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Hoelzer D, Bassan R, Boissel N, Roddie C, Ribera JM, Jerkeman M. ESMO Clinical Practice Guideline interim update on the use of targeted therapy in acute lymphoblastic leukaemia. Ann Oncol 2024; 35:15-28. [PMID: 37832649 DOI: 10.1016/j.annonc.2023.09.3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Affiliation(s)
- D Hoelzer
- ONKOLOGIKUM Frankfurt am Museumsufer, Frankfurt, Germany
| | - R Bassan
- Hematology Unit, Ospedale dell'Angelo e Ospedale SS, Giovanni e Paolo, Mestre-Venezia, Italy
| | - N Boissel
- Hematology Department, Saint-Louis Hospital, APHP, Institut de Recherche Saint-Louis, Université de Paris Cité, Paris, France
| | - C Roddie
- Research Department of Haematology, UCL Cancer Institute, London, UK
| | - J M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - M Jerkeman
- Department of Oncology, Skåne University Hospital and Lund University, Lund, Sweden
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2
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Marx C, Sonnemann J, Maddocks ODK, Marx-Blümel L, Beyer M, Hoelzer D, Thierbach R, Maletzki C, Linnebacher M, Heinzel T, Krämer OH. Global metabolic alterations in colorectal cancer cells during irinotecan-induced DNA replication stress. Cancer Metab 2022; 10:10. [PMID: 35787728 PMCID: PMC9251592 DOI: 10.1186/s40170-022-00286-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/09/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Metabolic adaptations can allow cancer cells to survive DNA-damaging chemotherapy. This unmet clinical challenge is a potential vulnerability of cancer. Accordingly, there is an intense search for mechanisms that modulate cell metabolism during anti-tumor therapy. We set out to define how colorectal cancer CRC cells alter their metabolism upon DNA replication stress and whether this provides opportunities to eliminate such cells more efficiently. METHODS We incubated p53-positive and p53-negative permanent CRC cells and short-term cultured primary CRC cells with the topoisomerase-1 inhibitor irinotecan and other drugs that cause DNA replication stress and consequently DNA damage. We analyzed pro-apoptotic mitochondrial membrane depolarization and cell death with flow cytometry. We evaluated cellular metabolism with immunoblotting of electron transport chain (ETC) complex subunits, analysis of mitochondrial mRNA expression by qPCR, MTT assay, measurements of oxygen consumption and reactive oxygen species (ROS), and metabolic flux analysis with the Seahorse platform. Global metabolic alterations were assessed using targeted mass spectrometric analysis of extra- and intracellular metabolites. RESULTS Chemotherapeutics that cause DNA replication stress induce metabolic changes in p53-positive and p53-negative CRC cells. Irinotecan enhances glycolysis, oxygen consumption, mitochondrial ETC activation, and ROS production in CRC cells. This is connected to increased levels of electron transport chain complexes involving mitochondrial translation. Mass spectrometric analysis reveals global metabolic adaptations of CRC cells to irinotecan, including the glycolysis, tricarboxylic acid cycle, and pentose phosphate pathways. P53-proficient CRC cells, however, have a more active metabolism upon DNA replication stress than their p53-deficient counterparts. This metabolic switch is a vulnerability of p53-positive cells to irinotecan-induced apoptosis under glucose-restricted conditions. CONCLUSION Drugs that cause DNA replication stress increase the metabolism of CRC cells. Glucose restriction might improve the effectiveness of classical chemotherapy against p53-positive CRC cells. The topoisomerase-1 inhibitor irinotecan and other chemotherapeutics that cause DNA damage induce metabolic adaptations in colorectal cancer (CRC) cells irrespective of their p53 status. Irinotecan enhances the glycolysis and oxygen consumption in CRC cells to deliver energy and biomolecules necessary for DNA repair and their survival. Compared to p53-deficient cells, p53-proficient CRC cells have a more active metabolism and use their intracellular metabolites more extensively. This metabolic switch creates a vulnerability to chemotherapy under glucose-restricted conditions for p53-positive cells.
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Affiliation(s)
- Christian Marx
- Department of Toxicology, University Medical Center, Johannes Gutenberg University Mainz, Building 905, Mainz, Germany.
- Department of Biochemistry, Center for Molecular Biomedicine (CMB), Institute for Biochemistry and Biophysics, Friedrich Schiller University of Jena, Jena, Germany.
- Leibniz Institute on Aging - Fritz Lipmann Institute (FLI), Jena, Germany.
- Current Address: Center for Pandemic Vaccines and Therapeutics (ZEPAI), Paul Ehrlich Institute, Langen, Germany.
| | - Jürgen Sonnemann
- Department of Paediatric Haematology and Oncology, Jena University Hospital, Children's Clinic, Jena, Germany
- Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - Oliver D K Maddocks
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Lisa Marx-Blümel
- Department of Paediatric Haematology and Oncology, Jena University Hospital, Children's Clinic, Jena, Germany
- Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - Mandy Beyer
- Department of Toxicology, University Medical Center, Johannes Gutenberg University Mainz, Building 905, Mainz, Germany
| | - Doerte Hoelzer
- Department of Human Nutrition, Institute of Nutrition, Friedrich Schiller University of Jena, Jena, Germany
- Current address: Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
| | - René Thierbach
- Department of Human Nutrition, Institute of Nutrition, Friedrich Schiller University of Jena, Jena, Germany
| | - Claudia Maletzki
- Molecular Oncology and Immunotherapy, Thoracic, Vascular and Transplantation Surgery, Clinic of General, University of Rostock, VisceralRostock, Germany
- Current address: Department of Medicine, Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Linnebacher
- Molecular Oncology and Immunotherapy, Thoracic, Vascular and Transplantation Surgery, Clinic of General, University of Rostock, VisceralRostock, Germany
| | - Thorsten Heinzel
- Department of Biochemistry, Center for Molecular Biomedicine (CMB), Institute for Biochemistry and Biophysics, Friedrich Schiller University of Jena, Jena, Germany
| | - Oliver H Krämer
- Department of Toxicology, University Medical Center, Johannes Gutenberg University Mainz, Building 905, Mainz, Germany.
- Department of Biochemistry, Center for Molecular Biomedicine (CMB), Institute for Biochemistry and Biophysics, Friedrich Schiller University of Jena, Jena, Germany.
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3
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Meyer FB, Goebel S, Spangel SB, Leovsky C, Hoelzer D, Thierbach R. Metformin alters therapeutic effects in the BALB/c tumor therapy model. BMC Cancer 2021; 21:629. [PMID: 34044797 PMCID: PMC8161985 DOI: 10.1186/s12885-021-08354-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/07/2020] [Accepted: 05/10/2021] [Indexed: 12/16/2022] Open
Abstract
Background Despite considerable medical proceedings, cancer is still a leading cause of death. Major problems for tumor therapy are chemoresistance as well as toxic side effects. In recent years, the additional treatment with the antidiabetic drug metformin during chemotherapy showed promising results in some cases. The aim of this study was to develop an in vitro tumor therapy model in order to further investigate the potential of a combined chemotherapy with metformin. Methods Cytotoxic effects of a combined treatment on BALB/c fibroblasts were proven by the resazurin assay. Based on the BALB/c cell transformation assay, the BALB/c tumor therapy model was established successfully with four different and widely used chemotherapeutics from different categories. Namely, Doxorubicin as a type-II isomerase inhibitor, Docetaxel as a spindle toxin, Mitomycin C as an alkylating agent and 5-Fluorouracil as an antimetabolite. Moreover, glucose consumption in the medium supernatant was measured and protein expressions were determined by Western Blotting. Results Initial tests for the combined treatment with metformin indicated unexpected results as metformin could partly mitigate the cytotoxic effects of the chemotherapeutic agents. These results were further confirmed as metformin induced resistance to some of the drugs when applied simultaneously in the tumor therapy model. Mechanistically, an increased glucose consumption was observed in non-transformed cells as well as in the mixed population of malignant transformed cell foci and non-transformed monolayer cells, suggesting that metformin could also increase glucose consumption in transformed cells. Conclusion In conclusion, this study suggests a cautious use of metformin during chemotherapy. Moreover, the BALB/c tumor therapy model offers a potent tool for further mechanistic studies of drug-drug interactions during cancer therapy. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08354-x.
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Affiliation(s)
- Felix B Meyer
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany
| | - Sophie Goebel
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany
| | - Sonja B Spangel
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany
| | - Christiane Leovsky
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany
| | - Doerte Hoelzer
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany
| | - René Thierbach
- Friedrich-Schiller-Universität Jena, Fakultät für Biowissenschaften, Institut für Ernährungswissenschaften, Abteilung Humanernährung, Jena, Germany.
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4
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Marx C, Schaarschmidt MU, Kirkpatrick J, Marx-Blümel L, Halilovic M, Westermann M, Hoelzer D, Meyer FB, Geng Y, Buder K, Schadwinkel HM, Siniuk K, Becker S, Thierbach R, Beck JF, Sonnemann J, Wang ZQ. Cooperative treatment effectiveness of ATR and HSP90 inhibition in Ewing's sarcoma cells. Cell Biosci 2021; 11:57. [PMID: 33743824 PMCID: PMC7981928 DOI: 10.1186/s13578-021-00571-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/30/2020] [Accepted: 03/12/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ewing's sarcoma is an aggressive childhood malignancy whose outcome has not substantially improved over the last two decades. In this study, combination treatments of the HSP90 inhibitor AUY922 with either the ATR inhibitor VE821 or the ATM inhibitor KU55933 were investigated for their effectiveness in Ewing's sarcoma cells. METHODS Effects were determined in p53 wild-type and p53 null Ewing's sarcoma cell lines by flow cytometric analyses of cell death, mitochondrial depolarization and cell-cycle distribution as well as fluorescence and transmission electron microscopy. They were molecularly characterized by gene and protein expression profiling, and by quantitative whole proteome analysis. RESULTS AUY922 alone induced DNA damage, apoptosis and ER stress, while reducing the abundance of DNA repair proteins. The combination of AUY922 with VE821 led to strong apoptosis induction independent of the cellular p53 status, yet based on different molecular mechanisms. p53 wild-type cells activated pro-apoptotic gene transcription and underwent mitochondria-mediated apoptosis, while p53 null cells accumulated higher levels of DNA damage, ER stress and autophagy, eventually leading to apoptosis. Impaired PI3K/AKT/mTOR signaling further contributed to the antineoplastic combination effects of AUY922 and VE821. In contrast, the combination of AUY922 with KU55933 did not produce a cooperative effect. CONCLUSION Our study reveals that HSP90 and ATR inhibitor combination treatment may be an effective therapeutic approach for Ewing's sarcoma irrespective of the p53 status.
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Affiliation(s)
- Christian Marx
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany
| | - Marc U Schaarschmidt
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany.,Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - Joanna Kirkpatrick
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany.,Francis Crick Institute, London, UK
| | - Lisa Marx-Blümel
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany.,Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - Melisa Halilovic
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany
| | | | - Doerte Hoelzer
- Department of Human Nutrition, Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany.,Biopharmaceutical New Technologies (BioNTech) Corporation, Mainz, Germany
| | - Felix B Meyer
- Department of Human Nutrition, Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany
| | - Yibo Geng
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Katrin Buder
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany
| | - Hauke M Schadwinkel
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany.,Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - Kanstantsin Siniuk
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany
| | - Sabine Becker
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany.,Research Center Lobeda, Jena University Hospital, Jena, Germany
| | - René Thierbach
- Department of Human Nutrition, Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany
| | - James F Beck
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany
| | - Jürgen Sonnemann
- Department of Pediatric Hematology and Oncology, Children's Clinic, Jena University Hospital, Jena, Germany. .,Research Center Lobeda, Jena University Hospital, Jena, Germany. .,Klinik Für Kinder- Und Jugendmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Zhao-Qi Wang
- Leibniz Institute On Aging - Fritz Lipmann Institute (FLI), Jena, Germany.,Faculty of Biology and Pharmacy, Friedrich Schiller University of Jena, Jena, Germany
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Bertz M, Kühn K, Koeberle SC, Müller MF, Hoelzer D, Thies K, Deubel S, Thierbach R, Kipp AP. Selenoprotein H controls cell cycle progression and proliferation of human colorectal cancer cells. Free Radic Biol Med 2018; 127:98-107. [PMID: 29330096 DOI: 10.1016/j.freeradbiomed.2018.01.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/19/2017] [Accepted: 01/07/2018] [Indexed: 12/22/2022]
Abstract
Selenoprotein H (SELENOH) is supposed to be involved in redox regulation as well as in tumorigenesis. However, its role in healthy and transformed cells of the gastrointestinal tract remains elusive. We analyzed SELENOH expression in cells depending on their selenium supply and differentiation status and found that SELENOH expression was increased in tumor tissue, in undifferentiated epithelial cells from mice and in colorectal cancer lines as compared to more differentiated ones. Knockdown studies in human colorectal cancer cells revealed that repression of SELENOH decreased cellular differentiation and increased proliferation and migration. In addition, SELENOH knockdown cells have a higher competence to form colonies or tumor xenografts. In parallel, they show a faster cell cycle transition. The high levels of SELENOH in tumors as well as in undifferentiated, proliferative cells together with its inhibitory effects on proliferation and G1/S phase transition suggest SELENOH as a key regulator for cell cycle progression and for prevention of uncontrolled proliferation. As SELENOH expression is highly dependent on the selenium status, effects of selenium supplementation on cancer initiation and progression appear to involve SELENOH.
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Affiliation(s)
- Martin Bertz
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, D-14558 Nuthetal, Germany
| | - Katrin Kühn
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, D-14558 Nuthetal, Germany
| | - Solveigh C Koeberle
- Department of Molecular Nutritional Physiology, Institute of Nutrition, University of Jena, Jena D-07743, Germany
| | - Mike F Müller
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, D-14558 Nuthetal, Germany
| | - Doerte Hoelzer
- Department of Human Nutrition, Institute of Nutrition, University of Jena, Jena D-07743, Germany
| | - Karolin Thies
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, D-14558 Nuthetal, Germany
| | - Stefanie Deubel
- Department of Molecular Toxicology, German Institute of Human Nutrition, Potsdam-Rehbruecke, D-14558 Nuthetal, Germany
| | - René Thierbach
- Department of Human Nutrition, Institute of Nutrition, University of Jena, Jena D-07743, Germany
| | - Anna P Kipp
- Department of Molecular Nutritional Physiology, Institute of Nutrition, University of Jena, Jena D-07743, Germany.
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6
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, McCormick D, Powell A, Jones H, Bell J, Hargadon S, Hudson S, Kummer M, Badias F, Sauder S, Sutton E, Gensel K, Aguirre-Castaneda R, Benavides Lopez V, Hemp D, Allen S, Stear J, Davis E, Jones T, Baker A, Roberts A, Dart J, Paramalingam N, Levitt Katz L, Chaudhary N, Murphy K, Willi S, Schwartzman B, Kapadia C, Larson D, Bassi M, McClellan D, Shaibai G, Kelley L, Villa G, Kelley C, Diamond R, Kabbani M, Dajani T, Hoekstra F, Magorno M, Beam C, Holst J, Chauhan V, Wilson N, Bononi P, Sperl M, Millward A, Eaton M, Dean L, Olshan J, Renna H, Boulware D, Milliard C, Snyder D, Beaman S, Burch K, Chester J, Ahmann A, Wollam B, DeFrang D, Fitch R, Jahnke K, Bounmananh L, Hanavan K, Klopfenstein B, Nicol L, Bergstrom R, Noland T, Brodksy J, Bacon L, Quintos J, Topor L, Bialo S, Bream S, Bancroft B, Soto A, Lagarde W, Lockemer H, Vanderploeg T, Ibrahim M, Huie M, Sanchez V, Edelen R, Marchiando R, Freeman D, Palmer J, Repas T, Wasson M, Auker P, Culbertson J, Kieffer T, Voorhees D, Borgwardt T, DeRaad L, Eckert K, Gough J, Isaacson E, Kuhn H, Carroll A, Schubert M, Francis G, Hagan S, Le T, Penn M, Wickham E, Leyva C, Ginem J, Rivera K, Padilla J, Rodriguez I, Jospe N, Czyzyk J, Johnson B, Nadgir U, Marlen N, Prakasam G, Rieger C, Granger M, Glaser N, Heiser E, Harris B, Foster C, Slater H, Wheeler K, Donaldson D, Murray M, Hale D, Tragus R, Holloway M, Word D, Lynch J, Pankratz L, Rogers W, Newfield R, Holland S, Hashiguchi M, Gottschalk M, Philis-Tsimikas A, Rosal R, Kieffer M, Franklin S, Guardado S, Bohannon N, Garcia M, Aguinaldo T, Phan J, Barraza V, Cohen D, Pinsker J, Khan U, Lane P, Wiley J, Jovanovic L, Misra P, Wright M, Cohen D, Huang K, Skiles M, Maxcy S, Pihoker C, Cochrane K, Nallamshetty L, Fosse J, Kearns S, Klingsheim M, Wright N, Viles L, Smith H, Heller S, Cunningham M, Daniels A, Zeiden L, Parrimon Y, Field J, Walker R, Griffin K, Bartholow L, Erickson C, Howard J, Krabbenhoft B, Sandman C, Vanveldhuizen A, Wurlger J, Paulus K, Zimmerman A, Hanisch K, Davis-Keppen L, Cotterill A, Kirby J, Harris M, Schmidt A, Kishiyama C, Flores C, Milton J, Ramiro J, Martin W, Whysham C, Yerka A, Freels T, Hassing J, Webster J, Green R, Carter P, Galloway J, Hoelzer D, Ritzie AQL, Roberts S, Said S, Sullivan P, Allen H, Reiter E, Feinberg E, Johnson C, Newhook L, Hagerty D, White N, Sharma A, Levandoski L, Kyllo J, Johnson M, Benoit C, Iyer P, Diamond F, Hosono H, Jackman S, Barette L, Jones P, Shor A, Sills I, Bzdick S, Bulger J, Weinstock R, Douek I, Andrews R, Modgill G, Gyorffy G, Robin L, Vaidya N, Song X, Crouch S, O’Brien K, Thompson C, Thorne N, Blumer J, Kalic J, Klepek L, Paulett J, Rosolowski B, Horner J, Terry A, Watkins M, Casey J, Carpenter K, Burns C, Horton J, Pritchard C, Soetaert D, Wynne A, Kaiserman K, Halvorson M, Weinberger J, Chin C, Molina O, Patel C, Senguttuvan R, Wheeler M, Furet O, Steuhm C, Jelley D, Goudeau S, Chalmers L, Wootten M, Greer D, Panagiotopoulos C, Metzger D, Nguyen D, Horowitz M, Christiansen M, Glades E, 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Espinoza O, Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Sanders-Branca N, Sosenko J, Arazo L, Arce R, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Eck SP, Finney L, Fischer TA, Martin A, Muzamhindo CJ, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, 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Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, Silverberg J, Wittmer C, 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Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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7
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Hoelzer D, Leiske MN, Hartlieb M, Bus T, Pretzel D, Hoeppener S, Kempe K, Thierbach R, Schubert US. Tumor targeting with pH-responsive poly(2-oxazoline)-based nanogels for metronomic doxorubicin treatment. Oncotarget 2018; 9:22316-22331. [PMID: 29854280 PMCID: PMC5976466 DOI: 10.18632/oncotarget.24806] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 10/18/2017] [Accepted: 02/24/2018] [Indexed: 12/18/2022] Open
Abstract
The synthesis of a new nanogel drug carrier system loaded with the anti-cancer drug doxorubicin (DOX) is presented. Poly(2-oxazoline) (POx) based nanogels from block copolymer micelles were cross-linked and covalently loaded with DOX using pH-sensitive Schiff' base chemistry. DOX loaded POx based nanogels showed a toxicity profile comparable to the free drug, while unloaded drug carriers showed no toxicity. Hemolytic activity and erythrocyte aggregation of the drug delivery system was found to be low and cellular uptake was investigated by flow cytometry and fluorescence microscopy. While the amount of internalized drug was enhanced when incorporated into a nanogel, the release of the drug into the nucleus was delayed. For in vivo investigations the nanogel drug delivery system was combined with a metronomic treatment of DOX. Low doses of free DOX were compared to equivalent DOX loaded nanogels in a xenograft mouse model. Treatment with POx based nanogels revealed a significant tumor growth inhibition and increase in survival time, while pure DOX alone had no effect on tumor progression. The biodistribution was investigated by microscopy of organs of mice and revealed a predominant localization of DOX within tumorous tissue. Thus, the POx based nanogel system revealed a therapeutic efficiency despite the low DOX concentrations and could be a promising strategy to control tumor growth with fewer side effects.
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Affiliation(s)
- Doerte Hoelzer
- Institute of Nutrition, Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Meike N. Leiske
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Matthias Hartlieb
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
- Current address: Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, 14513 Teltow, Germany
| | - Tanja Bus
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
| | - David Pretzel
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Stephanie Hoeppener
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Kristian Kempe
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
- Current address: Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - René Thierbach
- Institute of Nutrition, Friedrich Schiller University Jena, 07743 Jena, Germany
| | - Ulrich S. Schubert
- Laboratory of Organic and Macromolecular Chemistry (IOMC), Friedrich Schiller University Jena, 07743 Jena, Germany
- Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, 07743 Jena, Germany
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8
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Hoelzer D, Bassan R, Dombret H, Fielding A, Ribera JM, Buske C. Acute lymphoblastic leukaemia in adult patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27:v69-v82. [PMID: 27056999 DOI: 10.1093/annonc/mdw025] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- D Hoelzer
- ONKOLOGIKUM Frankfurt am Museumsufer, Frankfurt, Germany
| | - R Bassan
- Hematology Unit, Ospedale dell'Angelo e Ospedale SS. Giovanni e Paolo, Mestre-Venezia, Italy
| | - H Dombret
- Institut Universitaire d'Hematologie Hopital St Louis, Paris, France
| | - A Fielding
- Cancer Institute, University College London, London, UK
| | - J M Ribera
- Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Jose Carreras Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - C Buske
- CCC Ulm, Institut für Experimentelle Tumorforschung, Universitätsklinikum Ulm, Ulm, Germany
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Hoelzer D, Gale RP. Prof. Theodor M. Fliedner (1 October 1929-9 November 2015): haematopoietic stem cell and radiation biology and pioneer. Leukemia 2016; 30:765-6. [PMID: 26769055 DOI: 10.1038/leu.2015.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- D Hoelzer
- University Hospital, Frankfurt, Germany
| | - R P Gale
- Imperial College London, London, UK
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10
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Hoelzer D, Harriss EB, Haas RJ. The behaviour of resting bone marrow cells in rats with acute leukaemia. Bibl Haematol 2015; 39:1008-13. [PMID: 4777983 DOI: 10.1159/000427805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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11
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Hoelzer D, Kurrle E, Harriss EB. Regulation of normal hemopoiesis in the acute leukemia L5222. Bibl Haematol 2015:229-33. [PMID: 1100046 DOI: 10.1159/000397537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Normal hemopoiesis becomes markedly depressed in rats during the development of the rat leukemia L5222. Whether this could be due to the influence of a circulating humoral factor was investigated by comparing the growth of normal bone marrow cells in diffusion chambers implanted into the peritoneal cavity of normal or leukemic hosts. Similar growth in total cell numbers was observed in both groups of hosts, and no significant difference could be detected between them. In an attempt to exclude the possibility that an inhibitor either did not penetrate to the peritoneum or was inactivated by the chamber membrane, normal serum, or serum from a highly leukemic rat was mixed with the bone marrow cell suspension in the chambers. Again, no difference in growth between the 2 groups could be detected. Therefore, the influence of a circulating humoral factor in the depression of normal bone marrow hemopoiesis in this experimental leukemia seems to be ruled out, and the decrease may be attributable to local events in the bone marrow such as short-range factors or cellular interaction between the leukemic and normal hemopoietic cell populations.
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Abstract
The purpose of evaluating prognostic factors in acute lymphoblastic leukemia is, first, to stratify patients into adverse- or good-risk groups, second, to determine different treatment options accordingly and, third, to evaluate their potential outcome. Prognostic factors are particularly relevant for disease-free survival and overall survival.
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Affiliation(s)
- D Hoelzer
- Department of Internal Medicine II, Hematology and Oncology, Goethe University Hospital , Frankfurt, Germany
| | - N Gökbuget
- Department of Internal Medicine II, Hematology and Oncology, Goethe University Hospital , Frankfurt, Germany
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13
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Pfeifer H, Lange T, Wystub S, Wassmann B, Maier J, Binckebanck A, Giagounidis A, Stelljes M, Schmalzing M, Dührsen U, Wunderle L, Serve H, Brück P, Schmidt A, Hoelzer D, Ottmann OG. Prevalence and dynamics of bcr-abl kinase domain mutations during imatinib treatment differ in patients with newly diagnosed and recurrent bcr-abl positive acute lymphoblastic leukemia. Leukemia 2012; 26:1475-81. [PMID: 22230800 DOI: 10.1038/leu.2012.5] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Imatinib is highly effective in newly diagnosed, but not in relapsed, Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL). BCR-ABL tyrosine kinase domain (TKD) mutations are associated with acquired imatinib resistance, but their role in primary resistance is uncertain. Using highly sensitive ligation-PCR and denaturing high-performance liquid chromatography (DHPLC), we identified baseline TKD mutations in 21% and 42% of imatinib-naïve patients with newly diagnosed (n=26) or recurrent (n=65) Ph+ ALL, respectively (P=ns). Within 4 weeks of starting the imatinib treatment, absolute levels of mutant bcr-abl transcripts increased significantly in patients with advanced, but not with de novo, Ph+ ALL. The net expansion of pre-existing mutant clones during imatinib treatment resulted in the rapid appearance of initially undetectable TKD mutations, which after 4 weeks were detectable in 70% of patients with advanced disease. There was a high degree of concordance between the type of mutations detected at relapse and during initial imatinib treatment. The profoundly different outgrowth dynamics of leukemic clones with bcr-abl mutations in imatinib-treated patients who differ in their disease history, provides clinical-translational evidence for a contributory role of non-mutational resistance mechanisms, possibly induced by prior chemotherapy. Moreover, the prevalence of pre-existing, clinically relevant TKD may have been underestimated in tyrosine kinase inhibitor-naïve patients with Ph+ ALL.
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Affiliation(s)
- H Pfeifer
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
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14
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Mousset S, Martin H, Berger A, Heß S, Bug G, Kriener S, Engels K, Hoelzer D, Klein SA. Human herpesvirus 6 in biopsies from patients with gastrointestinal symptoms after allogeneic stem cell transplantation. Ann Hematol 2011; 91:737-742. [PMID: 22048789 DOI: 10.1007/s00277-011-1354-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 06/12/2011] [Accepted: 10/08/2011] [Indexed: 10/16/2022]
Abstract
Gastrointestinal complications are frequent after allogeneic stem cell transplantation (allo-SCT). Main differential diagnoses are graft-versus-host disease (GvHD) and viral infections. In this retrospective analysis, we included 50 patients with severe vomiting or diarrhea in the first year after allo-SCT. One hundred two biopsies obtained by colonoscopy or endoscopy of the upper gastrointestinal tract were analysed by conventional histology for signs of GvHD and by qualitative polymerase chain reaction (PCR) for viral DNA of human herpesvirus 6 (HHV-6) and other virus of the herpes family. DNA of HHV-6 was detected in 38 of 75 initial samples (51%) and in 19 of 27 follow-up biopsies (70%). In the initial samples (n = 75), HHV-6 DNA was detected in 20/37 (54%) biopsies in the presence of GvHD compared to 18/38 (47%) biopsies without signs of GvHD. At the time of the first endoscopic investigation, most patients received antiviral prophylaxis with aciclovir. None of the follow-up biopsies was HHV-6 DNA negative after antiviral treatment with aciclovir, foscarnet or ganciclovir. By univariate analysis, no risk factor for HHV-6 detection could be demonstrated. In this cohort of patients with severe gastrointestinal complications, there was no significant difference in the overall survival between patients with or without HHV-6 DNA detection in the gastrointestinal tract. In summary, the detection of HHV-6 DNA had no impact on overall survival. Moreover, antiviral therapy against HHV-6 was without effect. Thus, positive PCR results in GI tract samples do not necessarily reflect reactivation of HHV-6. Further studies are needed to define the significance of HHV-6 for GI tract symptoms after allo-SCT.
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Affiliation(s)
- S Mousset
- Medizinische Klinik II, J. W. Goethe-Universität, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - H Martin
- Medizinische Klinik II, J. W. Goethe-Universität, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - A Berger
- Institut für Virologie, J. W. Goethe-Universität, Frankfurt am Main, Germany
| | - S Heß
- Medizinische Klinik II, J. W. Goethe-Universität, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - G Bug
- Medizinische Klinik II, J. W. Goethe-Universität, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S Kriener
- Institut für Pathologie, J. W. Goethe-Universität, Frankfurt am Main, Germany
| | - K Engels
- Institut für Pathologie, J. W. Goethe-Universität, Frankfurt am Main, Germany
| | - D Hoelzer
- Medizinische Klinik II, J. W. Goethe-Universität, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S A Klein
- III. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim, Germany
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Hehlmann R, Simonsson B, Baccarani M, Grimwade D, Apperley J, Barbui T, Bene MC, Buchner T, de Witte TJ, Foà R, Haferlach C, Hallek M, Hasford J, Hochhaus A, Hoelzer D, Ljungman P, Niederwieser D, Sanz MA, Saussele S. LeukemiaNet: A transnational model for cooperative leukemia research. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Lange T, Niederwieser D, Hoffmann V, Pfirrmann M, Maschmeyer G, Fischer T, Herold M, Sayer HG, Junghanss C, Krahl R, Al-Ali HK, Pönisch W, Vucinic V, Doelken G, Sauerland MC, Heinecke A, Hoelzer D, Hehlmann R, Berdel WE, Buchner T. Intergroup study in elderly patients with AML to compare complete remission rate and overall survival after intermediate-dose or low-dose AraC. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Hoelzer D, Ottmann O. Editorial. Oncol Res Treat 2010. [DOI: 10.1159/000216615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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18
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Heesch S, Schlee C, Neumann M, Stroux A, Kühnl A, Schwartz S, Haferlach T, Goekbuget N, Hoelzer D, Thiel E, Hofmann WK, Baldus CD. BAALC-associated gene expression profiles define IGFBP7 as a novel molecular marker in acute leukemia. Leukemia 2010; 24:1429-36. [PMID: 20535151 DOI: 10.1038/leu.2010.130] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Over expression of BAALC (brain and acute leukemia, cytoplasmic) predicts an inferior outcome in acute myeloid leukemia (AML) and acute lymphoblastic leukemia patients. To identify BAALC-associated genes that give insights into its functional role in chemotherapy resistance, gene expression signatures differentiating high from low BAALC expressers were generated from normal CD34(+) progenitors, T-acute lymphoblastic leukemia (T-ALL) and AML samples. The insulin-like growth factor binding protein 7 (IGFBP7) was one of the four genes (CD34, CD133, natriuretic peptide receptor C (NPR3), IGFBP7) coexpressed with BAALC and common to the three entities. In T-ALL, high IGFBP7-expression was associated with an immature phenotype of early T-ALL (P<0.001), expression of CD34 (P<0.001) and CD33 (P<0.001). Moreover, high IGFBP7-expression predicted primary therapy resistance (P=0.03) and inferior survival in T-ALL (P=0.03). In vitro studies revealed that IGFBP7 protein significantly inhibited the proliferation of leukemia cell lines (Jurkat cells: 42% reduction, P=0.002; KG1a cells: 65% reduction, P<0.001). In conclusion, IGFBP7 was identified as a BAALC coexpressed gene. Furthermore, high IGFBP7 was associated with stem cell features and treatment failure in T-ALL. In contrast to BAALC, which likely represents only a surrogate marker of treatment failure in acute leukemia, IGFBP7 regulates the proliferation of leukemic cells and might be involved in chemotherapy resistance.
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Affiliation(s)
- S Heesch
- Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Medizinische Klinik III, Berlin, Germany
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Folber F, Sálek C, Doubek M, Soukupová Maaloufová J, Valová T, Trka J, Gökbuget N, Vydra J, Kozák T, Horácek JM, Zák P, Cetkovský P, Hoelzer D, Mayer J. [Treatment of adult acute lymphoblastic leukemia according to GMALL 07/2003 study protocol in the Czech Republic - the first experience]. Vnitr Lek 2010; 56:176-182. [PMID: 20394203] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION We present two years' experience in the treatment of adult acute lymphoblastic leukemia (ALL) according to the German GMALL 07/2003 study protocol at CELL (Czech leukemia study group--for life) hematological centers in the Czech Republic. METHODS A total number of 37 patients were included in this analysis. We evaluated complete remission and molecular remission rate, incidence of relapse, patients' status at the end of the follow-up period, incidence of chemotherapy-related adverse events and causes of death. A statistical analysis of risk factors affecting survival was carried out. RESULTS Complete remission was achieved in 36 (97%) patients and molecular remission in 16 (62%) of 26 evaluable patients. Disease relapse occurred in 5 (14%) patients. At the end of the follow-up period with a median of 261 days, 28 (76%) patients were alive in complete remission, one (3%) with relapsed disease and 8 (22%) dead. Treatment toxicity resulted in death in 5 cases, relapse or progression of ALL in 3 patients. Adverse events most often followed consolidation I, induction phase I, consolidation II and induction phase II. Infectious complications in the context of febrile neutropenia, GIT mucositis and side effects of PEG-asparaginase were the most common adverse events observed. The toxicity of allogeneic transplantation was not unexpected, four (25%) patients died after transplantation. Two-year progression-free and overall survival were 66% and 70%, respectively. High risk ALL, age over 35 years, CNS infiltration, disease relapse and permanent minimal residual disease were identified as the major adverse prognostic risk factors. Practical experiences and possible pitfalls of the protocol are described in the discussion. CONCLUSION Our initial impression is promising. The treatment is feasible, the results very good and the toxicity acceptable. Patients at high risk should be headed to allogeneic transplantation, since the results ofconsolidation chemotherapy alone are very poor in this group. We believe that this study protocol could become a standard adult acute lymphoblastic leukemia treatment in the Czech Republic.
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Affiliation(s)
- F Folber
- Internl hematoonkologická kIinika Lékarské fakulty MU a FN Brno.
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Giebel S, Stella-Holowiecka B, Krawczyk-Kulis M, Gökbuget N, Hoelzer D, Doubek M, Mayer J, Piatkowska-Jakubas B, Skotnicki AB, Dombret H, Ribera JM, Piccaluga PP, Czerw T, Kyrcz-Krzemien S, Holowiecki J. Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL. Bone Marrow Transplant 2009; 45:1095-101. [PMID: 19855438 DOI: 10.1038/bmt.2009.308] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The role of autologous hematopoietic SCT (autoHSCT) in the treatment of high-risk (HR) adult ALL is controversial. In this study, we retrospectively analyzed the results of autoHSCT according to the status of minimal residual disease (MRD) at transplantation, as a joint analysis of the European Study Group for Adult ALL (EWALL). Data on 123 recipients of autoHSCT, aged 31 (16-59) years, with B-lineage (n=77) or T-lineage (n=46) ALL were included. In a cohort of Ph-negative ALL, the probability of leukemia-free survival at 5 years was higher for patients with MRD <0.1% compared with those with MRD > or = 0.1% (57 vs 17%, P=0.0002). The difference was significant for T-lineage ALL (62 vs 8%, P=0.001), and a tendency was observed for B-lineage ALL (54 vs 26%, P=0.17). In a multivariate analysis, adjusted for other potential prognostic factors, high MRD level remained the only independent factor associated with increased risk of failure (risk ratio, 2.8; P=0.0005). We conclude that MRD determines the outcome of autoHSCT in HR adult ALL. Our results suggest the need to reevaluate the role of this treatment option in prospective trials.
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Knauf WU, Ho AD, Heger G, Hoelzer D, Hunstein W, Thiel E. Detection of Minimal Residual Disease in Adult Acute Lymphoblastic Leukemia by Analysis of Gene Rearrangements and Correlation with Early Relapses. Leuk Lymphoma 2009; 5:57-63. [DOI: 10.3109/10428199109068105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rummel M, Schenk M, Renner C, Knuth A, Josten K, Reinhardt U, Rendenbach B, Pielken HJ, Wojatschek C, Lengfelder E, Mitrou P, Hoelzer D, Bergmann L. Fludarabine Plus Epirubicin in Untreated or Minimal Pretreated Patients with Chronic Lymphocytic Leukemia – Preliminary Results of a Phase-ll Study. Oncol Res Treat 2009. [DOI: 10.1159/000218964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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24
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25
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Hoelzer D, Kurrle E, Dietrich M, Meyer-Hamme KD, Fliedner TM. The effect of continuous cell removal on blast cell kinetics in acute leukaemia. Scand J Haematol 2009; 12:311-20. [PMID: 4525533 DOI: 10.1111/j.1600-0609.1974.tb00215.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Gökbuget N, Hoelzer D. Bedeutung von Multicenterstudiengruppen für die klinische Forschung in der Hämatologie und Onkologie. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2009; 52:417-24. [DOI: 10.1007/s00103-009-0830-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Thoene S, Rawat VPS, Heilmeier B, Hoster E, Metzeler KH, Herold T, Hiddemann W, Gökbuget N, Hoelzer D, Bohlander SK, Feuring-Buske M, Buske C. The homeobox gene CDX2 is aberrantly expressed and associated with an inferior prognosis in patients with acute lymphoblastic leukemia. Leukemia 2009; 23:649-55. [DOI: 10.1038/leu.2008.355] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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28
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Terwey TH, Massenkeil G, Tamm I, Hemmati PG, Neuburger S, Martus P, Dörken B, Hoelzer D, Arnold R. Allogeneic SCT in refractory or relapsed adult ALL is effective without prior reinduction chemotherapy. Bone Marrow Transplant 2008; 42:791-8. [PMID: 18711350 DOI: 10.1038/bmt.2008.258] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present 60 patients with refractory (n=8) or relapsed (n=52) adult ALL who received allogeneic hematopoietic SCT (HSCT) with (n=41) or without (n=19) prior reinduction chemotherapy. In our center, omission of reinduction is recommended if a suitable donor is promptly available, tumor burden is moderate and disease features suggest a highly aggressive course. Overall survival (OS) of the whole cohort at 1, 2 and 5 years was 42, 33 and 28%, respectively. Leukemia-free survival at 1, 2 and 5 years was 37, 33 and 24%. Deaths were due to relapse (n=25), acute or chronic GVHD (n=7), infections (n=8) or toxicity (n=4). Interestingly, patients who did not receive reinduction before HSCT had better outcomes than patients who received reinduction with OS at 1, 2 and 5 years being 58 vs 34%, 47 vs 25% and 47 vs 18%, respectively (P=0.039). Importantly, even achievement of a second CR after reinduction was not associated with improved survival compared to patients directly proceeding to HSCT. We conclude that patients who undergo HSCT for refractory or relapsed ALL can achieve long-term survival. In selected patients, reinduction chemotherapy can be omitted if immediate HSCT is feasible.
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Affiliation(s)
- T H Terwey
- Department of Hematology and Oncology, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany.
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Kalina U, Ballas K, Koyama N, Kauschat D, Miething C, Arnemann J, Martin H, Hoelzer D, Ottmann OG. Genomic Organization and Regulation of the Human Interleukin-18 Gene. Scand J Immunol 2008. [DOI: 10.1111/j.1365-3083.2000.00836.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Buchner T, Dohner H, Ehninger G, Ganser A, Hasford J, Hehlmann R, Hoelzer D, Niederwieser D, Pfirrmann M. Similar outcome of different treatment strategies in patients 16 to 60 years of age with acute myeloid leukemia (AML). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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31
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Dąbrowska-Iwanicka AP, Romejko-Jarosiśska J, Ostrowska B, Domaśska-Czyż K, Borawska A, Goekbuget N, Hoelzer D, Walewski JA. Primary mediastinal B-cell lymphoma treated with intensive chemotherapy and rituximab compared to CHOP—15 year experience from a single institution. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Baak U, Gökbuget N, Orawa H, Schwartz S, Hoelzer D, Thiel E, Burmeister T. Thymic adult T-cell acute lymphoblastic leukemia stratified in standard- and high-risk group by aberrant HOX11L2 expression: experience of the German multicenter ALL study group. Leukemia 2008; 22:1154-60. [PMID: 18368072 DOI: 10.1038/leu.2008.52] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Adult T-cell acute lymphoblastic leukemia (T-ALL) continues to represent an unfavorable disease. Molecularly based treatment stratifications could help improve outcome. The prognostic impact of HOX11 and HOX11L2 expression has been an area of controversy. We have investigated 286 adult T-ALL patients enrolled into the German Multicenter ALL (GMALL) therapy protocols by comparative real-time RT-PCR. High HOX11 expression and HOX11L2 expression were predominantly seen in thymic T-ALL (P<or=0.031). In a multivariate analysis HOX11L2 expression proved to be an independent adverse risk factor for relapse-free survival (RFS) with a hazard ratio (HR) of 2.02 (P=0.023) and an HR for overall survival (OS) of 1.81 (P=0.021), both adjusted for the immunophenotype. HOX11 expression was found to have a favorable impact on RFS (HR 0.51; P=0.048) but did not exhibit a significant impact on OS. A subgroup analysis for thymic T-ALL revealed a more pronounced negative correlation of HOX11L2 expression with RFS (HR 3.26; P=0.002) and OS (HR 2.38; P=0.009). Although the prognostic impact of HOX11 in T-ALL is less clear, HOX11L2 expression identifies a small subset of high-risk patients, who are so far classified as standard-risk group. Thus, patients with aberrant HOX11L2 expression should be considered early as candidates for intensified treatment regimes.
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Affiliation(s)
- U Baak
- Charité Campus Benjamin Franklin, Medizinische Klinik III, Berlin, Germany.
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Möller B, Kerschbaumer G, Komor M, Kerschbaumer F, Ottmann OG, Hoelzer D, Hofmann WK. Genomic imprinting of insulin-like growth factor 2 (IGF-2) in chronic synovitis. Growth Horm IGF Res 2007; 17:500-505. [PMID: 17590364 DOI: 10.1016/j.ghir.2007.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] [Received: 03/01/2007] [Revised: 05/10/2007] [Accepted: 05/15/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To search for relaxation or loss of IGF-2 imprinting (LOI) in rheumatoid arthritis (RA) synovial tissues. DESIGN The genotype of IGF-2 was determined in 25 freshly isolated synovial tissue samples with signs of active inflammation by polymerase chain reaction (PCR) and restriction fragment length polymorphism. Imprinting was determined in synovial tissue mononuclear cells (STMC) of five informative heterozygous patients by reverse transcriptase (RT)-PCR. Mitogen-stimulated peripheral blood mononuclear cells (PBMC) from six informative healthy donors were selected for control. RESULTS In vitro proliferation of CD4+ and CD8+ PB T cells, and also of CD19+ PB B cells was detectable upon mitogen stimulation. Furthermore, MHC II molecule expression on synovial B and T cells indicated in vivo cell activation. Monoallelic IGF-2 expression was seen in PBMC cultures from two healthy donors under both, resting and stimulating conditions. In two other PBMC cultures, LOI occurred exclusively after 24 h of stimulation. PBMC from two other healthy donors showed LOI under both, resting and stimulating conditions. Mitogen induced and spontaneous LOI was reversible in each one PBMC culture after 72 h. In contrast, none of the informative STMC cultures showed LOI. CONCLUSIONS LOI in lymphocytes may occur spontaneously or inducible. However, longstanding activation of lymphocytes in RA synovitis appears not to be related to this mechanism.
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Affiliation(s)
- B Möller
- Inselspital - University Hospital Bern, Klinik für Rheumatologie, klinische Immunologie und Allergologie, CH-3010 Bern, Switzerland.
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Burmeister T, Schwartz S, Taubald A, Jost E, Lipp T, Schneller F, Diedrich H, Thomssen H, Mey UJ, Eucker J, Rieder H, Gokbuget N, Hoelzer D, Thiel E. Atypical BCR-ABL mRNA transcripts in adult Acute lymphoblastic leukemia. Haematologica 2007; 92:1699-702. [DOI: 10.3324/haematol.11737] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Hoelzer D. OP25 Current therapy for ALL in adults. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70305-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Primary plasma cell leukemia (PCL) is a rare hematologic disorder with distinct features. The criterion for the diagnosis of PCL is based on the finding of malignant plasma cells in the peripheral blood (more than 2 x 10(9)/L or more than 20% of white blood cells). We report a case of a 74-year-old patient with primary nonsecretory PCL. Examination of blood smears led to the diagnosis of PCL, which was confirmed by bone marrow biopsy. Due to the patient's impaired general condition, intensive chemotherapy could not be administered. After an oral induction chemotherapy consisting of cyclophosphamide and high dose dexamethasone followed by one cycle of high-dose dexamethasone and thalidomide no evidence of the disease in the peripheral blood was detectable. Consequently, the patient was put on a thalidomide maintenance therapy. Six months after first diagnosis, the patient was found to have bone marrow and peripheral blood relapse with anemia and neutropenia in the clinical context of acute on chronic renal failure. After a limited response to further chemotherapy, the patient died 14 months after the first diagnosis while on dexamethasone maintenance. We conclude that monotherapy with thalidomide might be an alternative maintenance strategy with limited response duration for patients with primary PCL in impaired general condition.
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Affiliation(s)
- P Brück
- Department of Hematology and Oncology, University Hospital of the Johann-Wolfgang-Goethe-University, Frankfurt, Germany.
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Baldus CD, Martus P, Burmeister T, Schwartz S, Goekbuget N, Bloomfield CD, Hoelzer D, Hofmann WK, Thiel E. Identification of a new subgroup of adult acute T-lymphoblastic leukemia (T-ALL) with a very favorable outcome using low ERG and BAALC expression. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7014 Background: High expression of the oncogenic ETS transcription factor ERG is an independent adverse prognostic factor in T-ALL and acute myeloid leukemia (AML). The gene BAALC similarly shows high expression in hematopoietic progenitors, downregulation with onset of differentiation, and prognostic significance in AML. Therefore, we assessed whether combined expression of ERG and BAALC would better predict outcome in T-ALL. Methods: ERG and BAALC mRNA expression was determined by realtime RT-PCR in pretherapy bone marrow of 152 adults with newly diagnosed T-ALL treated on German ALL protocols (05/93, 06/99). Patients (pts) were designated low (n=76) or high (n=76) ERG expressers based on median ERG expression and as low (n=111) or high (n=37) BAALC grouping the lower quartiles 1–3 vs. quartile 4. HOX11 and HOX11L2 expression was determined and immunophenotyping differentiated 3 T-ALL groups (early, thymic, mature). Results: High BAALC expression correlated with immature T-ALL with a higher frequency of early T-ALL (P<0.0001), CD34 positivity (P<0.0001), co-expression of myeloid markers (CD13 and/or CD33; P=0.03), and high ERG expression (P=0.02). Pts with high BAALC had fewer complete remissions (73% vs. 89%, P=0.03) and a higher relapse rate (67% vs. 32%, P=0.01) than low BAALC pts. Excluding 33 pts that had received stem cell transplantation (SCT), high expression of ERG (P=0.002) and of BAALC (P=0.0004) was associated with inferior relapse-free survival (RFS) and overall survival (OS, ERG: P=0.004; BAALC: P=0.0001) compared to low expression of ERG and BAALC, respectively. In contrast, pts with low expression of both ERG and BAALC had the most favorable outcome (5y-RFS: low ERG/low BAALC 81% vs. high ERG and/or high BAALC 33%, P<0.0001; 5y-OS: low ERG/low BAALC 69% vs. high ERG and/or high BAALC 26%, P=0.0001). On multivariable analysis low ERG/low BAALC expression was of independent favorable prognostic significance (RFS, HR: 0.18, P=0.0003; OS, HR: 0.3, P=0.001); the only other prognostic factor was the immunophenotype. Conclusions: Low expression of both ERG and BAALC identifies T-ALL pts with a distinctly favorable long term outcome, thus detecting pts that may not benefit from further treatment intensification including SCT. No significant financial relationships to disclose.
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Affiliation(s)
- C. D. Baldus
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - P. Martus
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - T. Burmeister
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - S. Schwartz
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - N. Goekbuget
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - C. D. Bloomfield
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - D. Hoelzer
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - W. K. Hofmann
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
| | - E. Thiel
- Charite Campus Benjamin Franklin, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; The Ohio State University, Columbus, OH
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Hofmann WK, Takeuchi S, Takeuchi N, Thiel E, Hoelzer D, Koeffler H. Comparative analysis of hypermethylation of cell cycle control and DNA-mismatch repair genes in low-density and CD34+ bone marrow cells from patients with myelodysplastic syndrome. Leuk Res 2006; 30:1347-53. [DOI: 10.1016/j.leukres.2006.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Revised: 03/15/2006] [Accepted: 03/22/2006] [Indexed: 11/30/2022]
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Saussele S, Adam K, Hochhaus A, Béné MC, Büchner T, Burnett A, Finazzi G, Fonatsch C, Gluckman E, Gökbuget N, Grimwade DJ, Haferlach T, Hallek M, Hasford J, Hoelzer D, Ljungman P, Niederwieser D, Serve H, Simonsson B, de Witte TJ, Hehlmann R. Klinische Forschung im „European LeukemiaNet”. Dtsch Med Wochenschr 2006; 131:2423-6. [PMID: 17054061 DOI: 10.1055/s-2006-955027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Saussele
- III. Medizinische Universitätsklinik, Klinikum Mannheim der Universität Heidelberg, 68305 Mannheim.
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Baldus CD, Burmeister T, Martus P, Schwartz S, Goekbuget N, Bloomfield CD, Hoelzer D, Hofmann WK, Thiel E. High expression of the transcription factor ERG predicts unfavorable outcome in acute T-lymphoblastic leukemia (T-ALL) in adults. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6505 Background: In adult T-ALL long-term survival remains limited to 32–46%. Transcription factors are frequently targeted by chromosomal translocations resulting in disruption of hematopoietic proliferation and differentiation. The oncogenic ETS transcription factor ERG is expressed during early T-cell development and shut off once T-cell commitment is complete. We hypothesized that due to its specific involvement in T-cell maturation and oncogenic potential, ERG might contribute to leukemogenesis. Thus we have determined the prognostic impact of ERG expression in T-ALL. Patients and Methods: ERG mRNA expression was analyzed by real-time RT-PCR in pretreatment marrow samples of 105 adults with T-ALL treated on German ALL protocols. Patients (pts) were dichotomized at ERG’s median expression into low (n=52) and high (n=53) expressers. HOX11 and HOX11L2 expression was determined by real-time RT-PCR. Immunophenotyping was performed differentiating T-ALL into 3 subtypes: pre-T (CD2-), thymic (CD1a+), and mature (sCD3+). Results: High ERG expression was associated with a higher relapse rate (45%) compared to pts with low ERG expression (20%; P=0.01). High ERG expressers compared to low ERG expressers had an inferior overall survival (OS, P=0.02; 5-year OS: high ERG 26% vs low ERG 58%) and relapse-free survival (RFS, P=0.003; 5-year RFS: high ERG 34% vs low ERG 72%). On multivariable analysis high ERG expression (P=0.005), immunophenotypic subgroups (pre-T vs mature vs thymic; overall P=0.04), HOX11L2 positivity (P=0.055) and absence of HOX11 expression (P=0.017) were independent adverse risk factors predicting RFS. Patients with high ERG expression had a hazard ratio (HR) for relapse of 3.2. Within the good prognostic subgroup of thymic T-ALL (n=57) high ERG (HR 4.1; P=0.02) and presence of HOX11L2 (HR 6.6; P=0.008) were independent adverse factors for RFS. Conclusion: High expression of the oncogene ERG is an adverse factor in adult T-ALL. Within thymic T-ALL otherwise classified as standard risk, high ERG expression identified pts that were more than four times likely to fail long-term RFS. The prognostic impact of ERG may assist treatment stratification and suggest the need of more intensive regimens for these high risk thymic T-ALL pts. No significant financial relationships to disclose.
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Affiliation(s)
- C. D. Baldus
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - T. Burmeister
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - P. Martus
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - S. Schwartz
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - N. Goekbuget
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - C. D. Bloomfield
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - D. Hoelzer
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - W. K. Hofmann
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
| | - E. Thiel
- Charité University Medicine, Berlin, Germany; University of Frankfurt, Frankfurt, Germany; Ohio State University, Columbus, OH
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Burmeister T, Marschalek R, Schneider B, Meyer C, Gökbuget N, Schwartz S, Hoelzer D, Thiel E. Monitoring minimal residual disease by quantification of genomic chromosomal breakpoint sequences in acute leukemias with MLL aberrations. Leukemia 2006; 20:451-7. [PMID: 16424875 DOI: 10.1038/sj.leu.2404082] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [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: 01/03/2023]
Abstract
An estimated 10% of acute leukemias carry mixed-lineage leukemia (MLL) fusion genes. Approximately 50 different fusion partners of the MLL gene have already been molecularly identified. These leukemias are commonly regarded as high-risk cases and are treated accordingly with intensified therapy regimens, including hematopoietic stem cell transplantation. However, a subset of patients may achieve long-term remissions with conventional therapy. Monitoring minimal residual disease (MRD) is undoubtedly of great value in clinical decision making, also in the pre- and post-transplant setting. Here, we describe a novel method for detecting MRD in leukemias with MLL aberrations. The method is based on monitoring patient-specific chromosomal breakpoint DNA sequences. This has several advantages over other methods that are based either on detecting specific RNA molecules of MLL fusion genes or on surrogate markers. An accurate and absolute quantification of the MRD level is possible. No reference to housekeeping genes is necessary and the target structure is much more stable than any mRNA fusion transcript.
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Affiliation(s)
- T Burmeister
- Medizinische Klinik III, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, Berlin, Germany.
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Heil G, Hoelzer D, Sanz MA, Lechner K, Noens L, Szer J, Ganser A, Matcham J, Renwick J. Long-term survival data from a phase 3 study of Filgrastim as an adjunct to chemotherapy in adults with de novo acute myeloid leukemia. Leukemia 2006; 20:404-9. [PMID: 16424872 DOI: 10.1038/sj.leu.2404090] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [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: 11/08/2022]
Abstract
We previously reported the results of a double-blind, placebo-controlled study of Filgrastim in patients with de novo AML undergoing induction and consolidation chemotherapy. The study demonstrated that Filgrastim was effective and well tolerated and had no impact on complete remission or survival. We now report follow-up data on these patients, assessing long-term effects with emphasis on prognostic indicators. After a median follow-up of 7 years, 434 (83%) patients were dead, 73 (14%) were alive, and 14 (3%) were lost to follow-up. The proportions of deaths were similar in the Filgrastim (83%) and placebo (84%) groups. No differences in median time to death (1.04 years Filgrastim, 1.13 years placebo; P = 0.97) or median disease-free survival (0.86 years Filgrastim, 0.79 years placebo; P = 0.52) were evident. Proportional hazard modeling identified age, performance status, and French-American-British subtype as independent predictors for survival (P < 0.001, P = 0.005, and P = 0.036, respectively), whereas cytogenetic status was not (P = 0.118). Filgrastim had no effect on overall survival in any of these subgroup analyses as none of the treatment comparisons were statistically significant. These findings indicate that Filgrastim can be effectively used to support patients with AML undergoing induction and consolidation chemotherapy without worsening long-term disease outcome.
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Affiliation(s)
- G Heil
- Department of Internal Medicine, University of Ulm, Ulm, Germany.
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Boehrer S, Chow KU, Puccetti E, Ruthardt M, Godzisard S, Krapohl A, Schneider B, Hoelzer D, Mitrou PS, Rangnekar VM, Weidmann E. Deregulated expression of prostate apoptosis response gene-4 in less differentiated lymphocytes and inverse expressional patterns of par-4 and bcl-2 in acute lymphocytic leukemia. Hematol J 2005; 2:103-7. [PMID: 11424002 DOI: 10.1038/sj/thj/6200089] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/12/2000] [Accepted: 10/31/2000] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Prostate apoptosis response gene-4, known as par-4, is a new proapoptotic factor functionally required but not sufficient for apoptosis. Since there is evidence from prostate cancer cells that par-4 is involved in regulation of bcl-2 we assessed expression of par-4 and bcl-2 in different populations of normal and neoplastic lymphocytes. MATERIALS AND METHODS Expression of par-4 mRNA and protein in different subpopulations of normal and neoplastic lymphocytes was assessed by reverse transcription polymerase chain reaction and Western blot. RESULTS Par-4 mRNA was not detectable in lymphocytes of healthy volunteers (n = 10), but was present in the majority of samples of chronic lymphocytic leukemia (n = 30), chronic lymphocytic leukemia/prolymphocytic leukemia (n = 6) and acute lymphocytic leukemia (n = 10). Par-4 protein was expressed unanimously in samples of mononuclear cells from healthy volunteers and patients with CLL, but less frequently in immature lymphocytes, including neoplastic cells of CLL/PLL and ALL. The decreased frequency of par-4 expression in immature subpopulations was confirmed by results on lymphocytic cell lines at various stages of maturation. Comparing the expressional patterns of par-4 and bcl-2 there was an inverse relationship of both proteins in ALL and different lymphocytic cell lines, indicating a functional relationship of par-4 and bcl-2. CONCLUSIONS This study establishes par-4 as a factor expressed in the majority of normal and neoplastic lymphocytic cells, demonstrating a decreased frequency of protein expression in less differentiated lymphocytes and an inverse expressional pattern of par-4 and bcl-2 in lymphocytic cell lines and ALL.
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Affiliation(s)
- S Boehrer
- Department of Medicine III, Johann Wolfgang Goethe-University Hospital, Frankfurt am Main, Germany
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45
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Burmeister T, Schwartz S, Horst HA, Rieder H, Gökbuget N, Hoelzer D, Thiel E. Molecular heterogeneity of sporadic adult Burkitt-type leukemia/lymphoma as revealed by PCR and cytogenetics: correlation with morphology, immunology and clinical features. Leukemia 2005; 19:1391-8. [PMID: 15973450 DOI: 10.1038/sj.leu.2403847] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [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: 12/23/2022]
Abstract
Chromosomal translocations involving the MYC oncogene are a hallmark of Burkitt lymphoma but they are only found in a varying frequency in mature Burkitt-type acute lymphoblastic leukemia (B-ALL). We have investigated samples of 56 sporadic Burkitt leukemia/lymphoma patients for the translocations t(8;14)(q24;q32), t(2;8)(p11;q24) and t(8;22)(q24;q11). Long PCR was used for detecting the immunoglobulin heavy chain (IgH) translocation and cytogenetics and/or fluorescence in situ hybridization for detecting the 'variant' MYC translocations. A total of 29 samples (51.8%) were t(8;14)-positive by long PCR. Approximately one-third had a chromosomal breakpoint in the IgH joining region while the others had breakpoints in the IgH switch regions. Among them were two cases with a previously unreported MYC translocation into the IgE switch region. Long PCR was more reliable compared to conventional cytogenetics for detecting the t(8;14). Epstein-Barr virus was detected in high copy number in two (3.6%) t(8;14)-positive cases by real-time quantitative PCR. Human herpesvirus 8 was not detected in any case by nested PCR. A typical L3 or L3-compatible cytomorphology was highly predictive (>80%) but not specific of a MYC translocation. A total of 34 patients were treated according to the GMALL B-ALL therapy protocols and there was no significant difference in overall survival between patients with or without t(8;14).
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Affiliation(s)
- T Burmeister
- Charité, Campus Benjamin Franklin, Medizinische Klinik III, Berlin, Germany.
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46
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Rummel MJ, Al-Bartran S, Welslau M, Kofahl-Krause D, Duerk H, Hoelzer D, Mitrou PS. Bendamustine and rituximab act synergistically in vitro and are effective in the treatment of relapsed or refractory indolent and mantle cell lymphomas. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. J. Rummel
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - S. Al-Bartran
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - M. Welslau
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - D. Kofahl-Krause
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - H. Duerk
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - D. Hoelzer
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
| | - P. S. Mitrou
- Univ Clinic, Frankfurt, Germany; Nordwest Krankenhaus, Frankfurt, Germany; Onk. Schwerpunktpraxis, Aschaffenburg, Germany; MHH, Hannover, Germany; St. Marien Hosp, Hamm, Germany
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47
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Bergmann L, Heil G, Ganser A, Martin H, Rhagavachar A, Einsele H, Hoelzer D, Hoechsmann B. Effective treatment of refractory and relapsed AML with the triple combination of mitoxantrone, topotecan and cytosin-arabinoside (MTC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L. Bergmann
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - G. Heil
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - A. Ganser
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - H. Martin
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - A. Rhagavachar
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - H. Einsele
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - D. Hoelzer
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
| | - B. Hoechsmann
- Univ Hosp, Frankfurt, Germany; Medizinische Hochschule, Hannover, Germany; Klin Wuppertal, Wuppertal, Germany; Univ Hosp, Tuebingen, Germany; Univ Hosp Ulm, Ulm, Germany
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Hehlmann R, Berger U, Aul C, Büchner T, Döhner H, Ehninger G, Ganser A, Gökbuget N, Hoelzer D, Uberla K. [The competence network "acute and chronic leukemias"]. Dtsch Med Wochenschr 2004; 129:2660-5. [PMID: 15578322 DOI: 10.1055/s-2004-836093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/26/2022]
Abstract
Leukemias are a challenge and a cost factor to society because of their frequency in all age groups. They also serve as a model for a variety of diseases and possess exemplary relevance for basic research and patient care. Leukemia research and therapy have achieved high standards and even a leading position in Germany with regard to clinical trials, standardization of diagnostics and molecular studies of prognostic factors, signal transduction and gene expression. Progress is hampered, however, by fragmentation of leukemia trial groups, diagnostic approaches and treatment research activities. A network was therefore created to integrate the leading leukemia trial groups on chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphatic leukemia (ALL), myelodysplastic syndromes (MDS) and chronic myeloproliferative diseases (CMPD) and their interdisciplinary partners (diagnostics, treatment research, biometry) in cooperation with basic research and pharmaceutical industry to foster advancements in leukemia-related research and health care through clinical trials, promotion of translational research, introduction of standards for diagnostics and therapy, and development of evidence-based guidelines. Achievements include establishment of central information, communication and management structures, creation of an AML intergroup comprising five study groups, formation of a myelodysplastic syndromes study group and establishment of platforms for diagnostics, genomics and proteomics, and medical informatics. Exchange of scientific progress is mediated by intra- and internet, bi-annual newsletters, regular project group meetings and annual network symposia. Already now, the network structures leukemia therapy and research in Germany and supports the spread of scientific excellence in the field of leukemias.
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Affiliation(s)
- R Hehlmann
- Netzwerkzentrale des Kompetenznetzes "Akute und chronische Leukämien", III. Medizinische Universitätsklinik, Klinikum Mannheim der Universität Heidelberg.
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Bojunga J, Nowak D, Mitrou PS, Hoelzer D, Zeuzem S, Chow KU. Antioxidative treatment prevents activation of death-receptor- and mitochondrion-dependent apoptosis in the hearts of diabetic rats. Diabetologia 2004; 47:2072-80. [PMID: 15662549 DOI: 10.1007/s00125-004-1572-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [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] [Received: 05/20/2004] [Accepted: 07/18/2004] [Indexed: 10/26/2022]
Abstract
AIMS/HYPOTHESIS The mechanisms by which glucose injures cells of the cardiovascular system include generation of reactive oxygen species and induction of cellular apoptosis. To date, little is known about the molecular events of hyperglycaemia-induced apoptosis in the heart in vivo. METHODS Male Sprague-Dawley rats were rendered diabetic by a single intraperitoneal injection of 60 mg/kg body weight streptozotocin. Caspase activities in cardiac ventricular tissue were determined using fluorometric and immunoassay caspase-activity assay kits respectively. Expression levels of proteins of the apoptotic cascade were determined with western blot analyses using specific antibodies. RESULTS Four weeks of hyperglycaemia induced significant apoptosis in cardiac tissue. Determining the initiators of death-receptor-dependent apoptosis revealed induction of CD95/Fas and caspase-8. Examination of the activities of effector caspases revealed increased activity of caspase-6, but not caspase-3 and -7. On evaluating inhibitors of apoptosis, we found up-regulation of caspase-3 and -7-inhibiting X-linked inhibitors of apoptosis in diabetic rats. Hyperglycaemia also induced significant mitochondrion-dependent apoptosis. Our evaluation of expression levels of Bcl-2 family members showed increased expression of pro-apoptotic Bak and Bax in diabetic rats. Antioxidative treatment with lipoic acid significantly suppressed apoptosis and down-regulated caspase-6, -8 and -9 activity, as well as expression levels of pro-apoptotic Bcl-2 proteins without changing blood glucose levels. CONCLUSIONS/INTERPRETATION The present study indicates that reactive oxygen species induced by high glucose are involved in both death-receptor- and mitochondrion-dependent apoptosis in the heart in vivo. It also suggests that antioxidants may be a therapeutic option for preventing cardiovascular damage in diabetes mellitus in humans.
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Affiliation(s)
- J Bojunga
- Klinik für Innere Medizin II, Saarland University Hospital, Kirrberger Strasse, 66421, Homburg/Saar, Germany.
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50
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Arndt U, Kaltwasser JP, Gottschalk R, Hoelzer D, Möller B. Correction of iron-deficient erythropoiesis in the treatment of anemia of chronic disease with recombinant human erythropoietin. Ann Hematol 2004; 84:159-66. [PMID: 15565327 DOI: 10.1007/s00277-004-0950-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [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: 04/22/2004] [Accepted: 08/25/2004] [Indexed: 11/27/2022]
Abstract
Anemia of chronic disease (ACD) is a frequent complication of chronic inflammation in rheumatoid arthritis (RA). Recombinant human erythropoietin (rHuEpo) has been shown to be effective in correcting ACD, although with a variable rate of nonresponders. The first aim of this trial was to improve the response to rHuEpo by parenteral iron supplementation in cases of iron-deficient erythropoiesis (IDE). An additional goal was the evaluation of the zinc protoporphyrin content of erythrocytes (ZnPP), the soluble transferrin receptor (sTrfR) serum concentration, and the hemoglobin (Hb) content of reticulocytes (CHr) in stimulated erythropoiesis as diagnostic and prognostic parameters. Thirty RA patients with ACD were treated with subcutaneous 150 IU rHuEpo/kg body weight twice weekly. Intravenous iron supplementation (200 mg iron sucrose once weekly) was added in cases of IDE (n=23), which was defined by the presence of two of three criteria: saturation of transferrin (TrfS) < or =15%, hypochromic erythrocytes (HypoE) > or =10%, and a serum ferritin (Fn) concentration < or =50 microg/l. All 28 completers met the treatment goal, with an increase of the median Hb concentration from 10.3 g/dl to 13.3 g/dl. Epo treatment and iron supplementation was safe and well tolerated in all patients. Monitoring of Fn, TrfS, and HypoE every other week allowed a successful correction of anemia. Retrospective analysis of the evaluable parameters (CHr, sTrfR, and ZnPP) revealed no additional benefit for predicting or monitoring IDE in this setting, although the one or other may be advantageous in other therapeutic situations.
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Affiliation(s)
- U Arndt
- Medizinische Klinik III, Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
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