Journal Description
Lymphatics
Lymphatics
is an international, peer-reviewed, open access journal on lymphatics and related disorders published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: first decisions in 16 days; acceptance to publication in 5.8 days (median values for MDPI journals in the second half of 2023).
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Lymphatics is a companion journal of IJMS.
Latest Articles
The Rise of Lymphatic Intervention: A Rapid Evolution
Lymphatics 2024, 2(2), 79-82; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2020006 - 26 Apr 2024
Abstract
For centuries, the lymphatic system was a known unknown [...]
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Open AccessArticle
BCL2 Protein Progressively Declines during Robust CLL Clonal Expansion: Potential Impact on Venetoclax Clinical Efficacy and Insights on Mechanism
by
Hyunjoo Lee, Shabirul Haque, Rashmi Gupta, Jonathan E. Kolitz, Steven L. Allen, Kanti Rai, Nicholas Chiorazzi and Patricia K. A. Mongini
Lymphatics 2024, 2(2), 50-78; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2020005 - 28 Mar 2024
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CLL B cells express elevated pro-survival BCL2, and its selective inhibitor, venetoclax, significantly reduces leukemic cell load, leading to clinical remission. Nonetheless, relapses occur. This study evaluates the hypothesis that progressively diminished BCL2 protein in cycling CLL cells within patient lymph node niches
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CLL B cells express elevated pro-survival BCL2, and its selective inhibitor, venetoclax, significantly reduces leukemic cell load, leading to clinical remission. Nonetheless, relapses occur. This study evaluates the hypothesis that progressively diminished BCL2 protein in cycling CLL cells within patient lymph node niches contributes to relapse. Using CFSE-labeled, purified CLL populations known to respond with vigorous cycling in d6 cultures stimulated with TLR9-activating ODN (oligodeoxynucleotide) + IL15, we show that BCL2 protein progressively declines during consecutive cell divisions. In contrast, MCL1 and survivin are maintained/slightly elevated during cycling. Delayed pulsing of quiescent and activated CLL cultures with selective inhibitors of BCL2 or survivin revealed selective targeting of noncycling and cycling populations, respectively, raising implications for therapy. To address the hypothesis that BCL2-repressive miRs (miR15a/miR16-1), encoded in Chr13, are mechanistically involved, we compared BCL2 protein levels within ODN + IL15-stimulated CLL cells, with/without del(13q), yielding results suggesting these miRs contribute to BCL2 reduction. In support, within ODN-primed CLL cells, an IL15-driven STAT5/PI-3K pathway (required for vigorous cycling) triggers elevated p53 TF protein known to directly activate the miR15a/miR16-1 locus. Furthermore, IL15 signaling elicits the repression of BCL2 mRNA within 24 h. Additional comparisons of del(13q)+ and del(13q)−/− cohorts for elevated p53 TF expression during cycling suggest that a documented miR15a/miR16-1-mediated negative feedback loop for p53 synthesis is active during cycling. Findings that robust CLL cycling associates with progressively decreasing BCL2 protein that directly correlates with decreasing venetoclax susceptibility, combined with past findings that these cycling cells have the greatest potential for activation-induced cytosine deaminase (AICDA)-driven mutations, suggest that venetoclax treatment should be accompanied by modalities that selectively target the cycling compartment without eliciting further mutations. The employment of survivin inhibitors might be such an approach.
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Open AccessCommentary
Live to Move and Move to Live: The Health of the Lymphatic System Relies on Mobility and the Foot and Calf Pump Connection
by
Heather Barnhart
Lymphatics 2024, 2(2), 43-49; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2020004 - 26 Mar 2024
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The foot and calf muscle pump, collectively known as the venous muscle pump, plays a crucial role in the circulatory system (veins, arteries, and lymphatics), particularly in the return of blood from the lower extremities to the heart. Further, the venous muscle pump
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The foot and calf muscle pump, collectively known as the venous muscle pump, plays a crucial role in the circulatory system (veins, arteries, and lymphatics), particularly in the return of blood from the lower extremities to the heart. Further, the venous muscle pump is crucial to lymphatic health and essential in chronic edema/lymphedema management. This article will highlight the significance of the venous pump and review the functional anatomy and physiology of the foot and calf, integrating the connection to venous and lymphatic health. The complementary importance of mobility, exercise, and breathing will also be explored.
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Open AccessReview
Paraneoplastic Syndromes in Hodgkin’s Lymphoma
by
Yamna Jadoon, Goutham Patil, Chandravathi Loke and Prarthna V. Bhardwaj
Lymphatics 2024, 2(1), 25-42; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2010003 - 06 Feb 2024
Abstract
Hodgkin’s lymphoma (HL) is a monoclonal lymphoid neoplasm that is mainly characterized by multinucleated Reed–Sternberg cells on a background of non-neoplastic inflammatory cells. The incidence rate of Hodgkin’s lymphoma is 2.5 new cases per 100,000 people per year (1). Paraneoplastic syndromes are conditions
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Hodgkin’s lymphoma (HL) is a monoclonal lymphoid neoplasm that is mainly characterized by multinucleated Reed–Sternberg cells on a background of non-neoplastic inflammatory cells. The incidence rate of Hodgkin’s lymphoma is 2.5 new cases per 100,000 people per year (1). Paraneoplastic syndromes are conditions that are related to malignancy; however, they are not a result of tumor invasion or compression of malignant tissues. These paraneoplastic syndromes can occur virtually at any point in the disease course, and paraneoplastic syndromes in HL and their various forms are not well studied. In this review article, we will be discussing paraneoplastic syndromes in general and then delve into specific syndromes seen in HL, followed by a brief discourse regarding their early recognition and timely management.
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(This article belongs to the Collection Lymphomas)
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Open AccessReview
A Review of Anti-CD20 Antibodies in the Management of B-Cell Lymphomas
by
Himil Mahadevia, Mirdhula Ananthamurugan, Kashish Shah, Atharva Desai and Anuj Shrestha
Lymphatics 2024, 2(1), 10-24; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2010002 - 05 Jan 2024
Abstract
Anti-CD20 monoclonal antibodies (mAbs) have revolutionized the treatment of lymphomas by improving the survival of patients, particularly in conjunction with chemotherapy. Until recently, the gold standard was based on the utilization of Rituximab (RTX) combined with chemotherapy. With our better understanding of monoclonal
[...] Read more.
Anti-CD20 monoclonal antibodies (mAbs) have revolutionized the treatment of lymphomas by improving the survival of patients, particularly in conjunction with chemotherapy. Until recently, the gold standard was based on the utilization of Rituximab (RTX) combined with chemotherapy. With our better understanding of monoclonal antibody (mAb) engineering, anti-CD20 mAb therapy has evolved to enhance clinical outcomes by improving pharmacokinetics, safety, activity and immunogenicity. Efforts to improve the on-targeting CD20 expressed on lymphomas through novel bioengineering techniques have led to the development of newer anti-CD20 mAbs that have accentuated complement-dependent cytotoxicity (CDC), antibody-dependent cell medicated cytotoxicity (ADCC), and/or a direct killing effect. There are several anti-CD20 monoclonal antibodies that have been evaluated for the treatment of lymphomas, some of which are now approved in addition to RTX.
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(This article belongs to the Collection Lymphomas)
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Open AccessBrief Report
Motion Management: The Road Map to Accurate Radiation Treatment Delivery
by
Bouthaina Dabaja, Susan Wu and Nicholas J. Short
Lymphatics 2024, 2(1), 1-9; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics2010001 - 01 Jan 2024
Abstract
Radiation therapy is a key contributor to positive outcomes in hematological malignancies. However, this is contingent on minimizing the exposure of critical normal organs. The introduction of computed tomography (CT) for radiation treatment planning and the development of sophisticated dose calculation algorithms has
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Radiation therapy is a key contributor to positive outcomes in hematological malignancies. However, this is contingent on minimizing the exposure of critical normal organs. The introduction of computed tomography (CT) for radiation treatment planning and the development of sophisticated dose calculation algorithms has transformed the radiation therapy field and made it possible to transition from conventional involved-field radiation to modern involved-site radiation therapy. Thanks to rapid advances in drug discovery, treatment strategies for many hematological malignancies have evolved to incorporate targeted and cellular therapies, in some cases even allowing the replacement of chemotherapy. As a result, new opportunities have been created for radiation to address relapses after more lines of therapy, identify disease-involving sanctuary sites, and bridge to the subsequent therapy. When considering radiation in patients receiving novel therapies, who may also be more heavily pretreated, respecting the critical and normal structures at all costs is imperative. In this document, we will describe modern techniques used to deliver state-of-the-art radiation therapy and practical considerations to ensure the accurate treatment of the target while avoiding normal organs at risk.
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(This article belongs to the Collection Radiation Oncology)
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Open AccessReview
Incorporating Immunotherapy with Radiotherapy for Lymphomas
by
Paolo Strati and Michael T. Spiotto
Lymphatics 2023, 1(3), 273-286; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1030018 - 07 Dec 2023
Abstract
Radiotherapy and/or chemotherapy have been used for nearly 100 years to treat lymphoma. Recently, immunotherapy has been incorporated into the treatment of lymphomas. Here, we will review both the role of immunotherapy in lymphoma as well as the feasibility of incorporating immunotherapies with
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Radiotherapy and/or chemotherapy have been used for nearly 100 years to treat lymphoma. Recently, immunotherapy has been incorporated into the treatment of lymphomas. Here, we will review both the role of immunotherapy in lymphoma as well as the feasibility of incorporating immunotherapies with conventional lymphoma treatments, especially radiotherapy. Immunotherapy agents include checkpoint inhibitors that target the PD-1/PD-L1 axis, CTLA-4, or CD47. In addition, other immunotherapy agents such as bi-specific antibodies and CD19 CAR-T cell therapy are being implemented in various non-Hodgkin’s lymphomas. Extrapolating from observations in other disease sites and incorporating immunotherapy with conventional treatments of lymphoma, including radiotherapy, may have opposing effects. Radiotherapy may stimulate anti-tumor immune responses that synergize with immunotherapies. In contrast, radiotherapy, as well as chemotherapy, may also induce local and systemic immune dysfunction which reduces the efficacy of immunotherapies. With newer radiation treatment techniques and limited radiation fields, it is likely that the efficacy of immunotherapy can be maintained when included with conventional treatments. Therefore, there remains an unmet need to better understand the role of immunotherapy alone and in combination with current treatments in lymphoma patients.
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(This article belongs to the Collection Radiation Oncology)
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Open AccessPerspective
Evolution of Radiation Fields from Involved Field to Involved Site—A Summary of the Current Guidelines by the International Lymphoma Radiation Oncology Group
by
Hans Theodor Eich, Niklas Benedikt Pepper and Michael Oertel
Lymphatics 2023, 1(3), 262-272; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1030017 - 08 Nov 2023
Abstract
Radiation therapy has been proven to be highly effective in the treatment of lymphoma. With increasing rates of long-term survival, the reduction in toxicity has gained importance. The evolving understanding of the diseases’ biology, as well as technical and conceptual advances, allows for
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Radiation therapy has been proven to be highly effective in the treatment of lymphoma. With increasing rates of long-term survival, the reduction in toxicity has gained importance. The evolving understanding of the diseases’ biology, as well as technical and conceptual advances, allows for a precise and individualized application of irradiation. Smaller treatment fields and safety margins make it possible to spare healthy neighbouring tissue (organs at risk). The International Lymphoma Radiation Oncology Group (ILROG) has developed several guidelines to optimize radiotherapy treatment in lymphoma patients. Since its introduction in 2013, involved site radiotherapy (ISRT) has been adopted as the standard of care in most treatment regimens in adult lymphoma. This article serves as a summary of the current ILROG guidelines, also considering contemporary developments and possible future directions.
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(This article belongs to the Collection Radiation Oncology)
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Open AccessCommentary
It Is Time to Curb the Dogma in Lymphedema Management
by
Heather Barnhart
Lymphatics 2023, 1(3), 257-261; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1030016 - 12 Oct 2023
Abstract
Lymphedema is an under-recognized and underappreciated disease. Advances in imaging and a deeper understanding of the pathophysiology of lymphedema are shedding new light on this disease that affects millions of people worldwide. As new evidence continues to emerge about the microcirculation and revised
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Lymphedema is an under-recognized and underappreciated disease. Advances in imaging and a deeper understanding of the pathophysiology of lymphedema are shedding new light on this disease that affects millions of people worldwide. As new evidence continues to emerge about the microcirculation and revised Starling Principle, etiological factors, related conditions, specific genes, and surgical innovations, the traditional approach to management must also evolve. This evolution is vital to maximize outcomes and improve quality of life. This commentary is a call to action to embrace innovation to better manage lymphedema and expand educational opportunities by leveraging technology to properly train healthcare providers to manage this disease.
Full article
Open AccessReview
Understanding the Role of Bispecific Antibodies in the Management of B-Cell Non-Hodgkin Lymphoma: A New Immunotherapy That Is Here to Stay
by
Stanislav Ivanov, Meri Muminovic and Jose Sandoval-Sus
Lymphatics 2023, 1(3), 244-256; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1030015 - 06 Oct 2023
Abstract
Non-Hodgkin lymphomas (NHLs) represent a diverse group of hematologic malignancies derived from various cells. B-cell NHLs represent the largest fraction of lymphomas diagnosed and treated in the United States. Standard chemo-immunotherapies with rituximab and multiagent cytotoxic regimens have proven to be effective in
[...] Read more.
Non-Hodgkin lymphomas (NHLs) represent a diverse group of hematologic malignancies derived from various cells. B-cell NHLs represent the largest fraction of lymphomas diagnosed and treated in the United States. Standard chemo-immunotherapies with rituximab and multiagent cytotoxic regimens have proven to be effective in the management of these lymphoproliferative neoplasms; nonetheless, a considerable fraction of patients still experience relapse or have treatment-refractory disease. Therapeutic advances using novel immunotherapeutic agents as well as cell-based treatments, such as chimeric antigen receptor (CAR) T-cell therapies, have improved the outcomes of relapsed/refractory (R/R) B-cell NHL. Most of these new treatment strategies are not curative and most patients succumb to R/R disease, leaving this population with an unmet need for effective and well-tolerated therapeutic options. One of these up-and-coming options are bispecific antibodies (BsAb), either as single agent or in combination with other medications. Conclusion: BsAbs offer a novel “off the shelf” chemotherapy-free approach in the management of R/R B-cell NHL. Advancements in antibody construct design along with improved safety profile and clinical effectiveness of the most recent BsAbs suggest that these agents are a promising new option in the management of R/R B-cell NHL.
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(This article belongs to the Collection Lymphomas)
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Open AccessCommunication
Scanning Electron Microscopy Analysis of Lymphatic Regeneration in a Secondary Lymphedema Mouse Model: A Preliminary Study
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Kenji Hayashida, Ryohei Ogino, Shota Suda and Sho Yamakawa
Lymphatics 2023, 1(3), 237-243; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1030014 - 26 Sep 2023
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Under inflammatory conditions including lymphatic disorders, bone marrow-derived myeloid cells often express lymphatic endothelial cell (LEC) markers, and these cells are then called LEC progenitor cells, which extend lymphatic vessels by fusing with existing lymphatic vessels. However, studies on the mechanism of lymphatic
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Under inflammatory conditions including lymphatic disorders, bone marrow-derived myeloid cells often express lymphatic endothelial cell (LEC) markers, and these cells are then called LEC progenitor cells, which extend lymphatic vessels by fusing with existing lymphatic vessels. However, studies on the mechanism of lymphatic regeneration using three-dimensional images of lymphatic structures are limited. In this study, scanning electron microscopy (SEM) was used to observe the three-dimensional structure of lymphangiogenesis in a mouse model of secondary lymphedema. The model was established in C57BL/6J mice via circumferential incision in the inguinal region of the left hind limb. Skin samples were obtained from the lymphedema region on days 2, 5, and 8 after surgery. To determine lymphatic vessel positions using SEM analysis, we detected anti-lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) immunoreactivity in serial sections and overlaid them during SEM observation. On days 2 and 5, spherical cells, probably myeloid cells, were attached and fused to the LYVE-1-positive lymphatic vessel walls. On day 8, spherical cells were converted to string-shaped cells, forming a new lymphatic vessel wall resembling an intraluminal pillar. Our results showed the newly formed lymphatic vessel wall extended into the lumen, suggesting intussusceptive lymphangiogenesis.
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Open AccessReview
The Lymphatic System—A Surgeon’s Point of View
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Alexandre Almeida, Hagit Ofir and Assaf A. Zeltzer
Lymphatics 2023, 1(2), 220-236; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020013 - 21 Aug 2023
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Lymphedema is a chronic and debilitating disease that affects up to 250 million patients worldwide. Recent advances in understanding its pathophysiology, along with improved diagnosis and microsurgical techniques, have enhanced our ability to cope with the challenging task of treating this disease. This
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Lymphedema is a chronic and debilitating disease that affects up to 250 million patients worldwide. Recent advances in understanding its pathophysiology, along with improved diagnosis and microsurgical techniques, have enhanced our ability to cope with the challenging task of treating this disease. This review provides an overview of the disease from a surgeon’s point of view, including existing imaging modalities used for preoperative assessment, as well as surgical procedures used in its treatment. The advantages and drawbacks of various existing modalities used for the pre- or intraoperative assessment of lymphatic vessels are discussed. Lymphedema treatment has shifted from palliative debulking procedures (liposuction and direct excision) to those aimed at restoring lymphatic flow and countering the pathophysiology of the disease (lymphaticovenous anastomosis and vascularized lymph node transfer). A combination of both approaches can result in a synergistic benefit for patients and is discussed in this review. Despite recent advances, some controversies persist, and further studies are needed to better define surgical treatment algorithms.
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Open AccessFeature PaperReview
Diagnosis and Molecular Pathology of Lymphoblastic Leukemias and Lymphomas in the Era of Genomics and Precision Medicine: Historical Evolution and Current Concepts—Part 3: Mature Leukemias/Lymphomas
by
Rina Kansal
Lymphatics 2023, 1(2), 155-219; https://doi.org/10.3390/lymphatics1020012 - 01 Aug 2023
Abstract
The diagnosis and treatment of lymphoid neoplasms have undergone a continuously progressive positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on
[...] Read more.
The diagnosis and treatment of lymphoid neoplasms have undergone a continuously progressive positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on integrating molecular genetics with clinical, morphologic, immunophenotypic, and cytogenetic evaluation for diagnosis. As we think of moving forward with further advances in the genomics era, it is first helpful to understand our current state of knowledge and how we achieved it in the challenging and complex field of lymphoid neoplasms, which comprise very heterogeneous neoplastic diseases in children and adults, including clinically acute lymphoblastic leukemias (ALLs) arising from precursor lymphoid cells and clinically indolent and aggressive lymphomas arising from mature lymphoid cells. This work aims to provide an overview of the historical evolution and the current state of knowledge to anyone interested in the field of lymphoid neoplasms, including students, physicians, and researchers. Therefore, I discuss this complex topic in three review manuscripts, designated Parts 1–3. In Part 1, I explain the basis of the diagnostic classification of lymphoid neoplasms and its evolution up to the current fifth edition of the World Health Organization classification of hematolymphoid neoplasms, and the crucial importance of diagnostic tumor classifications in achieving and advancing patient care and precision medicine. In the second and third manuscripts, I discuss current diagnostic considerations for B-ALL and T-ALL (Part 2) and common indolent and aggressive mature leukemias/lymphomas (Part 3), including significant updates in the WHO 2022 classification, newly described entities, and concepts, including genetic predisposition to ALLs and lymphomas, and throughout emphasizing the essential integration of molecular genetics with clinical, morphologic (pathologic), immunophenotypic, and cytogenetic evaluation, as is required for precise diagnosis of the type of lymphoma/leukemia in any patient.
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(This article belongs to the Collection Lymphomas)
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Open AccessFeature PaperReview
Diagnosis and Molecular Pathology of Lymphoblastic Leukemias and Lymphomas in the Era of Genomics and Precision Medicine: Historical Evolution and Current Concepts—Part 2: B-/T-Cell Acute Lymphoblastic Leukemias
by
Rina Kansal
Lymphatics 2023, 1(2), 118-154; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020011 - 26 Jul 2023
Cited by 1
Abstract
The diagnosis and treatment of lymphoid neoplasms have undergone a continuously progressive positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on
[...] Read more.
The diagnosis and treatment of lymphoid neoplasms have undergone a continuously progressive positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on integrating molecular genetics with clinical, morphological, immunophenotypic, and cytogenetic evaluation for diagnosis. As we think of moving forward with further advances in the genomics era, it will be first helpful to understand our current state of knowledge and how we achieved it in the challenging and complex field of lymphoid neoplasms, which comprise very heterogeneous neoplastic diseases in children and adults, including clinically acute lymphoblastic leukemias (ALLs) arising from precursor lymphoid cells and clinically indolent and aggressive lymphomas arising from mature lymphoid cells. This work aims to provide an overview of the historical evolution and the current state of knowledge to anyone interested in the field of lymphoid neoplasms, including students, physicians, and researchers. Therefore, I have discussed this complex topic in three review manuscripts, designated Parts 1–3. In Part 1, I explain the basis of the diagnostic classification of lymphoid neoplasms and its evolution up to the current fifth edition of the World Health Organization classification of hematolymphoid neoplasms and the crucial importance of diagnostic tumor classifications in achieving and advancing patient care and precision medicine. In the second and third manuscripts, I discuss current diagnostic considerations for B-ALL and T-ALL (Part 2) and common indolent and aggressive mature leukemias/lymphomas (Part 3), including significant updates in the WHO 2022 classification, newly described entities, and concepts, including genetic predisposition to ALLs and lymphomas, and emphasizing throughout the essential integration of molecular genetics with clinical, morphologic, immunophenotypic, and cytogenetic evaluation, as required for the precise diagnosis of the type of lymphoma/leukemia in any patient.
Full article
(This article belongs to the Collection Acute Lymphoblastic Leukemia (ALL))
Open AccessReview
Translocation Tales: Unraveling the MYC Deregulation in Burkitt Lymphoma for Innovative Therapeutic Strategies
by
Amol Tandon, Jissy Akkarapattiakal Kuriappan and Vaibhav Dubey
Lymphatics 2023, 1(2), 97-117; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020010 - 11 Jul 2023
Cited by 1
Abstract
MYC deregulation, a cardinal event in Burkitt lymphoma (BL) pathogenesis, necessitates the elucidation of the molecular mechanisms governing MYC activation to devise innovative and effective therapeutic strategies. The t(8;14)(q24;q32) chromosomal translocation commonly observed in hematological malignancies results in MYC deregulation, endowing cancer cells
[...] Read more.
MYC deregulation, a cardinal event in Burkitt lymphoma (BL) pathogenesis, necessitates the elucidation of the molecular mechanisms governing MYC activation to devise innovative and effective therapeutic strategies. The t(8;14)(q24;q32) chromosomal translocation commonly observed in hematological malignancies results in MYC deregulation, endowing cancer cells with a competitive edge through heightened cell proliferation, cell cycle progression, apoptosis evasion, and metabolic reprogramming. Recent discoveries of recurrent MYC mutations in BL underscore the potential of precision medicine, employing tailored therapeutics to specifically inhibit MYC activity. However, the intricate genetic landscape of BL, featuring additional alterations, such as mutations in TP53, TCF3, and ID3, may necessitate a combinatorial approach targeting multiple oncogenic pathways for effective intervention. Despite significant strides in hematological malignancy treatment, a comprehensive understanding of the molecular mechanisms underpinning MYC’s oncogenic properties remains crucial for the potential development of highly potent and selective MYC-directed cancer therapies. This review offers an in-depth analysis of MYC translocation and its implications in Burkitt lymphoma, with a spotlight on cutting-edge advances in research and emerging therapeutic paradigms.
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(This article belongs to the Collection Lymphomas)
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Open AccessHypothesis
Lymphatics: Future Perspectives Unrealized Potential
by
Philip D. Houck, Hari Kumar Dandapantula and Janet Mary Massey
Lymphatics 2023, 1(2), 87-96; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020009 - 03 Jul 2023
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Proposed fundamental laws of biology and a model of health and disease underscore the importance of the lymphatic system. The lymphatics are responsible for two of the laws of biology and the fulcrum of health and disease balancing regeneration with degeneration through the
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Proposed fundamental laws of biology and a model of health and disease underscore the importance of the lymphatic system. The lymphatics are responsible for two of the laws of biology and the fulcrum of health and disease balancing regeneration with degeneration through the immune system. It is responsible for protection from the environment and repair of senile and damaged tissue. Life is constantly bombarded by forces that increase entropy. Lymphatics provide negative entropy to maintain health. Lymphatics help maintain cellular homeostasis removing products of metabolism. Using these principles, the role of lymphatics is investigated in salt sensitivity hypertension, cardio-renal system, the new pillar of heart failure and kidney disease—Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors, and brain diseases. The realization of organ lymphatics in maintenance of health and disease opens the avenue to new therapeutics. This is the unrealized potential of lymphatic study.
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Open AccessReview
Trends in Lymphadenectomy for Esophageal/Esophagogastric Junction Cancer
by
Erica Nishimura, Satoru Matsuda, Masashi Takeuchi, Hirofumi Kawakubo and Yuko Kitagawa
Lymphatics 2023, 1(2), 77-86; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020008 - 03 Jul 2023
Abstract
Lymph node (LN) metastasis is recognized to be an important prognostic factor for esophageal cancer (EC). However, there is no worldwide uniform classification system, and no consensus exists on the extent of the lymphadenectomy. Recently, an international observational cohort study was conducted to
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Lymph node (LN) metastasis is recognized to be an important prognostic factor for esophageal cancer (EC). However, there is no worldwide uniform classification system, and no consensus exists on the extent of the lymphadenectomy. Recently, an international observational cohort study was conducted to evaluate the distribution of LN metastasis in EC patients. Moreover, this could be a milestone to establish a standard classification system and provide new insights to determine the extent of LNs that should be target for treatment. With regard to surgical procedures, three-field lymphadenectomy seems to be promising to improve the prognosis with EC patients. However, extended lymphadenectomy could lead to postoperative complications. The development of minimally invasive esophagectomy (MIE) has allowed us to retrieve cervical paraesophageal nodes without cervical incision and reduce the incidence of postoperative complications. Therefore, it may be possible that the era of MIE could propose the modern extent of LN dissection in the future. Additionally, one of the key components in lymphadenectomy for EC was thoracic duct and surrounding tissues. Although there is some evidence of LN metastasis surrounding the TD, the survival benefit of TD resection is still debatable. With regard to esophagogastiric junction cancer, the extent of LN dissection could be determined by the length of esophageal involvement. We believe further understanding of LN metastasis of EC patients will contribute to establish a global standard of treatment and improve their prognosis.
Full article
Open AccessFeature PaperReview
Diagnosis and Molecular Pathology of Lymphoblastic Leukemias and Lymphomas in the Era of Genomics and Precision Medicine: Historical Evolution and Current Concepts—Part 1: Lymphoid Neoplasms
by
Rina Kansal
Lymphatics 2023, 1(2), 55-76; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1020007 - 21 Jun 2023
Cited by 2
Abstract
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The diagnosis and treatment of lymphoid neoplasms have undergone a progressively positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on integrating
[...] Read more.
The diagnosis and treatment of lymphoid neoplasms have undergone a progressively positive change in the last three decades, with accelerated progress in the previous decade due to the advent of genomics in cancer diagnosis. Significantly, there has been an increasing emphasis on integrating molecular genetics with clinical, morphologic, immunophenotypic, and cytogenetic evaluation for diagnosis. As we consider moving forward with further advances in the genomics era, it is first helpful to understand our current state of knowledge and how we achieved it in the challenging and complex field of lymphoid neoplasms, which comprise very heterogeneous neoplastic diseases in children and adults, including clinically acute lymphoblastic leukemias (ALLs) arising from precursor lymphoid cells and clinically indolent and aggressive lymphomas arising from mature lymphoid cells. This work aims to provide an overview of the historical evolution and the current state of knowledge to anyone interested in the field of lymphoid neoplasms, including students, physicians, and researchers. Therefore, I have discussed this complex topic in three review manuscripts, designated Parts 1–3. In Part 1, I explain the basis of the diagnostic classification of lymphoid neoplasms and its evolution up to the current fifth edition of the World Health Organization (WHO) classification of hematolymphoid neoplasms and the crucial importance of diagnostic tumor classifications in achieving and advancing patient care and precision medicine. In the second and third manuscripts, I discuss current diagnostic considerations for B-ALL and T-ALL (Part 2) and common indolent and aggressive mature leukemias/lymphomas (Part 3), including significant updates in the WHO 2022 classification, newly described entities and concepts, including genetic predisposition to ALLs and lymphomas, and throughout emphasizing the essential integration of molecular genetics with clinical, morphologic (pathologic), immunophenotypic, and cytogenetic evaluation, as is required for precise diagnosis of the type of lymphoma/leukemia in any patient.
Full article
Figure 1
Open AccessArticle
FDG PET/CT as a Tool for Early Detection of Bleomycin-Induced Pulmonary Toxicity
by
Hira Shaikh, Zulfa Omer, Roman A. Jandarov, Morgan P. McBee, Jennifer Scheler, Bruce Mahoney and Tahir Latif
Lymphatics 2023, 1(1), 45-54; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1010006 - 07 Jun 2023
Abstract
Bleomycin-induced pulmonary toxicity (BPT) is a serious and potentially fatal complication of bleomycin, a key component of Hodgkin lymphoma (HL) treatment. Before ours, only one published study evaluated the predictability of 18F-FDG-PET/CT for the early diagnosis of BPT. In this retrospective cohort study,
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Bleomycin-induced pulmonary toxicity (BPT) is a serious and potentially fatal complication of bleomycin, a key component of Hodgkin lymphoma (HL) treatment. Before ours, only one published study evaluated the predictability of 18F-FDG-PET/CT for the early diagnosis of BPT. In this retrospective cohort study, 18F-FDG-PET/CT scans of adult HL patients treated with bleomycin at an urban academic center over five years were assessed by radiologists blinded to the clinical information, and scans were correlated with clinical BPT. We found 11 HL patients with 54 interim or end-of-treatment 18F-FDG-PET/CT scans who had received bleomycin. Five of the eleven (5/11, 45%) patients had radiographic changes in PET/CT and developed clinical BPT. Patients with clinical BPT had higher FDG uptake in lungs compared to those who did not (SUVmax mean 2.66 (CI 1.8–3.7) vs. 0.86 (CI 0.4–1.9), Mann–Whitney U test, p < 0.05). In a separate cohort analysis, we compared HL patients with clinical BPT (9/25, 36%) and without clinical BPT (16/25, 64%) to assess potential risk factors. Low hemoglobin (p = 0.037) and high ESR values (p = 0.0289) were associated with clinical BPT. Furthermore, gender, stage, histology, prior lung radiation, G-CSF, or steroids did not significantly confer a higher risk of BPT. 18F-FDG-PET/CT imaging, which is routinely used to assess treatment response in HL, is useful for early detection of BPT, which can have high mortality and morbidity.
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(This article belongs to the Collection Radiation Oncology)
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What Is Next in Pediatric B-Cell Precursor Acute Lymphoblastic Leukemia
by
Aimee C. Talleur, Ching-Hon Pui and Seth E. Karol
Lymphatics 2023, 1(1), 34-44; https://0-doi-org.brum.beds.ac.uk/10.3390/lymphatics1010005 - 12 May 2023
Abstract
Cure rates now exceed 90% in many contemporary trials for children with B-cell acute lymphoblastic leukemia (B-ALL). However, treatment remains suboptimal, and therapy is toxic for all patients. New treatment options potentially offer the chance to reduce both treatment resistance and toxicity. Here,
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Cure rates now exceed 90% in many contemporary trials for children with B-cell acute lymphoblastic leukemia (B-ALL). However, treatment remains suboptimal, and therapy is toxic for all patients. New treatment options potentially offer the chance to reduce both treatment resistance and toxicity. Here, we review recent advances in ALL diagnostics, chemotherapy, and immunotherapy. In addition to describing recently published results, we also attempt to project the impact of these new developments into the future to imagine what B-ALL therapy may look like in the next few years.
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(This article belongs to the Collection Acute Lymphoblastic Leukemia (ALL))
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