Salivary gland lymphomas in patients with Sjögren's syndrome may frequently develop from rheumatoid factor B cells

Martin, Thierry; Weber, Jean-Christophe; Levallois, Honey; Labouret, Nathalie; Soley, Anne; Koenig, Séverine; Korganow, Anne‐Sophie; Pasquali, Jean‐Louis

doi:10.1002/1529-0131(200004)43:4<908::aid-anr24>3.0.co;2-k

Cited by 100 publications

(88 citation statements)

References 39 publications

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“…Levels of circulating IgM-RF correlate positively with the number of extraglandular disease manifestations (29). Most myoepithelial sialadenitis-associated B cell clones, and subsequently, lymphomas, express RF (30). Moreover, serious systemic complications of primary SS, such as vasculitis and nephritis, occur mainly in patients with elevated IgM-RF levels (29).…”

Section: Discussionmentioning

confidence: 99%

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

448

300

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Objective. To investigate the safety and efficacy of B cell depletion treatment of patients with active primary Sjögren's syndrome of short duration (early primary SS) and patients with primary SS and mucosaassociated lymphoid tissue (MALT)-type lymphoma (MALT/primary SS).Methods. Fifteen patients with primary SS were included in this phase II trial. Inclusion criteria for the early primary SS group were B cell hyperactivity (IgG >15 gm/liter), presence of autoantibodies (IgM rheumatoid factor, anti-SSA/SSB), and short disease duration (<4 years). Inclusion criteria for the MALT/ primary SS group were primary SS and an associated MALT-type lymphoma (Ann Arbor stage IE) localized in the parotid gland. Patients were treated with 4 infusions of rituximab (375 mg/m 2 ) given weekly after pretreatment with prednisone (25 mg) and clemastine. Patients were evaluated, using immunologic, salivary/ lacrimal function, and subjective parameters, at baseline and at 5 and 12 weeks after the first infusion.Results. Significant improvement of subjective symptoms and an increase in salivary gland function was observed in patients with residual salivary gland function. Immunologic analysis showed a rapid decrease of peripheral B cells and stable levels of IgG. Human antichimeric antibodies (HACAs) developed in 4 of 15 patients (27%), all with early primary SS. Three of these patients developed a serum sickness-like disorder. Of the 7 patients with MALT/primary SS, complete remission was achieved in 3, and disease was stable in 3 and progressive in 1.Conclusion. Findings of this phase II study suggest that rituximab is effective in the treatment of primary SS. The high incidence of HACAs and associated side effects observed in this study needs further evaluation.

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Section: Discussionmentioning

confidence: 99%

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

448

300

View full text Add to dashboard Cite

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“…It is noteworthy that patients with SS have an increased risk of developing monoclonal B cell nonHodgkin's lymphoma (NHL) marginal zone-like lymphoma, which frequently occur in the salivary glands (Martin et al, 2000;Thieblemont et al, 1995). The SS-associated lymphoproliferation ranges from essentially benign lesions through mucosa-associated lymphatic tissue-type lesions to frankly dysplastic lymphomas (Burke, 1999).…”

Section: Cd21mentioning

confidence: 99%

Attenuated Apoptosis of B Cell Activating Factor–Expressing Cells in Primary Sjögren's Syndrome

Szodoray

Jellestad

Teague

et al. 2003

Laboratory Investigation

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“…In H. pylori-induced gastritis there does appear to be a link between the Ig sequence of follicular B cells and MALT lymphoma [18,85]. In SS this may be less clearcut in that there is some evidence that MALT lymphoma B cells produce IgM rheumatoid factors [86]. Although this does not exclude a GC origin for these cells, neither does it support it.…”

Section: Mesa Formation and Malt Lymphomamentioning

confidence: 99%

Chemokines and Cell Trafficking in Sjögren's Syndrome

Amft

Bowman

2001

Scand J Immunol

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Sjögren's syndrome is a chronic inflammatory condition affecting exocrine glands, manifested clinically as dry eyes and dry mouth. It arises secondary to systemic immune‐mediated diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), scleroderma or ‘primary’ Sjögren's syndrome. Histologically it is characterized by peri‐ductal aggregates of CD4 T lymphocytes, the frequent occurrence of ectopic germinal centres and, in some patients, B‐cell infiltration of ductal epithelium (myoepithelial sialadenitis). This latter lesion is the precursor for the development of low grade (MALT) B‐cell lymphoma. The identification over recent years of chemokines and their receptors enables us to address the specific processes involved in the migration of inflammatory cells into exocrine glands, the development of their secondary structures and patterns of retention within the glands and potentially the subsequent transformation of B cells into mucosa associated lymphoid tissue (MALT) lymphoma.

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Salivary gland lymphomas in patients with Sjögren's syndrome may frequently develop from rheumatoid factor B cells

Abstract: Previous analyses of V gene use have provided indirect evidence that SG MNHL may frequently express RF. We demonstrate that this hypothesis is true in the 2 patients we studied. Large-scale studies will be needed to establish the exact frequency of RF specificity among SS-associated MNHL.

Cited by 100 publications

References 39 publications

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Attenuated Apoptosis of B Cell Activating Factor–Expressing Cells in Primary Sjögren's Syndrome

Chemokines and Cell Trafficking in Sjögren's Syndrome

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