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Rizzuto G, Leoncin M, Imbergamo S, Taurino D, Mico MC, Tosi M, Michelato A, Buklijas K, Spinelli O, Lussana F, Lessi F, Pizzi M, Bonaldi L, Binotto G, Rambaldi A, Gurrieri C. Sequential allogeneic transplantation and ruxolitinib maintenance for a synchronous PCM1-JAK2 positive myeloid sarcoma and acute B-lymphoblastic leukemia. Clin Case Rep 2022; 10:e05212. [PMID: 35028141 PMCID: PMC8741870 DOI: 10.1002/ccr3.5212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 11/08/2022] Open
Abstract
The translocation t(8;9)(p22;p24) results in the production of a chimeric PCM1-JAK2 fusion protein leading to the constitutive activation of the Janus Kinase 2 that renders this disease potentially sensitive to ruxolitinib. Here, we report an interesting case of PCM1-JAK2 myeloproliferative neoplasm evolving in myeloid sarcoma and B precursor ALL.
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Affiliation(s)
- Giuliana Rizzuto
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
- Department of Oncology‐HematologyUniversita` degli Studi di MilanoMilanItaly
| | - Matteo Leoncin
- Hematology and Clinical Immunology UnitUniversita` degli Studi di PadovaPaduaItaly
| | - Silvia Imbergamo
- Hematology and Clinical Immunology UnitUniversita` degli Studi di PadovaPaduaItaly
| | - Daniela Taurino
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Maria Caterina Mico
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Manuela Tosi
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Anna Michelato
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Ksenija Buklijas
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Orietta Spinelli
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Federico Lussana
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
| | - Federica Lessi
- Hematology and Clinical Immunology UnitUniversita` degli Studi di PadovaPaduaItaly
| | - Marco Pizzi
- Department of PathologyUniversità degli Studi di PadovaPaduaItaly
| | - Laura Bonaldi
- Oncological Immunology and Molecular DiagnosticIstituto Oncologico VenetoPaduaItaly
| | - Gianni Binotto
- Hematology and Clinical Immunology UnitUniversita` degli Studi di PadovaPaduaItaly
| | - Alessandro Rambaldi
- Hematology and Bone Marrow Transplantation UnitAzienda Socio‐Sanitaria Territoriale Papa Giovanni XXIIIBergamoItaly
- Department of Oncology‐HematologyUniversita` degli Studi di MilanoMilanItaly
| | - Carmela Gurrieri
- Hematology and Clinical Immunology UnitUniversita` degli Studi di PadovaPaduaItaly
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Caprioli C, Lussana F, Salmoiraghi S, Cavagna R, Buklijas K, Elidi L, Zanghi' P, Michelato A, Delaini F, Oldani E, Intermesoli T, Grassi A, Gianfaldoni G, Mannelli F, Ferrero D, Audisio E, Terruzzi E, De Paoli L, Cattaneo C, Borlenghi E, Cavattoni I, Tajana M, Scattolin AM, Mattei D, Corradini P, Campiotti L, Ciceri F, Bernardi M, Todisco E, Cortelezzi A, Falini B, Pavoni C, Bassan R, Spinelli O, Rambaldi A. Clinical significance of chromatin-spliceosome acute myeloid leukemia: a report from the Northern Italy Leukemia Group (NILG) randomized trial 02/06. Haematologica 2021; 106:2578-2587. [PMID: 32855275 PMCID: PMC8485674 DOI: 10.3324/haematol.2020.252825] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 12/05/2022] Open
Abstract
Secondary acute myeloid leukemia (sAML) after myelodysplastic or myeloproliferative disorders is a high-risk category currently identified by the clinical history or specific morphological and cytogenetic abnormalities. However, in the absence of these features, uncertainties to identify the secondary nature of some cases, otherwise defined as de novo AML, remain. In order to test whether a chromatinspliceosome (CS) mutational signature might better define the de novo AML group, we analyzed a prospective cohort of 413 newly diagnosed AML patients who were enrolled in a randomized clinical trial (NILG AML 02/06) and who provided samples for accurate cytogenetic and molecular characterization. Among clinically defined de novo AML, 17.6% carried CS mutations (CS-AML) and showed clinical characteristics closer to sAML (older age, lower white blood cell counts and higher rate of multilineage dysplasia). Outcomes in this group were adverse, more similar to those of sAML as compared to de novo AML (overall survival, 30% in CS-AML and 17% in sAML vs. 61% in de novo AML, P<0.0001; disease-free survival, 26% in CS-AML and 22% in sAML vs. 54% of de novo AML, P<0.001) and independently confirmed by multivariable analysis. Allogeneic transplant in first complete remission improved survival in both sAML and CS-AML patients. In conclusion, these findings highlight the clinical significance of identifying CS-AML for improved prognostic prediction and potential therapeutic implications. (NILG AML 02/06; clinicaltrials gov. Identifier: NCT00495287).
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Affiliation(s)
| | | | - Silvia Salmoiraghi
- ASST Ospedale Papa Giovanni XXIII and FROM Research Foundation, Bergamo, Italy
| | | | | | - Lara Elidi
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Elena Oldani
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Anna Grassi
- ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Dario Ferrero
- AOU Città della Salute e della Scienza, Torino, Italy
| | | | | | - Lorella De Paoli
- Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Renato Bassan
- Ospedale dell'Angelo e SS. Giovanni e Paolo, Venezia Mestre, Italy
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Rainero A, Angaroni F, D'Avila F, Conti A, Pirrone C, Micheloni G, Tararà L, Millefanti G, Maserati E, Valli R, Spinelli O, Buklijas K, Michelato A, Casalone R, Barlassina C, Barcella M, Sirchia S, Piscitelli E, Caccia M, Porta G. gDNA qPCR is statistically more reliable than mRNA analysis in detecting leukemic cells to monitor CML. Cell Death Dis 2018; 9:349. [PMID: 29500381 PMCID: PMC5834620 DOI: 10.1038/s41419-018-0387-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 02/07/2023]
Abstract
Chronic Myeloid Leukemia (CML) is a stem cell cancer that arises when t(9;22) translocation occurs in a hematopoietic stem cells. This event results in the expression of the BCR-ABL1 fusion gene, which codes for a constitutively active tyrosine kinase that is responsible for the transformation of a HSC into a CML stem cell, which then gives rise to a clonal myeloproliferative disease. The introduction of Tyrosine Kinase Inhibitors (TKIs) has revolutionized the management of the disease. However, these drugs do not seem to be able to eradicate the malignancy. Indeed, discontinuation trials (STIM; TWISER; DADI) for those patients who achieved a profound molecular response showed 50% relapsing within 12 months. We performed a comparative analysis on 15 CML patients and one B-ALL patient, between the standard quantitative reverse-transcriptase PCR (qRT-PCR) and our genomic DNA patient-specific quantitative PCR assay (gDNA qPCR). Here we demonstrate that gDNA qPCR is better than standard qRT-PCR in disease monitoring after an average follow-up period of 200 days. Specifically, we statistically demonstrated that DNA negativity is more reliable than RNA negativity in indicating when TKIs therapy can be safely stopped.
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Affiliation(s)
- Alessia Rainero
- Department of Medicine and Surgery, University of Insubria, Varese, Italy.
| | - Fabrizio Angaroni
- Department of Science and High Technology, University of Insubria, Como, Italy
- IFN (National Institute of Nuclear Physics), Como, Italy
| | - Francesca D'Avila
- Immunology and Functional Genomics Unit, Centro Cardiologico Monzino IRCCS, via Parea 4, 20138, Milan, Italy
| | - Andrea Conti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Cristina Pirrone
- Department of Biology and Life Sciences, University of Insubria, Varese, Italy
| | - Giovanni Micheloni
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Lucia Tararà
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giorgia Millefanti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Emanuela Maserati
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Roberto Valli
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Orietta Spinelli
- Department of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Ksenija Buklijas
- Department of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Anna Michelato
- Department of Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Rosario Casalone
- Department of Genetics and Cytogenetics, ASST Sette Laghi, Ospedale di Circolo Fondazione Macchi, Varese, Italy
| | | | - Matteo Barcella
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Silvia Sirchia
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Massimo Caccia
- Department of Science and High Technology, University of Insubria, Como, Italy
| | - Giovanni Porta
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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Michelato A, Bonvicini C, Ventriglia M, Scassellati C, Randazzo R, Bignotti S, Beneduce R, Riva MA, Gennarelli M. 3' UTR (AGG)n repeat of glial cell line-derived neurotrophic factor (GDNF) gene polymorphism in schizophrenia. Neurosci Lett 2004; 357:235-7. [PMID: 15003293 DOI: 10.1016/j.neulet.2003.12.089] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2003] [Revised: 12/19/2003] [Accepted: 12/22/2003] [Indexed: 10/26/2022]
Abstract
Association studies on gene polymorphisms of neurotransmitter systems have hypothesized an involvement of dopamine receptors in susceptibility to schizophrenia. However, structural and morphological abnormalities in different brain regions of schizophrenic patients support neurodevelopmental etiology for schizophrenia and neurotrophic factor genes could be candidates for genetic studies. The glial cell line-derived neurotrophic factor (GDNF) is a neurotrophic and potential differentiation factor for dopaminergic systems. We have performed, in an Italian sample, an association study on 3' UTR (AGG)n repeat in GDNF gene. Our results have evidenced a difference in the allele frequencies between patients and controls (CLUMP (T1) chi2 = 17.365, df = 9, P = 0.043) and the (AGG)n > or = 15 alleles (Fisher Exact Test (two side) chi2 = 11.818, df = 1, P = 0.0003) were more present in the controls group. Similarity, the carriers of (AGG)n > or = 15 (OR = 0.176 95% CI: 0.060-0.520) were more present in the same group. These results support that the (AGG)n > or = 15 alleles could be protective factors against schizophrenia and thus they suggest a possible involvement of GDNF gene in the genetic liability to illness.
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Affiliation(s)
- Anna Michelato
- Genetic Unit, I.R.C.C.S. 'San Giovanni di Dio', A.Fa.R., Fatebenefratelli, Via Pilastroni 4, 25123 Brescia, Italy
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Bocchio Chiavetto L, Boin F, Zanardini R, Popoli M, Michelato A, Bignotti S, Tura GB, Gennarelli M. Association between promoter polymorphic haplotypes of interleukin-10 gene and schizophrenia. Biol Psychiatry 2002; 51:480-4. [PMID: 11922883 DOI: 10.1016/s0006-3223(01)01324-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizophrenia is one of the most severe psychiatric disorders, with a worldwide incidence of 1%. Several reports show abnormal cytokine levels in psychotic patients and indicate a possible role of the immune response system in the pathogenesis of schizophrenia. Increased concentrations of interleukin 10 (IL-10) have been found in plasma of schizophrenic patients, suggesting its potential role as a candidate gene for susceptibility to schizophrenia. IL-10 gene maps on chromosome 1 (q31-q32), a locus associated with genetic susceptibility to schizophrenia. Three functional haplotypes of the gene (GCC, ACC, ATA) have been described, derived from different combinations of three "single nucleotide polymorphisms" and directly related to the expression levels of the protein. METHODS We analyzed allele, genotype, and haplotype distributions in an association case-control study involving 106 schizophrenic patients and 143 unrelated healthy volunteers using polymerase chain reaction (PCR)-Single Strand Conformation Polymorphism and PCR Restriction Fragment Length Polymorphism methods. RESULTS Our results show a significant increase of GCC homozygotes (the high IL-10-producing haplotype) in schizophrenic patients compared to control subjects (chi(2) = 13, p =.023; odds ratio = 3.03; 95% confidence interval, 1.274-7.355). CONCLUSIONS These data could partly explain the abnormal secretion of IL-10 occurring in schizophrenic patients in response to infections or different stressors and suggest a potential role of IL-10 as a candidate gene for susceptibility to schizophrenia.
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Spinelli O, Giussani U, Borleri G, Lazzari M, Michelato A, Dotti G, Barbui T, Rambaldi A. Need for an accurate molecular diagnosis to assess the donor origin of leukemia relapse after allogeneic stem cell transplantation. Haematologica 2000; 85:1153-7. [PMID: 11064467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Leukemia relapse occurring in donor cells after allogeneic hematopoietic stem cell transplantation has been reported in rare cases. Cytogenetic analysis and molecular probing of variable number of tandem repeats (VNTRs) have been used to confirm this unusual event in the few cases so far reported in the literature. The aim of this study was to demonstrate that extensive molecular characterization of leukemic cells at diagnosis and relapse may be necessary to avoid many technical pitfalls possibly leading to an erroneous diagnosis of leukemia relapse in donor cells after allogeneic transplantation. DESIGN AND METHODS We report the case of a 49- year old man who received an allogeneic transplantation from his HLA-identical sister because of BCR-ABL+ acute lymphoblastic leukemia (ALL). After having achieved complete hematologic and molecular remission, two years later an overt leukemia relapse occurred with cytogenetic findings suggesting a leukemia relapse in donor cells. The donor or patient origin of leukemic cells at relapse was further investigated by fluorescence in situ hybridization (FISH) karyotyping, reverse transcription (RT) polymerase chain reaction (PCR) analysis of BCR-ABL chimeric transcripts, PCR amplification of several VNTRs and the Y chromosome-specific DYS14 sequence and finally by amplification, cloning and sequencing of the CDRIII region of the immunoglobulin heavy chain (IgH) gene. RESULTS At the time of relapse, conventional and FISH karyotyping revealed the presence of a Phl+ chromosome and a female karyotype in all the 25 metaphases analyzed and PCR amplification of the Y chromosome-specific DYS14 sequence was negative. Moreover, the molecular evaluation of hematopoietic chimerism performed by the NZ-22 VNTR allowed us to demonstrate that at the time of relapse, a consistent proportion of hematopoietic cells was of donor origin. However, the molecular cloning and sequencing of the CDRIII region of the immunoglobuin heavy chain (IgH) gene rearrangement in leukemic blasts at diagnosis and relapse demonstrated their identity thus formally proving the patient origin of both leukemic clones. INTERPRETATION AND CONCLUSIONS While the simplest interpretation of the apparent female karyotype at relapse is the consequence of a loss of the Y chromosome which in leukemic blasts took place along with duplication of an X-chromosome, this case strongly emphasizes the need for accurate and extensive molecular characterization to prove the donor origin of a leukemia relapse after allogeneic transplantation.
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Affiliation(s)
- O Spinelli
- Divisione di Ematologia e Centro Trasfusionale, Ospedali Riuniti di Bergamo, Italy
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Barbieri AM, Soriani N, Ferlini A, Michelato A, Ferrari M, Carrera P. Seven novel additional small mutations and a new alternative splicing in the human dystrophin gene detected by heteroduplex analysis and restricted RT-PCR heteroduplex analysis of illegitimate transcripts. Eur J Hum Genet 1996; 4:183-7. [PMID: 8840119 DOI: 10.1159/000472193] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Around 35% of Duchenne and Becker muscular dystrophy (DMD/BMD) patients cannot be identified by techniques which identify major DMD rearrangements in the dystrophin gene. In order to characterize the gene defect in these patients, we screened 40 exons of the dystrophin gene by heteroduplex analysis on genomic DNA in 50 affected Italian males. Using conventional heteroduplex analysis and a modified heteroduplex analysis on restricted RT-PCR products of illegitimate transcripts, restricted RT-PCR heteroduplex analysis, we were able to identify 7 novel small mutations and a new alternative splicing involving exon 25 of the dystrophin gene in peripheral blood lymphocytes and skeletal muscle transcripts.
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Affiliation(s)
- A M Barbieri
- Clinical Molecular Biology Laboratory, IRCCS H S. Raffaele, Milano, Italy
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Schlitzer R, Roether W, Oster H, Junghans HG, Hausmann M, Johannsen H, Michelato A. Chlorofluoromethane and oxygen in the Eastern Mediterranean. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0198-0149(91)90088-w] [Citation(s) in RCA: 159] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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