The 2016 revision of the World Health Organization classification of lymphoid neoplasms

Tumours are known as wounds that do not heal - this implies that cells that are involved in angiogenesis and the response to injury, such as endothelial cells and fibroblasts, have a prominent role in the progression, growth and spread of cancers. Fibroblasts are associated with cancer cells at all stages of cancer progression, and their structural and functional contributions to this process are beginning to emerge. Their production of growth factors, chemokines and extracellular matrix facilitates the angiogenic recruitment of endothelial cells and pericytes. Fibroblasts are therefore a key determinant in the malignant progression of cancer and represent an important target for cancer therapies.

Fibroblasts in cancer

Macrophage Diversity Enhances Tumor Progression and Metastasis

The study of extracellular vesicles (EVs) has the potential to identify unknown cellular and molecular mechanisms in intercellular communication and in organ homeostasis and disease. Exosomes, with an average diameter of ~100 nanometers, are a subset of EVs. The biogenesis of exosomes involves their origin in endosomes, and subsequent interactions with other intracellular vesicles and organelles generate the final content of the exosomes. Their diverse constituents include nucleic acids, proteins, lipids, amino acids, and metabolites, which can reflect their cell of origin. In various diseases, exosomes offer a window into altered cellular or tissue states, and their detection in biological fluids potentially offers a multicomponent diagnostic readout. The efficient exchange of cellular components through exosomes can inform their applied use in designing exosome-based therapeutics.

The biology, function, and biomedical applications of exosomes

Macrophages are prominent in the stromal compartment of virtually all types of malignancy. These highly versatile cells respond to the presence of stimuli in different parts of tumors with the release of a distinct repertoire of growth factors, cytokines, chemokines, and enzymes that regulate tumor growth, angiogenesis, invasion, and/or metastasis. The distinct microenvironments where tumor-associated macrophages (TAM) act include areas of invasion where TAMs promote cancer cell motility, stromal and perivascular areas where TAMs promote metastasis, and avascular and perinecrotic areas where hypoxic TAMs stimulate angiogenesis. This review will discuss the evidence for differential regulation of TAMs in these microenvironments and provide an overview of current attempts to target or use TAMs for therapeutic purposes. (Cancer Res 2006; 66(2): 605-12)

https://cancerres.aacrjournals.org/content/canres/66/2/605.full.pdf

Distinct Role of Macrophages in Different Tumor Microenvironments

7539Background: In elderly pts with aggressive B-cell lymphoma, the feasibility of full dose curative chemotherapy is limited by comorbidities and subsequent higher treatment related mortality (TRM...

Age-dependent analysis of toxicity, mortality, and implementation of an anti-infective prophylaxis in 1171 elderly patients (pts) with aggressive B-cell lymphoma (aNHL): Data from consecutive phase II and III trials of the DSHNHL.

To irradiate or not to irradiate--that is the question.

PURPOSE Knowledge about oral health-related quality of life (OHRQoL) in adult patients with leukaemia is still limited. Accordingly, aim of this cross-sectional study was to assess OHRQoL and its associations to different parameters in adult patients with newly diagnosed acute leukaemia. MATERIALS AND METHODS Participants with first diagnosis of acute leukaemia were consecutively recruited in the Clinic of Hematology and Oncology of the University Medical Center Goettingen. OHRQoL was assessed using the German short form of oral health impact profile (OHIP-G14). Presence of oral initial symptoms, dental health (decayed- [D-T], missing- [M-T] and filled-teeth index [DMF-T]), dental behaviour and periodontal disease severity were assessed. For comparison, a healthy control group (HC) was recruited. RESULTS Thirty-nine patients with leukaemia and 38 HC were included. In the leukaemia group, a statistically significant and clinically relevant higher OHIP-sum score compared to HC was found (6.13 [3; 0-7] vs 0.87 [0; 0-2], p <0.01). The different subaspects of OHRQoL (patterns) 'oral function' and 'orofacial appearance' were statistically significantly worse in the leukaemia group (p <0.01). Time since diagnosis showed a clinically relevant association to the pattern 'psychosocial impact' (p = 0.06). Patients with oral initial symptoms had a statistically significantly worse OHIP-sum score (p <0.04, V = 0.775). DMF-T (p = 0.03, r = 0.242) and M-T (p = 0.03, r = 0.252) showed an association to OHIP sum score. Moreover, D-T (p = 0.03, r = 0.253) and M-T (p = 0.01, r = 0.296) were associated to orofacial appearance. Additionally, M-T showed an association to pattern 'oral function' (p = 0.01, r = 0.277). CONCLUSION Patients with newly diagnosed acute leukaemia show a reduced OHRQoL. This might be particularly caused by oral health situation, especially oral initial symptoms as well as missing teeth.

Oral Health-Related Quality of Life in Adult Patients with Newly Diagnosed Acute Leukaemia.

In der Erforschung, Klassifikation und Behandlung maligner Lymphome und Leukamien sind in den letzten Jahren wesentliche Fortschritte erzielt worden. Klinische Phase-III-Studien ermoglichen, aufbauend auf diesen Erkenntnissen, die Verbesserung bisheriger Therapieschemata auf der Basis rationaler Konzepte. Solche Therapieoptimierungsstudien verbessern zudem durch ihre Einbeziehung zahlreicher onkologischer Zentren und Praxen die Etablierung von auf breiter Basis anerkannten Therapiestandards. Zudem bieten die Studienzentralen den teilnehmenden Zentren wie auch ratund hilfesuchenden Patienten und Angehorigen die Moglichkeit, jederzeit uber aktuelle Entwicklungen informiert zu sein wie auch sachkundige Hilfe bei schwierigen Therapieentscheidungen zu suchen. Die Kompetenznetze Lymphome und Leukamien des BMBF wie die Forderung der Deutschen Krebshilfe haben in den letzten Jahren durch Studienunterstutzung und Informationsvernetzung von Spezialisten in Klinik und Praxis, hausarztlich tatigen Kollegen und den Patientenselbsthilfegruppen zu einer wesentlichen Verbesserung der Versorgung dieser Patienten beigetragen.

Lorenz Trümper

Papers

Age-dependent analysis of toxicity, mortality, and implementation of an anti-infective prophylaxis in 1171 elderly patients (pts) with aggressive B-cell lymphoma (aNHL): Data from consecutive phase II and III trials of the DSHNHL.

To irradiate or not to irradiate--that is the question.

Oral Health-Related Quality of Life in Adult Patients with Newly Diagnosed Acute Leukaemia.

Diagnostik und Therapiestrategien bei Lymphomen

New diagnostic and therapeutic strategies for aggressive lymphomas