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Kawa MP, Baumert B, Litwińska Z, Gniot M, Pius-Sadowska E, Rogińska D, Lewandowski K, Zdziarska B, Machaliński B. Potential Leukemic Cells Engraftment After Hematopoietic Stem Cell Transplantation From Unrelated Donors With Undiagnosed Chronic Leukemia. Transplant Proc 2018; 50:3789-3796. [PMID: 30509616 DOI: 10.1016/j.transproceed.2018.04.036] [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] [Received: 06/23/2017] [Revised: 03/16/2018] [Accepted: 04/12/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Donor-related neoplasms are a potential complication of treatment strategies involving stem cell transplantation. Although mechanisms for detection of short-term complications after these procedures are well developed, complications with delayed onset, notably transmission of chronic diseases such as chronic myeloid leukemia (CML), have been difficult to assess. Consequently, we studied the potential of human CML cells to engraft hematopoietic tissues after intravenous implantation in mice. METHODS Human peripheral blood cells, collected from CML patients presenting with moderately increased white blood cells count before treatment, were transplanted into sub-lethally irradiated, immunodeficient mice. Five weeks after transplantation the nuclear cells were isolated from the murine bone marrow, spleen, and peripheral blood and were used to quantitatively detect human CD45 antigen by flow cytometry; qRT-PCR was used to detect the BCR-ABL1 fusion gene, and the human or murine beta-glucuronidase housekeeping gene was used to examine human-murine chimerism. RESULTS We found that all evaluated animals had donor chimerism at the selected interval after transplant and the presence of a specific BCR-ABL1 fusion gene transcript was also detected. CONCLUSIONS Our results suggest that the risk of neoplasm transmission cannot be eliminated during hematopoietic stem cell transplantation from undiagnosed CML donors with borderline leukocytosis. The obtained data confirms the potential of leukemic cells to viably engraft the hematopoietic organs post-transplantation in an immunosuppressed recipient.
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Affiliation(s)
- M P Kawa
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - B Baumert
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Z Litwińska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland
| | - E Pius-Sadowska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - D Rogińska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - K Lewandowski
- Department of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland
| | - B Zdziarska
- Department of Hematology, Pomeranian Medical University, Szczecin, Poland
| | - B Machaliński
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.
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Lewandowski K, Gniot M, Wojtaszewska M, Kanduła Z, Becht R, Paczkowska E, Mędraś E, Wasilewska E, Iwoła M. Coexistence of JAK2 or CALR mutation is a rare but clinically important event in chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Int J Lab Hematol 2018; 40:366-371. [PMID: 29508552 DOI: 10.1111/ijlh.12798] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 09/01/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION There are 7 designated conditions under the category of myeloproliferative neoplasms (MPN), including chronic myelogenous leukemia (CML) and classical MPN, that is, polycythemia vera (PV), essential thrombocythaemia (ET), and primary myelofibrosis (PMF). Recently, reports about Philadelphia and JAK2 V617F-positive MPN cases have been described in literature. The coexistence of different molecular defects may change the clinical and laboratory manifestation of MPN and may result in an inappropriate interpretation of the response to treatment with tyrosine kinase inhibitors in CML patients. METHODS The morphological, cytogenetic, and molecular genetic data from a retrospective analysis of 592 adult patients aged 18-86 years diagnosed with CML were analyzed. RESULTS In 5 CML patients, the presence of JAK2 V617F or CALR mutation was confirmed. Three of 4 TKI-treated patients did not reach complete hematologic response due to the persistence of thrombocytosis and/or splenomegaly. In all of them (in 3 with JAK2 V617F mutation and 1 with CALR mutation), thrombocytosis was present at the time when complete cytogenetic response was documented. In 3 out of 4 reported CML patients, thrombocytosis and/or splenomegaly were still present even at the time when deep molecular response was reached. CONCLUSION In our opinion, a detailed evaluation and appropriate interpretation of clinical and laboratory data in such a category of patients seem to be extremely important, especially when a decision about the TKI change due to therapy failure is considered.
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Affiliation(s)
- K Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
| | - M Wojtaszewska
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
| | - Z Kanduła
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
| | - R Becht
- Department of Hematology, Pomeranian Medical University, Szczecin, Poland
| | - E Paczkowska
- Department of Hematology, Pomeranian Medical University, Szczecin, Poland
| | - E Mędraś
- Department of Haematology Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wrocław, Poland
| | - E Wasilewska
- Department of Hematology, Medical University of Białystok, Białystok, Poland
| | - M Iwoła
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
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4
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Cross NCP, White HE, Ernst T, Welden L, Dietz C, Saglio G, Mahon FX, Wong CC, Zheng D, Wong S, Wang SS, Akiki S, Albano F, Andrikovics H, Anwar J, Balatzenko G, Bendit I, Beveridge J, Boeckx N, Cerveira N, Cheng SM, Colomer D, Czurda S, Daraio F, Dulucq S, Eggen L, El Housni H, Gerrard G, Gniot M, Izzo B, Jacquin D, Janssen JJWM, Jeromin S, Jurcek T, Kim DW, Machova-Polakova K, Martinez-Lopez J, McBean M, Mesanovic S, Mitterbauer-Hohendanner G, Mobtaker H, Mozziconacci MJ, Pajič T, Pallisgaard N, Panagiotidis P, Press RD, Qin YZ, Radich J, Sacha T, Touloumenidou T, Waits P, Wilkinson E, Zadro R, Müller MC, Hochhaus A, Branford S. Development and evaluation of a secondary reference panel for BCR-ABL1 quantification on the International Scale. Leukemia 2016; 30:1844-52. [PMID: 27109508 PMCID: PMC5240017 DOI: 10.1038/leu.2016.90] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/24/2022]
Abstract
Molecular monitoring of chronic myeloid leukemia patients using robust BCR-ABL1 tests standardized to the International Scale (IS) is key to proper disease management, especially when treatment cessation is considered. Most laboratories currently use a time-consuming sample exchange process with reference laboratories for IS calibration. A World Health Organization (WHO) BCR-ABL1 reference panel was developed (MR1–MR4), but access to the material is limited. In this study, we describe the development of the first cell-based secondary reference panel that is traceable to and faithfully replicates the WHO panel, with an additional MR4.5 level. The secondary panel was calibrated to IS using digital PCR with ABL1, BCR and GUSB as reference genes and evaluated by 44 laboratories worldwide. Interestingly, we found that >40% of BCR-ABL1 assays showed signs of inadequate optimization such as poor linearity and suboptimal PCR efficiency. Nonetheless, when optimized sample inputs were used, >60% demonstrated satisfactory IS accuracy, precision and/or MR4.5 sensitivity, and 58% obtained IS conversion factors from the secondary reference concordant with their current values. Correlation analysis indicated no significant alterations in %BCR-ABL1 results caused by different assay configurations. More assays achieved good precision and/or sensitivity than IS accuracy, indicating the need for better IS calibration mechanisms.
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Affiliation(s)
- N C P Cross
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - H E White
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Ernst
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - L Welden
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia
| | - C Dietz
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - G Saglio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - F-X Mahon
- Bergonie Institute Cancer Center Bordeaux, INSERM U1218, University of Bordeaux, Bordeaux, France
| | - C C Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - D Zheng
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S-S Wang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - F Albano
- Department of Hematology, University of Bari, Bari, Italy
| | - H Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.,Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - J Anwar
- King's College Hospital London, London, UK
| | - G Balatzenko
- National Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria
| | - I Bendit
- Laboratorio de Biologia Tumoral, Disciplina de Hematologia do HC-FMUSP, São Paulo, Brazil
| | - J Beveridge
- PathWest Laboratory Medicine WA, Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KUL, Leuven, Belgium
| | - N Cerveira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - S-M Cheng
- Department of Hematology and Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - S Czurda
- Division of Molecular Microbiology, Children's Cancer Research Institute, Vienna, Austria
| | - F Daraio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - S Dulucq
- Laboratoire Hematologie, Centre Hospitalier Universitaire de Bordeaux, Universite Bordeaux, Bordeaux, France
| | - L Eggen
- Laboratory of Molecular Pathology, Oslo University Hospital, Oslo, Norway
| | - H El Housni
- Clinique de Genetique Oncologique-Service de genetique, Hopital Erasme, Brussels, Belgium
| | - G Gerrard
- Imperial Molecular Pathology, Hammersmith Hospital, London, UK
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | | | - J J W M Janssen
- Department of Hematology and Molecular Diagnostics, VU University Medical Center, Amsterdam, The Netherlands
| | - S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Jurcek
- Center of Molecular Biology and Gene Therapy, Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - D-W Kim
- Seoul St Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea
| | - K Machova-Polakova
- Department of Molecular Genetics, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Martinez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO, Madrid, Spain
| | - M McBean
- Division of Cancer Medicine, Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - S Mesanovic
- Pathology Department, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - G Mitterbauer-Hohendanner
- Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | | | - M-J Mozziconacci
- Departement de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - T Pajič
- Specialized Haematology Laboratory, Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - N Pallisgaard
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - P Panagiotidis
- Hematology Unit, First Department of Internal Medicine, Laiko Hospital, University of Athens, Athens, Greece
| | - R D Press
- Department of Pathology and Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Y-Z Qin
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China
| | - J Radich
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - T Sacha
- Chair and Department of Hematology, Jagiellonian University, Kraków, Poland
| | - T Touloumenidou
- Laboratory of Molecular Biology, Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - P Waits
- Bristol Genetics Laboratory, Bristol, UK
| | | | - R Zadro
- Faculty of Pharmacy and Biochemistry and University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - S Branford
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA, Australia.,School of Medicine, University of Adelaide, SA, Adelaide, Australia.,School of Molecular and Biomedical Science, University of Adelaide, Adelaide, SA, Australia
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