With a new test kit, the discovery enables more effective treatment for patients; Findings also impact 2008 WHO classification
An international research team has identified a new type of deadly intestinal lymphoma that is particularly common in Asia. The team, led by clinician-scientists from the SingHealth Academic Healthcare Cluster, also developed a new diagnostic test to accurately identify these patients.
The study, carried out by the Singapore Lymphoma Study Group at Singapore General Hospital (SGH) and the National Cancer Centre Singapore (NCCS), has an immediate impact on patient care, with doctors now able to diagnose patients accurately and tailor more effective treatment strategies to improve outcomes. It will also impact the most recent WHO classification of haematolymphoid neoplasms.
This is the largest study of this lymphoma type, involving 60 cases from centres in Singapore and around Asia, including South Korea, Hong Kong, Taiwan, Australia, China and Malaysia. The findings were advanced published online in Leukemia earlier this month.
The disease, almost unheard of before 2008, has been classified as an alternative type of enteropathy-associated T-cell lymphoma (EATL Type I), a disease common in Caucasians and associated with coeliac disease.
"We discovered that the intestinal lymphoma commonly seen in Asian patients has no links to coeliac disease or EATL Type I found in Caucasians," said Associate Professor Tan Soo Yong, Senior Consultant, Department of Pathology at SGH, and first author of the study. "Instead, we discovered that the pathology of this disease is very different and most likely originates from a unique epithelial cell type found in the intestine, making it a completely different disease type."
"We, therefore, propose to re-classify the disease, currently labelled EATL Type II, as 'Epitheliotropic Intestinal T-cell Lymphoma' (EITL)," added Assoc Prof Tan, who is also Director of the SingHealth Tissue Repository and a faculty at Duke-NUS. This would impact the WHO's classification.
In addition, the team has identified a novel biomarker, known as MATK (megakaryocyte-associated tyrosine kinase), and developed a diagnostic test that enables clinicians to accurately diagnose patients suffering from this type of lymphoma. Requests for this test have come in from around the world, including China and the U.S.