1
|
Møller HI, Persson G, Klok FB, Vojdeman FJ, Lebech M, Hviid TVF. Investigations of leukocyte and inflammatory markers in pregnancies complicated by preeclampsia. J Reprod Immunol 2023; 160:104163. [PMID: 37857159 DOI: 10.1016/j.jri.2023.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/14/2023] [Accepted: 10/07/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Preeclampsia is a frequent and potentially fatal pregnancy complication. It can be challenging to make a timely diagnosis. Identifying clinically useful biochemical markers would be a remedying tool to support the diagnosis of preeclampsia. The aim was to investigate differential cell counts and acute phase reactants as diagnostic markers of preeclamptic third-trimester pregnancies and in relation to pregnancy term, gravidity and the severity of hypertension. METHODS Based on a cohort of 421 pregnant women, we included 174 participants (case n = 84, control n = 90) during the third trimester. Peripheral blood was sampled to measure differential white blood cell counts and acute phase reactants on the day of inclusion. RESULTS The neutrophil-to-lymphocyte ratio and plasma haptoglobin levels were significantly increased in healthy pregnancies compared with preeclamptic pregnancies. Plasma ferritin levels and albumin levels were respectively increased and decreased in cases of preeclampsia compared with controls. Albumin was specific among multigravida. Plasma transferrin and high-sensitivity C-reactive protein (hs-CRP) levels were significantly decreased and increased, respectively, in cases with preterm preeclampsia compared with term preeclampsia. CONCLUSION Plasma ferritin and albumin levels reflected higher inflammation in cases with preeclampsia compared with healthy pregnancies; the same did plasma transferrin and hs-CRP levels in preterm versus term preeclampsia. When considering the normal ranges plasma albumin and hs-CRP levels identified preeclamptic from healthy third-trimester pregnancies and preterm from term preeclampsia cases, respectively, with near-acceptable diagnostic performances. Further validation of the diagnostic value will require larger sample-sized studies with paired plasma and serum samples.
Collapse
Affiliation(s)
- Hiba Iraqi Møller
- Centre for Immune Regulation and Reproductive Immunology (CIRRI) and the ReproHealth Research Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Gry Persson
- Centre for Immune Regulation and Reproductive Immunology (CIRRI) and the ReproHealth Research Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, Roskilde, Denmark
| | - Freja Bluhme Klok
- Centre for Immune Regulation and Reproductive Immunology (CIRRI) and the ReproHealth Research Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, Roskilde, Denmark
| | | | - Morten Lebech
- Department of Obstetrics and Gynecology, The ReproHealth Research Consortium ZUH, Zealand University Hospital, Denmark
| | - Thomas Vauvert F Hviid
- Centre for Immune Regulation and Reproductive Immunology (CIRRI) and the ReproHealth Research Consortium ZUH, Department of Clinical Biochemistry, Zealand University Hospital, Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| |
Collapse
|
2
|
Paulsen NH, Qvortrup C, Vojdeman FJ, Plomgaard P, Andersen SE, Ramlov A, Bertelsen B, Rossing M, Nielsen CG, Hoffmann-Lücke E, Greibe E, Spangsberg Holm H, Nielsen HH, Lolas IBY, Madsen JS, Bergmann ML, Mørk M, Fruekilde PBN, Bøttger P, Petersen PC, Nissen PH, Feddersen S, Bergmann TK, Pfeiffer P, Damkier P. Dihydropyrimidine dehydrogenase (DPD) genotype and phenotype among Danish cancer patients: prevalence and correlation between DPYD-genotype variants and P-uracil concentrations. Acta Oncol 2022; 61:1400-1405. [PMID: 36256873 DOI: 10.1080/0284186x.2022.2132117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Niels Herluf Paulsen
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark.,Clinical Pharmacology, Pharmacy and Environmental Medicine Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Camilla Qvortrup
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Fie Juhl Vojdeman
- Department of Clinical Biochemistry, Holbaek Hospital, Holbaek, Denmark
| | - Peter Plomgaard
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Anne Ramlov
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Birgitte Bertelsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Rossing
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Center for Genomic Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Claus Gyrup Nielsen
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Elke Hoffmann-Lücke
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark.,Institute for Clinical Medicine, Aarhus University of Health, Aarhus, Denmark
| | - Eva Greibe
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark.,Institute for Clinical Medicine, Aarhus University of Health, Aarhus, Denmark
| | | | - Heidi Hvid Nielsen
- Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark
| | | | - Jonna Skov Madsen
- Department of Biochemistry and Immunology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Marianne Lerbaek Bergmann
- Department of Biochemistry and Immunology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark
| | - Morten Mørk
- Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.,Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark
| | | | - Pernille Bøttger
- Department of Biochemistry and Immunology, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Peter Henrik Nissen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark.,Denmark and Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Feddersen
- Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Troels K Bergmann
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark.,Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Per Damkier
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark.,Clinical Pharmacology, Pharmacy and Environmental Medicine Department of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
3
|
Stroomberg HV, Vojdeman FJ, Madsen CM, Helgstrand JT, Schwarz P, Heegaard AM, Olsen A, Tjønneland A, Struer Lind B, Brasso K, Jørgensen HL, Røder MA. Vitamin D levels and the risk of prostate cancer and prostate cancer mortality. Acta Oncol 2021; 60:316-322. [PMID: 33103532 DOI: 10.1080/0284186x.2020.1837391] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vitamin D has a role in bone turnover and potentially bone-metastatic spread of prostate cancer (PCa). The aim of this observational study was to address the association between levels of serum vitamin D, diagnosis of PCa and subsequent mortality in men who underwent a biopsy of the prostate. METHODS All men who underwent prostatic biopsy in the Danish PCa Registry (DaPCaR) and who had a serum vitamin D measurement during the period 2004 to 2010 (n = 4,065) were identified. Men were categorized by clinical cut-offs based on seasonally adjusted serum vitamin D levels in <25 (deficient), 25-50 (insufficient), 50-75 (sufficient) and >75 nmol/L (high) serum vitamin D. Logistic regression model for association between vitamin D and risk of PCa diagnosis and multivariate survival analyses were applied. RESULTS No association between serum vitamin D and risk of PCa was found. Overall survival was lowest for serum vitamin D deficiency and a significantly higher PCa specific mortality (HR: 2.37, 95%CI: 1.45-3.90, p < .001) and other cause mortality (HR: 2.08, 95%CI: 1.33-3.24, p = .001) was found for PCa patients with serum vitamin D deficiency compared to serum vitamin D sufficiency. CONCLUSION No association was found between serum vitamin D categories and risk of PCa in men who underwent biopsy of the prostate. Men with PCa and serum vitamin D deficiency had a higher overall and PCa specific mortality compared to men with a sufficient level of serum vitamin D.
Collapse
Affiliation(s)
- Hein Vincent Stroomberg
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Fie Juhl Vojdeman
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | | | - John Thomas Helgstrand
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Peter Schwarz
- Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Anne-Marie Heegaard
- Deptartment of Drug Design and Pharmacology, Copenhagen University, Copenhagen, Denmark
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bent Struer Lind
- Deptartment of Clinical Biochemistry, Copenhagen University Hospital Hvidovre Hospital, Hvidovre, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Henrik Løvendahl Jørgensen
- Deptartment of Clinical Biochemistry, Copenhagen University Hospital Hvidovre Hospital, Hvidovre, Denmark
| | - Martin Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark
| |
Collapse
|
4
|
Glenthøj A, Samson M, Toft N, Diness BR, Askj R N, Vojdeman FJ, Birgens H, Sørensen MB, Petersen J. [The Danish screening programme for haemoglobinopathies]. Ugeskr Laeger 2021; 183:V07200536. [PMID: 33491643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The prevalence of people in Denmark descending from areas with a high prevalence of haemoglobinopathies is approximately one tenth and increasing. Since 1995, the Danish Health Authority has recommended haemoglobinopathy screening of pregnant women with ethnic roots outside Northern Europe. Partners of pregnant haemoglobinopathy carriers are also tested. Carrier state in both parents leads to genetic counselling, and prenatal diagnostics of the foetus (chorionic villus biopsy or amniocentesis) is offered, which can lead to abortion and/or preimplantation genetic screening for future pregnancies, as discussed in this review.
Collapse
|
5
|
Vojdeman FJ, Philips M, Funding E, Gøtze JP. [Diagnosing von Willebrand disease]. Ugeskr Laeger 2019; 181:V12180877. [PMID: 31036151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Von Willebrand disease (VWD) is an inherited bleeding disorder with abnormal primary haemostasis due to defects in, or decreased concentration of the glycoprotein von Willebrand factor. In Denmark, the estimated prevalence of VWD is 1% corresponding to approximately 50,000 patients, but only a few hundred have been diagnosed, mostly due to prolonged bleeding after a trauma or during surgery. Thus, VWD is underdiagnosed in the general population. Improved anamnestic screening for bleeding disorders such as VWD in certain high-risk groups can facilitate institution of prophylactic treatment.
Collapse
|
6
|
Vojdeman FJ, Madsen CM, Frederiksen K, Durup D, Olsen A, Hansen L, Heegaard AM, Lind B, Tjønneland A, Jørgensen HL, Schwarz P. Vitamin D levels and cancer incidence in 217,244 individuals from primary health care in Denmark. Int J Cancer 2019; 145:338-346. [PMID: 30613979 DOI: 10.1002/ijc.32105] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D has been linked to cancer development in both pre-clinical and epidemiological studies. Our study examines the association between serum levels of vitamin D and cancer incidence in the Capital Region of Denmark. Individuals who had vitamin D analyzed at The Copenhagen General Practitioners Laboratory between April 2004 and January 2010 were linked to Danish registries with end of follow-up date at Dec 31st 2014, excluding individuals with pre-existing cancer. Cox regression models adjusted for age in one-year intervals, sex, month of sampling, and Charlson Comorbidity Index were applied. The study population of 217,244 individuals had a median vitamin D level of 46 nmol/L (IQR 27-67 nmol/L). Non-melanoma skin cancer was the most frequent form of cancer, followed by breast-, lung-, and prostate cancers. No associations were found between increments of 10 nmol/L vitamin D and incidence of breast, colorectal, urinary, ovary or corpus uteri cancer. However, higher levels of vitamin D were associated with higher incidence of non-melanoma (HR 1.09 [1.09-1.1]) and melanoma skin cancer (HR 1.1 [1.08-1.13]) as well as prostate (HR 1.05 [1.03-1.07]) and hematological cancers (HR 1.03 [1.01-1.06]), but with lower incidence of lung cancer (HR 0.95 [0.93-0.97]). In our study, vitamin D levels are not associated with the incidence of several major cancer types, but higher levels are significantly associated with a higher incidence of skin, prostate, and hematological cancers as well as a lower incidence of lung cancer. These results do not support an overall protective effect against cancer by vitamin D.
Collapse
Affiliation(s)
- Fie Juhl Vojdeman
- Department of Clinical Biochemistry, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Christian Medom Madsen
- Department of Clinical Biochemistry, Herlev & Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | | | - Darshana Durup
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne-Marie Heegaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, Copenhagen University, Copenhagen
| | - Bent Lind
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Faculty of Health Sciences, Copenhagen University, Copenhagen
| | - Henrik Løvendahl Jørgensen
- Faculty of Health Sciences, Copenhagen University, Copenhagen.,Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Peter Schwarz
- Faculty of Health Sciences, Copenhagen University, Copenhagen.,Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
7
|
Xochelli A, Baliakas P, Kavakiotis I, Agathangelidis A, Sutton LA, Minga E, Ntoufa S, Tausch E, Yan XJ, Shanafelt T, Plevova K, Boudjogra M, Rossi D, Davis Z, Navarro A, Sandberg Y, Vojdeman FJ, Scarfo L, Stavroyianni N, Sudarikov A, Veronese S, Tzenou T, Karan-Djurasevic T, Catherwood M, Kienle D, Chatzouli M, Facco M, Bahlo J, Pott C, Pedersen LB, Mansouri L, Smedby KE, Chu CC, Giudicelli V, Lefranc MP, Panagiotidis P, Juliusson G, Anagnostopoulos A, Vlahavas I, Antic D, Trentin L, Montillo M, Niemann C, Döhner H, Langerak AW, Pospisilova S, Hallek M, Campo E, Chiorazzi N, Maglaveras N, Oscier D, Gaidano G, Jelinek DF, Stilgenbauer S, Chouvarda I, Darzentas N, Belessi C, Davi F, Hadzidimitriou A, Rosenquist R, Ghia P, Stamatopoulos K. Chronic Lymphocytic Leukemia with Mutated IGHV4-34 Receptors: Shared and Distinct Immunogenetic Features and Clinical Outcomes. Clin Cancer Res 2017; 23:5292-5301. [PMID: 28536306 DOI: 10.1158/1078-0432.ccr-16-3100] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/11/2017] [Accepted: 05/18/2017] [Indexed: 11/16/2022]
Abstract
Purpose: We sought to investigate whether B cell receptor immunoglobulin (BcR IG) stereotypy is associated with particular clinicobiological features among chronic lymphocytic leukemia (CLL) patients expressing mutated BcR IG (M-CLL) encoded by the IGHV4-34 gene, and also ascertain whether these associations could refine prognostication.Experimental Design: In a series of 19,907 CLL cases with available immunogenetic information, we identified 339 IGHV4-34-expressing cases assigned to one of the four largest stereotyped M-CLL subsets, namely subsets #4, #16, #29 and #201, and investigated in detail their clinicobiological characteristics and disease outcomes.Results: We identified shared and subset-specific patterns of somatic hypermutation (SHM) among patients assigned to these subsets. The greatest similarity was observed between subsets #4 and #16, both including IgG-switched cases (IgG-CLL). In contrast, the least similarity was detected between subsets #16 and #201, the latter concerning IgM/D-expressing CLL. Significant differences between subsets also involved disease stage at diagnosis and the presence of specific genomic aberrations. IgG subsets #4 and #16 emerged as particularly indolent with a significantly (P < 0.05) longer time-to-first-treatment (TTFT; median TTFT: not yet reached) compared with the IgM/D subsets #29 and #201 (median TTFT: 11 and 12 years, respectively).Conclusions: Our findings support the notion that BcR IG stereotypy further refines prognostication in CLL, superseding the immunogenetic distinction based solely on SHM load. In addition, the observed distinct genetic aberration landscapes and clinical heterogeneity suggest that not all M-CLL cases are equal, prompting further research into the underlying biological background with the ultimate aim of tailored patient management. Clin Cancer Res; 23(17); 5292-301. ©2017 AACR.
Collapse
Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ioannis Kavakiotis
- Department of informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Agathangelidis
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Eva Minga
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | | | - Eugen Tausch
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Xiao-Jie Yan
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Tait Shanafelt
- Department of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Karla Plevova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Myriam Boudjogra
- Department of Hematology, Hopital Pitie-Salpetriere and University Pierre et Marie Curie, Paris, France
| | - Davide Rossi
- Division of Haematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Alba Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Yorick Sandberg
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Lydia Scarfo
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Silvio Veronese
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Tatiana Tzenou
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Teodora Karan-Djurasevic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia
| | - Mark Catherwood
- Department of Haemato-Oncology, Belfast City Hospital, Belfast, United Kingdom
| | - Dirk Kienle
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Maria Chatzouli
- Hematology Department, Nikea General Hospital, Piraeus, Greece
| | - Monica Facco
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Padova, Italy
| | - Jasmin Bahlo
- Department I of Internal Medicine and Center of Integrated Oncology, University Hospital Cologne, Cologne, Germany
| | - Christiane Pott
- Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Larry Mansouri
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Charles C Chu
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Véronique Giudicelli
- IMGT®, the international ImMunoGeneTics information system®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UPR CNRS 1142, Montpellier, France
| | - Marie-Paule Lefranc
- IMGT®, the international ImMunoGeneTics information system®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UPR CNRS 1142, Montpellier, France
| | | | - Gunnar Juliusson
- Lund University and Hospital Department of Hematology, Lund Stem Cell Center, Lund, Sweden
| | | | - Ioannis Vlahavas
- Department of informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Darko Antic
- Clinic for Hematology, Clinical Center, Belgrade, Serbia.,Medical faculty, University of Belgrade, Belgrade, Serbia
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Padova, Italy
| | - Marco Montillo
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Carsten Niemann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Anton W Langerak
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michael Hallek
- Department I of Internal Medicine and Center of Integrated Oncology, University Hospital Cologne, Cologne, Germany
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Nicholas Chiorazzi
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Nikos Maglaveras
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Diane F Jelinek
- Department of Immunology, Mayo Clinic, Rochester, Minnesota, United States
| | | | - Ioanna Chouvarda
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikos Darzentas
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Frederic Davi
- Department of Hematology, Hopital Pitie-Salpetriere and University Pierre et Marie Curie, Paris, France
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece. .,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Università Vita-Salute San Raffaele and IRCCS Istituto Scientifico San Raffaele, Milan, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| |
Collapse
|
8
|
Vojdeman FJ, Van't Veer MB, Tjønnfjord GE, Itälä-Remes M, Kimby E, Polliack A, Wu KL, Doorduijn JK, Alemayehu WG, Wittebol S, Kozak T, Walewski J, Abrahamse-Testroote MCJ, van Oers MHJ, Geisler CH. The HOVON68 CLL trial revisited: performance status and comorbidity affect survival in elderly patients with chronic lymphocytic leukemia. Leuk Lymphoma 2016; 58:594-600. [PMID: 27484290 DOI: 10.1080/10428194.2016.1213831] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In the HOVON68 CLL trial, patients 65 to 75 years of age had no survival benefit from the addition of low-dose alemtuzumab to fludarabine and cyclophosphamide (FC) in contrast to younger patients. The reasons are explored in this 5-year trial update using both survival analysis and competing risk analysis on non-CLL-related mortality. Elderly FCA patients died more frequently from causes not related to CLL, and more often related to comorbidity (mostly cardiovascular) than to infection. In a Cox multivariate analysis, del(17p), performance status >0, and comorbidity were associated with a higher non-CLL-related mortality in the elderly independent of the treatment modality. Thus, while the 'fit' elderly with no comorbidity or performance status of 0 might potentially benefit from chemo-immunotherapy with FC, caution is warranted, when considering alemtuzumab treatment in elderly patients with cardiovascular comorbidity.
Collapse
Affiliation(s)
| | - Mars B Van't Veer
- b Department of Hematology , Leiden University Medical Centre , Leiden , The Netherlands
| | - Geir E Tjønnfjord
- c Department of Hematology , Oslo University Hospital and Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | | | - Eva Kimby
- e Division of Hematology, Department of Medicine at Huddinge , Karolinska Institute , Stockholm , Sweden
| | - Aaron Polliack
- f Department of Hematology , Hadassah University Hospital, Hebrew University Medical School , Jerusalem , Israel
| | - Ka L Wu
- g Department of Hematology , Stuivenberg Hospital , Antwerpen , Belgium
| | - Jeanette K Doorduijn
- h Department of Hematology , Erasmus MC Cancer Center , Rotterdam , The Netherlands
| | | | - Shulamiet Wittebol
- j Department of Internal Medicine , Gelderse Vallei, Amersfoot , The Netherlands
| | - Tomas Kozak
- k Department of Clinical Hematology, Third Faculty of Medicine , Charles University Hospital Kralovske Vinohrady , Prague , Czech Republic
| | - Jan Walewski
- l Lymphoid Malignancies , Maria Sklodowska-Curie Memorial Institute and Oncology Centre , Warszawa , Poland
| | | | - Marinus H J van Oers
- m Department of Hematology , Academisch Medisch Centrum , Amsterdam , The Netherlands
| | | |
Collapse
|
9
|
Andersen MA, Vojdeman FJ, Andersen MK, Brown PDN, Geisler CH, Weis Bjerrum O, Niemann CU. Hypogammaglobulinemia in newly diagnosed chronic lymphocytic leukemia is a predictor of early death. Leuk Lymphoma 2016; 57:1592-9. [DOI: 10.3109/10428194.2016.1142082] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
10
|
Baliakas P, Hadzidimitriou A, Sutton LA, Minga E, Agathangelidis A, Nichelatti M, Tsanousa A, Scarfò L, Davis Z, Yan XJ, Shanafelt T, Plevova K, Sandberg Y, Vojdeman FJ, Boudjogra M, Tzenou T, Chatzouli M, Chu CC, Veronese S, Gardiner A, Mansouri L, Smedby KE, Pedersen LB, van Lom K, Giudicelli V, Francova HS, Nguyen-Khac F, Panagiotidis P, Juliusson G, Angelis L, Anagnostopoulos A, Lefranc MP, Facco M, Trentin L, Catherwood M, Montillo M, Geisler CH, Langerak AW, Pospisilova S, Chiorazzi N, Oscier D, Jelinek DF, Darzentas N, Belessi C, Davi F, Rosenquist R, Ghia P, Stamatopoulos K. Clinical effect of stereotyped B-cell receptor immunoglobulins in chronic lymphocytic leukaemia: a retrospective multicentre study. Lancet Haematol 2014; 1:e74-84. [PMID: 27030157 DOI: 10.1016/s2352-3026(14)00005-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND About 30% of cases of chronic lymphocytic leukaemia (CLL) carry quasi-identical B-cell receptor immunoglobulins and can be assigned to distinct stereotyped subsets. Although preliminary evidence suggests that B-cell receptor immunoglobulin stereotypy is relevant from a clinical viewpoint, this aspect has never been explored in a systematic manner or in a cohort of adequate size that would enable clinical conclusions to be drawn. METHODS For this retrospective, multicentre study, we analysed 8593 patients with CLL for whom immunogenetic data were available. These patients were followed up in 15 academic institutions throughout Europe (in Czech Republic, Denmark, France, Greece, Italy, Netherlands, Sweden, and the UK) and the USA, and data were collected between June 1, 2012, and June 7, 2013. We retrospectively assessed the clinical implications of CLL B-cell receptor immunoglobulin stereotypy, with a particular focus on 14 major stereotyped subsets comprising cases expressing unmutated (U-CLL) or mutated (M-CLL) immunoglobulin heavy chain variable genes. The primary outcome of our analysis was time to first treatment, defined as the time between diagnosis and date of first treatment. FINDINGS 2878 patients were assigned to a stereotyped subset, of which 1122 patients belonged to one of 14 major subsets. Stereotyped subsets showed significant differences in terms of age, sex, disease burden at diagnosis, CD38 expression, and cytogenetic aberrations of prognostic significance. Patients within a specific subset generally followed the same clinical course, whereas patients in different stereotyped subsets-despite having the same immunoglobulin heavy variable gene and displaying similar immunoglobulin mutational status-showed substantially different times to first treatment. By integrating B-cell receptor immunoglobulin stereotypy (for subsets 1, 2, and 4) into the well established Döhner cytogenetic prognostic model, we showed these, which collectively account for around 7% of all cases of CLL and represent both U-CLL and M-CLL, constituted separate clinical entities, ranging from very indolent (subset 4) to aggressive disease (subsets 1 and 2). INTERPRETATION The molecular classification of chronic lymphocytic leukaemia based on B-cell receptor immunoglobulin stereotypy improves the Döhner hierarchical model and refines prognostication beyond immunoglobulin mutational status, with potential implications for clinical decision making, especially within prospective clinical trials. FUNDING European Union; General Secretariat for Research and Technology of Greece; AIRC; Italian Ministry of Health; AIRC Regional Project with Fondazione CARIPARO and CARIVERONA; Regione Veneto on Chronic Lymphocytic Leukemia; Nordic Cancer Union; Swedish Cancer Society; Swedish Research Council; and National Cancer Institute (NIH).
Collapse
Affiliation(s)
- Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Hematology Department and HCT Unit, G Papanicolaou Hospital, Thessaloniki, Greece
| | - Anastasia Hadzidimitriou
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Eva Minga
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | - Andreas Agathangelidis
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Molecular Oncology and Department of Onco-Hematology, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Michele Nichelatti
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Athina Tsanousa
- Department of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lydia Scarfò
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Molecular Oncology and Department of Onco-Hematology, IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Xiao-Jie Yan
- The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA
| | - Tait Shanafelt
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Karla Plevova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Yorick Sandberg
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Myriam Boudjogra
- Hôpital Pitié-Salpêtrière, Service d'Hématologie Biologique, Paris, France
| | - Tatiana Tzenou
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Maria Chatzouli
- Hematology Department, Nikea General Hospital, Piraeus, Greece
| | - Charles C Chu
- The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA
| | - Silvio Veronese
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Anne Gardiner
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Larry Mansouri
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Karin E Smedby
- Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | | | - Kirsten van Lom
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Véronique Giudicelli
- IMGT-the International ImMunoGeneTics Information System, University of Montpellier, LIGM, Institut de Génétique Humaine IGH, Montpellier, France
| | - Hana Skuhrova Francova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | | | | | - Gunnar Juliusson
- Lund University and Hospital Department of Hematology, Lund Stem Cell Center, Lund, Sweden
| | - Lefteris Angelis
- Department of Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Marie-Paule Lefranc
- IMGT-the International ImMunoGeneTics Information System, University of Montpellier, LIGM, Institut de Génétique Humaine IGH, Montpellier, France
| | - Monica Facco
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Italy; Venetian Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Italy; Venetian Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Mark Catherwood
- Department of Haemato-Oncology, Belfast City Hospital, Belfast, UK
| | - Marco Montillo
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - Anton W Langerak
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Nicholas Chiorazzi
- The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, NY, USA
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, UK
| | - Diane F Jelinek
- Department of Immunology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nikos Darzentas
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Frederic Davi
- Hôpital Pitié-Salpêtrière, Service d'Hématologie Biologique, Paris, France
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Paolo Ghia
- Università Vita-Salute San Raffaele, Milan, Italy; Division of Molecular Oncology and Department of Onco-Hematology, IRCCS, San Raffaele Scientific Institute, Milan, Italy.
| | - Kostas Stamatopoulos
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Hematology Department and HCT Unit, G Papanicolaou Hospital, Thessaloniki, Greece; Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| |
Collapse
|
11
|
Vojdeman FJ, Jurlander J, van't Veer M, Itälä-Remes M, Kimby E, Tjønnfjord GE, Walewski J, Kozák T, Polliack A, Montagna M, Regazzi M, Kirkby N, van Oers M, Geisler CH. Plasma alemtuzumab levels in patients with chronic lymphocytic leukemia treated with alemtuzumab combined with chemotherapy reflect the efficacy of the treatment: a hypothesis. Leuk Lymphoma 2013; 54:790-3. [PMID: 23025267 DOI: 10.3109/10428194.2012.720373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the HOVON68 trial comparing subcutaneous low-dose alemtuzumab (LD-A) used together with fludarabine (F) and cyclophosphamide (C) with FC alone in high-risk chronic lymphocytic leukemia (CLL), LD-AFC resulted in significantly more clinical and molecular responses than FC, but also in more opportunistic infections. In a subgroup analysis of alemtuzumab trough levels during treatment by a sensitive enzyme-linked immunosorbent assay (ELISA) method, detectable levels were found in 4/6 complete and 0/3 partial responders. A relationship between alemtuzumab plasma levels, response and duration of lymphocytopenia was evident. We hypothesize that following combination therapy, the response may not be a function of the alemtuzumab levels, but the opposite, that plasma alemtuzumab levels are a function of the efficacy of the entire treatment, and the fewer leukemic target cells that are remaining, the higher are the levels of plasma alemtuzumab. This concept may well provide a guide for alemtuzumab dosage in future trials.
Collapse
|