High-grade Transformation of Low-grade B-cell Lymphoma

Agbay, Rose L ou Marie C; Loghavi, Sanam; Medeiros, L. Jeffrey; Khoury, Joseph D.

doi:10.1097/pas.0000000000000561

Cited by 21 publications

(17 citation statements)

References 103 publications

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“…They postulated that the H/DC tumor arises from either a differentiated FL cell or a CPC at least at the pre-B-cell stage of differentiation. In contrast, Buser et al [74], who analyzed a compound pro-T LBL and indeterminate dendritic cell tumor simultaneously occurring at 3 different anatomical sites in a 59-year-old woman, found a tri (21) in both tumor components, whereas only the pro-T LBL additionally contained a monosomy (18) and NRAS G13D mutation. Therefore, they concluded that this composite tumor must have arisen by divergent cell differentiation from a CPC [74].…”

Section: Transdifferentiationmentioning

confidence: 99%

“…The 10-year risk of transformation in follicular lymphoma (FL), the most frequent low-grade B-NHL, ranges between 15 and 20%, with an annual transformation rate of about 2-3% [28]. Marginal zone lymphoma transforms into high-grade lymphoma in 10-14% of patients over time, although the true incidence rates of transformation are poorly documented [21].…”

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

“…1). Transformation, considered to represent clonal evolution, is usually associated with clinical disease progression and an adverse outcome [21]. In chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), high-grade transformation into diffuse large B-cell lymphoma (DLBCL) is known as Richter's syndrome (RS) and occurs in up to 10% of patients, with an estimated transformation rate of 0.5-1% per year [22].…”

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

“…Secondly and less frequently, patients are simultaneously diagnosed with a low-grade and a high-grade lym- [21], Parikh et al [22], and Montoto and Fitzgibbon [28]. CLL/SLL, chronic lymphocytic leukemia/small lymphocytic lymphoma; FL, follicular lymphoma; MZL, marginal zone lymphoma; LPL, lymphoplasmacytic lymphoma; DLBCL, diffuse large B-cell lymphoma; HL, Hodgkin lymphoma; PBL, plasmablastic lymphoma; BCL-U, B-cell lymphoma, unclassified; B-ALL, B-cell acute lymphoblastic leukemia; BL, Burkitt lymphoma.…”

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

See 3 more Smart Citations

Tumor Heterogeneity in Lymphomas: A Different Breed

Schürch¹,

Federmann²,

Quintanilla-Martı́nez³

et al. 2017

Pathobiology

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The facts that cancer represents tissues consisting of heterogeneous neoplastic, as well as reactive, cell populations and that cancers of the same histotype may show profound differences in clinical behavior have long been recognized. With the advent of new technologies and the demands of precision medicine, the investigation of tumor heterogeneity has gained much interest. An understanding of intertumoral heterogeneity in patients with the same disease entity is necessary to optimally guide personalized treatment. In addition, increasing evidence indicates that different tumor areas or primary tumors and metastases in an individual patient can show significant intratumoral heterogeneity on different levels. This phenomenon can be driven by genomic instability, epigenetic events, the tumor microenvironment, and stochastic variations in cellular function and antitumoral therapies. These mechanisms may lead to branched subclonal evolution from a common progenitor clone, resulting in spatial variation between different tumor sites, disease progression, and treatment resistance. This review addresses tumor heterogeneity in lymphomas from a pathologist's viewpoint. The relationship between morphologic, immunophenotypic, and genetic heterogeneity is exemplified in different lymphoma entities and reviewed in the context of high-grade transformation and transdifferentiation. In addition, factors driving heterogeneity, as well as clinical and therapeutic implications of lymphoma heterogeneity, will be discussed.

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Section: Transdifferentiationmentioning

confidence: 99%

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

Section: Intratumoral Heterogeneity In Lymphomamentioning

confidence: 99%

See 2 more Smart Citations

Tumor Heterogeneity in Lymphomas: A Different Breed

Schürch¹,

Federmann²,

Quintanilla-Martı́nez³

et al. 2017

Pathobiology

View full text Add to dashboard Cite

show abstract

“…RS is also loosely applied to CLL/SLL patients who develop less common lymphoid neoplasms such as Hodgkin lymphoma (HL), plasmablastic lymphoma or Blymphoblastic leukemia/lymphoma. Whereas, histologic transformation occurs in patients with other types of low-grade B-cell neoplasms [3], the term RS is only used in the context of CLL/SLL.…”

Section: Introductionmentioning

confidence: 99%

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

et al. 2016

Self Cite

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Although generally considered a clinically indolent neoplasm, CLL/SLL may undergo transformation to a clinically aggressive lymphoma. The most common form of transformation, to DLBCL, is also known as Richter syndrome. Transformation determines the course of the disease and is associated with unfavorable patient outcome. Precise detection of transformation and identification of predictive biomarkers and specific molecular pathways implicated in the pathobiology of transformation in CLL/SLL will enable personalized therapeutic approach and provide potential avenues for improving the clinical outcome of patients. In this review, we present an overview of the pathologic features, risk factors, and pathogenic mechanisms of CLL/ SLL transformation.

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Clinicopathologic characteristics and outcomes of transformed diffuse large B‐cell lymphoma in hepatitis C virus‐infected patients

Hosry

Miranda

Samaniego

et al. 2017

Intl Journal of Cancer

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Hepatitis C virus (HCV) causes a chronic but curable infection associated with the development of marginal zone lymphoma (MZL) and diffuse large B-cell lymphoma (DLBCL). Preliminary data have shown frequent transformation of indolent lymphoma to DLBCL in HCV-infected patients. To compare their clinicopathologic characteristics and oncologic outcomes, we reviewed the medical records and pathology reports of HCV-infected and uninfected patients with DLBCL that transformed from indolent lymphoma seen at The University of Texas MD Anderson Cancer Center (June 2004 to May 2015). To identify predictors of DLBCL relapse, patients with relapse after first-line chemotherapy were compared with those without it using univariate and logistic regression analyses. Compared with the uninfected patients (n = 63), HCV-infected patients (n = 21) were younger (median age =54 years [interquartile range= 49-62 years] vs. 62 years [53-66 years]; p = 0.01) and more often had advanced DLBCL (Ann Arbor stage 3-4; 95% vs. 76%; p = 0.05). Immunophenotypically, more HCV-infected than uninfected patients had CD10-negative B cells (76% vs. 43%; p = 0.008), CD5-positive B cells (39% vs. 7%; p = 0.004) and activated B-cell phenotypes (57% vs. 31%; p = 0.07). Comparison of the patients who had relapse after first-line chemotherapy (n = 42) and those who did not (n = 40) revealed that having CD5-positive B cells was the only factor associated with DLBCL relapse in multivariate analysis (odds ratio= 10.7; p = 0.02). HCV-infected patients with transformed DLBCL have unique clinicopathologic characteristics that make their lymphoma difficult to treat, potentially leading to unfavorable outcome. The impact of HCV eradication should be explored in such patients.

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High-grade Transformation of Low-grade B-cell Lymphoma

Cited by 21 publications

References 103 publications

Tumor Heterogeneity in Lymphomas: A Different Breed

Tumor Heterogeneity in Lymphomas: A Different Breed

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

Clinicopathologic characteristics and outcomes of transformed diffuse large B‐cell lymphoma in hepatitis C virus‐infected patients

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