
Malignant Lymphomas
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This book is an up to date compendium on the biology and molecular pathogenesis of lymphomas, which represent malignant cancers of the lymphoid system. With its focus on the biology and genetic basis of these diseases, the book is of interest to basic scientists, biologists, clinical hematologists and pathologists as well as medical students. Different chapters will cover all major lymphoma subtypes, as well as chronic lymphocytic leukemia and selected less common lymphoma entities such as T-cell lymphomas and central nervous system lymphomas.
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Content
- Intro
- Contents
- Preface
- List of contributing authors
- 1. Classification of lymphomas - past, present and future
- 1.1 Classification - what is it good for?
- 1.2 The history of lymphoma classification
- 1.2.1 19th century: Tumors of lymphoid cells and their relation to leukemia
- 1.2.2 20th century: Description of individual diseases and historical lymphoma classifications
- 1.2.3 The second half of the 20th century: Modern lymphoma classifications, controversy and consensus
- 1.3 The principles of the current WHO classification
- 1.4 Future lymphoma classification - towards new hierarchical classification principles?
- 2. Mature B-cell development and the germinal center reaction
- 2.1 Introduction
- 2.2 The peripheral B-cell repertoire
- 2.3 The germinal center reaction
- 2.3.1 Initiation of the GC reaction
- 2.3.2 GC formation and establishment of the mature GC
- 2.3.3 Somatic hypermutation
- 2.3.4 B cell movementswithin the zonal structure of the GC
- 2.3.5 Selection of high-affinity GC B cells
- 2.3.6 Class switch recombination
- 2.3.7 GC maintenance
- 2.3.8 Termination of the GC reaction and post-GC B-cell differentiation
- 2.4 Concluding remarks
- 3. T-cell development
- 3.1 Introduction
- 3.2 Overview
- 3.3 aßT -cell repertoire
- 3.3.1 Antigen presentation and MHC molecules
- 3.3.2 Peripheral aßT CR repertoires
- 3.4 The T-cell receptor
- 3.4.1 The variable chains of the T-cell receptor
- 3.4.2 The order and regulation of V(D)J recombination
- 3.4.3 Molecularmechanism of V(D)J recombination
- 3.4.4 Tumorigenic potential of TCR recombination
- 3.5 Thymus and early T-cell development
- 3.5.1 The thymus
- 3.5.2 Early T-cell development in the thymus
- 3.5.3 Positive selection
- 3.5.4 CD4 vs CD8 lineage commitment
- 3.5.5 Negative selection and exit from the thymus
- 3.6 TCR signaling - T-cell activation
- 3.6.1 TCR signaling complex
- 3.6.2 Activation and survival of naive T cells
- 3.6.3 Activated T-cell differentiation
- 3.6.4 Shutting down activated T cells
- 3.7 Concluding remarks
- 4. Mantle cell lymphoma
- 4.1 Introduction
- 4.2 Molecular pathogenesis ofMCL
- 4.2.1 Overexpression of cyclin D1 and cell cycle dysregulation
- 4.2.2 Additional genetic aberrations and deregulated signaling pathways
- 4.3 Clinical implications
- 4.4 BCR signaling inhibitors
- 4.5 PI3K/mTOR inhibitors
- 4.6 BCL2 inhibitors
- 4.7 Proteasome inhibitors
- 4.8 Concluding remarks
- 5. Follicular lymphoma
- 5.1 Introduction
- 5.2 Histology and grading
- 5.3 Transformed follicular lymphoma
- 5.4 Early steps of FL development: Initial genetic hit t(14
- 18)
- 5.5 Cell of origin
- 5.6 t(14
- 18) insufficient for lymphoma development
- 5.7 Intermediate steps in FL development
- 5.8 Existence of a progenitor clone
- 5.9 Molecular genetics of FL
- 5.9.1 Copy number alterations and copy neutral loss of heterozygosity
- 5.9.2 Genetic aberrations affecting key biological and signaling pathways
- 5.9.3 Alterations in epigenetic regulators
- 5.9.4 Alterations in immune modulators
- 5.9.5 Alterations affecting NF-?B signaling
- 5.9.6 Alterations affecting JAK-STAT signaling
- 5.9.7 Alterations affecting genes involved in cell proliferation and cell cycle regulation
- 5.9.8 Alterations in miscellaneous genes
- 5.10 Disease progression, transformation and clonal evolution
- 5.11 Other FL variants: Pediatric and t(14
- 18)-negative follicular lymphoma
- 5.12 Impact of the tumormicroenvironment
- 5.13 Susceptibility loci for FL
- 5.14 Concluding remarks
- 6. Genetics and molecular pathogenesis of marginal zone lymphoma
- 6.1 Introduction
- 6.2 Extranodalmarginal zone lymphoma of mucosa-associated lymphoid tissue
- 6.2.1 Etiology of MALT lymphoma
- 6.2.2 Role of immunological stimulation in the pathogenesis of MALT lymphoma
- 6.2.3 Genetic abnormalities in MALT lymphoma
- 6.2.4 Oncogenic cooperation between genetic abnormalities and antigenic stimulation
- 6.3 Splenic marginal zone lymphoma
- 6.3.1 Etiology of SMZL
- 6.3.2 Role of antigenic drive in pathogenesis of SMZL
- 6.3.3 Genetic abnormalities in SMZL
- 6.3.4 Oncogenic cooperation between genetic changes and antigenic stimulation
- 6.4 Concluding remarks
- 7. Burkitt lymphoma
- 7.1 Introduction
- 7.2 Cellular origin of Burkitt lymphoma
- 7.3 Genetic lesions involved in BL pathogenesis
- 7.3.1 Chromosomal translocations involving the c-MYC proto-oncogene
- 7.3.2 Mutations in TCF3 and ID3, and activation of PI3K signaling
- 7.3.3 Additional recurrent genetic lesions
- 7.4 Mouse models of Burkitt lymphoma
- 7.5 Conclusions and perspectives
- 8. Diffuse large B-cell lymphoma
- 8.1 Introduction
- 8.2 Cell of origin and classification
- 8.2.1 The "cell-of-origin" (COO) classification
- 8.2.2 The "comprehensive-consensus-cluster" (CCC) classification
- 8.3 Mechanisms of genetic lesion in DLBCL
- 8.3.1 Chromosomal translocations
- 8.3.2 Aberrant somatic hypermutation
- 8.4 The genetic landscape of DLBCL
- 8.5 Dysregulated pathways in DLBCL
- 8.5.1 Programs dysregulated in both GCB-DLBCL and ABC-DLBCL
- 8.5.2 Genetic lesions associated with GCB-DLBCL
- 8.5.3 Genetic lesions associated with ABC-DLBCL
- 8.5.4 Genetic lesions associated with histologic transformation of FL and CLL
- 8.6 Double-hit DLBCL
- 8.7 Concluding remarks
- 9. The biology of primary mediastinal large B-cell lymphoma
- 9.1 Introduction
- 9.2 Cell of origin and gene expression profiling
- 9.3 Molecular hallmarks of PMBCL
- 9.3.1 The mutational landscape of primary mediastinal large B-cell lymphoma
- 9.3.2 JAK-STAT pathway signaling
- 9.3.3 NF-?B signaling
- 9.3.4 Acquired immune privilege
- 9.3.5 Epigenetic changes
- 9.3.6 Biomarkers and therapeutic considerations
- 9.4 Concluding remarks
- 10. Molecular pathogenesis of primary central nervous system lymphoma
- 10.1 Introduction
- 10.2 Etiology
- 10.3 Clinical features and pathogenesis
- 10.4 Molecular pathogenesis of PCNSL
- 10.5 Role of the tumormicroenvironment in PCNSL
- 10.6 Concluding remarks
- 11. Chronic lymphocytic leukemia
- 11.1 Introduction
- 11.2 Clinical background
- 11.3 B-cell receptor signaling pathway
- 11.4 Notch signaling pathway
- 11.5 Other signaling pathways
- 11.6 Splicing
- 11.7 Apoptotic and cell cycle checkpoints
- 11.8 MYC network
- 11.9 Telomere function
- 11.10 Clonal architecture and evolution of CLL
- 11.11 Inherited susceptibility of CLL
- 11.12 Concluding remarks
- 12. Waldenström's macroglobulinemia
- 12.1 Introduction
- 12.2 Epidemiology and patient characteristics
- 12.3 Nature of the WM clone
- 12.4 Chromosomal abnormalities inWM
- 12.5 MYD88 somatic mutations
- 12.6 CXCR4 somaticmutations
- 12.7 Other recurrent mutations
- 12.8 Microenvironmental interactions in WM
- 12.9 Concluding remarks
- 13. Molecular pathogenesis of multiplemyeloma
- 13.1 Introduction
- 13.2 Clinical stages of plasma cell neoplasms: a new definition of multiple myeloma
- 13.3 Chromosome translocations of the immunoglobulin genes are present in half of patients with MGUS and MM
- 13.4 Three groups of primary IgH translocations in ~ 40% of MM
- 13.5 Hyperdiploidy with multiple trisomies is another primary genetic event
- 13.6 Universal dysregulation of a cyclin D/RB axis in MM
- 13.7 Secondary genetic events associated with progression of MGUS to MM
- 13.7.1 MYC
- 13.7.2 Deletion 13
- 13.7.3 RAS pathway
- 13.8 High-risk MM is associated with subclonal tumor heterogeneity
- 13.9 Concluding remarks and future directions
- 14. Biology of Hodgkin's lymphoma
- 14.1 Introduction
- 14.2 The cellular origin of the tumor cells in HL
- 14.3 Relationship of Hodgkin cells to Reed-Sternberg cells
- 14.4 The lost B-cell identity of HRS cells
- 14.5 Genetic lesions
- 14.6 Role of EBV in HL pathogenesis
- 14.7 Deregulated signaling pathways and transcription factors
- 14.8 Microenvironmental interactions
- 14.9 Lessons learnt from composite lymphomas
- 14.10 HL cell lines
- 15. Anaplastic large cell lymphoma
- 15.1 Introduction
- 15.2 Anaplastic large cell lymphoma, ALK-positive (ALK+ ALCL)
- 15.2.1 Clinical features
- 15.2.2 Morphology
- 15.2.3 Immunohistochemical markers
- 15.2.4 Patterns of ALK protein expression in ALK+ ALCL
- 15.2.5 Differential diagnosis
- 15.2.6 Genetic abnormalities and molecular pathogenesis of ALK+ ALCL
- 15.2.7 Prognostic factors and therapy
- 15.3 Anaplastic large cell lymphoma, ALK-negative (ALK- ALCL)
- 15.3.1 Epidemiology
- 15.3.2 Clinical features
- 15.3.3 Morphology and phenotype
- 15.3.4 Molecular studies
- 15.3.5 Prognosis
- 15.4 Primary cutaneous ALCL
- 15.5 Breast-implant ALCL
- 16. Molecular pathogenesis of malignant lymphomas: PTCL, NOS and AITL
- 16.1 Introduction
- 16.2 Follicular helper T cells in the pathogenesis of AITL
- 16.3 Gene expression profiling insights in the classification and biology of PTCL, NOS and AITL
- 16.4 The genetic landscape of AITL and PTCL, NOS
- 16.5 Lessons from animal models
- 16.6 Concluding remarks
- 17. Extranodal NK/T-cell lymphoma
- 17.1 Introduction
- 17.2 General clinicopathologic features
- 17.3 Receptor expression
- 17.4 The role of EBV in pathogenesis
- 17.5 Genetic and epigenetic alterations
- 17.6 ?d T-cell lymphoma
- 17.6.1 Cell of origin
- 17.6.2 Subtypes of lymphomas derived from ?d T cells
- 17.6.3 Hepatosplenic ?d T -cell lymphoma
- 17.6.4 Primary cutaneous ?d T -cell lymphoma
- 17.6.5 Mucosal ?d T -cell lymphoma
- 17.6.6 ?d T -cell lymphoma in the intestine
- 17.7 Gene expression profiling analysis
- 17.8 JAK/STAT pathway activation
- 17.9 Concluding remarks
- 18. Lymphomas associated with viral infection
- 18.1 Introduction
- 18.2 Epstein-Barr virus (EBV)
- 18.2.1 Patterns of EBV latency
- 18.2.2 EBV mediated lymphomagenesis
- 18.2.3 Lymphomas associatedwith EBV infection
- 18.3 Kaposi's sarcoma-associatedherpesvirus (KSHV)
- 18.4 KSHV-mediated lymphomagenesis
- 18.4.1 Lymphomas associated with KSHV infection
- 18.5 Human T-cell leukemia virus-1 (HTLV-1)
- 18.5.1 HTLV-1 mediated oncogenesis
- 18.5.2 Adult T-cell leukemia-lymphoma (ATL)
- 18.6 Hepatitis C virus
- 18.7 HIV and lymphomagenesis
- 18.8 Concluding remarks
- 19. Translating science into therapy of lymphoma
- 19.1 Introduction
- 19.2 Inhibition of the B-cell receptor signaling pathway
- 19.2.1 Historical overviewof BTK/PI3K inhibitors
- 19.2.2 Tumor hyperlymphocytosis
- 19.2.3 Diffuse large B-cell lymphoma
- 19.2.4 Follicular lymphoma
- 19.2.5 Waldenström'smacroglobulinemia (WM)
- 19.2.6 Marginal zone lymphomas
- 19.2.7 Chronic lymphocytic leukemia
- 19.2.8 Mantle Cell Lymphoma
- 19.3 Inducing the mitochondrial apoptosis pathway in lymphoma
- 19.4 Targeting ALK in lymphoma
- 19.5 Targeting immune cells in lymphoma
- 19.5.1 Lenalidomide
- 19.5.2 Immune checkpoints inhibitors
- 19.6 Targeting epigenetic deregulation
- 19.6.1 EZH2 inhibitors
- 19.6.2 IDH2
- 19.7 Concluding remarks
- Index
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