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Journal of Hematology & Oncology
Published in: Journal of Hematology & Oncology 1/2019

Open Access 01-12-2019 | Lymphoma | Research

APRIL and BAFF: novel biomarkers for central nervous system lymphoma

Authors: Matthias Mulazzani, Marion Huber, Sabine Borchard, Sigrid Langer, Barbara Angele, Elisabeth Schuh, Edgar Meinl, Martin Dreyling, Tobias Birnbaum, Andreas Straube, Uwe Koedel, Louisa von Baumgarten

Published in: Journal of Hematology & Oncology | Issue 1/2019

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Abstract

Background

Early diagnosis of CNS lymphoma (CNSL) is essential for successful therapy of this rapidly progressing brain tumor. However, in patients presenting with focal brain lesions, fast and reliable diagnosis of PCNSL remains a challenge. A proliferation-inducing ligand (APRIL) and B cell activating factor (BAFF) are important factors in the pathophysiology, diagnosis, and prognosis of systemic B cell malignancies. However, their utility as biomarkers for the diagnosis of CNSL and their effects on CNSL cells remain unclear.

Methods

In this prospective study, we analyzed the levels of APRIL and BAFF in the cerebrospinal fluid (CSF) of 116 patients with suspected focal brain lesions, including 53 CNSL patients. Additionally, we serially measured their levels during chemotherapy and relapse. Furthermore, we analyzed the effect of APRIL and BAFF on two B cell lymphoma cell lines using proliferation, viability, and chemotaxis assays.

Results

CSF levels of APRIL and BAFF reliably differentiated CNSL from other focal brain lesions (including primary and metastatic brain tumors, autoimmune-inflammatory lesions, and neuroinfectious lesions) with a specificity of 93.7% (APRIL, BAFF) and a sensitivity of 62.3% (APRIL) and 47.1% (BAFF). Serial CSF analysis of CNSL patients during chemotherapy and relapse demonstrates a close correlation of APRIL CSF levels and the course of this disease. In vitro, APRIL and BAFF showed anti-apoptotic effects during MTX treatment and mediated chemotaxis of malignant B cells.

Conclusion

This study extends the spectrum of valuable diagnostic biomarkers in CNSL. In patients with focal brain lesions, measurement of APRIL in CSF could help accelerating the diagnosis of CNSL. Moreover, our results highlight an important role of APRIL and BAFF in the pathophysiology of CNSL.
Appendix
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Metadata
Title
APRIL and BAFF: novel biomarkers for central nervous system lymphoma
Authors
Matthias Mulazzani
Marion Huber
Sabine Borchard
Sigrid Langer
Barbara Angele
Elisabeth Schuh
Edgar Meinl
Martin Dreyling
Tobias Birnbaum
Andreas Straube
Uwe Koedel
Louisa von Baumgarten
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Hematology & Oncology / Issue 1/2019
Electronic ISSN: 1756-8722
DOI
https://doi.org/10.1186/s13045-019-0796-4

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