The new biology of PTCL-NOS and AITL: current status and future clinical impact.

Autor: Timmins MA; Leicester Cancer Research Centre, Ernest and Helen Scott Haematology Research Institute, University of Leicester, Leicester, UK., Wagner SD; Leicester Cancer Research Centre, Ernest and Helen Scott Haematology Research Institute, University of Leicester, Leicester, UK., Ahearne MJ; Leicester Cancer Research Centre, Ernest and Helen Scott Haematology Research Institute, University of Leicester, Leicester, UK.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2020 Apr; Vol. 189 (1), pp. 54-66. Date of Electronic Publication: 2020 Feb 17.
DOI: 10.1111/bjh.16428
Abstrakt: Peripheral T-cell lymphomas (PTCL) comprise a heterogeneous group of aggressive lymphoproliferative disorders almost all of which are associated with poor clinical outcomes. Angioimmunoblastic T-cell lymphoma (AITL) and some peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) have similarities to normal CD4 + T-cell subsets in their gene expression profiles. A cell of origin model is, therefore, emerging and is likely to be refined in the future. Follicular helper (Tfh) T cells are now established as the cell of origin of AITL and about 20% of PTCL-NOS. Sequencing studies have identified recurrent genetic alterations in epigenetic modifiers, T-cell receptor signalling pathway intermediates or RHOA, most commonly a specific mutation leading to RHOA G17V. While PTCL-NOS remains a diagnosis of exclusion, advances in genomics have identified subgroups expressing transcription factors TBX 21 (Th1-like origin) and GATA3 (Th2-like origin). These findings suggest new biomarkers and new therapeutic avenues including the hypomethylating agent azacytidine, or inhibitors of proximal T-cell receptor (TCR) signalling and potentially certain monoclonal antibodies. The advances over the past few years, therefore, prompt stratified medicine approaches to test biologically based treatments and determine the clinical utility of the new disease classifications.
(© 2020 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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