Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis
T-cell/natural killer cell lymphoproliferative disorders are rare, associated with poor overall survival, and have limited treatment options. We report a case of a patient who developed hydroa vacciniforme-like lymphoma (HVLL, an EBV-peripheral T-cell lymphoma), refractory to multiple lines of syst...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2022-07-01
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| Series: | International Journal of Hematology-Oncology and Stem Cell Research |
| Subjects: | |
| Online Access: | https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1485 |
| _version_ | 1797760933866504192 |
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| author | Rohit Goswamy Helen Ajufo Abhishek Maiti Robert Brown Harinder Juneja Effrosyni Apostolidou |
| author_facet | Rohit Goswamy Helen Ajufo Abhishek Maiti Robert Brown Harinder Juneja Effrosyni Apostolidou |
| author_sort | Rohit Goswamy |
| collection | DOAJ |
| description |
T-cell/natural killer cell lymphoproliferative disorders are rare, associated with poor overall survival, and have limited treatment options. We report a case of a patient who developed hydroa vacciniforme-like lymphoma (HVLL, an EBV-peripheral T-cell lymphoma), refractory to multiple lines of systemic therapy including methotrexate, mycophenolate mofetil, dapsone, thalidomide, prednisone, and romidepsin. We conducted morphoproteomic analysis of the patient’s tumor which provided important biological insights. Histopathology showed primarily lymphohistiocytic infiltrates strongly positive EBV expression with a Ki-67 of >50% in the pretreatment biopsy and approximately 90% in the post-treatment biopsy, strong expression of Enhancer of Zester Homolog 2 (EZH2), a constitutively active mTOR pathway, 50% cytoplasmic BCL-2 expression; largely negative PD-1 positive CD8 T-cells. Based on this morphoproteomic analysis and published literature, we postulated that novel agents including venetoclax, tazemetostat, and other agents may provide a targeted approach for treating HVLL. This case illustrates the use of morphoproteomic analysis to better understand the biology of tumors.
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| first_indexed | 2024-03-12T19:06:39Z |
| format | Article |
| id | doaj.art-e04cb2e72d9842a7810a1c239ca2d024 |
| institution | Directory Open Access Journal |
| issn | 2008-2207 |
| language | English |
| last_indexed | 2024-03-12T19:06:39Z |
| publishDate | 2022-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | International Journal of Hematology-Oncology and Stem Cell Research |
| spelling | doaj.art-e04cb2e72d9842a7810a1c239ca2d0242023-08-02T06:16:26ZengTehran University of Medical SciencesInternational Journal of Hematology-Oncology and Stem Cell Research2008-22072022-07-01163Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic AnalysisRohit Goswamy0Helen Ajufo1Abhishek Maiti2Robert Brown3Harinder Juneja4Effrosyni Apostolidou5Department of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United StatesDepartment of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United StatesDepartment of Leukemia, University of Texas MD Anderson Cancer Center, Houston, Texas, United StatesDepartment of Pathology and Laboratory Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United StatesDepartment of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United StatesDepartment of Internal Medicine, University of Texas Health Sciences Center at Houston, Houston, Texas, United States T-cell/natural killer cell lymphoproliferative disorders are rare, associated with poor overall survival, and have limited treatment options. We report a case of a patient who developed hydroa vacciniforme-like lymphoma (HVLL, an EBV-peripheral T-cell lymphoma), refractory to multiple lines of systemic therapy including methotrexate, mycophenolate mofetil, dapsone, thalidomide, prednisone, and romidepsin. We conducted morphoproteomic analysis of the patient’s tumor which provided important biological insights. Histopathology showed primarily lymphohistiocytic infiltrates strongly positive EBV expression with a Ki-67 of >50% in the pretreatment biopsy and approximately 90% in the post-treatment biopsy, strong expression of Enhancer of Zester Homolog 2 (EZH2), a constitutively active mTOR pathway, 50% cytoplasmic BCL-2 expression; largely negative PD-1 positive CD8 T-cells. Based on this morphoproteomic analysis and published literature, we postulated that novel agents including venetoclax, tazemetostat, and other agents may provide a targeted approach for treating HVLL. This case illustrates the use of morphoproteomic analysis to better understand the biology of tumors. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1485Hydroa vacciniforme-like lymphoma (HVLL); Epstein-Barr virus; T-cell lymphoproliferative disorders; Resistance mechanisms; Morphoproteomics |
| spellingShingle | Rohit Goswamy Helen Ajufo Abhishek Maiti Robert Brown Harinder Juneja Effrosyni Apostolidou Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis International Journal of Hematology-Oncology and Stem Cell Research Hydroa vacciniforme-like lymphoma (HVLL); Epstein-Barr virus; T-cell lymphoproliferative disorders; Resistance mechanisms; Morphoproteomics |
| title | Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis |
| title_full | Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis |
| title_fullStr | Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis |
| title_full_unstemmed | Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis |
| title_short | Refractory Hydroa Vacciniforme-Like Lymphoma: Biological Insights from Morphoproteomic Analysis |
| title_sort | refractory hydroa vacciniforme like lymphoma biological insights from morphoproteomic analysis |
| topic | Hydroa vacciniforme-like lymphoma (HVLL); Epstein-Barr virus; T-cell lymphoproliferative disorders; Resistance mechanisms; Morphoproteomics |
| url | https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1485 |
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