2019
CVID-Associated Tumors: Czech Nationwide Study Focused on Epidemiology, Immunology, and Genetic Background in a Cohort of Patients With CVID
KRALICKOVA, Pavlina, Tomas MILOTA, Jiří LITZMAN, Ivana MALKUSOVA, Dalibor JILEK et. al.Základní údaje
Originální název
CVID-Associated Tumors: Czech Nationwide Study Focused on Epidemiology, Immunology, and Genetic Background in a Cohort of Patients With CVID
Autoři
KRALICKOVA, Pavlina (203 Česká republika), Tomas MILOTA (203 Česká republika, garant), Jiří LITZMAN (203 Česká republika, domácí), Ivana MALKUSOVA (203 Česká republika), Dalibor JILEK (203 Česká republika), Jitka PETANOVA (203 Česká republika), Jana VYDLAKOVA (203 Česká republika), Alena ZIMULOVA (203 Česká republika), Eva FRONKOVA (203 Česká republika), Michael SVATON (203 Česká republika), Veronika KANDEROVA (203 Česká republika), Marketa BLOOMFIELD (203 Česká republika), Zuzana PARACKOVA (203 Česká republika), Adam KLOCPERK (203 Česká republika), Jiri HAVIGER (203 Česká republika), Tomas KALINA (203 Česká republika) a Anna SEDIVA (203 Česká republika)
Vydání
Frontiers in Immunology, LAUSANNE, FRONTIERS MEDIA SA, 2019, 1664-3224
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30102 Immunology
Stát vydavatele
Švýcarsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 5.085
Kód RIV
RIV/00216224:14110/19:00109465
Organizační jednotka
Lékařská fakulta
UT WoS
000456198800002
Klíčová slova anglicky
common variable immunodeficiency; malignancy; lymphoma; gastric cancer; whole exome sequencing
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 16. 4. 2019 11:26, Soňa Böhmová
Anotace
V originále
Background: Common variable immunodeficiency disorder (CVID) is one of the most frequent inborn errors of immunity, increased occurrence of malignancies, particularly lymphomas, and gastric cancers, has long been noted among CVID patients. Multifactorial etiology, including immune dysregulation, infections, chronic inflammation, or genetic background, is suggested to contribute to tumor development. Here, we present the results of the first Czech nationwide study focused on epidemiology, immunology and genetic background in a cohort of CVID patients who also developed tumors Methods: The cohort consisted of 295 CVID patients followed for 3,070 patient/years. Standardized incidence ratio (SIR) was calculated to determine the risk of cancer, and Risk ratio (RR) was established to evaluate the significance of comorbidities. Moreover, immunophenotyping, including immunoglobulin levels and lymphocyte populations, was assessed. Finally, Whole exome sequencing (WES) was performed in all patients with lymphoma to investigate the genetic background. Results: Twenty-five malignancies were diagnosed in 22 patients in a cohort of 295 CVID patients. SIR was more than 6 times greater in comparison to the general population. The most common neoplasias were gastric cancers and lymphomas. History of Immune thrombocytopenic purpura (ITP) was established as a potential risk factor, with over 3 times higher risk of cancer development. The B cell count at diagnosis of lymphoma was reduced in the lymphoma group; moreover, post-treatment B and T cell lymphopenia, associated with poorer outcome, was found in a majority of the patients. Intriguingly, no NK cell depression was observed after the chemotherapy. WES revealed heterogeneous genetic background among CVID patients with tumors, identifying gene variants associated with primary immunodeficiencies (such as CTLA4, PIK3CD, PMS2) and/or increased cancer susceptibility (including BRCA1, RABEP1, EP300, KDM5A). Conclusions: The incidence of malignancy in our CVID cohort was found to be more than 6 times greater compared to the general population. Gastric cancers and lymphomas were the most frequently diagnosed tumors. ITP was identified as a risk factor for malignancy in CVID patients. WES analysis confirmed a wide genetic heterogeneity among CVID patients. The identified causative or modifying gene variants pointed to errors in mechanisms contributing to both immunodeficiency and malignancy.