Expression of KP1/CD68 macrophage-associated antigen in a series of 840 selected malignant neoplasms, including immunomorphologically characterized cases of non-Hodgkin's lymphoma (NHL) (434), Hodgkin's disease (HD) (115), soft tissue sarcoma (147), carcinoma (49), and other tumors (95), was examined. KP1 expression was detected in a significant number of NHLs (107 of 434; 24.7%), most of them (65 of 107; 60.7%) of the diffuse small cell subtype. Only 14 of the 155 large cell lymphomas, compared to 10 of the 51 Ki-1/CD30+ anaplastic large cell (ALC) lymphomas examined, were KP1 positive. Conversely, none of the T-lineage NHL--other than Ki-1/CD30+ ALC lymphomas--or the HD cases tested was labeled by KP1 antibody. Among the other neoplasms tested, KP1 was reactive with a variable proportion of cases of malignant fibrous histiocytoma (19 of 24; 79.2%), malignant schwannoma (8 of 22; 36.4%), liposarcoma (3 of 9; 33.3%), leiomyosarcoma (8 of 37; 21.6%), cutaneous or metastatic melanoma (51 of 73; 69.9%), and renal cell carcinoma (3 of 5; 60%). These results indicate that KP1 shows a relatively wide spectrum of immunoreactivity with malignant neoplasms of presumed non-histiocyte origin, thus arguing against its expected specificity and high value in diagnostic pathology. Although the significance of KP1 expression by some subsets of NHLs remains to be elucidated, its close association with B-cell NHLs, mostly of the diffuse small cell type, should stimulate further pathologic and clinical investigations.
In the present study, we have investigated whether RNA can be efficiently isolated from Bouin-fixed or formalin-fixed, paraffin-embedded lymphoid tissue specimens. To this aim, we applied a new and simple method that includes the combination of proteinase K digestion and column purification. By this method, we demonstrated that the amplification of long fragments could be accomplished after a pre-heating step before cDNA synthesis associated with the use of enzymes that work at high temperature. By means of PCR using different primers for two examined genes (glyceraldehyde-3-phosphate dehydrogenase [GAPDH]-and CD40), we amplified segments of cDNA obtained by reverse transcription of the isolated RNA extracted from Bouin-fixed or formalin-fixed paraffin-embedded tissues. Amplified fragments of the expected sizes were obtained for both genes tested indicating that this method is suitable for the isolation of high-quality RNA.
From September 1984 through December 1991, of those with human immunodeficiency virus infection seen at the acquired immune deficiency syndrome unit of the Centro di Riferimento Oncologico, Aviano, Italy, 71 patients had systemic non-Hodgkin's lymphomas. The most frequent histotypes were small noncleaved cell, anaplastic large cell (ALC) CD30/BerH2+, and large cell immunoblastic. In 22 representative cases of these histotypes, including 9 of small noncleaved cell, 9 of ALC CD30/BerH2+, and 4 of immunoblastic non-Hodgkin's lymphomas, Epstein-Barr virus genetic information was assessed by in situ hybridization and correlated with histologic and immunophenotypic findings. Expression of B-cell associated markers, usually including CD19, CD20, CD22, CDw75, and CD74, was found in 17 of the 22 evaluated cases. All small noncleaved cell and immunoblastic cases and four cases of ALC lymphomas expressed B-cell immunophenotypes, whereas the remaining ALC cases were immunologically undetermined. In situ hybridization detected Epstein-Barr virus in 12 of 22 cases (54.5%). Seven of nine ALC lymphomas were positive, as were three of five small noncleaved cell type (Burkitt's lymphoma), one of four small noncleaved cell type (non-Burkitt's variant), and one of four large cell immunoblastic type. The results of this study indicate that Epstein-Barr virus genomes might be identified in more than 50% of the evaluated high grade non-Hodgkin's lymphomas; this association occurred significantly more often in the small noncleaved cell lymphomas resembling endemic Burkitt's lymphoma (60%) and with ALC CD30/BerH2+ lymphomas (77.8%). These findings support the notion that Epstein-Barr virus may play a role in the development of non-Hodgkin's lymphomas in a proportion of human immunodeficiency virus-infected patients.
There have been several attempts to improve treatment and outcome of patients with primary mediastinal B-cell lymphoma (PMBL) and Burkitt's lymphoma (BL). In recent years, chemotherapy dose intensification and the addition of rituximab have led to a remarkable progress and have developed into integral parts of treatment for both entities of lymphoma [1][2][3][4]. Here, we report our monocenter results of a highdose methotrexate based alternating regimen with rituximab (B-ALL/ NHL 2002 protocol) in 15 patients with PMBL and 28 patients with sporadic BL. Since the early 1980s, protocols of GMALL have been continuously adapted and in the meantime they have become reference treatment for BL and B-ALL in Germany. The latest changes comprised the additional use of rituximab, standardized G-CSF support, implementation of high-dose cytarabine, intrathecal triple therapy, and age-adjusted stratification. Furthermore, we additionally amended supportive care with palifermin as it reduced severity and prevalence of mucositis [5].Almost all patients responded to chemotherapy, leading to an overall response rate of 98% (PMBL 100%, 95% confidence interval (CI) 1.0-1.0; BL 96.4%, 95%CI 0.68-1.0). Complete remission (CR) was achieved in 83.8% (PMBL 80%, BL 85.7%), and the rate of partial remission (PR) was 14% (20% PMBL, BL 10.7%). On average, the individual best response to chemotherapy was achieved after 3.68 courses.After initial response, three patients (two BL, one PMBL) experienced a progression or relapse within 3, 5, and 10 months, respectively. Thus, 5-year progression-free survival (PFS) was 93.3% (95%CI 0.74-1.0) for patients with PMBL and 82.1% (95%CI 0.67-0.96) for BL. Five-year overall survival (OS) was 100% for PMBL and 94.1% (95%CI 0.83-1.0) for BL in the younger group, and 100% and 63.6% (95%CI 0.35-0.92), respectively, in patients >55 years (Fig. 1a,b). Regarding the BL group, two patients died from treatment-related sepsis, a 74-year-old woman discontinued therapy, and two progressed during salvage therapy.Postchemotherapy consolidation radiotherapy was performed in 66.7% in PMBL and in 10.7% in BL. A total of 93% of patients with PMBL and 100% of patients with BL received prophylactic intrathecal therapy.Overall response and survival rate of 100% of all patients in the PMBL subgroup was observed. Fietz et al. [6] already reported a CR rate of 73% and an OS of 80% at 8.6 years in a cohort of 15 patients with PMBL treated according a prior B-ALL protocol of the GMALL (without rituximab). Improved OS in our cohort may be explained by recent changes such as the additional use of rituximab or high-dose cytarabine. Additional use of rituximab had predominantly shown benefit in nonmethotrexate but not in methotrexate-containing regimens [3,4,[7][8][9]. Preliminary results of a current protocol by Hoelzer et al. [10] with 42 patients with PMBL showed an inferior CR rate of 69%, but a comparable 3-year OS of 90% in patients younger than 55 years and of 67% in the elderly group (>55 years). However, this difference c...
The association of p53 overexpression with parameters of biological aggressiveness suggests an involvement of p53 in the neoplastic progression of HSTS. This assumption is supported by the findings that in tumors with a mixed diploid/aneuploid neoplastic cell population p53 protein expression was significantly (p < 0.01) higher in the aneuploid cell subpopulation. In conclusion, our study suggests that overexpression of p53 is present mainly in the most biologically aggressive forms of HSTS and may therefore represent a neoplastic progression index possibly useful for prognostic purposes.
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