Advances in the understanding and management of angioimmunoblastic T‐cell lymphoma

Leval, Laurence de; Gisselbrecht, Christian; Gaulard, Philippe

doi:10.1111/j.1365-2141.2009.08003.x

Cited by 212 publications

(244 citation statements)

References 136 publications

(194 reference statements)

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“…Early involvement by AITL has floridly reactive germinal centers and polymorphous infiltrates and may be difficult to diagnose (5). Immunophenotypic aberrancies for T-cell-associated antigens (CD2, CD3, CD4, CD5, and CD7) and for CD45 have been reported previously, and our results confirm those findings (8)(9)(10)(11).…”

Section: Vbeta Analysis By Flow Cytometry Is a New Techniquesupporting

confidence: 82%

“…Testing for CD94, CD161, and killer-cell immunoglobulin-like receptors was not helpful in our cases of AITL, in contrast to the diagnostic utility for clones of large granular lymphocytes in the blood (12). Increased CD10 has been described on T cells in 80% of AITL (5,(13)(14)(15), but nonneoplastic CD10-positive FHT may be increased also in lymph node biopsies with reactive hyperplasia and with B-cell lymphoma (6,7).…”

Section: Vbeta Analysis By Flow Cytometry Is a New Techniquementioning

confidence: 48%

“…Angioimmunoblastic T-cell lymphoma (AITL) is a mature T-cell lymphoma with unique lymph node histology: arborizing high endothelial venules, increased follicular-dendritic meshworks, and a polymorphous cellular infiltrate, including EBV-positive B immunoblasts and neoplastic follicular-helper T cells (FHT) (5). Early disease with floridly reactive germinal centers and polymorphous infiltrates may be difficult to diagnose.…”

mentioning

confidence: 99%

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Abnormal immunophenotype of the T‐cell‐receptor beta Chain in follicular‐helper T cells of angioimmunoblastic T‐cell lymphoma

Mao

Surowiecka

Linden

et al. 2015

Cytometry Part B Clinical

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Objective: Analysis for 24 variable regions of the T-cell-receptor beta chain by flow cytometry (Vbeta) is a new technique to detect clonal alpha-beta T lymphocytes and is characteristically performed on peripheral blood. Angioimmunoblastic T-cell lymphoma (AITL) has increased neoplastic follicular-helper T cells (FHT), which often express CD10; but nonneoplastic, CD10-positive T cells may be associated with reactive lymphadenopathy and with B-cell lymphomas. This study documents the utility of Vbeta analysis of FHT in specimens of AITL from blood, from marrow, and from lymph nodes.Methods: The electronic medical record in the flow cytometry laboratory was searched for specimens that were analyzed by flow cytometry for Vbeta and that were involved by AITL. Flow cytometry was performed for the following antigens: T-cell-associated proteins, CD10, CD56, CD94, CD161, killer-cell immunoglobulin-like receptors, alpha-beta T-cell receptor, gamma-delta T-cell receptor, and Vbeta.Results: Five patients had six specimens of blood (two), of bone marrow (one), or of lymph nodes (three). Immunophenotypic aberrances were detected for antigens: CD2 (2/6), CD3 (6/6), CD4 (1/6), CD5 (1/6), CD7 (5/6), and CD45 (2/6). All abnormal T-cell populations expressed CD4, and most expressed CD10 (5/6). Four specimens were clonally restricted for Vbeta. Two specimens lacked the alpha-beta Tcell receptor and Vbeta.Conclusions: Vbeta analysis by flow cytometry can be used to detect clonal alpha-beta FHT in AITL, which may be difficult to diagnose with early involvement. Abnormal Vbeta expression on CD10-positive T cells confirms that FHT are the neoplastic cells. V C 2015 International Clinical Cytometry Society

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Section: Vbeta Analysis By Flow Cytometry Is a New Techniquesupporting

confidence: 82%

Section: Vbeta Analysis By Flow Cytometry Is a New Techniquementioning

confidence: 48%

mentioning

confidence: 99%

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Abnormal immunophenotype of the T‐cell‐receptor beta Chain in follicular‐helper T cells of angioimmunoblastic T‐cell lymphoma

Mao

Surowiecka

Linden

et al. 2015

Cytometry Part B Clinical

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“…The fact that three of eight patients who achieved a complete remission with prednisone alone continued in remission for as long as 2 years at the time of the report is interesting. A review of other series of treatment of patients with angioimmunoblastic T-cell lymphoma revealed no obvious superior regimen [59].…”

Section: Angioimmunoblastic T-cell Lymphomamentioning

confidence: 99%

The aggressive peripheral T‐cell lymphomas: 2015

Armitage

2015

American J Hematol

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Background: T‐cell lymphomas make up approximately 10%–15% of lymphoid malignancies. The frequency of these lymphomas varies geographically, with the highest incidence in parts of Asia.Diagnosis: The diagnosis of aggressive peripheral T‐cell lymphoma (PTCL) is usually made using the World Health Organization classification. The ability of hematopathologists to reproducibly diagnosis aggressive PTCL is lower than that for aggressive B‐cell lymphomas, with a range of 72%–97% for the aggressive PTCLs.Risk Stratification: Patients with aggressive PTCL are staged using the Ann Arbor Classification. Although somewhat controversial, positron emission tomography scans seem to be useful as they are in aggressive B‐cell lymphomas. The most commonly used prognostic index is the International Prognostic Index. The specific subtype of aggressive PTCL is an important risk factor, with the best survival seen in anaplastic large‐cell lymphoma—particularly young patients with the anaplastic lymphoma kinase positive subtype.Risk‐Adapted Therapy: Anaplastic large‐cell lymphoma is the only subgroup to have a good response to a CHOP‐like regimen. Angioimmunoblastic T‐cell lymphoma has a prolonged disease‐free survival in only ∼20% of patients, but younger patients who have an autotransplant in remission seem to do better. PTCL‐not otherwise specified is not one disease. Anthracycline‐containing regimens have disappointing results, and a new approach is needed. Natural killer/T‐cell lymphoma localized to the nose and nasal sinuses seems to be best treated with radiotherapy‐containing regimens. Enteropathy‐associated PTCL and hepatosplenic PTCL are rare disorders with a generally poor response to therapy, although selected patients with enteropathy‐associated PTCL seem to benefit from intensive therapy. Am. J. Hematol. 90:666–673, 2015. © 2015 Wiley Periodicals, Inc.

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“…The clinical features are varied and include the sudden onset of constitutional symptoms, lymphadenopathy, hepatosplenomegaly, and various autoimmune phenomena, particularly hemolytic anemia and thrombocytopenia as well as polyclonal hypergammaglobulinemia [1] . Lung involvement can be observed on an X-ray image as diffuse patchy infiltrates or interstitial pneumonia in approximately 10% of cases [2] . This report describes the first case, to our knowledge, of AITL resulting in pulmonary hypertension.…”

Section: Introductionmentioning

confidence: 99%

Severe pulmonary arterial hypertension as a predominant manifestation of angioimmun- oblastic T-cell lymphoma: a case report

et al. 2012

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Angioimmunoblastic T-cell lymphoma is a rare and unique disease with peculiar clinical features among malignant lymphomas. We report here a case of severe pulmonary arterial hypertension appearing as the main manifestation of angioimmunoblastic T-cell lymphoma in a 55-year-old woman. The patient was treated with the THP-COP regimen, consisting of pirarubicin, cyclophosphamide, vincristine, and prednisolone for 1 cycle, followed by the CHOP regimen, including doxorubicin instead of pirarubicin, for 5 cycles. Soon after the initiation of chemotherapy, all the patient's symptoms and abnormal findings, including an elevated pulmonary artery pressure, completely disappeared. As of 3 months after the end of therapy, the patient remains in complete remission. To our knowledge, this is the first report of pulmonary arterial hypertension secondary to angioimmunoblastic T-cell lymphoma.

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Advances in the understanding and management of angioimmunoblastic T‐cell lymphoma

Cited by 212 publications

References 136 publications

Abnormal immunophenotype of the T‐cell‐receptor beta Chain in follicular‐helper T cells of angioimmunoblastic T‐cell lymphoma

Abnormal immunophenotype of the T‐cell‐receptor beta Chain in follicular‐helper T cells of angioimmunoblastic T‐cell lymphoma

The aggressive peripheral T‐cell lymphomas: 2015

Severe pulmonary arterial hypertension as a predominant manifestation of angioimmun- oblastic T-cell lymphoma: a case report

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