ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition

Author:

Kemps Paul G.12ORCID,Picarsic Jennifer3ORCID,Durham Benjamin H.45ORCID,Hélias-Rodzewicz Zofia67ORCID,Hiemcke-Jiwa Laura2ORCID,van den Bos Cor28ORCID,van de Wetering Marianne D.28,van Noesel Carel J. M.9ORCID,van Laar Jan A. M.1011ORCID,Verdijk Robert M.12ORCID,Flucke Uta E.13ORCID,Hogendoorn Pancras C. W.1ORCID,Woei-A-Jin F. J. Sherida H.14ORCID,Sciot Raf15ORCID,Beilken Andreas16ORCID,Feuerhake Friedrich17ORCID,Ebinger Martin18ORCID,Möhle Robert19,Fend Falko20ORCID,Bornemann Antje20,Wiegering Verena21ORCID,Ernestus Karen22,Méry Tina23,Gryniewicz-Kwiatkowska Olga24ORCID,Dembowska-Baginska Bozenna24ORCID,Evseev Dmitry A.25ORCID,Potapenko Vsevolod2627ORCID,Baykov Vadim V.28ORCID,Gaspari Stefania29ORCID,Rossi Sabrina30ORCID,Gessi Marco31ORCID,Tamburrini Gianpiero32ORCID,Héritier Sébastien33ORCID,Donadieu Jean733ORCID,Bonneau-Lagacherie Jacinthe34,Lamaison Claire35,Farnault Laure36ORCID,Fraitag Sylvie37ORCID,Jullié Marie-Laure38ORCID,Haroche Julien39,Collin Matthew40ORCID,Allotey Jackie31,Madni Majid41,Turner Kerry42ORCID,Picton Susan43,Barbaro Pasquale M.44ORCID,Poulin Alysa45,Tam Ingrid S.45ORCID,El Demellawy Dina46ORCID,Empringham Brianna47ORCID,Whitlock James A.47,Raghunathan Aditya48ORCID,Swanson Amy A.48,Suchi Mariko49ORCID,Brandt Jon M.50,Yaseen Nabeel R.51,Weinstein Joanna L.52ORCID,Eldem Irem53ORCID,Sisk Bryan A.53ORCID,Sridhar Vaishnavi54,Atkinson Mandy54,Massoth Lucas R.55ORCID,Hornick Jason L.56ORCID,Alexandrescu Sanda5657ORCID,Yeo Kee Kiat58ORCID,Petrova-Drus Kseniya5ORCID,Peeke Stephen Z.59ORCID,Muñoz-Arcos Laura S.60ORCID,Leino Daniel G.3ORCID,Grier David D.3ORCID,Lorsbach Robert3,Roy Somak3ORCID,Kumar Ashish R.6162ORCID,Garg Shipra31,Tiwari Nishant31,Schafernak Kristian T.31,Henry Michael M.63ORCID,van Halteren Astrid G. S.264ORCID,Abla Oussama47ORCID,Diamond Eli L.65ORCID,Emile Jean-François67ORCID

Affiliation:

1. Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands;

2. Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands;

3. Division of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH;

4. Human Oncology and Pathogenesis Program, Department of Medicine, and

5. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY;

6. Department of Pathology, Ambroise Paré Hospital, Assistance Publique–Hôpitaux de Paris, Boulogne, France;

7. EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France;

8. Department of Pediatric Oncology, Emma Children’s Hospital, and

9. Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands;

10. Department of Internal Medicine and Immunology, and

11. Section of Clinical Immunology, Department of Immunology, and

12. Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands;

13. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands;

14. Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium;

15. Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium;

16. Department of Pediatric Hematology and Oncology, and

17. Department of Pathology, Hannover Medical School, Hannover, Germany;

18. Department I – General Pediatrics, Children’s Hospital, Hematology and Oncology,

19. Department of Hematology and Oncology, and

20. Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany;

21. Department of Oncology, Hematology and Stem Cell Transplantation, University Children’s Hospital Würzburg, Würzburg, Germany;

22. Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany;

23. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany;

24. Department of Oncology, Children’s Memorial Health Institute, Warsaw, Poland;

25. Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia;

26. Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia;

27. Department of Bone Marrow Transplantation and

28. Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia;

29. Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children’s Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy;

30. Pathology Unit, Laboratories Department, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy;

31. Department of Pathology and

32. Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;

33. Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France;

34. Department of Pediatric Onco-Hematology and

35. Department of Pathology, Rennes University Hospital, Rennes, France;

36. Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France;

37. Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France;

38. Department of Pathology, University Hospital of Bordeaux, Bordeaux, France;

39. Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique–Hôpitaux de Paris, Paris, France;

40. Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom;

41. Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom;

42. Department of Histopathology and

43. Department of Pediatric Oncology, Leeds Children’s Hospital, Leeds, United Kingdom;

44. Department of Hematology, Queensland Children’s Hospital, Brisbane, QLD, Australia;

45. Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada;

46. Department of Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada;

47. Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;

48. Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN;

49. Department of Pathology, Medical College of Wisconsin, Milwaukee, WI;

50. Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children’s Hospital, Green Bay, WI;

51. Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL;

52. Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL;

53. Department of Pediatric Hematology and Oncology, St Louis Children’s Hospital, Washington University in St Louis, St Louis, MO;

54. Department of Pediatric Hematology and Oncology, Carilion Children’s Pediatric Hematology and Oncology, Roanoke, VA;

55. Department of Pathology, Massachusetts General Hospital, and

56. Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;

57. Department of Pathology, Boston Children’s Hospital, Boston, MA;

58. Department of Pediatric Oncology, Dana Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA;

59. Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY;

60. Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY;

61. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH;

62. Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH;

63. Center for Cancer and Blood Disorders, Phoenix Children’s Hospital, Phoenix, AZ;

64. Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and

65. Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY

Abstract

Abstract ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Cited by 58 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3