Auer rod-like inclusions in the cytoplasm of B-cell lymphoma cells with bone marrow infiltration

Abstract Abstract 1626 Diffuse large B cell lymphoma (DLBCL) is one of the most common types of non-Hodgkin's lymphoma. R-CHOP21 (C21) is considered the standard therapy but a large number of studies tested R-CHOP14 (C14). The aim of our study was to evaluate retrospectively a cohort of patients (pts) treated with C21 or C14. All pts with diagnosis of DLBCL or follicular grade IIIb lymphoma, treated with curative intent were accrued. From January 2002 to December 2010, 123 pts were treated with C21 and 142 were treated with C14. The median age was 63 (range 19–89). The two cohorts of pts were balanced for all clinical characteristics a part for age (<65 or >64 years) with more aged pts in C21 arm (p 0.000), PS with more advanced PS (2–3) in C21 arm (0.000) and LDH value which was more frequently elevated in C14 arm (p: 0.002). After induction therapy 190 pts (71%) obtained a complete remission: 82/123 (67%) after C21 and 108/142 (75%) after C14. After a median period of observation of 31 months 81 pts relapsed, 42 (51%) in the C21 arm and 39 (36%) in the C14 arm. Considering the two therapies, C21 vs C14, no differences were reported in OS, PFS and DFS: 61% vs 68%, 59% vs 58% and 74% vs 61% respectively. In univariate analysis OS was lower in older pts (p: 0.02), advanced stage (p: 0.02), symptomatic disease (p: 0.05), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.02) and intermediate or high risk IPI (p: 0.000); PFS was lower in advanced stage (p: 0.002), symptomatic disease (p: 0.009), elevated LDH (p: 0.001), bone marrow infiltration (p: 0.001) and intermediate high risk IPI (p: 0.000). In multivariate analysis OS was significantly better in low-intermediate IPI risk pts (p: 0.000) and in pts treated with C14 (p: 0.02); the PFS was better in low-intermediate IPI risk pts (p: 0.000). Considering only pts with low or low-intermediate IPI we observed that OS was significantly superior in the group treated with C14 (90% vs 64% p: 0.03), moreover in young pts (< 65 years) OS was better in pts treated with C14 (81% vs 58% p: 0.05). As expected hematological grade III/IV toxicity was more frequent in pts treated with C14, all pts but three (2%) completed the therapy without delay or dose reduction. No differences in extra-hematological toxicity were observed. Conclusions: In conclusion our results confirm that C14 do not improve the results of the standard C21 in the whole lymphoma population but in a subset of pts, young and low/intermediate risk pts, the C14 scheme seems to improve the OS. We will enlarge the cohort of studied patients but further prospective randomized studies are needed to verify this preliminary observations. Disclosures: No relevant conflicts of interest to declare.

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Prognostic significance of bone marrow infiltration detected by PET-CT in newly diagnosed diffuse large B cell lymphoma

Oncotarget ◽

10.18632/oncotarget.7616 ◽

2016 ◽

Vol 7 (14) ◽

pp. 19072-19080 ◽

Cited By ~ 6

Author(s):

Jin-Hua Liang ◽

Jin Sun ◽

Li Wang ◽

Lei Fan ◽

Yao-Yu Chen ◽

...

Keyword(s):

Bone Marrow ◽

B Cell ◽

Cell Lymphoma ◽

Prognostic Significance ◽

B Cell Lymphoma ◽

Bone Marrow Infiltration ◽

Newly Diagnosed ◽

Large B Cell Lymphoma ◽

Pet Ct ◽

Large B Cell

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Clinical characteristics and prognostic factors in diffuse large B-cell lymphoma with bone marrow involvement

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7588 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7588-7588

Author(s):

K. Lee ◽

J. Yi ◽

I. Choi ◽

J. Kim ◽

D. Kim ◽

...

Keyword(s):

Bone Marrow ◽

Prognostic Factors ◽

B Cell ◽

Clinical Characteristics ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Initial Diagnosis ◽

Lymphoma Cells ◽

Large B Cell Lymphoma ◽

Large B Cell

7588 Background: Although several studies have been reported about non-Hodgkin’s lymphomas (NHL) with bone marrow (BM) involvement, most of them have not performed immunophenotypic studies and contained heterogeneous NHL histologies. Until now, only a few studies with small sample sizes have been reported about clinical characteristics and prognostic factors in diffuse large B-cell lymphoma (DLBCL) with BM involvement. Methods: Between January 1993 and March 2004, 486 patients were diagnosed with DLBCL. Among 84 DLBCL patients who had BM involvement at initial diagnosis, 9 were not ineligible because of the lack of clinical data or unavailability of BM specimen. So, clinical factors and patterns of BM involvement of 75 patients were analyzed in this study. Results: At initial diagnosis, the median age was 57 years (range: 25∼79). In addition to BM, lymph nodes (76%), spleen (23%), Waldeyer’s ring (19%), gastrointestinal tract (16%), lung/pleura (15%), bone (15%), central nervous system (9%), nasal cavity (8%) and liver (7%) were also involved. Among 75 patients, 67 patients received anthracycline-containing chemotherapy; 4 patients received non-anthracycline-containing chemotherapy and 4 could not receive systemic chemotherapy because of combined medical conditions. The median survival was 32.3 months (5-year overall survival [OS]: 38%). In univariate analysis for prognostic factors, high-intermediate or high international prognostic index (IPI), B-symptoms, leucopenia, anemia, thrombocytopenia, pattern of BM involvement (interstitial or diffuse pattern), > 10% replacement of BM area by lymphoma cells, > 10% of large cell infiltration in BM-involved area by lymphoma at initial diagnosis were associated with poor OS (p < 0.05). Multivariate analysis indicated that > 10% replacement of BM area by lymphoma cells (p < 0.001), peripheral thrombocytopenia (p = 0.001) and high-intermediate or high IPI (p = 0.042) were independent predictors of poor OS. Conclusions: To our knowledge, this is the largest study about DLBCL patients with BM involvement. The BM areas involved by lymphoma cells, peripheral thrombocytopenia and IPI at initial diagnosis are independent prognostic factors in these patients. No significant financial relationships to disclose.

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A New Multi-Parameter Flow Cytometric Assay for Monitoring Lymphoma Growth and Spread in a Pre-Clinical Murine Model for Human Lymphoma.

Blood ◽

10.1182/blood.v104.11.4606.4606 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4606-4606

Author(s):

Paul J. Neeson ◽

Yvonne Paterson

Keyword(s):

Bone Marrow ◽

B Cell ◽

Tumor Response ◽

Cell Lymphoma ◽

High Sensitivity ◽

B Cell Lymphoma ◽

Lymphoma Cells ◽

Indirect Measure ◽

Flow Cytometric ◽

Inoculation Site

Abstract Murine lymphoma models are commonly used to test the efficacy of idiotype-based vaccines for B-cell lymphoma prior to human trials. Mouse survival has been used as an indirect measure of the tumor response to the vaccine. In this study, we describe a multiparameter flow cytometric (MPFC) assay that enables direct assessment of the tumor at the inoculation site and detection of lymphoma metastases. In initial experiments, we show that 38C13 mouse lymphoma cells expressed an aberrant phenotype compared to normal splenocytes. The combination of CD45, CD19, B220 and an anti-idiotypic antibody (S1C5) along with a sequential gating technique defined the 38C13 cells with high sensitivity and specificity. The specificity of the MPFC assay for 38C13 lymphoma cells was greater than a gating strategy using light scatter and idiotype antibody binding. The MPFC assay was used to monitor 38C13 tumor kinetics in the C3H/HeN mouse and demonstrated tumor growth at the inoculation site and metastases to the lymph nodes and bone marrow. The presence of 38C13 metastases in lymphoid organs and bone marrow predicted by the MPFC assay were confirmed by histology and immunohistochemistry (IHC). The MPFC assay will enable investigators to monitor 38C13 lymphoma tumor response to individual vaccines or other lymphoma therapy prior to clinical trials. Furthermore, the MPFC concept could be readily applied to other models of human B cell lymphoma.

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Assessment of bone marrow infiltration diagnosed by flow cytometry in canine large B cell lymphoma: Prognostic significance and proposal of a cut-off value

The Veterinary Journal ◽

10.1016/j.tvjl.2013.05.003 ◽

2013 ◽

Vol 197 (3) ◽

pp. 776-781 ◽

Cited By ~ 33

Author(s):

Laura Marconato ◽

Valeria Martini ◽

Luca Aresu ◽

Michele Sampaolo ◽

Fabio Valentini ◽

...

Keyword(s):

Bone Marrow ◽

Flow Cytometry ◽

B Cell ◽

Cell Lymphoma ◽

Prognostic Significance ◽

B Cell Lymphoma ◽

Bone Marrow Infiltration ◽

Large B Cell Lymphoma ◽

Large B Cell

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Bone Marrow-Liver-Spleen Type of Large B-Cell Lymphoma Associated with Hemophagocytic Syndrome: A Rare Aggressive Extranodal Lymphoma

Case Reports in Hematology ◽

10.1155/2017/8496978 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Kirill A. Lyapichev ◽

Jennifer R. Chapman ◽

Oleksii Iakymenko ◽

Offiong F. Ikpatt ◽

Uygar Teomete ◽

...

Keyword(s):

Bone Marrow ◽

B Cell ◽

Clinical Presentation ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Aggressive Lymphoma ◽

Lymphoma Cells ◽

Large B Cell Lymphoma ◽

Pathologic Features ◽

Large B Cell

Recently, an unusual subtype of large B-cell lymphoma (LBCL) with distinctive clinicopathologic features has been recognized; it is characterized by involvement of bone marrow with or without liver and/or spleen, but no lymph node or other extranodal sites, usually associated with fever, anemia, and hemophagocytic lymphohistiocytosis (HLH). Because of this distinctive clinical presentation, it has been designated “bone marrow-liver-spleen” (BLS) type of LBCL. To date there is only one series of 11 cases of BLS type of LBCL with detailed clinical, pathologic, and cytogenetic data. Herein, we describe a case of BLS type LBCL presenting with associated HLH in a 73-year-old female. The bone marrow core biopsy showed cytologically atypical large lymphoma cells present in a scattered interstitial distribution and hemophagocytosis and infrequent large lymphoma cells were seen in the bone marrow aspirate smears. Circulating lymphoma cells were not seen in the peripheral blood smears. The patient underwent treatment with chemotherapy (R-CHOP) but unfortunately passed away 2 months after initial presentation. BLS type of LBCL is a very rare and clinically aggressive lymphoma whose identification may be delayed by clinicians and hematopathologists due to its unusual clinical presentation and pathologic features.

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Tumor Control in a Model of Bone Marrow Transplantation and Acute Liver-Infiltrating B-Cell Lymphoma: an Unpredicted Novel Function of Cytomegalovirus

Journal of Virology ◽

10.1128/jvi.76.6.2857-2870.2002 ◽

2002 ◽

Vol 76 (6) ◽

pp. 2857-2870 ◽

Cited By ~ 14

Author(s):

Katja C. Erlach ◽

Jürgen Podlech ◽

Aysel Rojan ◽

Matthias J. Reddehase

Keyword(s):

Bone Marrow ◽

Bone Marrow Transplantation ◽

B Cell ◽

Marrow Transplantation ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Cmv Infection ◽

Lymphoma Cells ◽

Tumor Relapse ◽

Tnf Α

ABSTRACT Tumor relapse and cytomegalovirus (CMV) infection are major concerns in the therapy of hematopoietic malignancies by bone marrow transplantation (BMT). Little attention so far has been given to a possible pathogenetic interplay between CMV and lymphomas. CMV inhibits stem cell engraftment and hematopoietic reconstitution. Thus, by causing maintenance of bone marrow aplasia and immunodeficiency, CMV could promote tumor relapse. Alternatively, CMV could aid tumor remission. One might think of cytopathogenic infection of tumor cells, induction of apoptosis or inhibitory cytokines, interference with tumor cell extravasation or tumor vascularization, or bystander stimulation of an antitumoral immune response. To approach these questions, the established model of experimental BMT and murine CMV infection was extended by the introduction of liver-infiltrating, highly tumorigenic variant clone E12E of BALB/c-derived B-cell lymphoma A20. We document a remarkable retardation of lymphoma progression. First-guess explanations were ruled out: (i) lymphoma cells were not infected; (ii) lymphoma cells located next to infected hepatocytes did not express executioner caspase 3 but were viable and proliferated; (iii) an inhibitory effect of virus on the formation of tumor nodules in the liver became apparent by day 7 after BMT, long before the reconstitution of immune cells; and (iv) recombinant tumor necrosis factor alpha (TNF-α) did not substitute for virus; accordingly anti-TNF-α did not prevent the inhibition. Notably, while the antitumoral effect required replicative virus, prevention of cytopathogenic infection of the liver by antiviral CD8 T cells did not abolish lymphoma control. These findings are paradigmatic for a novel virus-associated antitumoral mechanism distinct from oncolysis.

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