Clonality analysis of lymphoproliferative disorders in patients with Sjögren's syndrome

Dong, Lingli; Yasukawa, Masaki; Takegami, T.; Jin, Z.-X.; Huang, Chi-Wei; Fukushima, Toshihiro; Sawaki, Toshioki; Kawanami, Takafumi; Saeki, Takako; Kitagawa, Kazuko; Sugai, Susumu; Okazaki, Toshiro; Hirose, Yuko; Umehara, Hisanori

doi:10.1111/j.1365-2249.2007.03486.x

Cited by 26 publications

(19 citation statements)

References 31 publications

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“…The other three SS patients concomitant with malignant B cells lymphomas showed different clonal expansion of B cells between nodal sites and salivary glands [62]. Similar cases were also observed in our study [62]. Forty-two patients showed evidence of monoclonal B cell expansion by PCR.…”

Section: Clonality Analysis In Lymphoma Devel-opmentsupporting

confidence: 88%

Sjogrens Syndrome and Lymphoma Development

Umehara¹,

Dong²,

Yasukawa³

et al. 2007

CIR

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Primary Sjögren's syndrome (pSS) is a systemic as well as an organ-specific autoimmune disease characterized by lymphocytic infiltration of the glandular epithelial tissue. It has been reported that pSS patients have a relatively increased risk for the development of lymphoma and various factors such as cytokine stimulation, environmental exposures and viral infections as well as genetic events may contribute to the development of lymphoma in pSS patients. Over the past few decades, numerous efforts have been undertaken to search for the relationship between lymphoma and pSS, for example advances in molecular biology for clonality analysis and well-linked register cohort studies for the predictive value of clinical, laboratory and histological findings. Despite this, mechanisms and prediction of lymphoma development in pSS patients still remain to be defined. In this review we have summarized the current knowledge concerning incidence and risk factors of lymphoma development in pSS patients. In addition, the most recent discoveries in the emergence and treatment of lymphoma in pSS patients and the possible mechanism of lymphoma development are also discussed.

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Section: Clonality Analysis In Lymphoma Devel-opmentsupporting

confidence: 88%

Sjogrens Syndrome and Lymphoma Development

Umehara¹,

Dong²,

Yasukawa³

et al. 2007

CIR

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“…In contrast, other studies showed that the detection of monoclonality by immunoglobulin gene rearrangement was not a reliable predictor of clinical behavior in MESA, inasmuch as initial and follow-up biopsy specimens from the same patients were identical [96]. Similar findings were observed in our study [98]. Thus, molecular genetic analysis of monoclonality has little practical value in the clinical diagnosis of salivary gland lymphoma in MESA, and these patients should be diligently followed-up for evidence of lymphoma development [104].…”

Section: Clonality Analysis In Lymphoma Developmentsupporting

confidence: 81%

“…Three longitudinally observed patients showed progressive clonal expansion with the presence of the same subclone in different tissues during the course of disease, with one developing MALT lymphoma in the parotid gland. The other three SS patients had malignant B cells between nodal sites and salivary glands [98]. Table 1 summarizes findings regarding monoclonality and lymphoma development in 45 patients with SS.…”

Section: Clonality Analysis In Lymphoma Developmentmentioning

confidence: 99%

Possible Mechanisms of Lymphoma Development in Sjogren’s Syndrome

Dong¹,

Chen²,

Yasukawa³

et al. 2013

CIR

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Primary Sjögren’s syndrome (pSS) is a systemic as well as an organ-specific autoimmune disease characterized by lymphocytic infiltration of the glandular epithelial tissue. SS patients have been reported to be at highest risk of developing lymphoproliferative neoplasms, when compared with patients with other rheumatoid diseases. Factors such as cytokine stimulation, environmental factors, viral infection and genetic events as well as vitamin deficiency may contribute to the development of lymphoma. Over the past few decades, numerous efforts have been made to assess the relationship between lymphoma and SS. These include epidemiological surveys, molecular biologic assessments of clonality and well-linked register cohort studies evaluating the predictive value of clinical, laboratory and histological findings. Nevertheless, the mechanisms and factors predictive of lymphoma development in pSS patients remain to be defined. This review summarizes updated knowledge on the incidence of and risk factors for lymphoma development in pSS patients, as well as discussing the most recent findings on the development and treatment of lymphoma in pSS patients and the possible mechanism of lymphoma development.

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“…In fact, a large number of SS patients develop B cell non‐Hodgkin's lymphoma (NHL), associated mainly with mucosa‐associated lymphoid tissue (MALT) lymphomas of primary gland origin, according to a concept introduced by Dong et al. [5], Tonami et al. [7] and Isaacson et al.…”

Section: Introductionmentioning

confidence: 99%

“…Infiltrated glands are frequently the site of B cell oligoclonal and monoclonal expansion, an undesirable condition leading to lymphoid malignancy in >14% of SS cases [5,6]. In fact, a large number of SS patients develop B cell non-Hodgkin's lymphoma (NHL), associated mainly with mucosa-associated lymphoid tissue (MALT) lymphomas of primary gland origin, according to a concept introduced by Dong et al [5], Tonami et al [7] and Isaacson et al [8]. Elevated serum levels of BAFF have been also found in patients with NHL [9].…”

Section: Introductionmentioning

confidence: 99%

Polymerase chain reaction (PCR) detection of B cell clonality in Sjögren's syndrome patients: a diagnostic tool of clonal expansion

Guzmán

Castillo

Aguilera

2010

Clinical and Experimental Immunology

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SummarySjögren's syndrome (SS) is an autoimmune disease characterized by clonal B cell attack of the exocrine glands and dysregulated expression of B cellactivating factor (BAFF). Based upon the current data of increased rates of lymphoid malignancy, as non-Hodgkin's lymphoma (NHL) is associated with SS, we propose the detection of clonal rearrangements of immunoglobulin heavy chain (IgH) gene in those patients as a predictor of malignant clonal expansion. To test our proposal, we examined the IgH clonal rearrangements in SS patients (60) and healthy control subjects (42) having chronic non-specific sialadenitis, to determine the presence of clonal B cells in minor labial salivary glands (MSG) of SS patients. Clonal B cell expansion was assessed by two polymerase chain reaction (PCR) assays: (i) semi-nested PCR, against sequences encoding framework regions FR3, FR2 and FR1c of the variable chain IgH gene in B cells present in the MSG infiltrate; and (ii) the PCR-enzyme-linked immunosorbent assay (ELISA) technique, against the major and minor breakpoint regions of the Bcl-2 oncogene coupled with a variable segment of the IgH to assess the Bcl-2/JH translocation. When FR3, FR2 and FR1c primers were employed, we detected B cell monoclonality in 87% of the SS patients and 19% of the control subjects. The association between inflammation severity of the MSG pattern and the presence of B cell clonality was found to be statistically significant (P < 0·01). We concluded that the presence of B cell clonality in MSG can be used as a index of an altered microenvironment favouring the development of lymphoma in SS patients.

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Clonality analysis of lymphoproliferative disorders in patients with Sjögren's syndrome

Cited by 26 publications

References 31 publications

Sjogrens Syndrome and Lymphoma Development

Sjogrens Syndrome and Lymphoma Development

Possible Mechanisms of Lymphoma Development in Sjogren’s Syndrome

Polymerase chain reaction (PCR) detection of B cell clonality in Sjögren's syndrome patients: a diagnostic tool of clonal expansion

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