Clinical spectrum, evolution, and management of autoimmune cytopenias associated with angioimmunoblastic T-cell lymphoma.
Details
Serval ID
serval:BIB_A0DD67064CA0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical spectrum, evolution, and management of autoimmune cytopenias associated with angioimmunoblastic T-cell lymphoma.
Journal
European journal of haematology
ISSN
1600-0609 (Electronic)
ISSN-L
0902-4441
Publication state
Published
Issued date
07/2019
Peer-reviewed
Oui
Volume
103
Number
1
Pages
35-42
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is frequently associated with autoimmune cytopenia (AIC). Whether such patients have a particular phenotype and require particular management is unclear.
Angioimmunoblastic T-cell lymphoma patients from the multicentric database of the Lymphoma Study Association presenting with AIC during disease course were included and matched to AITL patients without AIC (1/5 ratio).
At diagnosis, AIC patients (n = 28) had more spleen and bone marrow involvement (54% vs 19% and 71% vs 34%, P < 0.001), Epstein-Barr virus replication (89% vs 39%, P < 0.001), gamma globulin titers (median 23 vs 15 g/L, P = 0.002), and proliferating B cells and plasmablasts in biopsies, as compared to control patients (n = 136). The 28 AIC patients had 41 episodes of AIC, diagnosed concomitantly with AITL in 23 (82%) cases. After a median follow-up of 24 months (range 3-155), 10 patients relapsed, all associated with AITL relapse.
Our results provide new insight into AIC associated with AITL by highlighting the significant interplay between AITL and B-cell activation leading to subsequent autoimmunity.
Angioimmunoblastic T-cell lymphoma patients from the multicentric database of the Lymphoma Study Association presenting with AIC during disease course were included and matched to AITL patients without AIC (1/5 ratio).
At diagnosis, AIC patients (n = 28) had more spleen and bone marrow involvement (54% vs 19% and 71% vs 34%, P < 0.001), Epstein-Barr virus replication (89% vs 39%, P < 0.001), gamma globulin titers (median 23 vs 15 g/L, P = 0.002), and proliferating B cells and plasmablasts in biopsies, as compared to control patients (n = 136). The 28 AIC patients had 41 episodes of AIC, diagnosed concomitantly with AITL in 23 (82%) cases. After a median follow-up of 24 months (range 3-155), 10 patients relapsed, all associated with AITL relapse.
Our results provide new insight into AIC associated with AITL by highlighting the significant interplay between AITL and B-cell activation leading to subsequent autoimmunity.
Keywords
Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Autoimmune Diseases/complications, Autoimmune Diseases/diagnosis, Biopsy, Disease Management, Disease Susceptibility, Female, Humans, Immunoblastic Lymphadenopathy/diagnosis, Immunoblastic Lymphadenopathy/etiology, Immunoblastic Lymphadenopathy/mortality, Immunoblastic Lymphadenopathy/therapy, Immunoglobulins, Intravenous/therapeutic use, Lymphoma, T-Cell/diagnosis, Lymphoma, T-Cell/etiology, Lymphoma, T-Cell/mortality, Lymphoma, T-Cell/therapy, Male, Middle Aged, Neoplasm Staging, Pancytopenia/complications, Pancytopenia/diagnosis, Phenotype, Retrospective Studies, Symptom Assessment, Treatment Outcome, angioimmunoblastic T-cell lymphoma, autoimmune hemolytic anemia, immune thrombocytopenia, plasmablast, pure red cell aplasia
Pubmed
Web of science
Create date
16/04/2019 13:26
Last modification date
16/12/2019 6:19
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