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Rohmer J, Couteau‐Chardon A, Trichereau J, Panel K, Gesquiere C, Ben Abdelali R, Bidet A, Bladé J, Cayuela J, Cony‐Makhoul P, Cottin V, Delabesse E, Ebbo M, Fain O, Flandrin P, Galicier L, Godon C, Grardel N, Guffroy A, Hamidou M, Hunault M, Lengline E, Lhomme F, Lhermitte L, Machelart I, Mauvieux L, Mohr C, Mozicconacci M, Naguib D, Nicolini FE, Rey J, Rousselot P, Tavitian S, Terriou L, Lefèvre G, Preudhomme C, Kahn J, Groh M, Ackermann F, Adiko D, Ahwij N, Baruchel A, Beal C, Bemba M, Beylot Barry M, Beyne Rauzy O, Bielefeld P, Boisseau M, Bonmati C, Bonnote B, Borel C, Bouredji D, Brignier A, Brouillard M, Campos F, Carre M, Chalayer E, Chomel JC, Coiteux V, Contejean A, Corby A, Darre S, Dubruille V, Durel CA, El Yamani A, Etancelin P, Etienne N, Evon P, Gyan E, Hachulla E, Hermet M, Huguet F, Ianotto JC, Inchiappa L, Jdid I, Jondeau K, Joubert M, Legrand F, Lejeune C, Le Pendu C, Lidove O, Lemal R, Limal N, Lopinet E, Maloisel F, Marfaing A, Marroun I, Maurier F, Muller E, Muron T, Ojeda M, Paule R, Pignon JM, Rossi C, Roumier M, Sene D, Sene T, Simon L, Slama B, Suarez F, Tcherakian C, Torregrosa JM, Toussaint E, Vatan R, Visanica S, Voilat L, Zini JM. Epidemiology, clinical picture and long-term outcomes of FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia: Data from 151 patients. Am J Hematol 2020; 95:1314-1323. [PMID: 32720700 DOI: 10.1002/ajh.25945] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022]
Abstract
FIP1L1-PDGFRA-positive myeloid neoplasm with eosinophilia (F/P+ MN-eo) is a rare disease: robust epidemiological data are lacking and reported issues are scarce, of low sample-size and limited follow-up. Imatinib mesylate (IM) is highly efficient but no predictive factor of relapse after discontinuation has yet been identified. One hundred and fifty-one patients with F/P+ MN-eo (143 males; mean age at diagnosis 49 years; mean annual incidence: 0.18 case per million population) were included in this retrospective nationwide study involving all French laboratories who perform the search of F/P fusion gene (study period: 2003-2019). The main organs involved included the spleen (44%), skin (32%), lungs (30%), heart (19%) and central nervous system (9%). Serum vitamin B12 and tryptase levels were elevated in 74/79 (94%) and 45/57 (79%) patients, respectively, and none of the 31 patients initially treated with corticosteroids achieved complete hematologic remission. All 148 (98%) IM-treated patients achieved complete hematologic and molecular (when tested, n = 84) responses. Forty-six patients eventually discontinued IM, among whom 20 (57%) relapsed. In multivariate analysis, time to IM initiation (continuous HR: 1,01 [0.99-1,03]; P = .05) and duration of IM treatment (continuous HR: 0,97 [0,95-0,99]; P = .004) were independent factors of relapse after discontinuation of IM. After a mean follow-up of 80 (56) months, the 1, 5- and 10-year overall survival rates in IM-treated patients were 99%, 95% and 84% respectively. In F/P+ MN-eo, prompt initiation of IM and longer treatment durations may prevent relapses after discontinuation of IM.
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Affiliation(s)
- Julien Rohmer
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
| | - Amélie Couteau‐Chardon
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Intensive Care medicine Centre Hospitalier Annecy Genevois Saint‐Julien‐en‐Genevois France
| | - Julie Trichereau
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Kewin Panel
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Clinical Research Department Hôpital Foch Suresnes France
| | - Cyrielle Gesquiere
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
| | - Raouf Ben Abdelali
- Pole Hématologie et Oncologie Laboratoire CERBA Saint‐Ouen‐l'Aumône France
| | - Audrey Bidet
- Laboratory of Hematology CHU de Bordeaux Pessac France
| | | | - Jean‐Michel Cayuela
- Laboratory of Hematology Saint‐Louis Hospital, University of Paris Paris France
| | - Pascale Cony‐Makhoul
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Hematology Department CH Annecy Genevois Annecy France
| | - Vincent Cottin
- National Coordinating Reference Center for Rare Pulmonary Diseases Louis Pradel Hospital Lyon France
- Hospices Civils de Lyon, UMR754, University Claude Bernard Lyon 1 Lyon France
| | - Eric Delabesse
- Laboratory of Hematology Institut Universitaire du Cancer de Toulouse Oncopole, CHU de Toulouse Toulouse France
| | - Mikaël Ebbo
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Aix Marseille University, Department of Internal Medicine Hôpital de la Timone, AP‐HM, CNRS, INSERM, CIML Marseille France
| | - Olivier Fain
- Department of Internal Medicine CHU Saint Antoine Paris France
| | - Pascale Flandrin
- Laboratory of Hematology Hôpital Nord, CHU de Saint‐Étienne Saint‐Étienne France
| | - Lionel Galicier
- Department of Clinical Immunology Saint Louis hospital Paris France
| | - Catherine Godon
- Laboratoire de cytogénétique hématologique CHU de Nantes Nantes France
| | | | - Aurélien Guffroy
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Clinical Immunology and Internal Medicine, National Reference Center for Systemic Autoimmune Diseases (RESO), Tertiary Center for Primary Immunodeficiency Strasbourg University Hospital Strasbourg France
| | - Mohamed Hamidou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Nantes Nantes France
| | | | | | | | - Ludovic Lhermitte
- University of Paris, Institut National de Recherche Médicale U1151 Laboratory of Onco‐Hematology, Hôpital Necker Enfants‐Malades Paris France
| | - Irène Machelart
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine CHU de Bordeaux Bordeaux France
| | - Laurent Mauvieux
- Université de Strasbourg, INSERM U1113 Interface de Recherche Fondamentale et Appliquée en Cancérologie, Laboratoire d'hématologie du CHRU Strasbourg, Faculté de Médecine de Strasbourg Strasbourg France
| | - Catherine Mohr
- Service d'Hématologie Oncologie, CHU Groupe Hospitalier Sud Réunion Saint Pierre, Reunion France
| | - Marie‐Joelle Mozicconacci
- Institut Paoli‐Calmettes, Centre de Recherche en Cancérologie de Marseille, Biopathologie Marseille France
| | - Dina Naguib
- Laboratory of Hematology CHU Caen Caen France
| | - Franck E. Nicolini
- Department of Hematology INSERM U 1052, CRCL, Centre Léon Bérard Lyon France
| | - Jerome Rey
- Department of Hematology Institut Paoli‐Calmettes Marseille France
| | - Philippe Rousselot
- Hematology Department Versailles André Mignot Hospital, University Paris‐Saclay Le Chesnay France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse‐Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Louis Terriou
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | - Guillaume Lefèvre
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université de Lille, CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto‐immunes Systémiques Rares du Nord et Nord‐Ouest de France (CeRAINO) Lille France
| | | | - Jean‐Emmanuel Kahn
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Université Paris‐Saclay, Department of Internal Medicine Ambroise Paré hospital, Boulogne Billancourt Cedex France
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic syndromes (CEREO) Suresnes France
- Department of Internal Medicine Hôpital Foch Suresnes France
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Wang Y, Zhang L, Tang X, Luo J, Tu Z, Jiang K, Ren X, Xu F, Chan S, Li Y, Zhang Z, Ding K. GZD824 as a FLT3, FGFR1 and PDGFRα Inhibitor Against Leukemia In Vitro and In Vivo. Transl Oncol 2020; 13:100766. [PMID: 32247263 PMCID: PMC7125355 DOI: 10.1016/j.tranon.2020.100766] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022] Open
Abstract
GZD824 is a novel third-generation BCR-ABL inhibitor. It entered Phase II clinical trials in China and Phase Ib clinical trials in USA in 2019 for treatment of patients with resistant chronic myeloid leukemia (CML). We found that at concentrations below 10 nM, GZD824 significantly suppresses FLT3, FGFR1 and PDGFRα kinase activities and inhibits their signal pathways in MV4-11Flt3-ITD, KG-1FGFR1OP2-FGFR1 and EOL-1FIP1L1-PDGFRa leukemia cells. It selectively inhibits the growth of MV4-11Flt3-ITD, KG-1FGFR1OP2-FGFR1 and EOL-1FIP1L1-PDGFRa cells, and also effectively suppresses the growth of Ba/F3-FLT3-ITD cells harboring F691I and other mutations with IC50 values <10 nM. GZD824 induces G0/G1 phase arrest and apoptosis in MV4-11, KG-1 and EOL-1 cells and activates cleavage of caspase-3 and PARP. In MV4-11, Ba/F3-ITD-F691I and KG-1 mouse xenograft models, GZD824 at 10 or 20 mg/kg, q2d, p.o. almost completely eradicates tumors. It also inhibits the viability of primary leukemic blasts from a FLT3-ITD positive AML patient but not those expressing native FLT3. Thus GZD824 suppresses leukemia cells of FLT3-ITD-driven AML and other hematologic malignancies driven by FGFR1 or PDGFRa, and it may be considered to be a novel agent for the treatment of leukemia.
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Affiliation(s)
- Yuting Wang
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Lenghe Zhang
- Department of Hematology, Zhujiang Hospital, Southern Medical University, No. 253 GongYeDaDaoZhong, Guangzhou, Guangdong, 510280, China
| | - Xia Tang
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Jinfeng Luo
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, 190 Kaiyuan Avenue, Guangzhou Science Park, Guangzhou 510530, China
| | - Zhengchao Tu
- Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, 190 Kaiyuan Avenue, Guangzhou Science Park, Guangzhou 510530, China
| | - Kaili Jiang
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Xiaomei Ren
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Fang Xu
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Shingpan Chan
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China
| | - Yuhua Li
- Department of Hematology, Zhujiang Hospital, Southern Medical University, No. 253 GongYeDaDaoZhong, Guangzhou, Guangdong, 510280, China.
| | - Zhang Zhang
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China.
| | - Ke Ding
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE), Guangzhou City Key Laboratory of Precision Chemical Drug Development, School of Pharmacy, Jinan University, 601 Huangpu Avenue West, Guangzhou 510632, China.
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Stokes K, Yoon P, Makiya M, Gebreegziabher M, Holland-Thomas N, Ware J, Wetzler L, Khoury P, Klion AD. Mechanisms of glucocorticoid resistance in hypereosinophilic syndromes. Clin Exp Allergy 2019; 49:1598-1604. [PMID: 31657082 DOI: 10.1111/cea.13509] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/16/2019] [Accepted: 09/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Glucocorticoids (GC) are considered first-line therapy for most patients with hypereosinophilic syndrome (HES). Although response rates are generally high, many patients require moderate to high doses for control of eosinophilia and symptoms, and up to 15% of patients do not respond at all. Despite this, little is known about the mechanisms of GC resistance in patients with HES. OBJECTIVE To explore the aetiology of GC resistance in HES. METHODS Clinical data and samples from 26 patients with HES enrolled on a prospective study of GC responsiveness and 23 patients with HES enrolled on a natural history study of eosinophilia for whom response to GC was known were analysed retrospectively. Expression of GC receptor isoforms was assessed by quantitative RT-PCR in purified eosinophils. Serum cytokine levels were quantified by suspension array assay in multiplex. RESULTS Despite an impaired eosinophil response to GC after 7 days of treatment, the expected rise in absolute neutrophil count was seen in 7/7 GC-resistant patients, suggesting that GC resistance in HES is not a global phenomenon. Eosinophil mRNA expression of glucocorticoid receptor (GR) isoforms (α, β, and P) was similar between GC-sensitive (n = 20) and GC-resistant (n = 9) patients with HES. Whereas geometric mean serum levels were also comparable between GC-r (n = 11) and GC-s (n = 19) for all cytokines tested, serum IL-5 levels were >100 pg/mL only in GC-r patients. CONCLUSIONS AND CLINICAL RELEVANCE These data suggest that the mechanism of GC resistance in HES is not due to a global phenomenon affecting all lineages, but may be due, at least in some patients, to impairment of eosinophil apoptosis by increased levels of IL-5.
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Affiliation(s)
- Kindra Stokes
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Pryscilla Yoon
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Michelle Makiya
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Meheret Gebreegziabher
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Nicole Holland-Thomas
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - JeanAnne Ware
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Lauren Wetzler
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Paneez Khoury
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
| | - Amy D Klion
- Laboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland
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Iriyama N, Takahashi H, Naruse H, Miura K, Uchino Y, Nakagawa M, Iizuka K, Hamada T, Hatta Y, Nakayama T, Takei M. A novel fusion gene involving PDGFRB and GCC2 in a chronic eosinophilic leukemia patient harboring t(2;5)(q37;q31). Mol Genet Genomic Med 2019; 7:e00591. [PMID: 30697976 PMCID: PMC6465652 DOI: 10.1002/mgg3.591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/14/2018] [Accepted: 01/04/2019] [Indexed: 12/25/2022] Open
Abstract
Background Platelet‐derived growth factor receptor beta (PDGFRB) rearrangement has been reported in a number of patients with chronic eosinophilic leukemia (CEL), B‐acute lymphoblastic leukemia, myeloproliferative neoplasms, and juvenile myelomonocytic leukemia. Here, we report a case of CEL carrying a novel fusion gene involving PDGFRB and GRIP and coiled‐coil domain containing 2 (GCC2). Patient and methods A 54‐year‐old man presenting with a cough and dyspnea was diagnosed with acute eosinophilic pneumonia. Cytogenetic analysis of the bone marrow revealed the presence of t(2;5)(q37;q31). Fluorescence in situ hybridization analysis in the peripheral blood leukocytes revealed the presence of a split signal at PDGFRB gene. Imatinib treatment was effective, and disappearance of t(2;5)(q37;q31) in the bone marrow was confirmed after three months of imatinib therapy. Whole‐genome sequencing was performed in peripheral blood leukocytes collected before imatinib therapy. Results A novel fusion gene between exon 22 of GCC2 and exon 12 of PDGFRB was detected and the presence of GCC2‐PDGFRB was confirmed by PCR. Conclusion This is the first case report demonstrating the GCC2 gene as a partner of PDGFRB in the pathogenesis of CEL.
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Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromichi Takahashi
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.,Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromu Naruse
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.,Health Sciences Research Institute, Inc., Kanagawa, Japan
| | - Katsuhiro Miura
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshihito Uchino
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Masaru Nakagawa
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuhide Iizuka
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Hamada
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tomohiro Nakayama
- Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.,Division of Companion Diagnostics, Department of Pathology of Microbiology, Nihon University School of Medicine
| | - Masami Takei
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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Hochhaus A, le Coutre PD, Kantarjian HM, Baccarani M, Erben P, Reiter A, McCulloch T, Fan X, Novick S, Giles FJ. Effect of the tyrosine kinase inhibitor nilotinib in patients with hypereosinophilic syndrome/chronic eosinophilic leukemia: analysis of the phase 2, open-label, single-arm A2101 study. J Cancer Res Clin Oncol 2013; 139:1985-93. [PMID: 24057647 DOI: 10.1007/s00432-013-1529-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 12/18/2022]
Abstract
PURPOSE Hypereosinophilic syndrome (HES) and chronic eosinophilic leukemia (CEL) are characterized by sustained overproduction of eosinophils and organ dysfunction. CEL involves the presence of clonal genetic markers, such as a fusion of FIP1-like 1 protein and platelet-derived growth factor receptor α (FIP1L1-PDGFRα, or F/P) or PDGFRα-activating mutations. METHODS Sixteen patients with HES/CEL were enrolled in the phase 2 nilotinib registration trial (NCT00109707) and treated with nilotinib 400 mg twice daily. The median duration of treatment was 95 days (range 3-1,079). RESULTS Twelve patients had HES: 1 achieved a complete hematologic response (CHR), 3 achieved stable disease, 3 had progressive disease, and 5 were not evaluable for response. Four patients had CEL: 2 with the F/P fusion and 2 with PDGFRα-activating mutations. Both patients with an F/P fusion achieved a CHR; 1 also achieved a complete molecular response (CMR). Of the 2 patients with PDGFRα-activating mutations, 1 had stable disease and the other achieved CMR. At 24 months, overall survival in the HES group was 75.0 % (95 % CI 50.5-100.0) and no patients in the CEL group died. Median survival was not yet reached after a median follow-up of 32 months. The most common grade 3/4 hematologic laboratory abnormalities were lymphocytopenia (31.3 %) and neutropenia (25.0 %). The most common drug-related nonhematologic grade 3/4 adverse event was pruritus, which occurred in 2 patients (12.5 %). CONCLUSIONS Nilotinib 400 mg twice daily was effective in some patients with HES/CEL regardless of F/P mutation status, and the safety profile was consistent with other nilotinib studies.
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Affiliation(s)
- Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany,
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Legrand F, Renneville A, MacIntyre E, Mastrilli S, Ackermann F, Cayuela JM, Rousselot P, Schmidt-Tanguy A, Fain O, Michel M, de Jaureguiberry JP, Hatron PY, Cony-Makhoul P, Lefranc D, Sène D, Cottin V, Hamidou M, Lidove O, Baruchel A, Dubucquoi S, Bletry O, Preudhomme C, Capron M, Prin L, Kahn JE. The Spectrum of FIP1L1-PDGFRA-Associated Chronic Eosinophilic Leukemia: New Insights Based on a Survey of 44 Cases. Medicine (Baltimore) 2013; 92:e1-e9. [PMID: 23982058 PMCID: PMC4553979 DOI: 10.1097/md.0b013e3182a71eba] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Imatinib is the treatment of choice for FIP1L1/PDGFRA (F/P)-associated chronic eosinophilic leukemia (F/P CEL), but its optimal dosing, duration, and possibility of discontinuation are still a matter of debate. A retrospective multicenter study was conducted with 44 F/P CEL patients identified in the French Eosinophil Network and treated with imatinib. The most frequently involved systems were skin (57%), spleen (52%), and lung (45%), and eosinophilic heart disease was observed in 15 patients (34%). Complete hematologic response (CHR) was obtained in all patients, and complete molecular response (CMR) in 95% of patients (average initial imatinib dose, 165 mg/d). For 29 patients the imatinib dose was tapered with a maintenance dose of 58 mg/d (±34 mg/d), allowing sustained CHR and CMR. None of the patients developed resistance during a median follow-up of 52.3 months (range, 1.4-97.4 mo). Imatinib was stopped in 11 patients; 6 of the patients subsequently relapsed, but 5 remained in persistent CHR or CMR (range, 9-88 mo). These results confirm that an initial low-dose regimen of imatinib (100 mg/d) followed by a lower maintenance dose can be efficient for obtaining long-term CHR and CMR. Our data also suggest that imatinib can be stopped in some patients without molecular relapse.
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Affiliation(s)
- Fanny Legrand
- From the French Eosinophil Network-EA-2686 and Department of Immunology (FL, SM, DL, SD, LP, JEK); Laboratory of Hematology, INSERM U837-Institut de Recherche contre le Cancer (AR, CP); Department of Internal Medicine (PYH); and INSERM U995 (MC), CHRU de Lille, Université Lille-Nord de France, Lille; CNRS UMR 8147 and Department of Hematology (EM), Hôpital Necker-Enfants Malades Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-5 Descartes, Paris; Department of Internal Medicine (FA, OB, JEK), Hôpital Foch, Université Versailles Saint-Quentin en Yvelines, Suresnes; Laboratory of Hematology (JMC), Hôpital Saint-Louis (AP-HP), Université Paris-7 Diderot, Paris; Department of Hematology (PR), Hôpital André Mignot, Université Versailles Saint-Quentin en Yvelines, Le Chesnay; Department of Hematology (AST), CHU Angers, Angers; Department of Internal Medicine (OF), Hôpital Jean Verdier (AP-HP), Bondy; Department of Internal Medicine (MM), Hôpital Henri Mondor (AP-HP), Créteil; Department of Internal Medicine and Oncology (JPdJ), Hôpital d'Instruction des Armées Sainte-Anne, Toulon; Department of Hematology (PCM), Centre Hospitalier d'Annecy, Pringy; Department of Internal Medicine (DS), Hôpital Lariboisière (AP-HP), Paris; Department of Pneumology (VC), Hôpital Louis Pradel-Hospices Civils de Lyon, Lyon; Department of Internal Medicine A (MH), CHU Hotel-Dieu, Nantes; Department of Internal Medicine (OL), Hôpital Bichat-Claude Bernard (AP-HP), Paris; and Department of Pediatric Hematology (AB), Hôpital Robert Debré (AP-HP), Paris; France
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7
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Valent P, Klion AD, Rosenwasser LJ, Arock M, Bochner BS, Butterfield JH, Gotlib J, Haferlach T, Hellmann A, Horny HP, Leiferman KM, Metzgeroth G, Matsumoto K, Reiter A, Roufosse F, Rothenberg ME, Simon HU, Sotlar K, Vandenberghe P, Weller PF, Gleich GJ. ICON: Eosinophil Disorders. World Allergy Organ J 2013; 5:174-81. [PMID: 23282419 PMCID: PMC3651188 DOI: 10.1097/wox.0b013e31827f4192] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Peter Valent
- 1Department of Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Austria 2Eosinophil Pathology Unit, Laboratory of Parasitic Diseases, NIH/NIAID, Bethesda, MD 3Children's Mercy Hospital, Kansas City, MO 4LBPA CNRS UMR8113, Ecole Normale Supérieure de Cachan, Cachan, France 5Department of Medicine, Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD 6Division of Allergic Diseases, Mayo Clinic, Rochester, MN 7Division of Hematology, Stanford Cancer Center, Stanford, CA 8MLL Münchner Leukämielabor, Munich, Germany 9Department of Hematology, Medical University School of Gdansk, Gdańsk, Poland 10Institute of Pathology, Ludwig-Maximilians-University, Munich, Germany 11Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, UT 12III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany 13Department of Allergy and Immunology, National Research Institute for Children's Health and Development, Tokyo, Japan 14Department of Internal Medicine, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium 15Division of Allergy and Immunology, Cincinnati Children's Hospital, Medical Center, Cincinnati, OH 16Institute of Pharmacology, University of Bern, Bern, Switzerland 17Center for Human Genetics, University Hospitals Leuven and Katholieke Universiteit Leuven, Leuven, Belgium 18Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 19Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, UT
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Nilotinib and imatinib are comparably effective in reducing growth of human eosinophil leukemia cells in a newly established xenograft model. PLoS One 2012; 7:e30567. [PMID: 22348015 PMCID: PMC3279340 DOI: 10.1371/journal.pone.0030567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 12/19/2011] [Indexed: 01/18/2023] Open
Abstract
We developed a xenograft model of human Chronic Eosinophilic Leukemia (CEL) to study disease progression and remission-induction under therapy with tyrosine kinase inhibitors using imatinib and nilotinib as examples. The FIP1L1/PDGFRA+ human CEL cell lineEOL-1 was injected intravenously into scid mice, and MR imaging and FACS analysis of mouse blood samples were performed to monitor disease development and the effects of imatinib and nilotinib. Organ infiltration was analyzed in detail by immunohistochemistry after sacrifice. All animals developed CEL and within one week of therapy, complete remissions were seen with both imatinib and nilotinib, resulting in reduced total tumor volumes by MR-imaging and almost complete disappearance of EOL-1 cells in the peripheral blood and in tissues. The new model system is feasible for the evaluation of new tyrosine kinase inhibitors and our data suggest that nilotinib may be a valuable additional targeted drug active in patients with FIP1L1/PDGFRA+ CEL.
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Rathe M, Kristensen TK, Møller MB, Carlsen NLT. Myeloid neoplasm with prominent eosinophilia and PDGFRA rearrangement treated with imatinib mesylate. Pediatr Blood Cancer 2010; 55:730-2. [PMID: 20589620 DOI: 10.1002/pbc.22655] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The FIP1L1-PDGFRA fusion gene is the most frequent genetic aberration in myeloid neoplasms associated with eosinophilia and abnormalities of PDGFRA, PDGFRB, or FGFR1. Affected patients in adult populations are very sensitive to imatinib therapy. Pediatric cases are rare and so far only one case of FIP1L1-PDGFRA positive disease has been reported. We report a 2-year-old female with a myeloid neoplasm associated with eosinophilia and rearrangement of PDGFRA. Treatment with imatinib resulted in complete and durable clinical, hematological, and molecular remission within 3 months after starting treatment.
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Affiliation(s)
- Mathias Rathe
- Department of Pediatric Hematology and Oncology, H.C. Andersen Children's Hospital, Odense, Denmark.
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