Cancer Research and Treatment

Original Articles

Hematologic malignancy

Feasibility of Circulating Tumor DNA Analysis in Patients with Follicular Lymphoma: Sang Eun Yoon, Seung-Ho Shin, Dae Keun Nam, Junhun Cho, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2024;56(3):920-935. Published online January 16, 2024; DOI: https://doi.org/10.4143/crt.2023.869

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Purpose
The feasibility of sequencing circulating tumor DNA (ctDNA) in plasma as a biomarker to predict early relapse or poor prognosis in patients with follicular lymphoma (FL) receiving systemic immunochemotherapy is not clear.
Materials and Methods
We sequenced DNA from cell-free plasma that was serially obtained from newly diagnosed FL patients undergoing systemic immunochemotherapy. The mutation profiles of ctDNA at the time of diagnosis and at response evaluation and relapse and/or progression were compared with clinical course and treatment outcomes.
Results
Forty samples from patients receiving rituximab-containing immunochemotherapy were analyzed. Baseline sequencing detected mutations in all cases, with the major detected mutations being KMT2C (50%), CREBBP (45%), and KMT2D (45%). The concentration of ctDNA and tumor mutation burden showed a significant association with survival outcome. In particular, the presence of mutations in CREBBP and TP53 showed poor prognosis compared with patients without them. Longitudinal analysis of ctDNA using serially collected plasma samples showed an association between persistence or reappearance of ctDNA mutations and disease relapse or progression.
Conclusion
Analysis of ctDNA mutations in plasma at diagnosis might help predict outcome of disease, while analysis during follow-up may help to monitor disease status of patients with advanced FL. However, the feasibility of ctDNA measurement must be improved in order for it to become an appropriate and clinically relevant test in FL patients.

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Feasibility of Circulating Tumor DNA Detection in the Cerebrospinal Fluid of Patients With Central Nervous System Involvement in Large B-Cell Lymphoma
Seok Jin Kim, Jin Ju Kim, Mi Ri Park, Bon Park, Kyung Ju Ryu, Sang Eun Yoon, Won Seog Kim, Saeam Shin, Seung-Tae Lee
Annals of Laboratory Medicine.2025; 45(1): 90. CrossRef
Clinical applications of circulating tumor DNA in hematological malignancies: From past to the future
Jun-Ying Li, Li-Ping Zuo, Jian Xu, Chun-Yan Sun
Blood Reviews.2024; 68: 101237. CrossRef
Molecular Biomarkers in Prediction of High-Grade Transformation and Outcome in Patients with Follicular Lymphoma: A Comprehensive Systemic Review
Marie Hairing Enemark, Jonas Klejs Hemmingsen, Maja Lund Jensen, Robert Kridel, Maja Ludvigsen
International Journal of Molecular Sciences.2024; 25(20): 11179. CrossRef

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Prognostic Value of Baseline and Interim Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on 18F-FDG PET-CT in Patients with Follicular Lymphoma: Jin-Hua Liang, Yun-Ping Zhang, Jun Xia, Chong-Yang Ding, Wei Wu, Li Wang, Lei Cao, Hua-Yuan Zhu, Lei Fan, Tian-Nv Li, Jian-Yong Li, Wei Xu; Cancer Res Treat. 2019;51(4):1479-1487. Published online March 12, 2019; DOI: https://doi.org/10.4143/crt.2018.649

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Purpose
The purpose of this study was to investigate the prognostic significance of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) in patients with follicular lymphoma (FL) at baseline and mid-treatment with ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scans.
Methods
The study analyzed data from 48 patients with FL who were treated in Jiangsu Province Hospital and reviewed their baseline PET-CT scans. TMTV and TLG were computed by using the absolute value of 2.0, 2.5, and 3.0 thresholding method, respectively.
Results
Median age was 53 years, 75.0% of patients had stage III to IV disease, 43.8% had a Follicular Lymphoma International Prognostic Index 1 (FLIPI1) score of 3 to 5 and 20.8% had a FLIPI2 score of 3 to 5. Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off values for TMTV3.0 and TLG3.0 were 476.4 (sensitivity, 85.7%; specificity, 78.0%; area under the curve [AUC], 0.760; p=0.003) and 2,676.9 (sensitivity, 71.4%; specificity, 78.0%; AUC, 0.760; p=0.003). On multivariable analysis, TMTV3.0 and TLG3.0 were independent predictors of both progression-free survival (PFS) (hazard ratio [HR], 5.406; 95% confidence interval [CI], 1.326 to 22.040; p=0.019 and HR, 6.502; 95% CI, 1.079 to 39.182; p=0.042) and overall survival (OS) (HR, 4.111; 95% CI, 1.125 to 15.027; p=0.033 and HR, 5.885; 95% CI, 1.014 to 34.148; p=0.049). ROC curve analysis showed the optimal cut-off values for ΔTMTV3.0 and ΔTLG3.0 were 66.3% (sensitivity, 85.7%; specificity, 63.4%; AUC, 0.774; p < 0.001) and 64.5% (sensitivity, 85.7%; specificity, 65.9%; AUC, 0.777; p < 0.001).
Conclusion
Baseline TMTV and TLG are strong predictors of PFS and OS in FL. Furthermore, interim TMTV (ΔTMTV > 66.3%) and TLG (ΔTLG > 64.5%) reduction are valuable tools for early treatment response assessment in FL patients.

Citations

Citations to this article as recorded by

Personalised therapy in follicular lymphoma – is the dial turning?
Kim M. Linton, Lena Specht, Astrid Pavlovsky, Carrie A. Thompson, Eva Kimby, Daphne de Jong, Loretta J. Nastoupil, Anne‐Ségolène Cottereau, Carla Casulo, Clémentine Sarkozy, Jessica Okosun
Hematological Oncology.2024;[Epub] CrossRef
Metabolic tumor volume predicts outcome in patients with advanced stage follicular lymphoma from the RELEVANCE trial
A.S. Cottereau, L. Rebaud, J. Trotman, P. Feugier, L.J. Nastoupil, E. Bachy, I.W. Flinn, C. Haioun, L. Ysebaert, N.L. Bartlett, H. Tilly, O. Casasnovas, R. Ricci, C. Portugues, I. Buvat, M. Meignan, F. Morschhauser
Annals of Oncology.2024; 35(1): 130. CrossRef
Prognostic value of the combination of volume, massiveness and fragmentation parameters measured on baseline FDG pet in high-burden follicular lymphoma
S. Draye-Carbonnier, V. Camus, S. Becker, D. Tonnelet, E. Lévêque, A. Zduniak, F. Jardin, H. Tilly, P. Vera, P. Decazes
Scientific Reports.2024;[Epub] CrossRef
Baseline 18F-FDG PET/CT may contribute to the determination of initial treatment strategy for newly diagnosed follicular lymphoma
Qiao Yang, Hongzhe Zhang, Yan Zhang, Wei Zhang, Daobin Zhou, Yaping Luo
European Journal of Radiology.2024; 178: 111632. CrossRef
The value of semiquantitative PET features and end‐of‐therapy PET in grade 3B follicular lymphoma
Allison Barraclough, Sze Ting Lee, Diego Villa, Greg Hapgood, Don Wilson, Geoffrey Chong, Eliza A. Hawkes
British Journal of Haematology.2024;[Epub] CrossRef
Accuracy and prognostic impact of FDG PET/CT and biopsy in bone marrow assessment of follicular lymphoma at diagnosis: A Nation‐Wide cohort study
Isabel Ródenas‐Quiñonero, Tzu Chen‐Liang, Taida Martín‐Santos, Antonio Salar, Marta Fernández‐González, Carolina Celades, José‐Tomás Navarro, Ana Belén Martínez‐Garcia, Rafael Andreu, Aitana Balaguer, Alejandro Martin García‐Sancho, Mónica Baile, Javier L
Cancer Medicine.2023; 12(6): 6536. CrossRef
Prognostic value of 18F-FDG lesion dissemination features in patients with peripheral T-cell lymphoma (PTCL)
Yiting Xie, Yue Teng, Chong Jiang, Chongyang Ding, Zhengyang Zhou
Japanese Journal of Radiology.2023; 41(7): 777. CrossRef
Prognostic value of interim 18F-FDG PET/CT in adult follicular lymphoma treated with R-CHOP
Na Sun, Wenli Qiao, Yan Xing, Taisong Wang, Jinhua Zhao
Annals of Hematology.2023; 102(4): 795. CrossRef
Early biochemical and radiographic response after one cycle of [177Lu]Lu-PSMA I&T radioligand therapy in metastatic castration-resistant prostate cancer patients
Wojciech Cytawa, Robin Hendel, Bartłomiej Tomasik, Franz-Xaver Weinzierl, Thorsten Bley, Jacek Jassem, Andreas Schirbel, Andreas K. Buck, Ralph A. Bundschuh, Philipp E. Hartrampf, Rudolf A. Werner, Constantin Lapa
European Journal of Nuclear Medicine and Molecular Imaging.2023; 50(12): 3765. CrossRef
Early molecular imaging response assessment based on determination of total viable tumor burden in [68Ga]Ga-PSMA-11 PET/CT independently predicts overall survival in [177Lu]Lu-PSMA-617 radioligand therapy
Florian Rosar, Felix Wenner, Fadi Khreish, Sebastian Dewes, Gudrun Wagenpfeil, Manuela A. Hoffmann, Mathias Schreckenberger, Mark Bartholomä, Samer Ezziddin
European Journal of Nuclear Medicine and Molecular Imaging.2022; 49(5): 1584. CrossRef
Prognostic significance of clinical characteristics and 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma
Yizhen Liu, Jinjin Jiang, Lianfang Liu, Zezhou Wang, Baohua Yu, Zuguang Xia, Qunling Zhang, Dongmei Ji, Xiaojian Liu, Fangfang Lv, Xiaonan Hong, Shaoli Song, Junning Cao
Journal of International Medical Research.2022;[Epub] CrossRef
Pre‐treatment total metabolic tumour volumes in lymphoma: Does quantity matter?
Tarec Christoffer El‐Galaly, Diego Villa, Chan Yoon Cheah, Lars C. Gormsen
British Journal of Haematology.2022; 197(2): 139. CrossRef
Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT
Hongyan Li, Min Wang, Yajing Zhang, Fan Hu, Kun Wang, Chenyang Wang, Zairong Gao
Frontiers in Oncology.2022;[Epub] CrossRef
Time to omit interim CT imaging during frontline chemoimmunotherapy for patients with follicular lymphoma?
Ross Thomas Salvaris, Chan Yoon Cheah
Leukemia & Lymphoma.2022; 63(14): 3271. CrossRef
Prognostic Values of Baseline 18F-FDG PET/CT in Patients with Peripheral T-Cell Lymphoma
Yeye Zhou, Xiaoyi Zhang, Haifeng Qin, Zixuan Zhao, Jihui Li, Bin Zhang, Shibiao Sang, Yiwei Wu, Shengming Deng
BioMed Research International.2020; 2020: 1. CrossRef
The Incremental Prognostic Value of Baseline 18F-FDG PET/CT Imaging in Angioimmunoblastic T-Cell Lymphoma
Hui Wang, Wenjing Yu, Tao Wu, Yangyang Xue, Dan Zhang, Huiqin Xu
BioMed Research International.2020; 2020: 1. CrossRef

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Radiation Therapy Outcome and Clinical Features of Duodenal-Type Follicular Lymphoma: Hansang Lee, Dongryul Oh, Kyungmi Yang, Young Hyeh Ko, Yong Chan Ahn, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2019;51(2):547-555. Published online July 10, 2018; DOI: https://doi.org/10.4143/crt.2018.190

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Purpose
Duodenal-type follicular lymphoma (FL) is a rare variant of FL. There is still no consensus on the initial treatment, and clinical features including endoscopic findings are not familiar to most physicians. The objective of this study was to evaluate the outcome of patients who were initially treated with radiation therapy for duodenal-type FL.
Materials and Methods
We retrospectively analyzed 20 patients who were consecutively diagnosed with duodenaltype FL between 2008 and 2017. All patients received radiation therapywith curative intent.
Results
The median age of the patients was 52 years (range, 26 to 66 years), and females were predominant. Most patients (n=18, 90%) had stage I disease, and were diagnosed by a regular health examination in an asymptomatic state. The histological grade was one in 19 patients (95%), and the endoscopic findings were diffuse nodular (n=8), whitish granular (n=8), and mixed pattern (n=4). Radiation therapy was delivered to 17 patients with 24 Gy in 12 fractions, and to three patients with 30.6-36 Gy in 18 fractions. All patients were evaluated with endoscopy for response to radiation therapy, and complete response was achieved in 19 patients (95%). At the time of analysis, all patients survived without any evidence of late toxicities related with radiation therapy.
Conclusion
Taken together, radiation therapy alone could be effective in controlling duodenal lesion. A further study with longer follow-up duration is warranted to confirm our findings.

Citations

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Recent updates on treatment options for primary follicular lymphoma of the gastrointestinal tract
Masaya Iwamuro, Takehiro Tanaka, Daisuke Ennishi, Motoyuki Otsuka
Expert Review of Gastroenterology & Hepatology.2024; 18(7): 367. CrossRef
Duodenal-type follicular lymphoma: comprehensive insights into disease characteristics and established treatment strategies
Ahmed Alnughmush, Riad El Fakih, Ruah Alyamany, Nasir Bakshi, Saud Alhayli, Mahmoud Aljurf
Current Opinion in Oncology.2024; 36(6): 577. CrossRef
Clinical characteristics and outcomes of Brazilian patients with duodenal-type follicular lymphoma: a multicenter retrospective study
Guilherme Duffles, Arthur Braga, Talita Silveira, Yana Novis, Celso Arrais, Luciana Tucunduva, Ana Rita Fonseca, Davimar Borducchi, Pedro Neffa, Fernando Blumm, Marianne de Castro Gonçalves, Frederico Moreira, Fabio Nucci, Eduardo Rego, Vanderson Rocha
Leukemia & Lymphoma.2024; : 1. CrossRef
Bridging clinicopathologic features and genetics in follicular lymphoma: Towards enhanced diagnostic accuracy and subtype differentiation
Jan Bosch-Schips, Xenia Parisi, Fina Climent, Francisco Vega
Human Pathology.2024; : 105676. CrossRef
Duodenal Polyposis: An Incidental Finding of Duodenal-Type Follicular Lymphoma
Rachael Hagen, Jasmine Tidwell, Emily Weng, Steven A Goldenberg, Anjiya Shaikh
Cureus.2024;[Epub] CrossRef
Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
Jong Yun Baek, Do Hoon Lim, Dongryul Oh, Heerim Nam, Jae J Kim, Jun Haeng Lee, Byung-Hoon Min, Hyuk Lee
Cancer Research and Treatment.2022; 54(1): 294. CrossRef
Duodenal Follicular Lymphoma: Track or Treat?
M. Varanese, A. Lauro, I. Lattina, D. Tripodi, T. Daralioti, S. Khouzam, I. R. Marino, V. Stigliano, V. D’Andrea, S. Frattaroli, S. Sorrenti
Digestive Diseases and Sciences.2022; 67(5): 1733. CrossRef
Incidentally Found Mucosal Nodularity on the Second Portion of Duodenum
Joo Hyun Lim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(2): 163. CrossRef
Duodenal-type follicular lymphoma more than 10 years after treatment intervention: A retrospective single-center analysis
Makoto Saito, Akio Mori, Shihori Tsukamoto, Takashi Ishio, Emi Yokoyama, Koh Izumiyama, Masanobu Morioka, Takeshi Kondo, Hirokazu Sugino
World Journal of Gastrointestinal Oncology.2022; 14(8): 1552. CrossRef
Linfoma folicular duodenal primario: reporte de caso y revisión de la literatura
Lázaro Antonio Arango Molano, Andrés Sánchez Gil, Ileana Rocío Bautista Parada
Revista colombiana de Gastroenterología.2021; 36(4): 525. CrossRef
What do we know about duodenal‐type follicular lymphoma? From pathological definition to treatment options
Guilherme Duffles Amarante, Graham Collins, Vanderson Rocha
British Journal of Haematology.2020; 188(6): 831. CrossRef
Scientific Advances and the Evolution of Diagnosis, Subclassification and Treatment of Lymphoma
Judith A. Ferry
Archives of Medical Research.2020; 51(8): 749. CrossRef
Development of diffuse large B-cell lymphoma from duodenal type follicular lymphoma: a retrospective study of 23 cases
Masuho Saburi, Yoshiyuki Kondo, Masao Ogata, Yasuhiro Soga, Miyuki Abe, Kuniko Takano, Kazuhiro Kohno, Takayuki Nagai, Toshiyuki Nakayama
International Journal of Hematology.2020; 112(5): 658. CrossRef
Analysis of the response time to involved-field radiotherapy in primary gastrointestinal low-grade B-cell lymphoma
Kyu Hye Choi, Han Hee Lee, Seung-Eun Jung, Kyung-Sin Park, Joo-Hyun O, Young-Woo Jeon, Byung-Ock Choi, Seok-Goo Cho
Radiation Oncology.2020;[Epub] CrossRef

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Case Report

Primary Follicular Lymphoma in a Male Breast: A Case Report: Seung Pil Jung, Kang Min Han, Seok Jin Kim, Seok Jin Nam, Jeoung Won Bae, Jeong Eon Lee; Cancer Res Treat. 2014;46(1):104-107. Published online January 15, 2014; DOI: https://doi.org/10.4143/crt.2014.46.1.104

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Primary breast lymphoma (PBL) is a rare disease, particularly in males. Diffuse large B cell lymphoma is the most common PBL, while follicular lymphoma is less common. Furthermore, primary follicular lymphoma of a male breast is rarely reported. We report a male patient with primary follicular lymphoma of the breast and hepatocellular carcinoma (HCC). A 46-year-old man was diagnosed with liver cirrhosis secondary to chronic hepatitis B infection. Ten years later, he underwent segmentectomy of the liver due to HCC. Another 5 months later, he presented with a painless mass in the right chest wall. The mass was diagnosed as follicular lymphoma of the breast. The stage was IEA and he did not receive adjuvant therapy. Although only a few cases have been reported, lymphoma should be considered as a possible cause of breast mass, even in male patients.

Citations

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Clinicopathologic and mutational profiles of primary breast diffuse large B cell lymphoma in a male patient: case report and literature review
Fengbo Huang, Yachao Ruan, Xiaojuan He, Hui Lian, Jinhua Yang
World Journal of Surgical Oncology.2023;[Epub] CrossRef
Primary breast lymphoma in males: Incidence, demographics, prognostic factors, survival, and comparisons with females
Jie Zhang, Binbin Ma, Hong Ji, Rong Guo
Frontiers in Surgery.2022;[Epub] CrossRef
Hematologic Malignancies of the Breast: A Contemporary Series Investigating Incidence, Presentation, Accuracy of Diagnosis on Core Needle Biopsy, and Hormone Receptor Expression
Marie-Christine Guilbert, Jason L Hornick, Sona A Chikarmane, Susan C Lester
Breast Cancer: Basic and Clinical Research.2019;[Epub] CrossRef

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