HAEM5:Classic Hodgkin lymphoma: Difference between revisions
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{{DISPLAYTITLE:Classic Hodgkin lymphoma}} | {{DISPLAYTITLE:Classic Hodgkin lymphoma}} | ||
[[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | [[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | ||
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==Primary Author(s)*== | ==Primary Author(s)*== | ||
Xiaolin Hu, Ph.D., GeneDx | |||
==WHO Classification of Disease== | ==WHO Classification of Disease== | ||
| Line 79: | Line 80: | ||
!Clinical Relevance Details/Other Notes | !Clinical Relevance Details/Other Notes | ||
|- | |- | ||
| | |2p | ||
|gain | |||
| | |2p13 | ||
| | |REL | ||
|P | |||
| | |No | ||
|REL amplification promotes NF-κB signaling activation (PMID: 19380639) | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |9p | ||
|Gain | |||
| | |9p24.1 | ||
| | |CD274 (PD-L1), PDCD1LG2 (PD-L2), JAK2 | ||
|T, P | |||
| | |Yes (PMID:20628145) | ||
|9p24.1 amplification drives PD-L1/PD-L2 overexpression, relevant for immune checkpoint inhibitor therapy (PMID: 20628145, 27069084) | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |17p | ||
|Gain | |||
| | |17q21 | ||
| | |MAP3K14 | ||
|P | |||
| | |No | ||
|MAP3K14 (NIK) gain activates alternative NF-κB signaling (PMID: 19380639) | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |6q | ||
| | |Loss | ||
| | |6q23-24 | ||
| | |TNFAIP3 | ||
| | |P | ||
| | |No | ||
| | |Loss of TNFAIP3 (A20) disrupts NF-κB regulation (PMID: 19380639) | ||
|} | |} | ||
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!Notes | !Notes | ||
|- | |- | ||
| | |Aneuploidy, hypertetraploidy | ||
|No | |No | ||
| | |unkonwn | ||
|unknown | |||
|Common in HRS cells; contributes to genomic instability (PMID: 7632954) | |||
|} | |} | ||
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!Clinical Relevance Details/Other Notes | !Clinical Relevance Details/Other Notes | ||
|- | |- | ||
| | |TNFAIP3 | ||
|Inactivating mutation | |||
|Tumor Suppressor Gene | |||
| | |Recurrent (5-20%) | ||
| | |P | ||
| | |No | ||
| | |Loss of function mutations disrupt NF-κB regulation (PMID: 19380639) | ||
| | |- | ||
| | |SOCS1 | ||
|Frameshift and nonsense mutations | |||
|Tumor Suppressor Gene | |||
|Recurrent (5-20%) | |||
|P | |||
|No | |||
|SOCS1 mutations activate JAK/STAT signaling (PMID: 24531327) | |||
|- | |||
|STAT6 | |||
|Missense mutations | |||
|Oncogene | |||
|Recurrent (5-20%) | |||
|P | |||
|No | |||
|STAT6 mutations drive cytokine signaling alterations (PMID: 24531327, 29650799) | |||
|- | |- | ||
| | |B2M | ||
|Inactivating mutations | |||
| | |Tumor Suppressor Gene | ||
| | |Rare (<5%) | ||
|< | |P | ||
| | |No | ||
| | |Loss of MHC class I expression aids immune evasion (PMID: 21368758) | ||
| | |||
|- | |- | ||
| | |CIITA | ||
| | |Inactivating mutations | ||
| | |Tumor Suppressor Gene | ||
|< | |Rare (<5%) | ||
| | |P | ||
| | |No | ||
| | |Loss of MHC class II expression aids immune evasion (PMID: 21368758) | ||
|- | |- | ||
| | |XPO1 | ||
| | |Missense mutations | ||
| | |Oncogene | ||
| | |Rare (<5%) | ||
| | |Unknown | ||
| | |No | ||
| | |Emerging evidence of role in CHL pathogenesis (PMID: 33686198) | ||
|}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content. | |}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content. | ||
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==Epigenomic Alterations== | ==Epigenomic Alterations== | ||
Global downregulation of B-cell transcription factors (OCT2, BOB1, PU.1) and epigenetic silencing of B-cell program genes (PMID: 19465900, 14694522) | |||
==Genes and Main Pathways Involved== | ==Genes and Main Pathways Involved== | ||
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!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | !Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | ||
|- | |- | ||
| | |REL, TNFAIP3, NFKBIA, MAP3K14 | ||
| | |NF-κB signaling | ||
| | |Constitutive activation of classical and alternative NF-κB pathways promotes HRS cell survival (PMID: 19380639, 33686198) | ||
|- | |||
|JAK2, STAT6, SOCS1 | |||
|JAK/STAT signaling | |||
|Dysregulation leads to proliferation and survival of HRS cells (PMID: 24531327, 29650799) | |||
|- | |- | ||
| | |CD274 (PD-L1), PDCD1LG2 (PD-L2), B2M | ||
| | |Immune evasion | ||
|Upregulation of PD-L1/PD-L2 and loss of MHC I/II expression enables immune escape (PMID: 20628145, 21368758) | |||
|- | |- | ||
| | |EBV LMP1, LMP2A | ||
| | |Viral oncogenesis | ||
| | |LMP1 mimics CD40 signaling, LMP2A mimics BCR signaling to promote HRS cell survival in EBV+ CHL (PMID: 9501091, 17682125) | ||
|- | |- | ||
| | | | ||
| | | | ||
| | | | ||
|} | |} | ||
==Genetic Diagnostic Testing Methods== | ==Genetic Diagnostic Testing Methods== | ||
*Immunohistochemistry for CD30, CD15, PAX5, and EBV (EBER in situ hybridization) (PMID: 2477085, 6946981) | |||
*9p24.1 copy number assessment (FISH or NGS) may be used in refractory/relapsed cases to evaluate PD-L1/PD-L2 amplification for potential immunotherapy (PMID: 29394125). | |||
*TR clonality assays can help exclude T-cell lymphomas in challenging differential diagnoses (PMID: 24128129). | |||
*Targeted NGS panels for NF-κB and JAK/STAT pathway mutations (PMID: 33686198) | |||
==Familial Forms== | ==Familial Forms== | ||
Familial aggregation and monozygotic twin concordance suggest genetic predisposition (PMID: 26311361, 34208754) | |||
==Additional Information== | ==Additional Information== | ||