Partial restoration of CD20 protein expression and rituximab sensitivity after treatment with azacitidine in CD20-negative transformed diffuse large B cell lymphoma after using rituximab.
Partial restoration of CD20 protein expression and rituximab sensitivity after treatment with azacitidine in CD20-negative transformed diffuse large B cell lymphoma after using rituximab.
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使用利妥昔单抗治疗 CD20 阴性转化的弥漫性大 B 细胞淋巴瘤后，用阿扎胞苷治疗后 CD20 蛋白表达和利妥昔单抗敏感性部分恢复。
DOI：
10.1007/s00277-018-3354-1
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Kagami Y.
中科院分区：
文献类型：
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作者：
Hiraga J;Tomita A;Suzuki N;Takagi Y;Narita M;Kagami Y.
尊敬的编辑，第一代嵌合抗CD 20单克隆抗体利妥昔单抗是抗CD 20阳性B细胞淋巴瘤（BCL）的关键分子靶向治疗药物，在联合化疗中加入利妥昔单抗已获得良好的效果[1-3]。然而，利妥昔单抗治疗后的CD 20阴性表型变化已成为一个相当大的问题，利妥昔单抗耐药性显示出临床侵袭性表型[4-6]。我们先前报道了在体外使用CD 20阴性转化的BCL细胞用表观遗传调节剂如DNA甲基转移酶抑制剂（DNMTis）和组蛋白脱乙酰酶抑制剂（HDACis）处理后CD 20蛋白表达的部分诱导[4，5，7]。然而，表观遗传调节剂在体内对CD 20阴性转化的BCL中CD 20蛋白表达的影响的研究有限[8，9]，一位47岁的男性于15年前因淋巴结肿大入住我院（图1A），经免疫组化诊断为CD 20阳性表型的滤泡性淋巴瘤（FL）（图1 B，a-c）。他接受了包括利妥昔单抗在内的联合化疗共16个周期。(Fig. 1 A）。在首次诊断14年后，治疗相关急性髓细胞白血病/骨髓增生异常综合征（t-AML/t-MDS）伴复杂核型（包括-7），
Dear Editor, Rituximab, a first-generation chimeric monoclonal anti-CD20 antibody, is a key molecular targeted therapeutic against CD20-positive B cell lymphoma (BCL); favorable results have been obtained by adding rituximab to combination chemotherapy [1–3]. However, CD20-negative phenotypic changes after treatment with rituximab have become a considerable problem, with rituximab resistance showing clinically aggressive phenotype [4–6]. We previously reported the partial induction of CD20 protein expression after treatment with epigenetic modulators such as DNA methyltransferase inhibitors (DNMTis) and histone deacetylase inhibitors (HDACis) using CD20-negative transformed BCL cells in vitro [4, 5, 7]. However, studies on the effects of epigenetic modulators on CD20 protein expression in CD20-negative transformed BCL in vivo have been limited [8, 9].A 47-year-old man was admitted to our affiliated hospital 15 years ago (Fig. 1 A) with lymph node swelling, which was diagnosed as follicular lymphoma (FL) with CD20-positive phenotype by immunohistochemistry (Fig. 1 B, a–c). He was treated with combination chemotherapy including rituximab for a total of 16 cycles.(Fig. 1 A). After 14 years from initial diagnosis, therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/t-MDS) with complex karyotypes including− 7 was con-