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Search Results (1,259)

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Keywords = Hodgkin lymphoma

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17 pages, 714 KB  
Systematic Review
Radiogenomics in Lymphoma and Multiple Myeloma: A Systematic Review of Current Evidence and Future Directions
by Valentina Formica, Gayane Aghakhanyan, Valentina Baccolini, Francesca Pia Caputo, Salvatore Claudio Fanni, Roberto Francischello, Giuseppe Migliara, Duccio Volterrani, Riccardo Antonio Lencioni, Paolo Villari, Emanuele Neri and Dania Cioni
J. Clin. Med. 2026, 15(11), 4048; https://doi.org/10.3390/jcm15114048 - 23 May 2026
Abstract
Background/Objectives: Radiogenomics integrates quantitative imaging features with genomic and molecular data to better characterize tumor biology and support precision oncology. While extensively investigated in solid tumors, its application to hematologic malignancies remains relatively unexplored despite the widespread use of advanced imaging in lymphoma [...] Read more.
Background/Objectives: Radiogenomics integrates quantitative imaging features with genomic and molecular data to better characterize tumor biology and support precision oncology. While extensively investigated in solid tumors, its application to hematologic malignancies remains relatively unexplored despite the widespread use of advanced imaging in lymphoma and multiple myeloma. Methods: A systematic review was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched up to December 2025 for studies investigating radiogenomic associations in hematologic malignancies. Study quality was assessed using PROBAST and METRICS. Two reviewers independently screened all records and performed data extraction through consensus. Results: Twelve studies were included, covering multiple myeloma and various lymphoma subtypes (aggressive B-cell lymphoma, classical Hodgkin lymphoma, and primary CNS lymphoma). Imaging modalities included PET/CT, MRI and CT. Across studies, radiomic and imaging-derived features were associated with cytogenetic abnormalities, gene expression profiles, and circulating tumor DNA metrics. In multiple myeloma, MRI and CT-based radiomics showed promising ability to predict high-risk cytogenetic abnormalities. In lymphoma, PET-derived volumetric and dissemination features correlated with molecular risk profiles and tumor microenvironment characteristics. Several studies demonstrated improved prognostic performance when imaging features were combined with genomic or clinical variables. Conclusions: Radiogenomic approaches in hematologic malignancies show promising potential for non-invasive risk stratification and improved prognostic assessment. However, current evidence remains limited by small cohorts, heterogeneous methodologies, and a lack of external validation. Prospective multicenter studies and standardized imaging–genomic pipelines will be essential to enable clinical translation. Full article
(This article belongs to the Section Hematology)
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13 pages, 283 KB  
Article
Association of Polymorphisms of Inflammatory-Relevant Genes with Cancer Risk
by Sara AlSrayea, Maryam H. Alrashid, Nasmah K. Bastaki and Jasem Al-Barrak
Curr. Issues Mol. Biol. 2026, 48(6), 548; https://doi.org/10.3390/cimb48060548 - 23 May 2026
Abstract
Colorectal cancer (CRC) and non-Hodgkin lymphoma (NHL) are among the most prevalent cancer types globally by incidence and mortality. Both types are influenced differentially by chronic inflammation. Central to this inflammation are inflammatory genes that are meticulously regulated by nuclear factor kappa B [...] Read more.
Colorectal cancer (CRC) and non-Hodgkin lymphoma (NHL) are among the most prevalent cancer types globally by incidence and mortality. Both types are influenced differentially by chronic inflammation. Central to this inflammation are inflammatory genes that are meticulously regulated by nuclear factor kappa B (NF-κB) and tumor necrosis factor-α (TNF-α). NF-κB is negatively regulated by IκBα (encoded by NFKBIA), while TNF-α’s actions can be modulated by ghrelin (encoded by GHRL). We investigated four single nucleotide polymorphisms (SNPs) in NFKB1 (rs4648068), NFKBIA (rs2233406), TNF-α (rs1800629), and GHRL (rs1629816) as biomarkers for CRC and NHL risk in a cohort of Kuwaiti individuals. DNA samples from patients and controls were collected and genotyped for all SNPs, and their association with CRC or NHL risk was assessed. While rs4648068 showed a modest association with increased CRC risk, it had no significant impact on NHL risk. Conversely, rs2233406 increased NHL risk without affecting CRC risk. Interestingly, while rs1800629 showed a protective effect against NHL, it showed an increased risk for CRC. Finally, rs1629816 was associated with greater NHL but not CRC risk. Our findings suggests that variations of these inflammatory genes may be useful indicators for predicting cancer risk but might have unpredictable effects on cancer susceptibility, depending on the cancer type. Full article
(This article belongs to the Special Issue Future Challenges of Targeted Therapy of Cancers, 3rd Edition)
23 pages, 5400 KB  
Article
Pathogenic Mutations in the Tumor Microenvironment Drive Tumor Progression in Diffuse Large B-Cell Lymphoma Through Tumor–Stroma Cross-Talk
by Vaishali Aggarwal, Radhika Srinivasan, Amanjit Bal, Pankaj Malhotra, Subhash Varma and Ashim Das
Cancers 2026, 18(11), 1697; https://doi.org/10.3390/cancers18111697 - 22 May 2026
Viewed by 108
Abstract
Background: Diffuse Large B-cell Lymphoma (DLBCL) is a biologically heterogeneous subtype of non-Hodgkin’s lymphoma (NHL), accounting for 30–40% of cases worldwide. Despite the incorporation of rituximab into standard chemo-immunotherapy regimen, approximately one-third of patients present with relapsed or refractory disease, implicating the [...] Read more.
Background: Diffuse Large B-cell Lymphoma (DLBCL) is a biologically heterogeneous subtype of non-Hodgkin’s lymphoma (NHL), accounting for 30–40% of cases worldwide. Despite the incorporation of rituximab into standard chemo-immunotherapy regimen, approximately one-third of patients present with relapsed or refractory disease, implicating the need for improved prognostic markers and therapeutic targets. Gene expression profiling successfully classified DLBCL into Germinal Center B-cell-like (GCB) and non-GCB subtypes, which differ in genetic alterations, response to therapy, and clinical outcome. While intrinsic tumor biology has been extensively studied, the contribution of the tumor microenvironment (TME) to disease progression and therapeutic resistance still remains incompletely understood. Methods: In this study, we investigated the mutational landscape of stromal-related genes in DLBCL and evaluated their impact on gene expression, downstream signaling pathways, and tumor progression. Results: A total of 176 DLBCL patients were screened, of which 113 were enrolled based on availability of complete clinical data. The cohort demonstrated male predominance (male:female ratio: 2.1:1), advanced disease stage in 72.6% of patients, and elevated serum lactate dehydrogenase levels in 57.5%. Based on immunohistochemistry, 43.4% cases were classified as GCB-DLBCL and 56.6% as non-GCB DLBCL. Although the International Prognostic Index (IPI) retained prognostic significance for event-free survival (EFS) and overall survival (OS), considerable heterogeneity was observed within similar risk groups. Whole-exome sequencing (WES) uncovered recurrent somatic mutations in key oncogenic and epigenetic regulators, including TNFAIP3, NFIB, NOTCH1, TSC2, EZH2, EP300, KMT2D, and B2M, with subtype-specific distribution. Pathway enrichment analysis implicated role of Notch, Wnt, mTOR, JAK-STAT, TGF-β, and antigen-presentation pathways. Comprehensive WES analysis identified multiple novel mutations in genes associated with the stromal/extracellular matrix with distinct patterns in GCB and non-GCB DLBCL, accompanied by concordant alterations in gene expression profiles, suggesting functional relevance within the TME. Functional validation through primary cell culture demonstrated significantly elevated Th2 (IL-4, IL-6, IL-10) and Th17 (IL-17) cytokines in co-cultures containing both neoplastic cells and stromal components, underscoring the role of TME in DLBCL progression. Conclusions: Taken together, this study provides novel insights into stromal mutational signatures and cytokine-mediated tumor–stroma interactions, offering potential prognostic biomarkers and therapeutic targets for the improved management of DLBCL. Full article
16 pages, 8118 KB  
Case Report
Recurrent Hodgkin’s Lymphoma Detected Using Abnormal NIPT in Pregnancy: A Case Report and Literature Review
by Claudia Szlek, Puja Punukollu, Lindsey Grater, Debra Ware, Lawrence Devoe, Natalia Schlabritz-Lutsevich, Heidi David, William Toussaint and James Maher
Diagnostics 2026, 16(10), 1490; https://doi.org/10.3390/diagnostics16101490 - 14 May 2026
Viewed by 227
Abstract
Background: Non-invasive prenatal testing (NIPT) examines cell-free DNA (cfDNA) in maternal serum, which includes both maternal DNA and apoptotic placental DNA. The presence of multiple aneuploidies or widespread abnormal patterns of gains and losses across chromosomes in a structurally normal fetus has [...] Read more.
Background: Non-invasive prenatal testing (NIPT) examines cell-free DNA (cfDNA) in maternal serum, which includes both maternal DNA and apoptotic placental DNA. The presence of multiple aneuploidies or widespread abnormal patterns of gains and losses across chromosomes in a structurally normal fetus has been linked to maternal cancer. Case Presentation: The patient was a 22-year-old G1P0 with a history of classical Hodgkin’s lymphoma in remission. Her NIPT collected at 14 weeks and 3 days was reported as a “no call”. A second NIPT at a different laboratory showed multiple chromosomal aneuploidies (trisomy 18, 21, and monosomy X) with normal fetal anatomy on ultrasound. The patient was asymptomatic and was referred to hematology–oncology specifically to address the concern that these NIPT results could be related to cancer recurrence. Imaging was deferred as she was already on an established surveillance protocol for her Hodgkin’s lymphoma. At 26 weeks of gestation, the patient presented with a cough and dyspnea. Chest x-ray raised concern for disease recurrence, and biopsy confirmed recurrent Hodgkin’s lymphoma. She received two cycles of ICE chemotherapy. Cesarean delivery at 34 weeks and 2 days was performed for non-reassuring fetal heart tones. She continued chemotherapy, followed by BEAM conditioning and autologous stem cell transplantation. Genetic testing of the neonate revealed a normal karyotype; the placenta karyotype yielded no interpretable results. Discussion and Conclusions: Certain patterns of abnormal NIPT results may be associated with maternal malignancy and warrant further investigation. The absence of standardized protocols for reporting such NIPT results can complicate timely interdisciplinary evaluation and treatment. However, diagnostic testing should be offered with a positive NIPT result, a no-call or test failure, and abnormal ultrasound results, even with a “low-risk” NIPT result. Full article
(This article belongs to the Special Issue Recent Advances in Genomics for Prenatal Diagnosis)
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17 pages, 11271 KB  
Case Report
Safety and Efficacy of Mosunetuzumab: Experience in the Hospital Cardinale Giovanni Panico
by Giulio Turco, Donatella Tarantino, Antonietta Giuseppa Ferraro, Giuseppina Greco and Domenico Tricarico
Antibodies 2026, 15(3), 40; https://doi.org/10.3390/antib15030040 - 13 May 2026
Viewed by 245
Abstract
Background/Objective: Follicular lymphoma (FL) is one of the most common indolent B-cell non-Hodgkin lymphomas (NHL) and is characterized by recurrent relapses despite advances in therapy. Bispecific antibodies that redirect T lymphocytes toward malignant B cells represent a major innovation in the treatment of [...] Read more.
Background/Objective: Follicular lymphoma (FL) is one of the most common indolent B-cell non-Hodgkin lymphomas (NHL) and is characterized by recurrent relapses despite advances in therapy. Bispecific antibodies that redirect T lymphocytes toward malignant B cells represent a major innovation in the treatment of relapsed or refractory disease. Mosunetuzumab is a CD20×CD3 bispecific antibody that induces T-cell mediated cytotoxicity against B-cell malignancies. In this manuscript, we describe the clinical experience with mosunetuzumab in three patients with relapsed or refractory FL treated at the Hospital Card. G. Panico, Tricase (LE). Methods: Clinical history, prior therapies, treatment responses, and safety outcomes are reported. Results: The cases illustrate the potential efficacy and manageable safety profile of mosunetuzumab in heavily pretreated FL patients. Conclusion: The effectiveness of this drug is confirmed in our center. Full article
(This article belongs to the Section Antibody-Based Therapeutics)
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23 pages, 2865 KB  
Article
Anaplastic Large Cell Lymphoma in Children: 20-Year Immune-Oriented Treatment Experience
by Anastasiya S. Volkova, Timur T. Valiev, Mikhail V. Kiselevskiy, Irina Zh. Shubina, Kirill I. Kirgizov, Svetlana R. Varfolomeeva and Ivan S. Stilidi
Cancers 2026, 18(10), 1583; https://doi.org/10.3390/cancers18101583 - 13 May 2026
Viewed by 271
Abstract
Background: Anaplastic large cell lymphoma (ALCL) accounts for up to 15% of all pediatric and adolescent non-Hodgkin lymphomas and is characterized by significant clinical, morphological, and immunohistochemical heterogeneity. Expression of T-cell markers on tumor cells is considered as one of the factors [...] Read more.
Background: Anaplastic large cell lymphoma (ALCL) accounts for up to 15% of all pediatric and adolescent non-Hodgkin lymphomas and is characterized by significant clinical, morphological, and immunohistochemical heterogeneity. Expression of T-cell markers on tumor cells is considered as one of the factors in an unfavorable prognosis in ALCL. However, no treatment protocols based on ALCL immunological heterogeneity have been used, yet. Objective: To compare the effectiveness of immunophenotype-oriented chemotherapy in children with ALCL treated according to the ALCL NII DOiG 2003 protocol versus the standard NHL-BFM 95 protocol. Methods: A retrospective–prospective analysis of 100 newly diagnosed ALCL patients, who were treated between 2000 and 2023, was performed across five pediatric oncology and hematology centers in Russia. Patients were divided into two groups: those treated with the NHL-BFM 95 protocol (n = 52) and those treated with the ALCL NII DOiG 2003 protocol (n = 48). Comparative analysis used Kaplan–Meier survival curves constructed for each group, and statistical analysis was performed with IBM SPSS Statistics 21.0. Results: The 10-year overall survival was significantly higher in the ALCL NII DOiG 2003 group (95.3 ± 3.3%) compared to that of the NHL-BFM 95 group (82.0 ± 5.4%, p = 0.037). Event-free survival was also improved (95.3 ± 3.3% vs. 68.6 ± 6.5%, p = 0.001), as well as the relapse-free survival (97.3 ± 2.7% vs. 74.4 ± 6.4%, p = 0.003). Conclusions: The immunophenotype-oriented approach of the ALCL NII DOiG 2003 protocol provides significantly improved long-term outcomes compared to the common NHL-BFM 95. These findings support the benefit of personalized immunologically targeted therapy in pediatric ALCL treatment. Full article
(This article belongs to the Special Issue Current Research in Pediatric Hematological Oncology)
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10 pages, 3815 KB  
Article
Features of Thyroid Lymphoma: A Single-Center Experience
by Enrico Battistella, Luca Pomba, Riccardo Toniato, Andrea Piotto, Ivana Cataldo, Mariella Lo Schirico and Antonio Toniato
Cancers 2026, 18(10), 1574; https://doi.org/10.3390/cancers18101574 - 12 May 2026
Viewed by 339
Abstract
Background: Primary thyroid lymphoma (PTL) is a rare malignancy, accounting for less than 5% of thyroid cancers and less than 2% of extranodal lymphomas. It predominantly affects older women and is strongly associated with autoimmune thyroiditis, particularly Hashimoto’s thyroiditis. Diagnosis is often challenging [...] Read more.
Background: Primary thyroid lymphoma (PTL) is a rare malignancy, accounting for less than 5% of thyroid cancers and less than 2% of extranodal lymphomas. It predominantly affects older women and is strongly associated with autoimmune thyroiditis, particularly Hashimoto’s thyroiditis. Diagnosis is often challenging due to non-specific clinical, imaging, and cytological findings, and the role of surgery has progressively shifted from therapeutic to primarily diagnostic. Methods: We conducted a retrospective single-center case series including nine patients treated for PTL between 2015 and 2025 at a tertiary referral endocrine surgery center. An analysis was conducted on clinical presentation, pre-existing thyroid disease, diagnostic work-up, histopathological subtypes, treatment strategies and outcomes. All patients underwent preoperative ultrasound and fine-needle aspiration cytology (FNAC); surgical intervention was performed to confirm cytology results, when cytology was inconclusive or when compressive symptoms were present. Results: The cohort included six females and three males, with a median age of 65.2 years. Four patients had Hashimoto’s thyroiditis and three had multinodular goiter. FNAC was diagnostic or suggestive of lymphoma in three cases only, and surgical biopsy or thyroidectomy for a definitive diagnosis was performed in eight cases. One case started follow-up after cytology and flow cytometry. Histological subtypes were heterogeneous, including diffuse large B-cell lymphoma, Burkitt’s lymphoma, Hodgkin lymphoma, follicular lymphoma, high-grade B-cell lymphoma, and MALT lymphoma. Seven patients received combined chemoimmunotherapy. A complete response was obtained in eight patients, with a minimum follow-up of three years; one patient died of unrelated causes. Conclusions: PTL remains a rare and diagnostically challenging thyroid malignancy. FNAC alone is frequently insufficient, and surgical biopsy retains an important role in cases with high clinical suspicion or compressive symptoms. While surgery has limited therapeutic value, a multidisciplinary approach and timely, tailored treatment are crucial to achieving favorable outcomes. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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19 pages, 6164 KB  
Article
Longitudinal Patient-Reported Symptom Change Patterns and Prediction of Future Health-Related Quality of Life in Childhood Cancer Survivors: A Machine Learning Approach from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort
by Farideh Bagherzadeh-Khiabani, Kevin R. Krull, Shizue Izumi, Sedigheh Mirzaei, Tiange Zheng, Jose Miguel Martinez Martinez, Kirsten K. Ness, Gregory T. Armstrong, Melissa M. Hudson, Leslie L. Robison, Yutaka Yasui and I-Chan Huang
Cancers 2026, 18(10), 1546; https://doi.org/10.3390/cancers18101546 - 10 May 2026
Viewed by 513
Abstract
Background: Adult survivors of childhood cancer face a significant risk for treatment-related late effects that may impair health-related quality of life (HRQoL). Incorporating longitudinal changes in patient-reported symptoms beyond treatment-based risk factors may enhance the prediction of HRQoL. Methods: Survivors (n = [...] Read more.
Background: Adult survivors of childhood cancer face a significant risk for treatment-related late effects that may impair health-related quality of life (HRQoL). Incorporating longitudinal changes in patient-reported symptoms beyond treatment-based risk factors may enhance the prediction of HRQoL. Methods: Survivors (n = 576) dually enrolled in the St. Jude Lifetime Cohort Study and Childhood Cancer Survivor Study reported 37 symptoms across 10 domains at three time points over 20 years to ascertain longitudinal symptom change patterns. HRQoL was subsequently assessed using SF-36 scores. Prediction models were developed using Bayesian Information Criterion Elastic Net (BIEN), first including demographic, diagnosis, and treatment variables, then adding symptom change patterns. Prediction of suboptimal HRQoL (score < 40) was evaluated using 10-fold cross-validated area under the receiver operating characteristic curve values (AUC). Results: Participants (median baseline age 26.7 years, 52% female, 90% non-Hispanic white, 41% leukemia, and 30% Hodgkin/non-Hodgkin lymphoma survivors) most frequently reported symptom domains of sensory, pain, and anxiety (50–60% at any time point), followed by depression and memory (40–50%). Consistent absence throughout follow-up was the most common pattern (41.7–98.1%), while patterns requiring symptom presence at ≥1 time point were less common (0.0–16.7%), and persistent presence throughout follow-up was rare (0.0–6.8%). Across 10 SF36-HRQoL scores, symptom-enhanced models improved prediction over non-symptom models (AUCs 0.75–0.85 vs. 0.56–0.66; p-values < 0.001). Conclusions: Longitudinal symptom change patterns substantially improved future HRQoL prediction, achieving prediction accuracy that may be of clinical effectiveness. This supports regular symptom assessment and further research towards symptom-informed risk stratification in survivorship care. Full article
(This article belongs to the Special Issue Long-Term Cancer Survivors: Rehabilitation and Quality of Life)
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17 pages, 931 KB  
Article
Pre-Transplant Prognostic Nutritional Index Independently Predicts Progression-Free Survival After Autologous Stem Cell Transplantation in Lymphoma
by Hüseyin Atacan, Volkan Aslan, Alper Topal, Nurlan Mammadzada, Gizem Yıldırım, Gökçe Gül Güneysu, Berkan Karadurmuş, Esmanur Kaplan Tüzün, Ömer Faruk Kuzu, Efe Cem Erdat, Musa Barış Aykan, İsmail Ertürk and Nuri Karadurmuş
J. Clin. Med. 2026, 15(9), 3549; https://doi.org/10.3390/jcm15093549 - 6 May 2026
Viewed by 284
Abstract
Background: Autologous stem cell transplantation (ASCT) is a standard treatment for relapsed or high-risk lymphoma. While disease-related factors are well-known, the impact of host-related factors like nutritional status remains less defined. We aimed to evaluate the prognostic value of the prognostic nutritional index [...] Read more.
Background: Autologous stem cell transplantation (ASCT) is a standard treatment for relapsed or high-risk lymphoma. While disease-related factors are well-known, the impact of host-related factors like nutritional status remains less defined. We aimed to evaluate the prognostic value of the prognostic nutritional index (PNI) and other factors in lymphoma patients undergoing ASCT. Methods: We conducted a single-center retrospective cohort study including adult patients with Hodgkin and non-Hodgkin lymphoma who underwent ASCT between January 2015 and December 2023. Pre-transplant clinical, laboratory, and transplant-related variables were analyzed. The prognostic nutritional index (PNI) was calculated using serum albumin and absolute lymphocyte count and dichotomized according to the cohort median. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier and Cox regression analyses. We conducted a retrospective single-center cohort study including adult patients with Hodgkin and non-Hodgkin lymphoma who underwent ASCT between January 2015 and December 2023. Results: A total of 43 patients were included. Median age was 38 years, and 72.1% were male. Patients transplanted in complete remission (CR) had significantly longer PFS compared with those transplanted in partial remission (PR) (log-rank p = 0.022). Patients with higher pre-ASCT PNI demonstrated significantly improved PFS (median 45 vs. 7 months; log-rank p = 0.021). In multivariable Cox regression analysis, both higher PNI (HR 0.39; 95% CI 0.16–0.97; p = 0.043) and complete remission prior to ASCT (HR 0.41; 95% CI 0.17–0.98; p = 0.046) remained independently associated with improved PFS. Higher infused CD34+ (hematopoietic stem cell) dose was associated with shorter hospitalization but showed no statistically significant association with engraftment kinetics or survival. No variable was independently associated with OS, likely due to the limited number of death events. Conclusions: Pre-transplant prognostic nutritional index and disease response independently predict progression-free survival after ASCT in lymphoma. These findings highlight the complementary role of host-related and disease-related factors in transplant outcomes and suggest that PNI may serve as a practical tool for pre-transplant risk stratification and patient optimization. Given the small sample size and limited number of events, these findings should be interpreted with caution. Full article
(This article belongs to the Section Oncology)
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15 pages, 888 KB  
Review
Diagnostic Challenges in Nodal T-Follicular Helper (TFH) Cell Lymphoma
by Neha Seth, Phyu Thin Naing and Pratik Q. Deb
BioMed 2026, 6(2), 12; https://doi.org/10.3390/biomed6020012 - 2 May 2026
Viewed by 342
Abstract
Nodal T-follicular helper cell lymphomas comprise a biologically similar but morphologically diverse family of T-cell neoplasms, including angioimmunoblastic T-cell lymphoma, nodal T-follicular helper cell lymphoma, follicular-type, and nodal TFH lymphoma, not otherwise specified. Despite recurrent molecular alterations involving RHOA, IDH2, TET2 [...] Read more.
Nodal T-follicular helper cell lymphomas comprise a biologically similar but morphologically diverse family of T-cell neoplasms, including angioimmunoblastic T-cell lymphoma, nodal T-follicular helper cell lymphoma, follicular-type, and nodal TFH lymphoma, not otherwise specified. Despite recurrent molecular alterations involving RHOA, IDH2, TET2, and DNMT3A, the diagnosis of TFH lymphomas remains challenging because of their mimicry of other lymphoid neoplasms and reactive lymphadenopathy. A key pitfall is confusion with classical Hodgkin lymphoma, as admixed Epstein–Barr virus-positive large B-cells with Reed–Sternberg cell-like morphology and immunophenotype can be found in TFH lymphomas. Similarly, follicular-type TFH lymphoma is often misclassified as follicular B-cell lymphoma unless T-cell lineage is investigated by immunophenotyping and the absence of BCL2 or BCL6 rearrangement is established. The ‘not otherwise specified’ category should be reserved for cases with proven T-follicular helper immunophenotype but lacks definitive angioimmunoblastic or follicular architecture. Comparing current frameworks, 5th edition of the World Health Organization classification permits rare CD4/CD8 double negative cases, while International Consensus Classification requires CD4 positivity. Some of these distinctions may appear taxonomic as all T-follicular helper T-cell lymphoma subtypes share molecular alterations, prognosis, and treatment approach. However, these classifications are meaningful from the perspective of a histopathologic diagnosis as a wrong diagnosis may lead to ineffective treatment approach. Accurate recognition of these lymphomas prevents misclassification, avoids inappropriate regimens, and ensures eligibility for proper clinical trials. A structured approach integrating morphology, multiparameter immunohistochemistry, flow cytometry, and molecular testing provides the best safeguard against diagnostic pitfalls and refines classification across subtypes. Full article
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18 pages, 1288 KB  
Review
Hodgkin Reed-Sternberg Cells of Classic Hodgkin Lymphoma: Morphology, Phenotype, Genotype, and Cell of Origin
by Annunziata Gloghini, Daniele Lorenzini, Chiara Costanza Volpi, Desirè Viola Trupia and Giancarlo Pruneri
Cancers 2026, 18(9), 1446; https://doi.org/10.3390/cancers18091446 - 30 Apr 2026
Viewed by 649
Abstract
Classic Hodgkin lymphoma (cHL) is a distinctive B-cell malignancy defined by the presence of scarce but pathobiologically dominant Hodgkin Reed-Sternberg (HRS) cells within an inflammatory tumor microenvironment (TME). Although representing less than 10% of total tumor cellularity, HRS cells shape the TME by [...] Read more.
Classic Hodgkin lymphoma (cHL) is a distinctive B-cell malignancy defined by the presence of scarce but pathobiologically dominant Hodgkin Reed-Sternberg (HRS) cells within an inflammatory tumor microenvironment (TME). Although representing less than 10% of total tumor cellularity, HRS cells shape the TME by recruiting and functionally polarizing immune and stromal elements through cytokine- and chemokine-mediated signaling. Morphologically, HRS cells are large, atypical, often binucleated or multinucleated cells with prominent eosinophilic nucleoli and abundant cytoplasm, giving rise to the classic “owl’s eye” appearance. Distinct morphological variants—including lacunar, mummified, mononuclear, and anaplastic forms—contribute to the histopathologic diversity across cHL subtypes such as nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted disease. The immunophenotype of HRS cells is equally characteristic, with strong and uniform CD30 expression, frequent CD15 positivity, reduced expression of B-cell markers (CD20, CD79A/B), and partial retention of PAX5, reflecting profound lineage dysregulation. Aberrant expression of activation markers and immune-evasion molecules, including PD-L1 driven by recurrent 9p24.1 amplification, underscores their capacity for immune escape. Genetically, HRS cells display alterations affecting NF-κB, JAK/STAT, and PI3K/AKT pathways, facilitated by somatic mutations, chromosomal gains, and epigenetic remodeling that silence B-cell-defining genes. Despite reprogramming, clonality and somatic hypermutation patterns confirm their origin from germinal center B-cells, even in EBV-associated cases. Collectively, the morphology, phenotype, and genotype of HRS cells reveal a complex pathogenic network in which intrinsic oncogenic pathways and extrinsic TME interactions co-operate to sustain malignant transformation. Understanding these integrated mechanisms provides a biological foundation for current therapeutic strategies. Full article
(This article belongs to the Special Issue Advances in Hodgkin Lymphoma (HL))
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14 pages, 248 KB  
Article
Anatomy of a Cohort: 40-Year Follow-Up of a Sjögren’s Cohort
by Blanca Viejo-Sosa, Uxía Couto-Lareo, Mònica Angerri-Nadal and David A. Isenberg
J. Clin. Med. 2026, 15(9), 3316; https://doi.org/10.3390/jcm15093316 - 27 Apr 2026
Viewed by 252
Abstract
Background: Sjögren’s disease (SjD) is a chronic autoimmune rheumatic disorder primarily affecting exocrine glands, leading to dryness and systemic involvement. B-cell hyperactivity and autoantibody production drive its pathogenesis and contribute to increased lymphoma risk. Although several long-term studies exist, we present a [...] Read more.
Background: Sjögren’s disease (SjD) is a chronic autoimmune rheumatic disorder primarily affecting exocrine glands, leading to dryness and systemic involvement. B-cell hyperactivity and autoantibody production drive its pathogenesis and contribute to increased lymphoma risk. Although several long-term studies exist, we present a review of a closely monitored cohort assessed over 40 years. Methods: Retrospective observational study at University College London Hospital included patients fulfilling the 2016 ACR/EULAR criteria for SjD between 1986–2025. Patients with associated SjD were excluded. Associations between serological markers and clinical features were analysed using chi-square or Fisher’s exact tests (p < 0.05). Differences between ethnic groups were also assessed. Results: 283 patients were included, 93.3% female, with mean age at diagnosis of 50.1 ± 15.2 years and mean follow-up of 12.5 ± 8.6 years. Common manifestations were fatigue (61.5%), parotid swelling (30.5%), arthritis (25.8%), and Raynaud’s phenomenon (27.6%). Anti-Ro and anti-La antibodies were present in 75.7% and 45.2%, respectively; rheumatoid factor in 57.3%. Lymphoma developed in 9.9% (mostly non-Hodgkin MALT) and was associated with hypergammaglobulinemia (p = 0.03; RR = 2.56) and parotid swelling (p < 0.001; RR = 5.53). Serological markers correlated with systemic features including lymphadenopathy, vasculitis, and pulmonary involvement. Caucasian patients showed higher mortality (p < 0.001; RR = 3.89) and peripheral nervous system involvement (p = 0.02; RR = 2.18), and less ANA positivity (p = 0.004; RR = 0.88), anti-Ro (p = <0.001; RR = 0.77) and RF (p = 0.04; RR = 0.81) and hypergammaglobulinemia (p = <0.001; RR = 0.63) when compared with non-Caucasian patients. Conclusions: This long-term cohort confirms the strong association between B-cell activation markers and adverse outcomes in Sjögren’s disease. Hypergammaglobulinemia and parotid swelling emerged as key predictors of lymphoma, supporting their role in risk stratification. These findings reinforce the importance of long-term monitoring and may help guide personalized clinical management and surveillance strategies. Full article
(This article belongs to the Special Issue Sjogren’s Syndrome: Clinical Advances and Insights)
21 pages, 25601 KB  
Article
FOXM1 and NFκB Form a Positive Feedback Loop to Promote Cell Growth and Drug Resistance in Mantle Cell Lymphoma
by Yujie Zhang, Yuqi Song, Meaad Almowaled, Chuquan Shang, Leizhao Hua, Irwindeep Sandhu, Anthea Peters, Michael P. Chu, Peng Wang and Raymond Lai
Cells 2026, 15(9), 776; https://doi.org/10.3390/cells15090776 - 25 Apr 2026
Viewed by 436
Abstract
Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma characterized by the t(11;14)(q13;q32) cytogenetic abnormality and cyclin D1 overexpression. We have found evidence that Forkhead box M1 (FOXM1), a transcription factor with oncogenic potential, is important in the pathogenesis of MCL. Relatively [...] Read more.
Mantle cell lymphoma (MCL) is an aggressive B-cell non-Hodgkin lymphoma characterized by the t(11;14)(q13;q32) cytogenetic abnormality and cyclin D1 overexpression. We have found evidence that Forkhead box M1 (FOXM1), a transcription factor with oncogenic potential, is important in the pathogenesis of MCL. Relatively high levels of FOXM1 proteins were detectable in all six MCL cell lines examined. By immunohistochemistry, we consistently found a subset of FOXM1-positive cells in MCL tumors. Analysis of two Gene Expression Omnibus (GEO) datasets from MCL patients showed that elevated FOXM1 levels significantly correlate with a worse clinical outcome. In MCL cell lines, inhibition of FOXM1 using thiostrepton or shRNA effectively triggered apoptosis and significantly reduced cell growth. FOXM1 forms a positive feedback loop with NFκB in MCL cells. Specifically, inhibition of FOXM1 dramatically decreased the protein level/transcription activity of p65, while enforced FOXM1 expression upregulated p65 and downregulated IκBα, a key NFκB inhibitor. Conversely, curcumin-mediated NFκB inhibition decreased the protein level/DNA binding of FOXM1, while transduction of a constitutively active IKKα construct into MCL cells significantly dampened the inhibitory effects of thiostrepton. Confocal microscopy revealed that FOXM1 and p65 colocalize with each other. In conclusion, FOXM1 and NFκB work collaboratively in promoting the growth and drug resistance of MCL, and FOXM1 may be a potentially useful therapeutic target. Full article
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Article
Early Immune Signature Features, Including TLR2 and TLR4 Expression, Are Associated with Complete Remission After CD19 CAR-T Cell Therapy
by Serena Di Iasio, Chiara Di Nunzio, Elisabetta De Santis, Concetta Stella, Daniela Valente, Dalila Salvatore, Emanuela Merla, Grazia Dell’Olio, Costanzo Padovano, Mattia Colucci, Gaja Bruno, Barbara Pasculli, Mario Caldarelli, Paola Parrella, Giovanni Gambassi, Rossella Cianci, Angelo M. Carella and Vincenzo Giambra
Pharmaceuticals 2026, 19(5), 671; https://doi.org/10.3390/ph19050671 - 25 Apr 2026
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Abstract
Background/Objectives: CD19-directed chimeric antigen receptor T (CAR-T) cell therapy induces profound immune remodeling. Nonetheless, biomarkers predicting complete remission (CR) remain poorly defined. We characterized longitudinal cytokine and immune-cell dynamics after CAR-T infusion and identified early immunological features associated with CR. Methods: Longitudinal immune [...] Read more.
Background/Objectives: CD19-directed chimeric antigen receptor T (CAR-T) cell therapy induces profound immune remodeling. Nonetheless, biomarkers predicting complete remission (CR) remain poorly defined. We characterized longitudinal cytokine and immune-cell dynamics after CAR-T infusion and identified early immunological features associated with CR. Methods: Longitudinal immune profiling was performed in 18 patients with non-Hodgkin lymphoma, including 14 with relapsed/refractory diffuse large B-cell lymphoma treated with anti-CD19 CAR-T cells. Peripheral blood was collected at the baseline and days 7, 14, 21, 28, and 60 post-infusion. Multiparameter flow cytometry quantified lymphoid and myeloid subsets and Toll-like receptor (TLR)2 and TLR4 expression. Serum cytokines were measured by multiplex assays. Machine-learning-based feature selection identified variables associated with CR. Results: Two inflammatory waves were observed. The first, at day 7, featured elevated IL-6, IL-10, IFN-α, IFN-γ, and TNF-α, accompanied by increased CD4+ T cells, HLA-DRhigh classical monocytes, and non-classical monocytes. The second, at days 21–28, showed increased IL-5, IL-6, IL-12, IFN-γ, and GM-CSF, with expansion of CD4+ and CD8+ T cells, regulatory T cells, NK-T cells, and non-classical monocytes. TLR2 expression was significantly upregulated at day 7 on T-cell subsets and on classical and intermediate monocytes. An exploratory feature-selection analysis identified baseline and day-7 TLR2 and TLR4 expression on lymphoid and myeloid cells, early IFN-γ levels, and monocyte frequencies as variables associated with CR. Conclusions: Together, these data show that anti-CD19 CAR-T therapy induces two coordinated waves of cytokine release and immune-cell activation. Moreover, the findings suggest that early modulation of innate immune features, particularly TLR2 expression, is associated with complete remission, although these biomarker relationships remain exploratory and require validation in larger cohorts. Full article
(This article belongs to the Special Issue Comprehensive Strategies in Cancer Immunotherapy)
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18 pages, 2269 KB  
Article
Soluble E-Cadherin as a New Prognostic Biomarker Able to Predict Survival in Newly Diagnosed Diffuse Large B-Cell Lymphoma
by Paola Carolina Rabesquini Marcelino da Silva, Igor Cerejo Tavares da Silva de Almeida, Joaquim Gasparini dos Santos, Leonardo Jun Otuyama, Cadiele Oliana Reichert, Hebert Fabrício Culler, Nélio Cézar de Aquino, Lilian de Souza França, Sheila Aparecida Coelho da Siqueira, Renata de Oliveira Costa, Vanderson Rocha, Sérgio Paulo Bydlowski, Débora Levy, Juliana Pereira and Luís Alberto de Pádua Covas Lage
Biomolecules 2026, 16(5), 637; https://doi.org/10.3390/biom16050637 - 24 Apr 2026
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Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, constituting an important public health problem. Although curable, it presents a widely variable prognosis. The main tool used for prognostic stratification in DLBCL is the International Prognostic Index (IPI), [...] Read more.
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, constituting an important public health problem. Although curable, it presents a widely variable prognosis. The main tool used for prognostic stratification in DLBCL is the International Prognostic Index (IPI), which does not consider crucial biological variables for understanding its prognostic heterogeneity. Cell adhesion molecules (CAMs) play a central role in cancer biology and can be evaluated in affected tissues or in plasma, in soluble forms (sCAMs). CAMs promote proliferation, survival, and dissemination of malignant cells. Although extensively studied in solid tumors, their role remains unclear in hematological malignancies, particularly in DLBCL. Methods: This is a prospective and longitudinal study involving 87 newly diagnosed DLBCL (ND-DLBCL) patients aiming to quantify plasma levels of sCAMs (sICAM-1, sVCAM-1, sP-selectin, and sE-cadherin) at diagnosis and assessing its potential prognostic impact, as well as establishing clinical-biological associations. Results: Plasma quantification of sICAM-1, sVCAM-1, and sP-selectin did not present prognostic impact in DLBCL. However, continuous increases in sE-cadherin levels, as well as sE-cadherin ≥ 126.55 ng/mL were associated with lower response rates to R-CHOP regimen, higher frequency of recurrence following first-line therapy, and shortened survival. Additionally, sE-cadherin concentration ≥ 126.55 ng/mL was an independent predictor related to decreased overall survival. Conclusion: sE-cadherin measured at diagnosis has emerged as a new prognostic biomarker able to predict response, relapse and survival in ND-DLBCL. Full article
(This article belongs to the Special Issue Novel Diagnostic Tools and Biomarkers in Hematology)
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