angioimmunoblastic T-cell lymphoma

PCR-based clonality detection in angioimmunoblastic T-cell lymphoma

CLINICAL PRESENTATION, DIAGNOSIS, AND MANAGEMENT OF LYMPHOID MALIGNANCIES , , ,

Yu.V. Sidorova, Ye.Ye. Nikulina, N.G. Chernova, L.G. Gorenkova, Ye.A. Gilyazitdinova, S.K. Kravchenko, A.M. Kovrigina, and A.B. Sudarikov

Hematology Research Center, RF Ministry of Health, Moscow, Russian Federation

ABSTRACT

In this article, we discuss the issues of angioimmunoblastic T-cell lymphoma diagnosis, particularly the PCR-based methods of clonality detection. Assessments of T-and B-cell clonality was based on TCRG (Vg-Jg), TCRB (Vb-Jb, Db-Jb), IGH (FR1, FR2, and FR3), IGK (Vk-Jk, Vk/intron-Kde), or IGL (Vl-Jl) gene rearrangements in 15 patients. Clonal TCRG gene rearrangements were found in 66.7 % of primary biopsy samples. The combined use of primers for TCRG and TCRB gene rearrangements confirmed T-cell monoclonal population in most cases (86.7 %). The rate of B-cell clonality detection was 26.6 %. The presence of B-cell clones was not associated with monoclonal secretion in the blood or detecting Epstein-Barr virus positive B-cells in the biopsy samples. PCR-based clonality analysis is an important step in diagnosis of angioimmunoblastic T-cell lymphoma that enables identifying monoclonal origin of T-lymphocytes in most cases. However, when interpreting the results obtained by this method, it is necessary to consider the possibility of detecting B-cell monoclonal products of unclear origin.

Keywords: angioimmunoblastic T-cell lymphoma, PCR, clonality, T-cell antigen receptor

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Prolonged chemotherapy for angioimmunoblastic T-cell lymphoma

EXPERIMENTAL STUDIES ,

N.G. Chernova1, Yu.E. Vinogradova2, Yu.V. Sidorova1, I.B. Kaplanskaya1, E.A. Gilyazitdinova1, L.G. Gorenkova1, D.S. Marin1, A.M. Kremenetskaya1, A.I. Vorobyev1, and S.K. Kravchenko1

1 Hematology Research Center, RF MH, Moscow, Russian Federation

2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation

ABSTRACT

Introduction: Current СНОР-like therapy for angioimmunoblastic T-cell lymphoma demonstrates unsatisfactory results with respect to the achievement of complete remission. It indicates the need in the search for new approaches to therapy of angioimmunoblastic T-cell lymphoma.

Objective: To define the rational approaches to the diagnosis and treatment of angioimmunoblastic T-cell lymphoma (AITL).

Materials and methods: Within the period from 2002 to 2012, we followed-up 15 patients with angioimmunoblastic T-cell lymphoma, with median age of 61 years (range 29–77) and the male/female ratio of 11/4. All patients had stage IV disease; the bone marrow, lungs, spleen, and skin were involved in 14 (93 %), 9 (60 %), 12 (80 %), and 6 (40 %) patients, respectively.

Results: We used prolonged chemotherapy GMALL 2002 and ALL-2009 regimens for treatment of angioimmunoblastic T-cell lymphoma (11 patients). Complete remission was achieved in 55 % of cases with median follow up of 33 mouths.

Conclusion: The usage of short-term chemotherapy programs (CHOP-like) for treatment of angioimmunoblastic T-cell lymphoma doesn’t seem to give good results. Administration of prolonged chemotherapy is more appropriate and allows achieving remission of the disease.

Keywords: angioimmunoblastic T-cell lymphoma, prolonged chemotherapy.

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  6. Dupuis J., Boye K., Martin N. et al. Expression of CXCL13 by neoplastic cells in angioimmunoblastic T-cell lymphoma (AITL). A new diagnostic marker providing evidence that AITL derives from follicular helper T-cells. Am. J. Surg. Pathol. 2006; 30: 490–4.
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  9. Yu H., Shahsafaei A., Dorfman D. Germinal-center T-helper cell markers PD-1 and CXCL13 are both expressed by neoplastic cells in angioimmunoblastic T-cell lymphoma. Am. J. Clin. Pathol. 2009; 131: 33–41.
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T-cell lymphomas: therapeutic possibilities for a limited choice

MY CHOISE , , , , ,

V.A. Doronin

N.N. Blokhin Russian Cancer Research Center, RAMS, Moscow, Russian Federation

ABSTRACT

Peripheral and cutaneous T-cell lymphomas (PTCLs and CTCLs) are a group of distinct non-Hodgkin’s lymphomas (NHLs) with wide variation of molecular and genetic features, symptom patterns, and clinical manifestations. The diversity and rarity of these hematological disorders make clinical studies difficult, and treatment is improving slower than in more common B-cell NHLs. Thus, no standard therapies have been established for T-cell lymphomas so far. Treatment is often conducted within the frame of clinical trials. This article offers perspectives regarding the tailoring of treatment for patients with PTCL and CTCL. Novel therapies are also discussed.

Keywords: T-cell lymphomas, peripheral T-cell lymphoma, not otherwise specified, angioimmunoblastic T-cell lymphoma, anaplastic large cell lymphoma, cutaneous T-cell lymphomas.

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