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Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2015; 14: 6-11

Лимфома Ходжкина: нодулярный вариант с лимфоидным преобладанием

Евстратов Дмитрий Андреевич, Абрамов Дмитрий Сергеевич, Коновалов Дмитрий Михайлович, Мякова Наталья Валерьевна

https://doi.org/10.24287/1726-1708-2015-14-2-6-11

Аннотация

Нодулярный вариант с лимфоидным преобладанием лимфомы Ходжкина (nodular lymphocyte-predominant Hodgkin lymphoma - NLPHL) является редким вариантом и встречается в 5% случаев от общего числа пациентов с лимфомой Ходжкина. Опухолевые клетки при NLPHL экспрессируют CD20, CD79a, BCL-6, факторы транскрипции B-клеток (BSAP, BOB-1, Oct-2), также могут экспрессировать PU.1 (белок-активатор транскрипции, участвующий в дифференцировке В-лимфоцитов). Профиль экспрессии генов опухолевых клеток NLPHL схож с таковым клеток Березовского-Штернберга-Рида классической лимфомы Ходжкина. Важной биологической особенностью NLPHL является возможность трансформации в агрессивную В-клеточную неходжкинскую лимфому. В лечении пациентов с NLPHL применяют различные методы: от хирургического до комбинированной химиолучевой терапии и таргетной терапии ритуксимабом.
Список литературы

1. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al, eds. WHO classification of tumors of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC: WHO; 2008.

2. Райт Д, Эддис Б, Леонг Э. Морфологическая диагностика патологии лимфатических узлов. Пер. с англ. И Самсоновой. М.: Медицинская литература, 2008. / Rayt D, Eddis B, Leong E. Morfologicheskaya diagnostika patologii limfaticheskikh uzlov. Per. s angl. I Samsonovoy. Moscow: Meditsinskaya literatura, 2008. (In Russian).

3. Diehl V, Sextro M, Franklin J, Hansmann ML, Harris N, Jaffe E, et al. Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin’s Disease. J Clin Oncol. 1999;17(3):776-83.

4. Nogovâ L, Reineke T, Brillant C, Sieniawski M, Rüdiger T, Josting A, et al. Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol. 2008;26(3):434-9.

5. Xing KH, Savage KJ. Modern management of lymphocyte-predominant Hodgkin lymphoma. Br J Haematol. 2013;161(3):316-29.

6. Marafioti T, Hummel M, Anagnostopoulos I, Foss HD, Falini B, Delsol G, et al. Origin of nodular lymphocyte-predominant Hodgkin’s disease from a clonal expansion of highly mutated germinal-center B-cells. N Engl J Med. 1997;337(7):453-8.

7. Fan Z, Natkunam Y, Bair E, Tibshirani R, Warnke RA. Characterization of variant patterns of nodular lymphocyte predominant Hodgkin lymphoma with immunohistologic and clinical correlation. Am J Surg Pathol. 2003;27(10):1346-56.

8. Brune V, Tiacci E, Pfeil I, Döring C, Eckerle S, van Noesel CJ, et al. Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med. 2008;205(10):2251-68.

9. Al-Mansour M, Connors JM, Gascoyne RD, Skinnider B, Savage KJ. Transformation to aggressive lymphoma in nodular lymphocyte-predominant Hodgkin’s lymphoma. J Clin Oncol. 2010;28(5):793-9.

10. Engert A, Plütschow A, Eich HT, Lohri A, Dörken B, Borchmann P, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363(7):640-52.

11. Wirth A, Yuen K, Barton M, Roos D, Gogna K, Pratt G, et al. Long-term outcome after radiotherapy alone for lymphocyte-predominant Hodgkin lymphoma: a retrospective multicenter study of the Australasian Radiation Oncology Lymphoma Group. Cancer. 2005;104(6):1221-9.

12. Chen RC, Chin MS, Ng AK, Feng Y, Neuberg D, Silver B, et al. Early-stage, lymphocyte-predominant Hodgkin’s lymphoma: patient outcomes from a large, single institution series with long follow-up. J Clin Oncol. 2010;28(1):136-41.

13. Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin’s disease. J Clin Oncol. 2004;22(14):2835-41.

14. Engert A, Franklin J, Eich HT, Brillant C, Sehlen S, Cartoni C, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25(23):3495-502.

15. Fermé C, Eghbali H, Meerwaldt JH, Rieux C, Bosq J, Berger F, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin’s disease. N Engl J Med. 2007;357(19):1916-27.

16. Feugier P, Labouyrie E, Djeridane M, Jenabian A, Dubruille V, Berthou C, et al. Comparison of initial characteristics and long-term outcome of patients with lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma at clinical stages IA and IIA prospectively treated by brief anthracycline-based chemotherapies plus extended high-dose irradiation. Blood. 2004;104(9):2675-81.

17. Savage KJ, Skinnider B, Al-Mansour M, Sehn LH, Gascoyne RD, Connors JM. Treating limited-stage nodular lymphocyte predominant Hodgkin lymphoma similarly to classical Hodgkin lymphoma with ABVD may improve outcome. Blood. 2011;118(17):4585-90.

18. Mauz-Körholz C, Gorde-Grosjean S, Hasenclever D, Shankar A, Dörffel W, Wallace WH, et al. Resection alone in 58 children with limited stage, lymphocyte-predominant Hodgkin lymphoma-experience from the European network group on pediatric Hodgkin lymphoma. Cancer. 2007;110(1):179-85.

19. Eichenauer DA, Fuchs M, Pluetschow A, Klimm B, Halbsguth T, Böll B, et al. Phase study of rituximab in newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group. Blood. 2011;118(6):4363-5.

20. Advani RH, Horning SJ, Hoppe RT, Daadi S, Allen J, Natkunam Y, et al. Mature results of a phase II study of rituximab therapy for nodular lymphocyte-predominant Hodgkin lymphoma. J Clin Oncol. 2014;32(9):912-8.

21. Xing KH, Connors JM, Lai A, Al-Mansour M, Sehn LH, Villa D, et al. Advanced-stage nodular lymphocyte predominant Hodgkin lymphoma compared with classical Hodgkin lymphoma: a matched pair outcome analysis. Blood. 2014; 123(23):3567-73.

22. Canellos GP, Mauch P. What is appropriate systemic chemotherapy for lymphocyte-predominant Hodgkin’s lymphoma? J Clin Oncol. 2010;28(1):e8.

23. Fanale MA, Lai C-M, McLaughilin P, Romaguera J, Fayad L, Hagemeister F, et al. Outcomes of nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) patients treated with R-CHOP. Blood (ASH Annual Meeting. Orlando, Florida, USA, 4-7 December, 2010). 2010;116(21): abstr. 2812.

24. Karuturi M, Hosing C, Fanale M, Medeiros LJ, Alousi AM, de Lima MJ, et al. Highdose chemotherapy and autologous stem cell transplantation for nodular lymphocyte-predominant Hodgkin lymphoma. Biol Blood Marrow Transplant. 2013;19(6):991-4.

25. Bierman P, Naushad H, Loberiza F, BocieK RG, Voce JM, Armitage JO, et al. Highdose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) for lymphocyte predominant Hodgkin’s disease. Blood (ASH Annual Meeting. Orlando, Florida, USA, 4-7 December, 2006). 2006;108(11): abstr. 3061.

26. Park HC, Jung SH, Ahn JS, Kim MY, Yang DH, Kim YK, et al. Rituximab plus ifosfamide, carboplatine and etoposide for T-cell/hystiocyte-rich B-cell lymphoma arising in nodular lymphocyte-predominant Hodgkin’s lymphoma. Case Rep Oncol. 2012;5(2):413-9.

Pediatric Hematology/Oncology and Immunopathology. 2015; 14: 6-11

Nodular lymphocyte-predominant Hodgkin’s lymphoma

Evstratov D. A., Abramov D. S., Konovalov D. M., Myakova N. V.

https://doi.org/10.24287/1726-1708-2015-14-2-6-11

Abstract

Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) is a rare variant, diagnosed in 5% of all patients with Hodgkin's lymphoma. Tumor cells in NLPHL express CD20, CD79a, BCL-6, B-cell transcription factors (BSAP, BOB-1, Oct-2), can express PU.1 (transcription factor necessary for B-cell development). The profile of NLPHL tumor cell expression is similar to that of Berezovsky-Sternberg-Reed cells in classical Hodgkin's lymphoma. An important biological characteristic of NLPHL is probability of its transformation into aggressive B-cell non-Hodgkin's lymphoma. Patients with NLPHL receive various treatments: from surgery to combined chemoradiotherapy and rituximab target therapy.
References

1. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al, eds. WHO classification of tumors of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC: WHO; 2008.

2. Rait D, Eddis B, Leong E. Morfologicheskaya diagnostika patologii limfaticheskikh uzlov. Per. s angl. I Samsonovoi. M.: Meditsinskaya literatura, 2008. / Rayt D, Eddis B, Leong E. Morfologicheskaya diagnostika patologii limfaticheskikh uzlov. Per. s angl. I Samsonovoy. Moscow: Meditsinskaya literatura, 2008. (In Russian).

3. Diehl V, Sextro M, Franklin J, Hansmann ML, Harris N, Jaffe E, et al. Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin’s Disease. J Clin Oncol. 1999;17(3):776-83.

4. Nogovâ L, Reineke T, Brillant C, Sieniawski M, Rüdiger T, Josting A, et al. Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol. 2008;26(3):434-9.

5. Xing KH, Savage KJ. Modern management of lymphocyte-predominant Hodgkin lymphoma. Br J Haematol. 2013;161(3):316-29.

6. Marafioti T, Hummel M, Anagnostopoulos I, Foss HD, Falini B, Delsol G, et al. Origin of nodular lymphocyte-predominant Hodgkin’s disease from a clonal expansion of highly mutated germinal-center B-cells. N Engl J Med. 1997;337(7):453-8.

7. Fan Z, Natkunam Y, Bair E, Tibshirani R, Warnke RA. Characterization of variant patterns of nodular lymphocyte predominant Hodgkin lymphoma with immunohistologic and clinical correlation. Am J Surg Pathol. 2003;27(10):1346-56.

8. Brune V, Tiacci E, Pfeil I, Döring C, Eckerle S, van Noesel CJ, et al. Origin and pathogenesis of nodular lymphocyte-predominant Hodgkin lymphoma as revealed by global gene expression analysis. J Exp Med. 2008;205(10):2251-68.

9. Al-Mansour M, Connors JM, Gascoyne RD, Skinnider B, Savage KJ. Transformation to aggressive lymphoma in nodular lymphocyte-predominant Hodgkin’s lymphoma. J Clin Oncol. 2010;28(5):793-9.

10. Engert A, Plütschow A, Eich HT, Lohri A, Dörken B, Borchmann P, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363(7):640-52.

11. Wirth A, Yuen K, Barton M, Roos D, Gogna K, Pratt G, et al. Long-term outcome after radiotherapy alone for lymphocyte-predominant Hodgkin lymphoma: a retrospective multicenter study of the Australasian Radiation Oncology Lymphoma Group. Cancer. 2005;104(6):1221-9.

12. Chen RC, Chin MS, Ng AK, Feng Y, Neuberg D, Silver B, et al. Early-stage, lymphocyte-predominant Hodgkin’s lymphoma: patient outcomes from a large, single institution series with long follow-up. J Clin Oncol. 2010;28(1):136-41.

13. Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin’s disease. J Clin Oncol. 2004;22(14):2835-41.

14. Engert A, Franklin J, Eich HT, Brillant C, Sehlen S, Cartoni C, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25(23):3495-502.

15. Fermé C, Eghbali H, Meerwaldt JH, Rieux C, Bosq J, Berger F, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin’s disease. N Engl J Med. 2007;357(19):1916-27.

16. Feugier P, Labouyrie E, Djeridane M, Jenabian A, Dubruille V, Berthou C, et al. Comparison of initial characteristics and long-term outcome of patients with lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma at clinical stages IA and IIA prospectively treated by brief anthracycline-based chemotherapies plus extended high-dose irradiation. Blood. 2004;104(9):2675-81.

17. Savage KJ, Skinnider B, Al-Mansour M, Sehn LH, Gascoyne RD, Connors JM. Treating limited-stage nodular lymphocyte predominant Hodgkin lymphoma similarly to classical Hodgkin lymphoma with ABVD may improve outcome. Blood. 2011;118(17):4585-90.

18. Mauz-Körholz C, Gorde-Grosjean S, Hasenclever D, Shankar A, Dörffel W, Wallace WH, et al. Resection alone in 58 children with limited stage, lymphocyte-predominant Hodgkin lymphoma-experience from the European network group on pediatric Hodgkin lymphoma. Cancer. 2007;110(1):179-85.

19. Eichenauer DA, Fuchs M, Pluetschow A, Klimm B, Halbsguth T, Böll B, et al. Phase study of rituximab in newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group. Blood. 2011;118(6):4363-5.

20. Advani RH, Horning SJ, Hoppe RT, Daadi S, Allen J, Natkunam Y, et al. Mature results of a phase II study of rituximab therapy for nodular lymphocyte-predominant Hodgkin lymphoma. J Clin Oncol. 2014;32(9):912-8.

21. Xing KH, Connors JM, Lai A, Al-Mansour M, Sehn LH, Villa D, et al. Advanced-stage nodular lymphocyte predominant Hodgkin lymphoma compared with classical Hodgkin lymphoma: a matched pair outcome analysis. Blood. 2014; 123(23):3567-73.

22. Canellos GP, Mauch P. What is appropriate systemic chemotherapy for lymphocyte-predominant Hodgkin’s lymphoma? J Clin Oncol. 2010;28(1):e8.

23. Fanale MA, Lai C-M, McLaughilin P, Romaguera J, Fayad L, Hagemeister F, et al. Outcomes of nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL) patients treated with R-CHOP. Blood (ASH Annual Meeting. Orlando, Florida, USA, 4-7 December, 2010). 2010;116(21): abstr. 2812.

24. Karuturi M, Hosing C, Fanale M, Medeiros LJ, Alousi AM, de Lima MJ, et al. Highdose chemotherapy and autologous stem cell transplantation for nodular lymphocyte-predominant Hodgkin lymphoma. Biol Blood Marrow Transplant. 2013;19(6):991-4.

25. Bierman P, Naushad H, Loberiza F, BocieK RG, Voce JM, Armitage JO, et al. Highdose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) for lymphocyte predominant Hodgkin’s disease. Blood (ASH Annual Meeting. Orlando, Florida, USA, 4-7 December, 2006). 2006;108(11): abstr. 3061.

26. Park HC, Jung SH, Ahn JS, Kim MY, Yang DH, Kim YK, et al. Rituximab plus ifosfamide, carboplatine and etoposide for T-cell/hystiocyte-rich B-cell lymphoma arising in nodular lymphocyte-predominant Hodgkin’s lymphoma. Case Rep Oncol. 2012;5(2):413-9.