决定异体 CAR T 细胞排斥与扩增的细胞和分子机制
Cellular and molecular mechanisms determining allogeneic CAR T cell rejection and expansion.
我们评估了11例接受单一批次cemacabtagene ansegedleucel(cema-cel)治疗的大B细胞淋巴瘤患者,cemacabtagene ansegedleucel是一种异体抗CD19 CAR T产品。
英文原题:Epstein-Barr virus-positive T- and NK-cell lymphoproliferative disorders: Report from the 2023 SH/EA4HP Lymphoma Workshop.
EBV+ T细胞和NK细胞LPDs的诊断复杂,需结合临床信息及形态学和分子特征的多参数方法。
总结2023年血液病理学会/欧洲血液病理学协会研讨会关于EBV阳性T细胞和NK细胞淋巴增殖性疾病(LPDs)的结论。
第3场研讨会共收到38例病例。
病例包括结外NK/T细胞淋巴瘤(ENKTCL),鼻型(n = 16)、儿童EBV+ T细胞和NK细胞LPD(n = 12)、原发性结内EBV+ T细胞和NK细胞淋巴瘤(n = 5),以及其他EBV+ T细胞和NK细胞LPD(n = 5)。ENKTCL病例突出了一些不寻常的特征,如惰性行为、小细胞形态和T细胞表型,包括CD4和CD30表达的病例。ENKTCL的鉴别诊断通过4例其他原发性皮肤淋巴瘤的病例进行了说明。还讨论了系统性慢性活动性EBV病诊断的困难、其并发症,以及儿童EBV+ LPD之间有时难以界定的界限。提交的病例还揭示了在当前分类下未被识别的EBV+ T细胞白血病/淋巴瘤病例,以及与B细胞淋巴瘤治疗相关的EBV+ CD8+细胞毒性淋巴瘤病例。强调了需要降低阈值来调查EBV存在的必要性。
OBJECTIVES: To summarize the conclusions of the 2023 Society for Hematopathology/European Association for Haematopathology workshop regarding Epstein-Barr virus (EBV)-positive T- and natural killer (NK)-cell lymphoproliferative disorders (LPDs). METHODS: There were 38 cases submitted to session 3 of the workshop. RESULTS: Cases included extranodal NK/T-cell lymphoma (ENKTCL), nasal type (n = 16), EBV+ T- and NK-cell LPDs in children (n = 12), primary nodal EBV+ T- and NK-cell lymphoma (n = 5), and other EBV+ T- and NK-cell LPDs (n = 5). The ENKTCL cases highlighted some unusual features like indolent behavior, small cell morphology, and T-cell phenotype, including cases with CD4 and CD30 expression. The differential diagnosis of ENKTCL was illustrated by 4 cases with other primary cutaneous lymphomas. The difficulty in the diagnosis of systemic chronic active EBV disease, its complications, and the sometimes elusive boundaries among the EBV+ LPDs in children are also discussed. The submitted cases also unveiled cases of EBV+ T-cell leukemia/lymphoma not recognized under current classifications and cases of EBV+ CD8+ cytotoxic lymphomas associated with treatment for B-cell lymphomas. The need to have a low threshold to investigate the presence of EBV is highlighted. CONCLUSIONS: The diagnosis of EBV+ T- and NK-cell LPDs is complex and requires a multiparameter approach incorporating clinical information and morphologic and molecular features.
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