Lymphocytes/cytology/immunology
;
Lymphoma, Large B-Cell, Diffuse/complications/*diagnosis/drug therapy
;
Lymphoma, T-Cell, Peripheral/complications/*diagnosis/drug therapy
;
Middle Aged
;
Prednisone/therapeutic use
;
Receptors, Antigen, T-Cell, gamma-delta/genetics
;
Tomography, X-Ray Computed
;
Vincristine/therapeutic use
4.Pediatric B-cell Lymphoma, Unclassifiable, With Intermediate Features Between Those of Diffuse Large B-cell Lymphoma and Burkitt Lymphoma: A Report of Two Cases.
Shanxiang ZHANG ; David WILSON ; Magdalena CZADER
Annals of Laboratory Medicine 2015;35(2):254-256
No abstract available.
Adolescent
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
Burkitt Lymphoma/*pathology
;
Child, Preschool
;
Cyclophosphamide/therapeutic use
;
Doxorubicin/therapeutic use
;
Female
;
Gene Rearrangement
;
Herpesvirus 4, Human/metabolism
;
Humans
;
Immunohistochemistry
;
Lymphoma, B-Cell/*diagnosis/drug therapy
;
Lymphoma, Large B-Cell, Diffuse/*pathology
;
Male
;
Prednisone/therapeutic use
;
Proto-Oncogene Proteins c-myc/genetics
;
Tomography, X-Ray Computed
;
Vincristine/therapeutic use
;
Viral Matrix Proteins/immunology/metabolism
5.A Case of Small Bowel Diffuse Large B-cell Lymphoma Mimicking Crohn's Disease.
Tae Hyoung KOO ; Won Jong CHOI ; Seung Hee HAN ; Su Young KIM ; Jong Hun LEE
The Korean Journal of Gastroenterology 2015;65(4):241-245
A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn's disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn's disease.
Aged
;
Antibodies/blood
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
;
Capsule Endoscopy
;
Crohn Disease/diagnosis/drug therapy
;
Diagnostic Errors
;
Humans
;
Immunoglobulin A/blood
;
Intestinal Perforation/surgery
;
Lymphoma, Large B-Cell, Diffuse/*diagnosis/drug therapy/pathology
;
Male
;
Mesalamine/therapeutic use
;
Positron-Emission Tomography
;
Saccharomyces cerevisiae/immunology
;
Tomography, X-Ray Computed
6.Bone Marrow Flow Cytometry in Staging of Patients With B-cell Non-Hodgkin Lymphoma.
Borahm KIM ; Seung Tae LEE ; Hee Jin KIM ; Sun Hee KIM
Annals of Laboratory Medicine 2015;35(2):187-193
BACKGROUND: Bone marrow biopsies are routinely performed for staging patients with B-cell non-Hodgkin lymphoma (NHL). In addition to histomorphological studies, ancillary tools may be needed for accurate diagnosis. We investigated the clinical utility of multiparameter flow cytometric examination of bone marrow aspirates. METHODS: A total of 248 bone marrow specimens from 232 patients diagnosed with B-cell NHL were examined. Monoclonal antibodies directed against CD19, CD20, CD10 (or CD5), and kappa and lambda immunoglobulins were used. Multi-stage sequential gating was performed to select specific cells of interest, and the results were compared with bone marrow histology. RESULTS: The concordance rate between histomorphology and flow cytometry was 91.5% (n=227). Eight cases (3.2%) were detected by flow cytometry alone and were missed by histomorphology analysis, and 6 of these 8 cases showed minimal bone marrow involvement (0.09-2.2%). The diagnosis in these cases included large cell lymphoma (n=3), mantle cell lymphoma (n=3), and mucosa-associated lymphoid tissue (MALT) lymphoma (n=2). Thirteen cases were histopathologically positive and immunophenotypically negative, and the diagnoses in these cases included diffuse large cell lymphoma (n=7), T-cell/histiocyte-rich large B-cell lymphoma (n=2), anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma (n=1), follicular lymphoma (n=1), MALT lymphoma (n=1), and unclassifiable lymphoma (n=1). CONCLUSIONS: Multi-color flow cytometry can be a useful method for assessing bone marrow in staging NHL and also plays a complementary role, especially in detecting small numbers of lymphoma cells.
Antibodies, Monoclonal/immunology
;
Antigens, CD19/immunology/metabolism
;
Antigens, CD20/immunology/metabolism
;
Bone Marrow/*pathology
;
Female
;
Flow Cytometry
;
Humans
;
Immunophenotyping
;
Lymphoma, B-Cell/*pathology
;
Male
;
Neoplasm Staging
;
Neprilysin/immunology/metabolism
7.Expression of CD58 in childhood B-lineage acute lymphoblastic leukemia and its feasibility in minimal residual disease detection.
Ya-Fei LI ; Xiao-Ming ZHAO ; Guang-Yao SHENG ; Bao-Hong YUE ; Yuan LUO
Chinese Journal of Contemporary Pediatrics 2015;17(8):825-829
<b>OBJECTIVEb>To measure the expression of lymphocyte function-associated antigen-3 (CD58) in childhood B-lineage acute lymphoblastic leukemia (B-ALL) and to explore the feasibility of CD58 as an indicator for minimal residual disease (MRD) detection in childhood B-ALL.
<b>METHODSb>Eighty-seven children diagnosed with B-ALL between January 2014 and September 2014 were enrolled, and 20 hospitalized children who had no tumor or blood disease and had normal bone marrow cell morphology served as the control group. The expression features of CD58 in bone marrow samples from the two groups (at diagnosis, on day 15 of induction chemotherapy) were analyzed by four-color flow cytometry (FCM). Quantitative real-time polymerase chain reaction (qRT-PCR) and FCM were used to detect MRD in B-ALL patients on day 33 of induction chemotherapy.
<b>RESULTSb>The mean fluorescence intensity of CD58 expression in the 87 B-ALL cases (91±33) was significantly higher than that in the 20 controls (14±6) (P<0.01); CD58 was over-expressed in 44 of the B-ALL cases. In the B-ALL children, the expression of CD58 on day 15 of induction chemotherapy (105±22) was not significantly different from that at diagnosis (107±26) (P>0.05). In the 44 B-ALL patients with CD58 over-expression, FCM showed 9 MRD(+) cases and 35 MRD(-) cases, while qRT-PCR showed 11 MRD(+) cases and 33 MRD(-) cases; 42 cases (95%) showed consistent results of the two tests, so there was no significant difference between the two methods in detecting MRD (P>0.05).
<b>CONCLUSIONSb>CD58 is over-expressed and stable in children with B-ALL, and it can be considered as an indicator for MRD detection in childhood B-ALL.
Adolescent ; CD58 Antigens ; analysis ; Cell Lineage ; Child ; Child, Preschool ; Feasibility Studies ; Female ; Humans ; Induction Chemotherapy ; Infant ; Male ; Neoplasm, Residual ; diagnosis ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; immunology
8.New Guidelines for Helicobacter pylori Treatment: Comparisons between Korea and Japan.
The Korean Journal of Gastroenterology 2014;63(3):151-157
Korea and Japan show the highest incidence of gastric cancer and Helicobacter pylori infection. New 2013 guidelines on H. pylori infection differ between the two countries with regard to the indications for H. pylori eradication, diagnostic methods, and treatment regimens. Indications for eradication in Korean guideline focus on specific diseases such as peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma, and after resection of early gastric cancer, while Japanese guideline includes all H. pylori-associated gastritis for the prevention of dissemination. With regard to the diagnosis, either noninvasive or invasive method (except for bacterial culture) is recommended in Korea, while two noninvasive tests including serum anti-H. pylori IgG antibody level are preferred in Japan. As for the treatment regimens, second-line treatment (quadruple bismuth-containing regimen) is recommended without first-line triple therapy in areas of high clarithromycin resistance in Korea. However, there is no bismuth-based second-line treatment in Japan, and the Japanese regimen consists of a lower dose of antibiotics for a shorter duration (7 days). Such discrepancies between the two countries are based not only on the differences in the literature search and interpretation, but also on the different approvals granted by the national health insurance system, manufacturing process of the antibiotics, and diagnostic techniques in each country. Collaborations are required to minimize the discrepancies between the two countries based on cost-effectiveness.
Anti-Bacterial Agents/pharmacology/*therapeutic use
;
Antibodies/blood
;
Bismuth/pharmacology/therapeutic use
;
Disease Eradication/trends
;
Drug Administration Schedule
;
Guidelines as Topic
;
Helicobacter Infections/complications/diagnosis/*drug therapy
;
*Helicobacter pylori/drug effects/immunology
;
Humans
;
Japan
;
Lymphoma, B-Cell, Marginal Zone/complications/surgery
;
Republic of Korea
;
Stomach Neoplasms/complications/surgery
9.Cytomegalovirus appendicitis with concurrent bacteremia after chemotherapy for acute leukemia.
Min Jung CHO ; Jongmin LEE ; Joo Yeun HU ; Jung Woo LEE ; Sung Yeon CHO ; Dong Gun LEE ; Seok LEE
The Korean Journal of Internal Medicine 2014;29(5):675-678
No abstract available.
Adult
;
Antineoplastic Combined Chemotherapy Protocols/*adverse effects
;
Appendicitis/diagnosis/*etiology/therapy
;
Bacteremia/*etiology/therapy
;
Consolidation Chemotherapy/adverse effects
;
Cytomegalovirus Infections/diagnosis/*etiology/therapy
;
Humans
;
Immunocompromised Host
;
Male
;
Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/*drug therapy/immunology/therapy
10.The immunophenotypic characteristics of 260 patients with CD5 + B cell lymphoproliferative disorders.
Shuhua YI ; Zengjun LI ; Huijun WANG ; Wei LIU ; Rui LYU ; Zhen YU ; Junyuan QI ; Lugui QIU
Chinese Journal of Hematology 2014;35(4):337-341
<b>OBJECTIVEb>To explore the immunophenotypic characteristics of CD5⁺ B cell lymphoproliferative disorders (B-LPD) of Chinese patients.
<b>METHODSb>Immunophenotyping of bone marrow and (or) of peripheral blood was performed in patients with B-LPD by four color multiparameter flow cytometry analysis using a panel of monoclonal antibodies, and the patients clinical data were retrospectively analyzed. The difference in immunophenotypes and the related clinical features were retrospectively analyzed. Fluorescence in situ hybridization (FISH) for t(11;14) detection was applied to diagnose or exclude mantle cell lymphoma.
<b>RESULTSb>(1)A total 260 CD5⁺ B-LPD patients were enrolled in this study, including 186 chronic lymphocytic leukemia (CLL), 40 mantle cell lymphoma (MCL), other B-LPD including 5 splenic marginal zone lymphoma (SMZL), 2 B-cell prolymphocytic leukemia (B-PLL), 3 hairy cell leukemia (HCL). The other 26 cases (10%)were not classified and defined as unclassified B-LPD (BLPD-U). MCL patients were all positive for t(11;14) detected by FISH, while all the BLPD-U patients were negative for t(11;14). (2) All patients expressed CD19, CD20 and CD5. According to the immunophenotypic score system, 186 CLL patients scored 4-5, 99.5% of patients with CD23⁺, 11.3% with sIgM⁺, 10.2% with FMC7⁺, 44.1% with CD22⁺ and 51.1% with CD11c⁺. MCL patients scored 2-3, with 50% expressing CD23 and sIgM, 81.6% expressing FMC7, 92.1% expressing CD22 and 5.3% expressing CD11c. In aspect of BLPD-U and other B-LPD, the expression of CD23, sIgM, FMC7, CD22 and CD11c were 73.1% and 50%, 34.6% and 50%, 88.5% and 100%, 92.3% and 90%, 69.2% and 70%, respectively. (3)In comparison of CLL with MCL, there was a significant difference in the expression of CD23, sIgM, FMC7, CD22 and CD11c between the two groups (P<0.01). Between MCL and BLPD-U, similar expression type of CD23, sIgM, FMC7 and CD22 was found except CD11c, which was highly expressed in BLPD-U (P<0.001). The difference of CD11c expression was also statistically significant between MCL and other B-LPD (P<0.01). In comparison of MCL with other B-LPD, there was a significant difference in the expression of CD11c (P<0.01). The expression of CD23 and sIgM in MCL are 7%-21% and 82%-100% respectively in Western population, while the expression of other immunophenotypic markers is similar with our study.
<b>CONCLUSIONb>The significant high incidence of CD23 and low incidence of sIgM compared to the Western population was observed in Chinese patients, and CD11c coud serve as a useful marker to distinguish MCL from CLL and other CD5⁺ B-LPD.
Adult ; Aged ; Aged, 80 and over ; Cell Count ; Female ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; Leukemia, Lymphocytic, Chronic, B-Cell ; immunology ; Lymphoma, Mantle-Cell ; immunology ; Lymphoproliferative Disorders ; immunology ; Male ; Middle Aged ; Retrospective Studies

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