No description available.

The clinicopathological feature of primary cutaneous lymphomas according to WHO/EORTC classification and their relationship to EBV in Taiwan has never been reported. This retrospective study collected the patients with cutaneous lymphomas from 1990 and 2006. The morphology, EBER in situ hybridization and immunohistochemistry of primary cutaneous lymphomas were studied to reclassify based on the WHO/EORTC classification. A total of 54 patients were included. Twenty-nine were primary cutaneous lymphomas and 25 were secondary cutaneous lymphomas. The age ranged from 21 to 86 years old (mean 62 years old). Twenty-one (72.4%) were primary cutaneous T-cell and NK-cell lymphoma, including 5 extranodal NK/T-cell lymphoma, nasal type (17.2%), 5 primary cutaneous peripheral T-cell lymphoma, unspecified (17.2%), 4 mycosis fungoides (13.8%), 1 Sezary syndrome, 3 primary cutaneous anaplastic large cell lymphoma, 2 primary cutaneous small-medium CD4+ T-cell lymphoma and 1 subcutaneous panniculitis-like T-cell lymphoma. Eight cases were primary cutaneous B-cell lymphoma (27.6%) including 3 cutaneous marginal zone B-cell lymphoma (10.3%), 3 cutaneous follicle center B-cell lymphoma (10.3%), and 2 diffuse large B-cell lymphoma, leg type (6.9%). Seventeen cases were secondary cutaneous T-cell and NK -cell lymphoma. Eight cases were secondary cutaneous B-cell lymphoma. All primary and secondary extranodal NK/T-cell lymphoma, nasal type, were positive for EBER, however, one of them (10%) without both angiocentric growth pattern and necrosis in histomorphological examination. This is the first clinicopathological study of cutaneous lymphoma according to recent WHO/EORTC classification in Taiwan. In comparison with the Western countries, mycosis fungoides is less common whereas primary extranodal NK/T-cell lymphoma, nasal type, and peripheral T-cell lymphoma, unspecified, is more common in Taiwan. EBER in situ hybridization study is helpful in the diagnosis of extranodal NK/T-cell lymphoma, nasal type, especially in tumor without both angiocentric growth pattern and necrosis.

Apoptosis is a cell death pathway that regulates tissue homeostasis, and is often altered in oncogenesis. Autophagy is a lysosome degradation pathway that mediates cellular adaptation in response to stresses. Altered autophagy pathways are proposed to be associated with pathogenesis of neurodegenerative diseases and oncogenesis. The goal of this work is to study the complex link between apoptosis and autophagy pathways, and their possible roles in the development of cancer. Using transgenic mice models, we found that impaired apoptosis by overexpression of a dominant negative form of Caspase-9 (Casp9DN) failed to accelerate T-cell lymphoma either by itself or in tumor-prone Bax overexpressing transgenic mice. Additionally, heterozygous disruption of Beclin 1, a central upstream autophagy regulator, failed to promote T-cell lymphoma in either Casp9DN or tumor-prone Bax overexpressing transgenic mice. However, caspase inhibition enhanced a unique form of selective mitochondrial autophagy, referred to as mitochondrial outer membrane permeabilization (MOMP)-induced mitophagy. Parkin, a protein mutated in early-onset Parkinson's disease, mediates mitophagy following protonophore (CCCP) treatment, suggesting that Parkin may also play a role in MOMP-induced mitophagy. Thus, two different types of mitochondrial stresses, MOMP and CCCP, cause mitochondrial depolarization and induce mitophagy. We therefore examined if there is a mechanistic link between two mitophagy pathways. Focusing on the roles of autophagy and apoptosis regulators using isogenic hematopoietic cell lines, our studies demonstrate that MOMP-induced mitophagy is dependent upon Bcl-2 family members, but independent of Parkin or ULK1 (an autophagy regulator). In contrast, CCCP-induced mitophagy is dependent upon Parkin and ULK1, but independent of Bcl-2 family members. However, we found that both pathways ultimately result in the following properties: reduced mitochondrial respiration rate, altered cellular metabolism, and high sensitivity to 2-DG (an inhibitor of glycolysis). Interestingly, 2-DG induced cell death in cells following Parkin-dependent mitophagy is independent of Bcl-2 and Bax/Bak. Overall, the work in this dissertation demonstrates that the two different mitochondrial stresses, MOMP and protonophore (CCCP) treatment, lead to two mechanistically distinct mitophagy pathways, but both alter mitochondrial respiration and cellular metabolism.

<p>The Notch signalling pathway is an evolutionary conserved pathway, named after the Notch receptors, Notch1-4 in mammals, which upon cell-cell contact and ligand binding releases the intracellular domain (NICD). NICD translocates into the nucleus where it binds the transcriptional repressor RBP-Jk, which together with co-activators belonging to the Mastermind-like family of proteins form a transcriptional activation complex. This complex activates genes controlling cell fate decision, embryonic development, proliferation, differentiation, adult homeostasis and stem cell maintenance. On the other hand, disrupted Notch signalling may result in pathological conditions like cancer, although the mechanisms behind the disruption are often complex and in many cases largely unknown.</p><p>Notch1 drives the lymphocyte differentiation towards a T-cell fate and activating mutations in the gene have been suggested to be involved in T-cell lymphoma. In <em>paper I, </em>genetic alterations in <em>Notch1 </em>and the Notch1 regulating gene <em>CDC4 </em>were investigated in tumours from murine T-cell lymphoma induced with phenolphthalein, 1,3-butadiene or 2’,3’-dideoxycytidine. We identified activating <em>Notch1</em> mutations in 39% of the lymphomas, suggesting that <em>Notch1 </em>is<em> </em>an important target gene for mutations in chemically induced lymphomas.<em></em></p><p>While it is known that constitutively activated Notch signalling has a clear oncogenic function in several solid malignancies as well, the molecular mechanisms are less known in this context. Unpublished data of our lab, together with other recent studies, suggest that mutations of Notch and Notch-related genes <em>per se</em> are uncommon in solid malignancies including colorectal cancer, while a growing body of evidence indicates that aberrant Wnt/b-catenin signalling may result in pro-tumoural Notch activation in these contexts. In <em>paper II</em>, we therefore investigated potential transcriptional interactions between the Notch and Wnt signalling pathways in colorectal cancer cell lines. The proximal Notch and Wnt pathway gene promoters were bioinformatically identified and screened for putative TCF/LEF1 and RBP-Jk sites. In canonical Wnt signalling, Apc negatively regulates b-catenin leading to repression of TCF/LEF1 target genes. Upon repression of the Wnt pathway we observed that several genes in the Notch pathway, including <em>Notch2</em>, were transcriptionally downregulated. We also confirmed binding of Lef1 to <em>Notch2</em> as well as other Notch pathway gene promoters and luciferase assays showed an increased activity for at least one LEF1/TCF-site in the <em>Notch2</em> promoter upon co-transfection of HT29 or HCT116 cells with mutated b-catenin. HT29 cell lines were also treated with the g-secretase inhibitor DAPT, leading to inactivation of the Notch pathway by preventing release of NICD. However, results showed no effects on Apc, b-catenin or their target <em>cyclin D1</em>. Taken together, these results indicate that the Wnt pathway may function as a regulator of the Notch pathway through the TCF/LEF1 target gene program in colon cancer cell lines.</p><p>In summary, Notch pathway deregulation is of importance in both murine T-cell lymphoma and human colorectal cancer, although the mechanisms differ. The current results give new insights in Notch pathway alterations as well as the signalling networks in which the Notch pathway interacts, and thus increase the understanding of Notch’s involvement in malignant diseases.</p> / Studies on molecular genetic alterations in colorectal cancer

Abstract Cutaneous T cell lymphoma (CTCL) is a rare, incurable, chronic disease accounting for approximately 3% of non-Hodgkin's lymphoma diagnoses every year. Patients with CTCL have skin lesions that can vary in severity putting patients at risk for developing symptoms that may impair their quality of life (QOL). The disease burden can lead to increased depressive symptoms, fatigue distress, and anxiety that the disease may be worsening. Seventy-five participants agreed to take part in an exploratory, prospective study to evaluate depressive symptoms, anxiety, fatigue distress, and spirituality as predictors of QOL in CTCL patients. Demographic variables including stage of disease, ethnicity, age, gender, marital status, level of education, and time since diagnosis, were also included in the analyses to assess for relationships. Bivariate correlations, t-tests, and regression analyses were conducted to assess for relationships among the predictor variables and QOL. The analyses revealed that the proposed model explained 64% of the variance, and depressive symptoms (t= -2.4, p= 0.020) and stage of disease (t= -3.0, p= 0.004) significantly predicted the QOL of CTCL patients. Evaluating for predictors that influence the QOL helps us to better understand the needs of the patients afflicted with CTCL. The importance of studying the QOL of the CTCL patients lies in the fact that nurses can assist in helping patients alleviate some of the symptoms they experience, thereby improving their QOL. Further study is warranted in developing interventions to assist in the preservation of QOL.

Peripheral T-cell non-Hodgkin lymphoma (PTCL) are heterogeneous, rare, and aggressive diseases mostly incurable with current cell cycle therapies. Aurora kinases (AKs) are key regulators of mitosis that drive PTCL proliferation. Alisertib (AK inhibitor) has a response rate similar to 30% in relapsed and refractory PTCL (SWOG1108). Since PTCL are derived from CD4(+)/CD8(+) cells, we hypothesized that Program Death Ligand-1 (PDL1) expression is essential for uncontrolled proliferation. Combination of alisertib with PI3K alpha (MLN1117) or pan-PI3K inhibition (PF-04691502) or vincristine (VCR) was highly synergistic in PTCL cells. Expression of PD-L1 relative to PD-1 is high in PTCL biopsies (similar to 9-fold higher) and cell lines. Combination of alisertib with pan-PI3K inhibition or VCR significantly reduced PD-L1, NF-kappa B expression and inhibited phosphorylation of AKT, ERK1/2 and AK with enhanced apoptosis. In a SCID PTCL xenograft mouse model, alisertib displayed high synergism with MLN1117. In a syngeneic PTCL mouse xenograft model alisertib demonstrated tumor growth inhibition (TGI) similar to 30%, whilst anti-PD-L1 therapy alone was ineffective. Alisertib + anti-PD-L1 resulted in TGI > 90% indicative of a synthetic lethal interaction. PF-04691502 + alisertib + anti-PD-L1 + VCR resulted in TGI 100%. Overall, mice tolerated the treatments well. Co-targeting AK, PI3K and PD-L1 is a rational and novel therapeutic strategy for PTCL.

Le syndrome hyperéosinophilique dit "lymphoïde" avec cellules T circulantes CD3-CD4+ (SHE-L CD3-CD4+) se caractérise par une hyperéosinophilie secondaire à la présence d'un clone lymphocytaire T producteur de cytokines comme l'IL-5. Trente patients seulement ont été rapportés dans la littérature, neuf d'entre eux ont présenté un lymphome T périphérique au cours du suivi. Il n'existe aucune grande série de la littérature décrivant les données cliniques, les caractéristiques immunophénotypiques, histopathologiques et moléculaires de la maladie. Le travail de Thèse a permis de confirmer la prédominance des manifestations cutanées et ganglionnaires dans le SHE-L CD3-CD4+, mais également d'autres atteintes d'organes dont l'infiltrat à éosinophiles a été démontré (poumon, tube digestif, glande lacrymale, parotide, synoviale). Les cellules CD3-CD4+ circulantes peuvent être détectées à des taux extrêmement variables, des plus faibles (<1% des lymphocytes circulants) ne devant pas être négligés, aux plus élevés (>90% des lymphocytes circulants) ne devant pas faire évoquer systématiquement une hémopathie maligne. Nous décrivons également les 2 premiers cas de lymphomes angio-immunoblastiques (LAI) survenant au cours du SHE-L CD3-CD4+. Nous avons ensuite pu décrire pour la première fois les caractéristiques histopathologiques ganglionnaires et extra-ganglionnaires (peau, tube digestif,...) du SHE-L CD3-CD4+. Nous décrivons des caractéristiques ganglionnaires et cutanées très similaires au LAI qui soulignent les difficultés du diagnostic différentiel. Nous démontrons également la persistance du même clone lymphocytaire T dans le sang et les tissus lésés sur des prélévements espacés de plusieurs années pour un patient donné (maximum: 23 ans). Enfin, les caractéristiques immunophénotypiques des cellules T circulantes (expression du CD2, CD5, CD7, TCRalphabeta) sont très proches de celles observées dans le LAI. L'ensemble de ces données définissent le SHE-L CD3-CD4+ comme un syndrome lymphoprolifératif clonal T indolent périphérique, à ne pas confondre avec le LAI. Nous proposons des éléments de diagnostic différentiel comme l'expression du CD10 et des marqueurs CXCL13 et PD1 (marqueurs dits "T helper folliculaire"), absents dans le SHE-L mais spécifiques du LAI. La dernière partie du travail de Thèse a porté sur la caractérisation moléculaire du SHE-L CD3-CD4+ par une approche type single nucleotid polymorphism array (SNPa, n=4 patients) en complément d'une étude antérieure par une approche type comparative genomic hybridization array (CGHa, n=1 patient). La comparaison du génome complet des cellules CD3-CD4+ et CD3+CD4+ par SNPa pour un patient donné, a permis d'identifier une zone commune de perte d'hétérozygotie sur le bras long du chromosome 7. L'identification par CGHa d'un gain sur le même segment chromosomique chez un autre patient permet de restreindre la zone d'intérêt à un segment chromosomique porteur de 77 gènes. Des compléments d'investigation (SNPa) sont en cours afin de restreindre le segment chromosomique d'intérêt et d'identifier le gène muté en cause par des méthodes de séquençage. Cette approche devrait permettre d'identifier pour la première fois les mécanismes moléculaires à l'origine de l'émergence du clone lymphocytaire T dans le SHE-L CD3-CD4+. En conclusion, le travail de Thèse a permis d'apporter des éléments nouveaux dans le diagnostic du SHE-L CD3-CD4+, d'en décrire les caractéristiques histopathologiques et immunophénotypiques en faveur d'un syndrome lymphoprolifératif T clonal indolent périphérique, sans équivalent dans la classification OMS actuelle des hémopathies. Enfin, nous espérons pouvoir identifier un ou des gènes d'intérêt, et proposer des mécanismes moléculaires en cause dans ce syndrome lymphoprolifératif clonal T. / The CD3-CD4+ lymphoid variant of hypereosinophilic syndrome (CD3-CD4+ L-HES) is defined by a hypereosinophilia secondary to a clonal T-cell subset producing cytokines like interleukine-5. Only thirty patients have already been described, nine of them have developed a T-cell lymphoma during follow-up. No large series has described clinical features and immunophenotypic, histopathological and molecular characteristics of the disease. This work confirmed the predominance of skin and lymph nodes involvement in CD3-CD4+ L-HES, but also of other organs in which eosinophils infiltrates were demonstrated (lung, digestive tract, lachrymal gland, parotid, synovium). CD3-CD4+ circulating T-cells can be detected at very low level (<1% of total lymphocytes) which should not be neglected, or at very high level (>90% of total lymphocytes) which should not considered as a malignant disorder. We also describe the two first cases of angioimmunoblastic T-cell lymphoma (AITL) occurred in CD3-CD4+ L-HES. We have also described for the first time the nodal and extra nodal histopathological characteristics of CD3-CD4+ L-HES, which are similar to AITL and which highlight the difficulty of differential diagnosis. We also demonstrate the same T-cell clone in blood and damaged tissues in samples spaced up for several years (maximum 23 years). Secondly, immunophenotypic characteristics of circulating T-cells (CD2, CD5, CD7, TCRalphabeta) are really closed to those of circulating T-cells in AITL. Overall, our data define CD3-CD4+ L-HES as a peripheral indolent clonal T-cell lymphoproliferative disorder, which should not be confused with AITL. We suggest some differential diagnosis tools like CD10 and Tfh markers (CXCL13, PD1) which are absent in CD3-CD4+ L-HES but specific of AITLThe last part of the work focused on the molecular characterization of the CD3-CD4 + L-HES by a single nucleotid polymorphism array approach (SNPa, n = 4 patients) in complement of an earlier study using comparative genomic hybridization array approach (CGHa, n = 1 patient). The comparison of the full genome of CD3-CD4 + and CD3+CD4+ T-cells in a given patient identified a common segment of loss of heterozygosity on the long arm of chromosome 7. Identification by CGHa of a gain on the same chromosomal segment in another patient allows restricting the area of interest to a chromosomal segment which represents 77 genes. Complementary investigations (SNPa) are underway to restrict the chromosomal segment of interest and identify the potential mutated genes by sequencing methods. This approach should identify for the first time the molecular mechanisms underlying the emergence of clonal T-cells in the CD3-CD4 + L-HES.In conclusion, the work brings some new usefull features for the diagnosis of CD3-CD4+ L-HES, describes some histopathological and immunophenotypic features in favor of a peripheral indolent clonal T-cell lymphoproliferative disorder, without any equivalent in the 2008 WHO classification of lymphoid neoplasms. Finally, we hope to identify one or more genes of interest, and to propose some molecular mechanisms involved in this clonal lymphoproliferative T-cell disease.

The Notch signalling pathway is an evolutionary conserved pathway, named after the Notch receptors, Notch1-4 in mammals, which upon cell-cell contact and ligand binding releases the intracellular domain (NICD). NICD translocates into the nucleus where it binds the transcriptional repressor RBP-Jk, which together with co-activators belonging to the Mastermind-like family of proteins form a transcriptional activation complex. This complex activates genes controlling cell fate decision, embryonic development, proliferation, differentiation, adult homeostasis and stem cell maintenance. On the other hand, disrupted Notch signalling may result in pathological conditions like cancer, although the mechanisms behind the disruption are often complex and in many cases largely unknown. Notch1 drives the lymphocyte differentiation towards a T-cell fate and activating mutations in the gene have been suggested to be involved in T-cell lymphoma. In paper I, genetic alterations in Notch1 and the Notch1 regulating gene CDC4 were investigated in tumours from murine T-cell lymphoma induced with phenolphthalein, 1,3-butadiene or 2’,3’-dideoxycytidine. We identified activating Notch1 mutations in 39% of the lymphomas, suggesting that Notch1 is an important target gene for mutations in chemically induced lymphomas. While it is known that constitutively activated Notch signalling has a clear oncogenic function in several solid malignancies as well, the molecular mechanisms are less known in this context. Unpublished data of our lab, together with other recent studies, suggest that mutations of Notch and Notch-related genes per se are uncommon in solid malignancies including colorectal cancer, while a growing body of evidence indicates that aberrant Wnt/b-catenin signalling may result in pro-tumoural Notch activation in these contexts. In paper II, we therefore investigated potential transcriptional interactions between the Notch and Wnt signalling pathways in colorectal cancer cell lines. The proximal Notch and Wnt pathway gene promoters were bioinformatically identified and screened for putative TCF/LEF1 and RBP-Jk sites. In canonical Wnt signalling, Apc negatively regulates b-catenin leading to repression of TCF/LEF1 target genes. Upon repression of the Wnt pathway we observed that several genes in the Notch pathway, including Notch2, were transcriptionally downregulated. We also confirmed binding of Lef1 to Notch2 as well as other Notch pathway gene promoters and luciferase assays showed an increased activity for at least one LEF1/TCF-site in the Notch2 promoter upon co-transfection of HT29 or HCT116 cells with mutated b-catenin. HT29 cell lines were also treated with the g-secretase inhibitor DAPT, leading to inactivation of the Notch pathway by preventing release of NICD. However, results showed no effects on Apc, b-catenin or their target cyclin D1. Taken together, these results indicate that the Wnt pathway may function as a regulator of the Notch pathway through the TCF/LEF1 target gene program in colon cancer cell lines. In summary, Notch pathway deregulation is of importance in both murine T-cell lymphoma and human colorectal cancer, although the mechanisms differ. The current results give new insights in Notch pathway alterations as well as the signalling networks in which the Notch pathway interacts, and thus increase the understanding of Notch’s involvement in malignant diseases. / Studies on molecular genetic alterations in colorectal cancer

Chronic itch has a significant impact on quality of life for millions of patients worldwide, on a level comparable to that of chronic pain. Yet, although there are a host of effective drugs available for pain, there are no therapies that specifically target chronic itch. Current experimental approaches to investigate the pathogenesis of chronic pruritus and to test novel therapeutic agents are largely limited to rodent models. However, rodent models display significant dermatological, neurophysiological, and immunological differences from humans with chronic itch. The disadvantages of the current rodent paradigms call for the design of a valid primate model of chronic itch. For four years, we have monitored scratching behavior in a primate colony (n=35) of Cynomolgus macaques (Macaca fascicularis) suffering from idiopathic chronic itch. By comparing molecular and genetic analyses of the primates’ skin to their quantified scratching behavior, we attempted to characterize the underlying mechanisms of chronic itch in this model. Furthermore, the expression of itch-related proteins was examined in both the primate model and in humans with pruritic diseases. The first aim of the study was to characterize the underlying molecular and genetic basis of chronic itch in the primate model. We were able to distinguish specific peripheral targets related to pruritus by correlating the genetic and protein expression results to the primates’ scratching severity. In Aim 1a, RNA-sequencing was performed on skin biopsies from the primates to identify differentially expressed genes in pruritic, lichenified versus non-pruritic, non-lichenified skin. These results were then correlated to the quantified primate scratching behavior. This led to the identification of over 400 genes that were differentially expressed in the skin based on scratching intensity. Many of these differentially expressed transcripts were associated with sensory nerve fibers, keratinocytes, mast cells, or lymphocytes. Selected genes that were overexpressed and correlated to itch intensity were then targeted for immunohistochemical and proteomic analysis in Aim 1b. Immunohistochemical examination of the primate skin biopsies revealed that histamine levels were not elevated in primates that exhibited increased scratching behavior. However, mast cells containing tryptase were significantly increased in the skin of primates with severe scratching as compared to primates with mild scratching. The increased levels of gastrin-releasing peptide and substance P in lichenified skin were also found to be correlated to the primates’ scratching behavior. Of note, transient receptor potential channels V1, V3, and A1 were increased in the epidermis of primate skin, but the numbers of TRPV1+ and TRPA1+ nerve fibers were not significantly different between lichenified and non-lichenified skin. Transcriptome analysis of the opioid receptors and their ligands showed that primates with severe scratching behavior had a significant imbalance between the µ- and κ-opioid receptors and ligands. The µ-opioids had upregulated gene expression, while the κ-opioids were downregulated. In Aim 2, to further characterize this primate model of chronic itch, we compared immunohistochemical results from the primate studies to human findings. Lesional and non-lesional skin biopsies from patients with atopic dermatitis, psoriasis, and cutaneous T-cell lymphoma underwent immunohistochemical analysis in order to reveal the similarities and differences between the primate model and different types of chronic itch in humans. As in the primate model, substance P was found to be increased in the skin of lesional atopic and psoriasis skin. Additionally, similar to primate skin, human atopic and psoriatic skin had high levels of tryptase and its receptor in the epidermis. While IL-31 was only slightly elevated in primates, patients with cutaneous T-cell lymphoma or atopic dermatitis showed a significant correlation between itch severity and IL-31 levels. In conclusion, our primate model displayed expression patterns of many endogenous pruritogens and receptors that were similar to those of humans with atopic dermatitis or psoriasis. While the primate model did not completely mimic these specific pruritic diseases, the overlap of pruritic components suggests a commonality of signaling pathways across several different chronic itch states. The similarity of this primate model to human disease offers the combined advantages of experimental modeling and long-term behavioral follow-up. / Biomedical Sciences

Mouse models of human disease are valuable tools for studying pathogenesis and for evaluating novel therapies. T-cell lymphoma is a relatively rare disease in humans, affecting 100-150 persons yearly in Sweden. It exists in both aggressive and more indolent forms. We have established a mouse model for an aggressive T-cell lymphoma, the T-cell lymphoma/leukemia (TLL) mouse. In the present thesis, the TLL mouse model was characterized and used for experimental therapeutic and primary prevention studies. The TLL mouse was established unintentionally in our laboratory during work on VH-gene replacement in a “knock-in” mouse experimental setting. The generated chimeras all developed aggressive T-cell lymphomas affecting the lymphoid organs, lungs, kidneys and liver. The lymphoma phenotype segregated from the targeted locus and we could demonstrate the presence of Moloney murine leukemia virus (MMLV) in the germline of the affected mice. MMLV is a retrovirus known to induce T-cell lymphomas when inoculated in newborn mice.  We further characterized two TLL substrains; TLL-2 and TLL-14 carrying the proviral integrations on chromosomes 2 and 14 respectively. Significant differences were found between the substrains regarding lymphoma frequency and immunophenotype, the TLL-14 substrain developing tumors with higher frequency than TLL-2 and with a more mature immunophenotype. A transfer model was developed in which TLL cells could be readily transferred intravenously to syngenic recipients causing aggressive lymphomas. The transfer model was used in a therapeutic study where the selective COX-2 inhibitor celecoxib was evaluated as a single agent and in combination with the established anti-tumor agent cyclophosphamide. The study was based on results from other tumor types that have indicated celecoxib, originally an anti-inflammatory and analgetic drug, to have possible anti-tumor effects. In our TLL model, however, we could not demonstrate any benefit of celecoxib monotherapy or any additive effect to cyclophosphamide. Dietary fatty acids, in particular omega-3 fatty acids, have been a focus of public and scientific interest due to observed effects on the prevention of cardiovascular disease, cancer and inflammatory conditions. In addition, omega-3 fatty acids inhibit T-cell proliferation in vitro. We supplemented the diet of TLL mice with omega-3 and omega-6 fatty acids respectively and could demonstrate a significant delay in lymphoma onset between 5-8 months of age in the group receiving an omega-3 rich diet.