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Hayashi RJ, Hermiston ML, Wood BL, Teachey DT, Devidas M, Chen Z, Annett RD, Asselin BL, August K, Cho S, Dunsmore KP, Freedman JL, Galardy PJ, Harker-Murray P, Horton TM, Jaju A, Lam A, Messinger YH, Miles RR, Okada M, Patel S, Schafer ES, Schechter T, Shimano KA, Singh N, Steele A, Sulis ML, Vargas S, Winter SS, Wood C, Zweider-McKay PA, Loh ML, Hunger SP, Raetz EA, Bollard CM, Allen CE. MRD at the End of Induction and EFS in T-cell Lymphoblastic Lymphoma: Children's Oncology Group Trial AALL1231. Blood 2024:blood.2023021184. [PMID: 38457359 DOI: 10.1182/blood.2023021184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/10/2024] Open
Abstract
Defining prognostic variables in T-lymphoblastic lymphoma (T-LL) remains a challenge. AALL1231 was a COG phase 3 clinical trial for newly diagnosed with T Acute Lymphoblastic leukemia or T-LL patients randomizing children and young adults to a modified augmented BFM backbone to receive standard therapy (Arm A) or with addition of bortezomib (Arm B). Optional bone marrow (BM) samples to assess minimal residual disease (MRD) at the end of induction (EOI) were collected in T-LL analyzed to assess the correlation of MRD at the EOI to event-free survival (EFS). Eighty-six (41%) of the 209 T-LL patients accrued to this trial submitted samples for MRD assessment. Patients with MRD <0.1% (n= 75) at EOI had a superior 4-year EFS versus those with MRD >0.1% (n= 11), (89.0±4.4% versus 63.6±17.2%, p= 0.025). Overall survival did not significantly differ between the two groups. Cox regression for EFS using Arm A as a reference demonstrated that MRD EOI ≥0.1% was associated with a greater risk of inferior outcome (Hazard Ratio, HR= 3.73 (1.12-12.40, p= 0.032), which was independent of treatment arm assignment. Consideration to incorporate MRD at EOI into future trials will help establish its value in defining risk groups. CT# NCT02112916.
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Affiliation(s)
- Robert J Hayashi
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States
| | - Michelle L Hermiston
- University of California, San Francisco, San Francisco, California, United States
| | - Brent L Wood
- Childrens Hospital Los Angeles, Los Angeles, California, United States
| | | | - Meenakshi Devidas
- St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Zhiguo Chen
- University of Florida, Gainesville, Florida, United States
| | - Robert D Annett
- University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
| | - Barbara L Asselin
- University of Rochester Medical Center, Rochester, New York, United States
| | - Keith August
- Children's Mercy Hospital, Kansas City, Missouri, United States
| | - Steve Cho
- Wisconsin Institute for Medical Research, United States
| | | | | | | | | | - Terzah M Horton
- Baylor College of Medicine/Dan L. Duncan Cancer Center and Texas Children's Cancer Center, Houston, Texas, United States
| | - Alok Jaju
- Phoenix Children's Hospital, Phoenix, Arizona, United States
| | | | - Yoav H Messinger
- Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States
| | - Rodney R Miles
- University of Utah -- Huntsman Cancer Institute, Salt Lake City, Utah, United States
| | - Maki Okada
- University of Alberta- Stollery Children's Hospital, Edmonton, AB, Canada, United States
| | | | | | | | - Kristin A Shimano
- University of California San Francisco, San Francisco, California, United States
| | - Neelam Singh
- Michigan State University Clinical Center, East Lansing, Michigan, United States
| | - Amii Steele
- Carolinas Medical Center/Levine Cancer Institute, Charlotte, North Carolina, United States
| | - Maria Luisa Sulis
- Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | - Sarah Vargas
- childrens oncology group, Monrovia, California, United States
| | | | - Charlotte Wood
- University of Florida, gainesville, Florida, United States
| | | | - Mignon L Loh
- Seattle Children's Hospital, the Ben Town Center for Childhood Cancer Research, University of Washington, Seattle, WA., Seattle, Washington, United States
| | - Stephen P Hunger
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | | | | | - Carl E Allen
- Baylor College of Medicine, Houston, Texas, United States
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Grant GJ, Sahni DR, Florell AJ, Hull CM, Florell SR, Miles RR, Wada DA, Bowen AR. An atypical case of eosinophilic pustular folliculitis with associated secondary follicular mucinosis treated with indomethacin. JAAD Case Rep 2023; 34:86-89. [PMID: 37025561 PMCID: PMC10070191 DOI: 10.1016/j.jdcr.2022.12.022] [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: 01/29/2023] Open
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Burke GAA, Minard-Colin V, Aupérin A, Alexander S, Pillon M, Delgado R, Zsíros J, Uyttebroeck A, Dartigues P, Miles RR, Kazanowska B, Chiang AK, Haouy S, Bollard CM, Csoka M, Wheatley K, Barkauskas DA, Adamson PC, Vassal G, Patte C, Gross TG. Reply to R. Lakhotia et al. J Clin Oncol 2022; 40:2064-2066. [PMID: 35377710 DOI: 10.1200/jco.21.02912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/03/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- G A Amos Burke
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Veronique Minard-Colin
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Anne Aupérin
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Sarah Alexander
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Marta Pillon
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Rafael Delgado
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - József Zsíros
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Anne Uyttebroeck
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Peggy Dartigues
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Rodney R Miles
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Bernarda Kazanowska
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Alan K Chiang
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Stéphanie Haouy
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Catherine M Bollard
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Monika Csoka
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Keith Wheatley
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Donald A Barkauskas
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Peter C Adamson
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Gilles Vassal
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Catherine Patte
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
| | - Thomas G Gross
- G.A. Amos Burke, MBChB, PhD, Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom; Veronique Minard-Colin, MD, PhD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Anne Aupérin, MD, PhD, Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France; Sarah Alexander, MD, Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada; Marta Pillon, MD, PhD, Pediatric Hematology and Oncology, University of Padova, Padova, Italy; Rafael Delgado, MD, PhD, Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain; József Zsíros, MD, PhD, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Anne Uyttebroeck, MD, PhD, Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium; Peggy Dartigues, MD, Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Rodney R. Miles, MD, PhD, Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT; Bernarda Kazanowska, MD, PhD, Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland; Alan K. Chiang, MD, PhD, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong; Stéphanie Haouy, MD, Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France; Catherine M. Bollard, MBChB, MD, Center for Cancer and Immunology Research, Children's National Hospital and The George Washington University, Washington, DC; Monika Csoka, MD, PhD, Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary; Keith Wheatley, PhD, Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Donald A. Barkauskas, PhD, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Peter C. Adamson, MD, Global Head, Oncology Development and Pediatric Innovation at Sanofi, Cambridge, MA; Gilles Vassal, MD, PhD, Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Catherine Patte, MD, Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France; and Thomas G. Gross, MD, PhD, Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
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Teachey DT, Devidas M, Wood BL, Chen Z, Hayashi RJ, Hermiston ML, Annett RD, Archer JH, Asselin BL, August KJ, Cho SY, Dunsmore KP, Fisher BT, Freedman JL, Galardy PJ, Harker-Murray P, Horton TM, Jaju AI, Lam A, Messinger YH, Miles RR, Okada M, Patel SI, Schafer ES, Schechter T, Singh N, Steele AC, Sulis ML, Vargas SL, Winter SS, Wood C, Zweidler-McKay P, Bollard CM, Loh ML, Hunger SP, Raetz EA. Children's Oncology Group Trial AALL1231: A Phase III Clinical Trial Testing Bortezomib in Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia and Lymphoma. J Clin Oncol 2022; 40:2106-2118. [PMID: 35271306 PMCID: PMC9242409 DOI: 10.1200/jco.21.02678] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To improve the outcomes of patients with T-cell acute lymphoblastic leukemia (T-ALL) and lymphoblastic lymphoma (T-LL), the proteasome inhibitor bortezomib was examined in the Children's Oncology Group phase III clinical trial AALL1231, which also attempted to reduce the use of prophylactic cranial radiation (CRT) in newly diagnosed T-ALL. PATIENTS AND METHODS Children and young adults with T-ALL/T-LL were randomly assigned to a modified augmented Berlin-Frankfurt-Münster chemotherapy regimen with/without bortezomib during induction and delayed intensification. Multiple modifications were made to the augmented Berlin-Frankfurt-Münster backbone used in the predecessor trial, AALL0434, including using dexamethasone instead of prednisone and adding two extra doses of pegaspargase in an attempt to eliminate CRT in most patients. RESULTS AALL1231 accrued 824 eligible and evaluable patients from 2014 to 2017. The 4-year event-free survival (EFS) and overall survival (OS) for arm A (no bortezomib) versus arm B (bortezomib) were 80.1% ± 2.3% versus 83.8% ± 2.1% (EFS, P = .131) and 85.7% ± 2.0% versus 88.3% ± 1.8% (OS, P = .085). Patients with T-LL had improved EFS and OS with bortezomib: 4-year EFS (76.5% ± 5.1% v 86.4% ± 4.0%; P = .041); and 4-year OS (78.3% ± 4.9% v 89.5% ± 3.6%; P = .009). No excess toxicity was seen with bortezomib. In AALL0434, 90.8% of patients with T-ALL received CRT. In AALL1231, 9.5% of patients were scheduled to receive CRT. Evaluation of comparable AALL0434 patients who received CRT and AALL1231 patients who did not receive CRT demonstrated no statistical differences in EFS (P = .412) and OS (P = .600). CONCLUSION Patients with T-LL had significantly improved EFS and OS with bortezomib on the AALL1231 backbone. Systemic therapy intensification allowed elimination of CRT in more than 90% of patients with T-ALL without excess relapse.
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Affiliation(s)
- David T Teachey
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Brent L Wood
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | - Zhiguo Chen
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Robert J Hayashi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO
| | - Michelle L Hermiston
- Department of Pediatrics, Benioff Children's Hospital and the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Robert D Annett
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - J Hunter Archer
- Department of Biostatistics, University of Florida, Gainesville, FL
| | - Barbara L Asselin
- Department of Pediatrics and Wilmot Cancer Institute at URMC, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Steve Y Cho
- University of Wisconsin-Madison and the University of Wisconsin Carbone Cancer Center, Madison, WI
| | | | - Brian T Fisher
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA
| | - Jason L Freedman
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA
| | - Paul J Galardy
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | | | - Terzah M Horton
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | | | - Allison Lam
- Miller Children's and Women's Hospital, Long Beach, CA
| | | | - Rodney R Miles
- Department of Pathology and ARUP Institute for Clinical & Experimental Pathology, University of Utah, Salt Lake City, UT
| | - Maki Okada
- Miller Children's and Women's Hospital, Long Beach, CA
| | - Samir I Patel
- Division of Radiation Oncology, Department of Oncology, University of Alberta, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Eric S Schafer
- Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Tal Schechter
- Haematology/Oncology, Child Health Evaluative Services (CHES) Program Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Neelam Singh
- Michigan State University Clinical Center, Lansing, MI
| | - Amii C Steele
- Carolinas Medical Center/Levine Cancer Institute, Charlotte, NC
| | - Maria Luisa Sulis
- Department of Pediatric Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Stuart S Winter
- Children's Minnesota Research Institute, Children's Minnesota Research Institute and Cancer and Blood Disorders Program, Minneapolis, MN
| | - Charlotte Wood
- Department of Biostatistics, University of Florida, Gainesville, FL
| | | | | | - Mignon L Loh
- Department of Pediatrics, Benioff Children's Hospital and the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Stephen P Hunger
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA
| | - Elizabeth A Raetz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, New York University Langone Health, New York, NY
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Underdown MJ, Miles RR, Gross TG, Winters AC. Importance of clinical correlation in the diagnosis of pediatric B-cell lymphomas. Pediatr Blood Cancer 2022; 69:e29527. [PMID: 34962700 DOI: 10.1002/pbc.29527] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Mary J Underdown
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rodney R Miles
- Department of Pathology and ARUP Laboratories, University of Utah, Salt Lake City, Utah, USA
| | - Thomas G Gross
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amanda C Winters
- Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Burke GAA, Minard-Colin V, Aupérin A, Alexander S, Pillon M, Delgado R, Zsíros J, Uyttebroeck A, Dartigues P, Miles RR, Kazanowska B, Chiang AK, Haouy S, Bollard CM, Csoka M, Wheatley K, Barkauskas DA, Adamson PC, Vassal G, Patte C, Gross TG. Dose-Adjusted Etoposide, Doxorubicin, and Cyclophosphamide With Vincristine and Prednisone Plus Rituximab Therapy in Children and Adolescents With Primary Mediastinal B-Cell Lymphoma: A Multicenter Phase II Trial. J Clin Oncol 2021; 39:3716-3724. [PMID: 34570655 PMCID: PMC9150887 DOI: 10.1200/jco.21.00920] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/07/2021] [Accepted: 08/24/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE A dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) regimen has been shown to deliver excellent survival for adults with primary mediastinal large B-cell lymphoma (PMLBL) without the use of radiotherapy. No international prospective evaluation of this regimen has previously been reported in children and adolescents. PATIENTS AND METHODS We conducted an international single-arm phase II trial involving patients younger than age 18 years with PMLBL who were to receive six courses of DA-EPOCH-R. The primary end point was event-free survival (EFS). Overall survival and toxicity were also assessed. This trial was registered (ClinicalTrials.gov identifier: NCT01516567). RESULTS Analyses were based on 46 patients. The median age was 15.4 years (interquartile range: 14-16 years). The median follow-up was 59.0 months (interquartile range: 52.6-69.2 months). Fourteen events were observed (eight relapses or progressions (including three parenchymal CNS relapses), four residual lymphoma, and two second malignancies). The 4-year EFS was 69.6% (95% CI, 55.2 to 80.9), which did not differ from the rate observed historically (P = .59). Seven deaths occurred (six disease-related and one second malignancy). The overall survival was 84.8% (95% CI, 71.8 to 92.4). Twenty-two patients (48%) reached dose levels ≥ 4. Nonhematologic adverse events grade ≥ 3 or cardiac adverse events grade ≥ 2 occurred in 47 of 276 (17%) courses and 30 of 46 patients (65%). CONCLUSION DA-EPOCH-R did not improve the EFS compared with a historical control in this first prospective multisite international study of children and adolescents with PMLBL. Further studies are required to determine the optimum therapy for children and adolescents with this lymphoma.
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Affiliation(s)
- G. A. Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Anne Aupérin
- Unit of Biostatistics and Epidemiology, Gustave Roussy, Oncostat 1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - Sarah Alexander
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Marta Pillon
- Pediatric Hematology and Oncology, University of Padova, Padova, Italy
| | - Rafael Delgado
- Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain
| | - József Zsíros
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Peggy Dartigues
- Department of Biopathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Rodney R. Miles
- Department of Pathology and ARUP Laboratories and Huntsman Cancer Institute, Salt Lake City, UT
| | - Bernarda Kazanowska
- Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Alan K. Chiang
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Stéphanie Haouy
- Department of Paediatric Haematology, Oncology, CHU Arnaud de Villeneuve, Montpellier, France
| | - Catherine M. Bollard
- Center for Cancer and Immunology Research, Children's National Health System and The George Washington University, Washington, DC
| | - Monika Csoka
- Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary
| | - Keith Wheatley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Donald A. Barkauskas
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Peter C. Adamson
- Oncology Development & Pediatric Innovation, Sanofi, Cambridge, MA
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Catherine Patte
- Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Thomas G. Gross
- Department of Pediatrics, Center for Cancer and Blood Diseases, Children's Hospital Colorado, Aurora, CO
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Mangum DS, Meyer JA, Mason CC, Shams S, Maese LD, Gardiner JD, Downie JM, Pei D, Cheng C, Gleason A, Luo M, Pui CH, Aplenc R, Hunger SP, Loh M, Greaves M, Trede N, Raetz E, Frazer JK, Mullighan CG, Engel ME, Miles RR, Rabin KR, Schiffman JD. Association of Combined Focal 22q11.22 Deletion and IKZF1 Alterations With Outcomes in Childhood Acute Lymphoblastic Leukemia. JAMA Oncol 2021; 7:1521-1528. [PMID: 34410295 DOI: 10.1001/jamaoncol.2021.2723] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Alterations in the IKZF1 gene drive B-cell acute lymphoblastic leukemia (B-ALL) but are not routinely used to stratify patients by risk because of inconsistent associations with outcomes. We describe a novel deletion in 22q11.22 that was consistently associated with very poor outcomes in patients with B-ALL with IKZF1 alterations. Objective To determine whether focal deletions within the λ variable chain region in chromosome 22q11.22 were associated with patients with B-ALL with IKZF1 alterations with the highest risk of relapse and/or death. Design, Setting, and Participants This cohort study included 1310 primarily high-risk pediatric patients with B-ALL who were taken from 6 independent clinical cohorts, consisting of 3 multicenter cohorts (AALL0232 [2004-2011], P9906 [2000-2003], and patients with Down syndrome who were pooled from national and international studies) and 3 single-institution cohorts (University of Utah [Salt Lake City], Children's Hospital of Philadelphia [Philadelphia, Pennsylvania], and St. Jude Children's Hospital [Memphis, Tennessee]). Data analysis began in 2011 using patients from the older studies first, and data analysis concluded in 2021. Exposures Focal 22q11.22 deletions. Main Outcomes and Measures Event-free and overall survival was investigated. The hypothesis that 22q11.22 deletions stratified the prognostic effect of IKZF1 alterations was formulated while investigating nearby deletions in VPREB1 in 2 initial cohorts (n = 270). Four additional cohorts were then obtained to further study this association (n = 1040). Results This study of 1310 patients with B-ALL (717 male [56.1%] and 562 female patients [43.9%]) found that focal 22q11.22 deletions are frequent (518 of 1310 [39.5%]) in B-ALL and inconsistent with physiologic V(D)J recombination. A total of 299 of 1310 patients with B-ALL had IKZF1 alterations. Among patients with IKZF1 alterations, more than half shared concomitant focal 22q11.22 deletions (159 of 299 [53.0%]). Patients with combined IKZF1 alterations and 22q11.22 deletions had worse outcomes compared with patients with IKZF1 alterations and wild-type 22q11.22 alleles in every cohort examined (combined cohorts: 5-year event-free survival rates, 43.3% vs 68.5%; hazard ratio [HR], 2.18; 95% CI, 1.54-3.07; P < .001; 5-year overall survival rates, 66.9% vs 83.9%; HR, 2.05; 95% CI, 1.32-3.21; P = .001). While 22q11.22 deletions were not prognostic in patients with wild-type IKZF1 , concomitant 22q11.22 deletions in patients with IKZF1 alterations stratified outcomes across additional risk groups, including patients who met the IKZF1plus criteria, and maintained independent significance in multivariate analysis for event-free survival (HR, 2.05; 95% CI, 1.27-3.29; P = .003) and overall survival (HR, 1.83; 95% CI, 1.01-3.34; P = .05). Conclusions and Relevance This cohort study suggests that 22q11.22 deletions identify patients with B-ALL and IKZF1 alterations who have very poor outcomes and may offer a new genetic biomarker to further refine B-ALL risk stratification and treatment strategies.
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Affiliation(s)
- David Spencer Mangum
- Nemours/Alfred I. DuPont Hospital for Children, Division of Pediatric Hematology/Oncology, Wilmington, Delaware
| | - Julia A Meyer
- Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of Utah, Salt Lake City.,Division of Pediatric Hematology and Oncology, University of California, San Francisco
| | - Clinton C Mason
- Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of Utah, Salt Lake City
| | | | - Luke D Maese
- Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of Utah, Salt Lake City
| | - Jamie D Gardiner
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City
| | | | - Deqing Pei
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Cheng Cheng
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Adam Gleason
- Department of Pathology & Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Minjie Luo
- Department of Pathology & Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ching-Hon Pui
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Richard Aplenc
- Division of Oncology and the Center for Childhood Cancer Research, The Children's Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Stephen P Hunger
- Division of Oncology and the Center for Childhood Cancer Research, The Children's Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Mignon Loh
- Division of Pediatric Hematology and Oncology, University of California, San Francisco
| | - Mel Greaves
- Institute of Cancer Research, London, England
| | | | - Elizabeth Raetz
- Department of Pediatrics, NYU Langone Health, New York, New York
| | - J Kimble Frazer
- Jimmy Everest Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Charles G Mullighan
- Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael E Engel
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Virginia, Charlottesville
| | - Rodney R Miles
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City
| | - Karen R Rabin
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Joshua D Schiffman
- Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of Utah, Salt Lake City.,Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City.,PEEL Therapeutics, Inc, Salt Lake City, Utah
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8
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Goldman S, Barth M, Shiramizu B, Shi Q, Hochberg J, Klejmont L, Harrison L, Basso J, Chu Y, Islam H, Gerard P, Agsalda-Garcia M, Shieh T, Oesterheld J, Heym K, Kirov I, Drachtman R, Harker-Murray P, Perkins S, Miles RR, Cairo M. A dose substitution of anthracycline intensity with dose-dense rituximab in children and adolescents with good-risk mature B-cell lymphoma. Leukemia 2021; 35:2994-2997. [PMID: 33941850 DOI: 10.1038/s41375-021-01256-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/15/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Stan Goldman
- Department of Pediatric Hematology/Oncology, Medical City Children's Hospital, Dallas, TX, USA
| | - Matthew Barth
- Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Bruce Shiramizu
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, University of Hawaii, Honolulu, HI, USA
| | - Qiuhu Shi
- Department of Biostatistics, New York Medical College, Valhalla, NY, USA
| | - Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Liana Klejmont
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Lauren Harrison
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Jackie Basso
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Yaya Chu
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Humayun Islam
- Department of Pathology, New York Medical College, Valhalla, NY, USA
| | - Perry Gerard
- Department of Radiology, New York Medical College, Valhalla, NY, USA
| | - Melissa Agsalda-Garcia
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, University of Hawaii, Honolulu, HI, USA
| | - Tiffany Shieh
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, University of Hawaii, Honolulu, HI, USA
| | | | - Kenneth Heym
- Cook Children's Medical Center, Fort Worth, TX, USA
| | - Ivan Kirov
- Children's Hospital Orange County, Irvine, CA, USA
| | | | | | - Sherrie Perkins
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Rodney R Miles
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Mitchell Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA. .,Department of Pathology, New York Medical College, Valhalla, NY, USA. .,Department of Medicine, New York Medical College, Valhalla, NY, USA. .,Department of Microbiology & Immunology, New York Medical College, Valhalla, NY, USA. .,Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA.
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9
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Ng DP, Miles RR, Andersen EF, Toydemir RM. Flow Cytometry Is More Sensitive Than Fluorescence In Situ Hybridization for Detecting Minimal Residual Disease. Am J Clin Pathol 2021; 156:715-716. [PMID: 34165497 DOI: 10.1093/ajcp/aqab080] [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: 11/13/2022] Open
Affiliation(s)
| | - Rodney R Miles
- University of Utah and ARUP Laboratories Salt Lake City, UT, USA
| | - Erica F Andersen
- University of Utah and ARUP Laboratories Salt Lake City, UT, USA
| | - Reha M Toydemir
- University of Utah and ARUP Laboratories Salt Lake City, UT, USA
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10
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Hayashi RJ, Winter SS, Dunsmore KP, Devidas M, Chen Z, Wood BL, Hermiston ML, Teachey DT, Perkins SL, Miles RR, Raetz EA, Loh ML, Winick NJ, Carroll WL, Hunger SP, Lim MS, Gross TG, Bollard CM. Successful Outcomes of Newly Diagnosed T Lymphoblastic Lymphoma: Results From Children's Oncology Group AALL0434. J Clin Oncol 2020; 38:3062-3070. [PMID: 32552472 PMCID: PMC7479761 DOI: 10.1200/jco.20.00531] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The Children's Oncology Group (COG) protocol AALL0434 evaluated the safety and efficacy of multi-agent chemotherapy with Capizzi-based methotrexate/pegaspargase (C-MTX) in patients with newly diagnosed pediatric T-cell lymphoblastic lymphoma (T-LL) and gained preliminary data using nelarabine in high-risk patients. PATIENTS AND METHODS The trial enrolled 299 patients, age 1-31 years. High-risk (HR) patients had ≥ 1% minimal detectable disease (MDD) in the bone marrow at diagnosis or received prior steroid treatment. Induction failure was defined as failure to achieve a partial response (PR) by the end of the 4-week induction. All patients received the augmented Berlin-Frankfurt-Muenster (ABFM) C-MTX regimen. HR patients were randomly assigned to receive or not receive 6 5-day courses of nelarabine incorporated into ABFM. Patients with induction failure were nonrandomly assigned to ABFM C-MTX plus nelarabine. No patients received prophylactic cranial radiation; however, patients with CNS3 disease (CSF WBC ≥ 5/μL with blasts or cranial nerve palsies, brain/eye involvement, or hypothalamic syndrome) were ineligible. RESULTS At end-induction, 98.8% of evaluable participants had at least a PR. The 4-year event-free survival (EFS) and overall survival (OS) were 84.7% ± 2.3% and 89.0% ± 2.0%. The 4-year disease-free survival (DFS) from end-induction was 85.9% ± 2.6%. There was no difference in DFS observed between the HR and standard-risk groups (P = .29) or by treatment regimen (P = .55). Disease stage, tumor response, and MDD at diagnosis did not demonstrate thresholds that resulted in differences in EFS. Nelarabine did not show an advantage for HR patients. CNS relapse occurred in only 4 patients. CONCLUSION COG AALL0434 produced excellent outcomes in one of the largest trials ever conducted for patients with newly diagnosed T-LL. The COG ABFM regimen with C-MTX provided excellent EFS and OS without cranial radiation.
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Affiliation(s)
- Robert J. Hayashi
- Pediatric Hematology/Oncology, Washington School of Medicine, St Louis Children’s Hospital, St Louis, MO
| | - Stuart S. Winter
- Children’s Minnesota Cancer and Blood Disorders Program, Minneapolis, MN
| | | | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN
| | - Zhiguo Chen
- Department of Biostatistics, College of Medicine and College of Public Health and Health Professions, University of Florida, Gainesville, FL
| | - Brent L. Wood
- Laboratory Medicine, Seattle Children’s Hospital, Seattle, WA
| | - Michelle L. Hermiston
- Department of Pediatrics, UCSF Benioff Children’s Hospital and the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - David T. Teachey
- Division of Oncology, Department of Pediatrics, Center for Childhood Cancer Research, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sherrie L. Perkins
- Department of Pathology, University of Utah Health Sciences Center, ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
| | - Rodney R. Miles
- Department of Pathology, University of Utah Health Sciences Center, ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT
| | - Elizabeth A. Raetz
- Department of Pediatrics and Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, New York, NY
| | - Mignon L. Loh
- Department of Pediatrics, UCSF Benioff Children’s Hospital and the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Naomi J. Winick
- Pediatric Hematology/Oncology, University of Texas Southwestern/Simmons Cancer Center, Dallas, TX
| | - William L. Carroll
- Department of Pediatrics and Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, New York, NY
| | - Stephen P. Hunger
- Division of Oncology, Department of Pediatrics, Center for Childhood Cancer Research, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Megan S. Lim
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, and The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas G. Gross
- National Cancer Institute Center for Global Health, Rockville, MD
| | - Catherine M. Bollard
- Division of Blood and Marrow Transplantation, Children’s National Health System, Washington, DC
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11
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Laggis CW, Lamb A, Secrest AM, Ufkes N, Halwani AS, Tao R, Gaffney D, Miles RR, Florell SR, Wada D. Favourable outcomes in folliculotropic mycosis fungoides after multimodality treatment in a single institution. J Eur Acad Dermatol Venereol 2020; 35:e42-e45. [PMID: 32594555 DOI: 10.1111/jdv.16790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022]
Affiliation(s)
- C W Laggis
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - A Lamb
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - A M Secrest
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - N Ufkes
- Medical University of South Carolina School of Medicine, Charleston, SC, USA
| | - A S Halwani
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncology, University of Utah, Salt Lake City, UT, USA
| | - R Tao
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - D Gaffney
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA
| | - R R Miles
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Pathology, University of Utah, Salt Lake City, UT, USA.,ARUP Laboratories, Salt Lake City, UT, USA
| | - S R Florell
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - D Wada
- Department of Dermatology, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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12
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Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med 2020; 382:2207-2219. [PMID: 32492302 PMCID: PMC7720281 DOI: 10.1056/nejmoa1915315] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Rituximab added to chemotherapy prolongs survival among adults with B-cell cancer. Data on its efficacy and safety in children with high-grade, mature B-cell non-Hodgkin's lymphoma are limited. METHODS We conducted an open-label, international, randomized, phase 3 trial involving patients younger than 18 years of age with high-risk, mature B-cell non-Hodgkin's lymphoma (stage III with an elevated lactate dehydrogenase level or stage IV) or acute leukemia to compare the addition of six doses of rituximab to standard lymphomes malins B (LMB) chemotherapy with standard LMB chemotherapy alone. The primary end point was event-free survival. Overall survival and toxic effects were also assessed. RESULTS Analyses were based on 328 patients who underwent randomization (164 patients per group); 85.7% of the patients had Burkitt's lymphoma. The median follow-up was 39.9 months. Events were observed in 10 patients in the rituximab-chemotherapy group and in 28 in the chemotherapy group. Event-free survival at 3 years was 93.9% (95% confidence interval [CI], 89.1 to 96.7) in the rituximab-chemotherapy group and 82.3% (95% CI, 75.7 to 87.5) in the chemotherapy group (hazard ratio for primary refractory disease or first occurrence of progression, relapse after response, death from any cause, or second cancer, 0.32; 95% CI, 0.15 to 0.66; one-sided P = 0.00096, which reached the significance level required for this analysis). Eight patients in the rituximab-chemotherapy group died (4 deaths were disease-related, 3 were treatment-related, and 1 was from a second cancer), as did 20 in the chemotherapy group (17 deaths were disease-related, and 3 were treatment-related) (hazard ratio, 0.36; 95% CI, 0.16 to 0.82). The incidence of acute adverse events of grade 4 or higher after prephase treatment was 33.3% in the rituximab-chemotherapy group and 24.2% in the chemotherapy group (P = 0.07); events were related mainly to febrile neutropenia and infection. Approximately twice as many patients in the rituximab-chemotherapy group as in the chemotherapy group had a low IgG level 1 year after trial inclusion. CONCLUSIONS Rituximab added to standard LMB chemotherapy markedly prolonged event-free survival and overall survival among children and adolescents with high-grade, high-risk, mature B-cell non-Hodgkin's lymphoma and was associated with a higher incidence of hypogammaglobulinemia and, potentially, more episodes of infection. (Funded by the Clinical Research Hospital Program of the French Ministry of Health and others; ClinicalTrials.gov number, NCT01516580.).
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Affiliation(s)
- Véronique Minard-Colin
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Anne Aupérin
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Marta Pillon
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - G A Amos Burke
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Donald A Barkauskas
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Keith Wheatley
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Rafael F Delgado
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Sarah Alexander
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Anne Uyttebroeck
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Catherine M Bollard
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - József Zsiros
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Monika Csoka
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Bernarda Kazanowska
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Alan K Chiang
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Rodney R Miles
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Andrew Wotherspoon
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Peter C Adamson
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Gilles Vassal
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Catherine Patte
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
| | - Thomas G Gross
- From the Departments of Pediatric and Adolescent Oncology (V.M.-C., C.P.) and Clinical Research (G.V.), INSERM Unité 1015 (V.M.-C.), and the Unit of Biostatistics and Epidemiology and INSERM Unité 1018 (A.A.), Gustave Roussy, Université Paris-Saclay, Villejuif, France; the Department of Pediatric Hematology and Oncology, University of Padua, Padua, Italy (M.P.); the Department of Paediatric Haematology, Oncology, and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge (G.A.A.B.), Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham (K.W.), and the Department of Histopathology, Royal Marsden NHS Foundation Trust, London (A.W.) - all in the United Kingdom; the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (D.A.B.); the Department of Pediatric Hematology and Oncology, University of Valencia, Valencia, Spain (R.F.D.); the Division of Haematology-Oncology, Hospital for Sick Children, Toronto (S.A.); the Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium (A.U.); the Center for Cancer and Immunology Research, Children's National Health System and George Washington University, Washington, DC (C.M.B.); Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.Z.); the Department of Pediatric Hematology and Oncology, Semmelweis University, Budapest, Hungary (M.C.); the Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology, Wroclaw Medical University, Wroclaw, Poland (B.K.); the Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong (A.K.C.); the Department of Pathology, University of Utah, Salt Lake City (R.R.M.); Children's Hospital of Philadelphia, Philadelphia (P.C.A.); and the National Cancer Institute, Center for Global Health, Rockville, MD (T.G.G.)
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13
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Luetkens T, Radhakrishnan SV, Scherer SD, Davis P, Vander Mause ER, Olson ML, Yousef S, Panse J, Abdiche Y, Li KD, Miles RR, Matsui W, Welm AL, Atanackovic D. YIA20-003: CD229 CAR T Cells Eliminate Multiple Myeloma and Tumor Propagating Cells but Show Limited Targeting of Normal T Cells. J Natl Compr Canc Netw 2020. [DOI: 10.6004/jnccn.2019.7458] [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: 11/17/2022]
Affiliation(s)
- Tim Luetkens
- aHuntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | | | | | - Patricia Davis
- bUniversity of Utah and ARUP Laboratories, Salt Lake City, UT
| | | | - Michael L. Olson
- aHuntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Sara Yousef
- aHuntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Jens Panse
- cUniversity Hospital RWTH Aachen, Aachen, Germany
| | | | - K. David Li
- bUniversity of Utah and ARUP Laboratories, Salt Lake City, UT
| | - Rodney R. Miles
- bUniversity of Utah and ARUP Laboratories, Salt Lake City, UT
| | | | - Alana L. Welm
- aHuntsman Cancer Institute, University of Utah, Salt Lake City, UT
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14
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Panea RI, Love CL, Shingleton JR, Reddy A, Bailey JA, Moormann AM, Otieno JA, Ong'echa JM, Oduor CI, Schroeder KMS, Masalu N, Chao NJ, Agajanian M, Major MB, Fedoriw Y, Richards KL, Rymkiewicz G, Miles RR, Alobeid B, Bhagat G, Flowers CR, Ondrejka SL, Hsi ED, Choi WWL, Au-Yeung RKH, Hartmann W, Lenz G, Meyerson H, Lin YY, Zhuang Y, Luftig MA, Waldrop A, Dave T, Thakkar D, Sahay H, Li G, Palus BC, Seshadri V, Kim SY, Gascoyne RD, Levy S, Mukhopadyay M, Dunson DB, Dave SS. The whole-genome landscape of Burkitt lymphoma subtypes. Blood 2019; 134:1598-1607. [PMID: 31558468 PMCID: PMC6871305 DOI: 10.1182/blood.2019001880] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/28/2019] [Indexed: 01/10/2023] Open
Abstract
Burkitt lymphoma (BL) is an aggressive, MYC-driven lymphoma comprising 3 distinct clinical subtypes: sporadic BLs that occur worldwide, endemic BLs that occur predominantly in sub-Saharan Africa, and immunodeficiency-associated BLs that occur primarily in the setting of HIV. In this study, we comprehensively delineated the genomic basis of BL through whole-genome sequencing (WGS) of 101 tumors representing all 3 subtypes of BL to identify 72 driver genes. These data were additionally informed by CRISPR screens in BL cell lines to functionally annotate the role of oncogenic drivers. Nearly every driver gene was found to have both coding and non-coding mutations, highlighting the importance of WGS for identifying driver events. Our data implicate coding and non-coding mutations in IGLL5, BACH2, SIN3A, and DNMT1. Epstein-Barr virus (EBV) infection was associated with higher mutation load, with type 1 EBV showing a higher mutational burden than type 2 EBV. Although sporadic and immunodeficiency-associated BLs had similar genetic profiles, endemic BLs manifested more frequent mutations in BCL7A and BCL6 and fewer genetic alterations in DNMT1, SNTB2, and CTCF. Silencing mutations in ID3 were a common feature of all 3 subtypes of BL. In vitro, mass spectrometry-based proteomics demonstrated that the ID3 protein binds primarily to TCF3 and TCF4. In vivo knockout of ID3 potentiated the effects of MYC, leading to rapid tumorigenesis and tumor phenotypes consistent with those observed in the human disease.
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Affiliation(s)
- Razvan I Panea
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Cassandra L Love
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Jennifer R Shingleton
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Anupama Reddy
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI
| | - Ann M Moormann
- Department of Medicine, University of Massachusetts, Worcester, MA
| | - Juliana A Otieno
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Ministry of Health, Kisumu, Kenya
| | | | - Cliff I Oduor
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Kristin M S Schroeder
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
- Bugando Medical Center, Mwanza, Tanzania
| | | | - Nelson J Chao
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Megan Agajanian
- Department of Cell Biology and Physiology, Washington University in St. Louis, St. Louis, MO
| | - Michael B Major
- Department of Cell Biology and Physiology, Washington University in St. Louis, St. Louis, MO
| | | | | | - Grzegorz Rymkiewicz
- Poland Flow Cytometry Laboratory, Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, UT
| | - Bachir Alobeid
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | - Govind Bhagat
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | | | - Sarah L Ondrejka
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - Eric D Hsi
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - William W L Choi
- Department of Pathology, Hong Kong Sanatorium and Hospital, Hong Kong, China
| | - Rex K H Au-Yeung
- The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
- Institute of Human Genetics, Christian-Albrechts-University, Kiel, Germany
| | - Wolfgang Hartmann
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Georg Lenz
- Medical Department A, Hematology, Oncology and Pneumology, University of Münster, Münster, Germany
| | - Howard Meyerson
- Department of Pathology, Case Western Reserve University, Cleveland, OH
| | | | | | - Micah A Luftig
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - Alexander Waldrop
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Tushar Dave
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Devang Thakkar
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Harshit Sahay
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Guojie Li
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Brooke C Palus
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
| | - Vidya Seshadri
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - So Young Kim
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC
| | - Randy D Gascoyne
- Department of Pathology and Experimental Therapeutics, BC Cancer Agency and BC Cancer Research Centre, Vancouver, BC, Canada
| | - Shawn Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL; and
| | | | - David B Dunson
- Department of Statistical Science, Duke University, Durham, NC
| | - Sandeep S Dave
- Center for Genomic and Computational Biology and Department of Medicine, Duke University, Durham, NC
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15
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Clark JJ, Hawkes JE, Florell SR, Miles RR, Wada DA. Cutaneous T-Cell Acute Lymphoblastic Leukemia and the Expression Pattern of Terminal Deoxynucleotidyl Transferase Immunostaining in Mycosis Fungoides and Spongiotic Dermatitis. Dermatopathology (Basel) 2019; 6:182-188. [PMID: 31616658 PMCID: PMC6787418 DOI: 10.1159/000501581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/10/2019] [Accepted: 06/17/2019] [Indexed: 01/04/2023] Open
Abstract
Background/Aims T-cell acute lymphoblastic leukemia (T-ALL) is an uncommon, aggressive malignancy that rarely presents in the skin and is generally not considered as part of the differential diagnosis by dermatologists and dermatopathologists. We describe an unusual case of T-ALL presenting with folliculocentric, erythematous papules on the face, histologically resembling mycosis fungoides (MF). Immunostaining for terminal deoxynucleotidyl transferase (TdT) was positive in tumor cells, supporting the diagnosis of cutaneous involvement by T-ALL. TdT is a nuclear enzyme expressed by immature lymphoid malignancies, but the expression pattern of this marker is not well characterized in the skin. We aimed to assess TdT staining in skin biopsies with similar-appearing lymphocytic infiltrates. Methods We evaluated the immunostaining profile of TdT in a cohort of 23 patients, including 13 cases of MF and 10 cases of spongiotic dermatitis. Results The lymphocytes in the MF and spongiotic dermatitis cases lacked nuclear staining for TdT. Nonspecific, granular, cytoplasmic staining was observed in a small number of background cells. Conclusions TdT may assist dermatopathologists in discriminating malignant infiltrates of T-ALL from other conditions.
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Affiliation(s)
- Joshua J Clark
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | - Jason E Hawkes
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA.,Laboratory for Investigative Dermatology, Rockefeller University, New York, New York, USA
| | - Scott R Florell
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | - Rodney R Miles
- Department of Pathology and ARUP Laboratories, Salt Lake City, Utah, USA.,Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - David A Wada
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA.,Huntsman Cancer Institute, Salt Lake City, Utah, USA
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16
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Chisholm KM, Mohlman J, Liew M, Termuhlen A, Cairo MS, Gross TG, Perkins SL, Miles RR. IRF4 translocation status in pediatric follicular and diffuse large B-cell lymphoma patients enrolled in Children's Oncology Group trials. Pediatr Blood Cancer 2019; 66:e27770. [PMID: 31012208 PMCID: PMC6941672 DOI: 10.1002/pbc.27770] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/22/2022]
Abstract
Large B-cell lymphoma with IRF4 rearrangement is a provisional entity in the 2017 World Health Organization classification. In order to characterize these lymphomas in children from the United States, IRF4 FISH and immunohistochemical stains were performed on 32 follicular lymphoma and diffuse large B-cell lymphoma (DLBCL) from Children's Oncology Group studies. Two DLBCLs (6%) had IRF4 rearrangements, one involving the ileocecal valve and another involving the tonsil and cerebrospinal fluid. Both cases had strong, diffuse IRF4/MUM1 immunohistochemical staining, which may be a pathologic clue to the diagnosis. Reclassification of these cases may have prognostic and therapeutic implications.
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Affiliation(s)
- Karen M. Chisholm
- Department of Laboratories, Seattle Children’s Hospital, Seattle, WA, USA,Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Jeffrey Mohlman
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Michael Liew
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - Amanda Termuhlen
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mitchell S. Cairo
- Department of Pediatrics, Medicine, Pathology, Microbiology and Immunology and Cell Biology and Anatomy, New York Medical College, Valhalla, NY, USA
| | | | - Sherrie L. Perkins
- Department of Pathology, University of Utah, Salt Lake City, UT, USA,ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - Rodney R. Miles
- Department of Pathology, University of Utah, Salt Lake City, UT, USA,ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
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17
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Patel AB, Miles RR, Deininger MW. Lysozyme nephropathy in chronic myelomonocytic leukemia. Clin Case Rep 2019; 7:1263-1264. [PMID: 31183108 PMCID: PMC6553339 DOI: 10.1002/ccr3.2188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 11/07/2022] Open
Abstract
Lysozyme nephropathy is a frequently unrecognized cause of renal disease in chronic myelomonocytic leukemia and may serve as a novel indication for treatment in this patient population. We demonstrate that in newly diagnosed CMML patients, plasma lysozyme levels are positively correlated with both absolute monocyte count and serum creatinine.
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Affiliation(s)
- Ami B. Patel
- Division of Hematology and Hematologic MalignanciesUniversity of UtahSalt Lake CityUtah
| | - Rodney R. Miles
- Department of Pathology, ARUP LaboratoriesUniversity of UtahSalt Lake CityUtah
| | - Michael W. Deininger
- Division of Hematology and Hematologic MalignanciesUniversity of UtahSalt Lake CityUtah
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18
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Abstract
In the modern era, clinicians and pathologists increasingly make challenging diagnoses in patients with suspected lymphoma using minimal amounts of diagnostic material. The increase in utilization of minimally invasive procedures, such as fine needle aspiration or needle core biopsies, lead to challenges in our ability to make accurate histopathological assessments of disease, including the integration of new diagnostic and prognostic testing, with smaller amounts of material. The trend towards minimally invasive diagnostics is also often in conflicting interest with researchers seeking to study tissue specimens to better understand the biology and genetics of these diseases to move the field forward. Thankfully, there are emerging fields which seek to extract large amounts of diagnostic and prognostic data out of material that is circulating in the blood of patients with lymphoma. Here we will review recent exciting data regarding the use of circulating tumour cells, circulating tumour DNA, and the detection and utility of circulating exosomes and how it can assist in diagnosis, prognosis and therapeutic monitoring. These advances hold the promise to enable continued safe patient care while also advancing discovery, translational and clinical research.
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Affiliation(s)
- Paul J Galardy
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA.,Division of Pediatric Haematology-Oncology, Mayo Clinic, Rochester, MN, USA
| | - Tibor Bedekovics
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth Macintyre
- Diagnostic Haematology, Necker-Enfants Malades Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades (INEM), Institut national de recherche médicale (INSERM) U1151, Paris, France
| | - Rodney R Miles
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
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19
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Pearson ADJ, Scobie N, Norga K, Ligas F, Chiodin D, Burke A, Minard-Colin V, Adamson P, Marshall LV, Balakumaran A, Benettaib B, Bhargava P, Bollard CM, Bolotin E, Bomken S, Buechner J, Burkhardt B, Caron H, Copland C, Demolis P, Egorov A, Farhan M, Zugmaier G, Gross T, Horton-Taylor D, Klapper W, Lesa G, Marcus R, Miles RR, Nottage K, Pacaud L, Ricafort R, Schrappe M, Sterba J, Vezan R, Weiner S, Kim SY, Reaman G, Vassal G. ACCELERATE and European Medicine Agency Paediatric Strategy Forum for medicinal product development for mature B-cell malignancies in children. Eur J Cancer 2019; 110:74-85. [PMID: 30772656 DOI: 10.1016/j.ejca.2019.01.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 01/02/2019] [Accepted: 01/18/2019] [Indexed: 11/17/2022]
Abstract
Paediatric Strategy Forums have been created by the multistakeholder organisation, ACCELERATE, and the European Medicines Agency to facilitate dialogue between all relevant stakeholders and suggest strategies in critical areas of paediatric oncology drug development. As there are many medicines being developed for B-cell malignancies in adults but comparatively few in children with these malignancies, a Paediatric Strategy Forum was held to discuss the best approach to develop these products for children. It was concluded that as current frontline therapy is highly successful, despite associated acute toxicity, de-escalation of this or substitution of presently used drugs with new medicines can only be undertaken when there is an effective salvage regimen, which is currently not available. Therefore priority should be given to developing treatment for patients with relapsed and refractory mature B-cell lymphomas. The consensus of the clinicians attending the meeting was that CAR T-cells, T-cell engagers and antibody drug conjugates (excluding those with a vinca alkaloid-like drug) presently have the greatest probability of providing benefit in relapse in view of their mechanism of action. However, as producing autologous CAR T-cells currently takes at least 4 weeks, they are not products which could be quickly employed initially at relapse in rapidly progressing mature B-cell malignancies but only for the consolidation phase of the treatment. Global, industry-supported, academic-sponsored studies testing compounds from different pharmaceutical companies simultaneously should be considered in rare populations, and it was proposed that an international working group be formed to develop an overarching clinical trials strategy for these disease groups. Future Forums are planned for other relevant paediatric oncologic diseases with a high unmet medical need and relevant molecular targets.
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Affiliation(s)
| | | | | | - Franca Ligas
- Paediatric Medicines Office, Product Development Scientific Support Department, European Medicines Agency, London, UK
| | | | - Amos Burke
- Department of Paediatric Haematology and Oncology, Addenbrooke's Hospital Cambridge, UK
| | | | | | - Lynley V Marshall
- Paediatric Drug Development, Children and Young People's Unit, The Royal Marsden NHS Foundation Trust, London, UK; Divisions of Clinical Studies and Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | | | | | | | - Catherine M Bollard
- Centre for Cancer and Immunology Research, Children's National Health System, The George Washington University, Washington DC, USA
| | | | - Simon Bomken
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, UK
| | - Jochen Buechner
- Department of Paediatric Hematology and Oncology, Oslo University Hospital, Norway
| | - Birgit Burkhardt
- Pediatric Hematology, Oncology and BMT, University Hospital Münster, Germany
| | | | | | | | - Anton Egorov
- Centre for Therapeutic Innovation in Oncology, Servier, France
| | - Mahdi Farhan
- Debiopharm International SA, Lausanne, Switzerland
| | | | | | | | | | - Giovanni Lesa
- Paediatric Medicines Office, Product Development Scientific Support Department, European Medicines Agency, London, UK
| | | | - Rodney R Miles
- University of Utah, Department of Pathology, Salt Lake City, UT, USA
| | | | | | - Rosanna Ricafort
- Oncology Clinical Development, Bristol-Myers Squibb Pharma EEIG, NJ, USA
| | | | - Jaroslav Sterba
- Pediatric Oncology Department, University Hospital Brno, School of Medicine Masaryk University, Brno, Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, ICRC Brno, St. Anna University Hospital Brno, Czech Republic
| | | | - Susan Weiner
- Children's Cause for Cancer Advocacy, Washington DC, USA
| | | | - Gregory Reaman
- Office of Hematology and Oncology Products, U.S. Food and Drug Administration, MD, USA
| | - Gilles Vassal
- Department of Clinical Research, Gustave Roussy, Paris-Sud University, Paris, France
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20
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Yan D, Pomicter AD, Tantravahi S, Mason CC, Senina AV, Ahmann JM, Wang Q, Than H, Patel AB, Heaton WL, Eiring AM, Clair PM, Gantz KC, Redwine HM, Swierczek SI, Halverson BJ, Baloglu E, Shacham S, Khorashad JS, Kelley TW, Salama ME, Miles RR, Boucher KM, Prchal JT, O'Hare T, Deininger MW. Nuclear-Cytoplasmic Transport Is a Therapeutic Target in Myelofibrosis. Clin Cancer Res 2018; 25:2323-2335. [PMID: 30563936 DOI: 10.1158/1078-0432.ccr-18-0959] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/31/2018] [Accepted: 12/14/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE Myelofibrosis is a hematopoietic stem cell neoplasm characterized by bone marrow reticulin fibrosis, extramedullary hematopoiesis, and frequent transformation to acute myeloid leukemia. Constitutive activation of JAK/STAT signaling through mutations in JAK2, CALR, or MPL is central to myelofibrosis pathogenesis. JAK inhibitors such as ruxolitinib reduce symptoms and improve quality of life, but are not curative and do not prevent leukemic transformation, defining a need to identify better therapeutic targets in myelofibrosis. EXPERIMENTAL DESIGN A short hairpin RNA library screening was performed on JAK2V617F-mutant HEL cells. Nuclear-cytoplasmic transport (NCT) genes including RAN and RANBP2 were among top candidates. JAK2V617F-mutant cell lines, human primary myelofibrosis CD34+ cells, and a retroviral JAK2V617F-driven myeloproliferative neoplasms mouse model were used to determine the effects of inhibiting NCT with selective inhibitors of nuclear export compounds KPT-330 (selinexor) or KPT-8602 (eltanexor). RESULTS JAK2V617F-mutant HEL, SET-2, and HEL cells resistant to JAK inhibition are exquisitely sensitive to RAN knockdown or pharmacologic inhibition by KPT-330 or KPT-8602. Inhibition of NCT selectively decreased viable cells and colony formation by myelofibrosis compared with cord blood CD34+ cells and enhanced ruxolitinib-mediated growth inhibition and apoptosis, both in newly diagnosed and ruxolitinib-exposed myelofibrosis cells. Inhibition of NCT in myelofibrosis CD34+ cells led to nuclear accumulation of p53. KPT-330 in combination with ruxolitinib-normalized white blood cells, hematocrit, spleen size, and architecture, and selectively reduced JAK2V617F-mutant cells in vivo. CONCLUSIONS Our data implicate NCT as a potential therapeutic target in myelofibrosis and provide a rationale for clinical evaluation in ruxolitinib-exposed patients with myelofibrosis.
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Affiliation(s)
- Dongqing Yan
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | | | - Srinivas Tantravahi
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah.,Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
| | - Clinton C Mason
- Department of Pediatrics, The University of Utah, Salt Lake City, Utah
| | - Anna V Senina
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Jonathan M Ahmann
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Qiang Wang
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah.,Department of Hematology, Nanfang Hospital, Southern Medical University
| | - Hein Than
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah.,Department of Haematology, Singapore General Hospital, Singapore
| | - Ami B Patel
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah.,Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
| | - William L Heaton
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Anna M Eiring
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Phillip M Clair
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Kevin C Gantz
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Hannah M Redwine
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Sabina I Swierczek
- Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
| | | | | | | | - Jamshid S Khorashad
- Department of Cellular Pathology, Hammersmith Hospital, Imperial College Health Care NHS Trust, London, United Kingdom
| | - Todd W Kelley
- Department of Pathology, The University of Utah, Salt Lake City, Utah
| | - Mohamed E Salama
- Department of Pathology, The University of Utah, Salt Lake City, Utah
| | - Rodney R Miles
- Department of Pathology, The University of Utah, Salt Lake City, Utah
| | - Kenneth M Boucher
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah
| | - Josef T Prchal
- Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
| | - Thomas O'Hare
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah.,Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
| | - Michael W Deininger
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, Utah. .,Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, Utah
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21
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Chu Y, Lee S, Shah T, Yin C, Barth M, Miles RR, Ayello J, Morris E, Harrison L, Van de Ven C, Galardy P, Goldman SC, Lim MS, Hermiston M, McAllister-Lucas LM, Giulino-Roth L, Perkins SL, Cairo MS. Ibrutinib significantly inhibited Bruton's tyrosine kinase (BTK) phosphorylation, in-vitro proliferation and enhanced overall survival in a preclinical Burkitt lymphoma (BL) model. Oncoimmunology 2018; 8:e1512455. [PMID: 30546948 DOI: 10.1080/2162402x.2018.1512455] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 04/25/2018] [Revised: 07/27/2018] [Accepted: 08/12/2018] [Indexed: 12/15/2022] Open
Abstract
Pediatric and adult patients with recurrent/refractory Burkitt lymphoma (BL) continue to have poor outcomes, emphasizing the need for newer therapeutic agents. Bruton's tyrosine kinase (BTK) is activated following B-cell receptor stimulation and in part regulates normal B-cell development. Ibrutinib, a selective and irreversible BTK inhibitor, has been efficacious in chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), Waldenström's macroglobulinemia, and marginal zone lymphoma. In this study, we investigated the efficacy of ibrutinib alone and in selective adjuvant combinations against BL in-vitro and in a human BL xenografted immune-deficient NOD.Cg-PrkdcscidIl2rgtm1Wjl/SzJ (NSG) mouse model. Our data demonstrated that phospho-BTK level was significantly reduced in BL cells treated with ibrutinib (p < 0.001). Moreover, we observed a significant decrease in cell proliferation as well as significant decrease in IC50 of ibrutinib in combination with dexamethasone, rituximab, obinutuzumab, carfilzomib, and doxorubicin (p < 0.001). In-vivo studies demonstrated ibrutinib treated mice had a significantly prolonged survival with median survival of mice following ibrutinib treatment (32 days) (24 days) (p < 0.02). In conclusion, our findings demonstrate the significant in-vitro and preclinical in-vivo effects of ibrutinib in BL. Based on our preclinical results in this investigation, there is an on-going clinical trial comparing overall survival in children and adolescents with relapsed/refractory BL treated with chemoimmunotherapy with or without ibrutinib (NCT02703272).
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Affiliation(s)
- Yaya Chu
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Sanghoon Lee
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA.,Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA
| | - Tishi Shah
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Changhong Yin
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Matthew Barth
- Department of Pediatrics, University of Buffalo, Buffalo, NY, USA
| | - Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Janet Ayello
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Erin Morris
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - Lauren Harrison
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | - Paul Galardy
- Department of Pediatrics, Mayo Clinic, Rochester, MN, USA
| | - Stanton C Goldman
- Division of Pediatric Hematology/Oncology, Medical City Children's Hospital, Dallas, TX, USA
| | - Megan S Lim
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, PA, USA
| | - Michelle Hermiston
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | | | - Lisa Giulino-Roth
- Departments of Pediatrics and Pathology and Laboratory Medicine, Weill Cornell Medical College, NY, NY, USA
| | - Sherrie L Perkins
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA.,Department of Cell Biology & Anatomy, New York Medical College, Valhalla, NY, USA.,Department of Microbiology & Immunology, New York Medical College, Valhalla, NY, USA.,Department of Medicine, New York Medical College, Valhalla, NY, USA.,Department of Pathology, New York Medical College, Valhalla, NY, USA
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22
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Merzianu M, Groman A, Hutson A, Cotta C, Brynes RK, Orazi A, Reddy V, Teruya-Feldstein J, Amre R, Balasubramanian M, Brandao G, Cherian S, Courville E, Czuchlewski D, Fan G, Grier D, Hoehn D, Inamdar KV, Juskevicius R, Kaur P, Lazarchick J, Lewis MR, Miles RR, Myers JB, Nasr MR, Qureishi HN, Olteanu H, Robu VG, Salaru G, Vajpayee N, Vos J, Zhang L, Zhang S, Aye L, Brega E, Coad JE, Grantham J, Ivelja S, McKenna R, Sultan K, Wilding G, Hutchison R, Peterson L, Cheney RT. Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study. Am J Clin Pathol 2018; 150:393-405. [PMID: 30052721 PMCID: PMC6166687 DOI: 10.1093/ajcp/aqy066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To assess bone marrow (BM) sampling in academic medical centers. METHODS Data from 6,374 BM samples obtained in 32 centers in 2001 and 2011, including core length (CL), were analyzed. RESULTS BM included a biopsy (BMB; 93%) specimen, aspirate (BMA; 92%) specimen, or both (83%). The median (SD) CL was 12 (8.5) mm, and evaluable marrow was 9 (7.6) mm. Tissue contraction due to processing was 15%. BMB specimens were longer in adults younger than 60 years, men, and bilateral, staging, and baseline samples. Only 4% of BMB and 2% of BMB/BMA samples were deemed inadequate for diagnosis. BM for plasma cell dyscrasias, nonphysician operators, and ancillary studies usage increased, while bilateral sampling decreased over the decade. BM-related quality assurance programs are infrequent. CONCLUSIONS CL is shorter than recommended and varies with patient age and sex, clinical circumstances, and center experience. While pathologists render diagnoses on most cases irrespective of CL, BMB yield improvement is desirable.
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Affiliation(s)
- Mihai Merzianu
- Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Adrienne Groman
- Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Alan Hutson
- Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Claudiu Cotta
- Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | | | - Attilio Orazi
- Pathology, Weill Cornell Medical College, New York, NY
| | | | | | - Ramila Amre
- Pathology, McGill University Health Centre , Royal Victoria Hospital, Montreal, Canada
| | | | - Guilherme Brandao
- Pathology, McGill University Jewish General Hospital, Montreal, Canada
| | | | | | | | - Guang Fan
- Pathology, Oregon Health and Science University, Portland
| | - David Grier
- Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Daniela Hoehn
- Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | | | - Ridas Juskevicius
- Pathology, East Carolina University Brody School of Medicine, Greenville, NC
| | - Prabhjot Kaur
- Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - John Lazarchick
- Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston
| | - Michael R Lewis
- Pathology and Laboratory Medicine, University of Vermont, Burlington
| | | | - Jerome B Myers
- Pathology, Penrose Saint Francis Health Services, Colorado Springs, CO
| | | | - Hina N Qureishi
- Pathology and Microbiology, University of Nebraska Medical Center, Omaha
| | | | | | - Gratian Salaru
- Clinical Pathology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Neerja Vajpayee
- Pathology, State University of New York Upstate Medical University, Syracuse
| | - Jeffrey Vos
- Pathology, West Virginia University, Morgantown
| | - Ling Zhang
- Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Shanxiang Zhang
- Pathology and Laboratory Medicine, Indiana University, Indianapolis
| | - Le Aye
- Pathology, Keck School of Medicine of USC, Los Angeles
| | - Elisa Brega
- Pathology, McGill University Jewish General Hospital, Montreal, Canada
| | | | | | - Sinisa Ivelja
- Pathology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Robert McKenna
- Laboratory Medicine and Pathology, University of Minnesota, Minneapolis
| | | | - Gregory Wilding
- Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Robert Hutchison
- Pathology, State University of New York Upstate Medical University, Syracuse
| | | | - Richard T Cheney
- Pathology and Anatomical Sciences, University at Buffalo–The State University of New York
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23
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Borga C, Park G, Foster C, Burroughs-Garcia J, Marchesin M, Shah R, Hasan A, Ahmed ST, Bresolin S, Batchelor L, Scordino T, Miles RR, Te Kronnie G, Regens JL, Frazer JK. Simultaneous B and T cell acute lymphoblastic leukemias in zebrafish driven by transgenic MYC: implications for oncogenesis and lymphopoiesis. Leukemia 2018; 33:333-347. [PMID: 30111845 PMCID: PMC6365377 DOI: 10.1038/s41375-018-0226-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 03/13/2018] [Revised: 05/30/2018] [Accepted: 07/04/2018] [Indexed: 01/17/2023]
Abstract
Precursor-B cell acute lymphoblastic leukemia (pre-B ALL) is the most common pediatric cancer, but there are no useful zebrafish pre-B ALL models. We describe the first highly- penetrant zebrafish pre-B ALL, driven by human MYC. Leukemias express B lymphoblast-specific genes and are distinct from T cell ALL (T-ALL)—which these fish also develop. Zebrafish pre-B ALL shares in vivo features and expression profiles with human pre-B ALL, and these profiles differ from zebrafish T-ALL or normal B and T cells. These animals also exhibit aberrant lymphocyte development. As the only robust zebrafish pre-B ALL model and only example where T-ALL also develops, this model can reveal differences between MYC-driven pre-B vs. T-ALL and be exploited to discover novel pre-B ALL therapies.
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Affiliation(s)
- Chiara Borga
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Gilseung Park
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Clay Foster
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Jessica Burroughs-Garcia
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Matteo Marchesin
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Rikin Shah
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Ameera Hasan
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Syed T Ahmed
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Silvia Bresolin
- Department of Women's and Children's Health, University of Padua, Padua, 35128, Italy
| | - Lance Batchelor
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Teresa Scordino
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Rodney R Miles
- Department of Pathology, University of Utah and ARUP Institute for Clinical & Experimental Pathology, Salt Lake City, UT, 84108, USA
| | - Geertruy Te Kronnie
- Department of Women's and Children's Health, University of Padua, Padua, 35128, Italy
| | - James L Regens
- Center for Intelligence and National Security, University of Oklahoma, Norman, OK, 73019, USA
| | - J Kimble Frazer
- Section of Pediatric Hematology-Oncology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
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24
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Zabriskie MS, Antelope O, Verma AR, Draper LR, Eide CA, Pomicter AD, Tran TH, Druker BJ, Tyner JW, Miles RR, Graham JM, Hwang JY, Varley KE, Toydemir RM, Deininger MW, Raetz EA, O'Hare T. A novel AGGF1-PDGFRb fusion in pediatric T-cell acute lymphoblastic leukemia. Haematologica 2017; 103:e87-e91. [PMID: 29284681 DOI: 10.3324/haematol.2017.165282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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] Open
Affiliation(s)
| | - Orlando Antelope
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anupam R Verma
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Lauren R Draper
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Christopher A Eide
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.,Howard Hughes Medical Institute, Portland, OR, USA
| | | | - Thai Hoa Tran
- Helen Diller Family Cancer Research Center, Benioff Children's Hospital, San Francisco, CA, USA
| | - Brian J Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.,Howard Hughes Medical Institute, Portland, OR, USA
| | - Jeffrey W Tyner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Rodney R Miles
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - James M Graham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jae-Yeon Hwang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Katherine E Varley
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Reha M Toydemir
- Department of Pathology, University of Utah, Salt Lake City, UT, USA.,Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, UT, USA
| | - Michael W Deininger
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth A Raetz
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA .,Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Thomas O'Hare
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA .,Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
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25
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Modzelewska K, Boer EF, Mosbruger TL, Picard D, Anderson D, Miles RR, Kroll M, Oslund W, Pysher TJ, Schiffman JD, Jensen R, Jette CA, Huang A, Stewart RA. MEK Inhibitors Reverse Growth of Embryonal Brain Tumors Derived from Oligoneural Precursor Cells. Cell Rep 2017; 17:1255-1264. [PMID: 27783941 DOI: 10.1016/j.celrep.2016.09.081] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 04/25/2016] [Revised: 08/04/2016] [Accepted: 09/23/2016] [Indexed: 12/18/2022] Open
Abstract
Malignant brain tumors are the leading cause of cancer-related deaths in children. Primitive neuroectodermal tumors of the CNS (CNS-PNETs) are particularly aggressive embryonal tumors of unknown cellular origin. Recent genomic studies have classified CNS-PNETs into molecularly distinct subgroups that promise to improve diagnosis and treatment; however, the lack of cell- or animal-based models for these subgroups prevents testing of rationally designed therapies. Here, we show that a subset of CNS-PNETs co-express oligoneural precursor cell (OPC) markers OLIG2 and SOX10 with coincident activation of the RAS/MAPK (mitogen-activated protein kinase) pathway. Modeling NRAS activation in embryonic OPCs generated malignant brain tumors in zebrafish that closely mimic the human oligoneural/NB-FOXR2 CNS-PNET subgroup by histology and comparative oncogenomics. The zebrafish CNS-PNET model was used to show that MEK inhibitors selectively eliminate Olig2+/Sox10+ CNS-PNET tumors in vivo without impacting normal brain development. Thus, MEK inhibitors represent a promising rationally designed therapy for children afflicted with oligoneural/NB-FOXR2 CNS-PNETs.
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Affiliation(s)
- Katarzyna Modzelewska
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Elena F Boer
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Timothy L Mosbruger
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Daniel Picard
- Division of Hematology-Oncology, Arthur and Sonia Labatt Brain Tumour Research Centre, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M4N1X8, Canada
| | - Daniela Anderson
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Rodney R Miles
- Department of Pathology and ARUP Laboratories, University of Utah, 500 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Mitchell Kroll
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - William Oslund
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Theodore J Pysher
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; Primary Children's Hospital/Intermountain Healthcare, Salt Lake City, UT 84113, USA
| | - Joshua D Schiffman
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA; Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Randy Jensen
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Cicely A Jette
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA
| | - Annie Huang
- Division of Hematology-Oncology, Arthur and Sonia Labatt Brain Tumour Research Centre, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M4N1X8, Canada
| | - Rodney A Stewart
- Department of Oncological Sciences and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT 84112, USA.
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26
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Meyer JA, Zhou D, Mason CC, Downie JM, Rodic V, Abromowitch M, Wistinghausen B, Termuhlen AM, Angiolillo AL, Perkins SL, Lones MA, Barnette P, Schiffman JD, Miles RR. Genomic characterization of pediatric B-lymphoblastic lymphoma and B-lymphoblastic leukemia using formalin-fixed tissues. Pediatr Blood Cancer 2017; 64. [PMID: 27957801 DOI: 10.1002/pbc.26363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 08/19/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Recurrent genomic changes in B-lymphoblastic leukemia (B-ALL) identified by genome-wide single-nucleotide polymorphism (SNP) microarray analysis provide important prognostic information, but gene copy number analysis of its rare lymphoma counterpart, B-lymphoblastic lymphoma (B-LBL), is limited by the low incidence and lack of fresh tissue for genomic testing. PROCEDURE We used molecular inversion probe (MIP) technology to analyze and compare copy number alterations (CNAs) in archival formalin-fixed paraffin-embedded pediatric B-LBL (n = 23) and B-ALL (n = 55). RESULTS Similar to B-ALL, CDKN2A/B deletions were the most common alteration identified in 6/23 (26%) B-LBL cases. Eleven of 23 (48%) B-LBL patients were hyperdiploid, but none showed triple trisomies (chromosomes 4, 10, and 17) characteristic of B-ALL. IKZF1 and PAX5 deletions were observed in 13 and 17% of B-LBL, respectively, which was similar to the reported frequency in B-ALL. Immunoglobulin light chain lambda (IGL) locus deletions consistent with normal light chain rearrangement were observed in 5/23 (22%) B-LBL cases, compared with only 1% in B-ALL samples. None of the B-LBL cases showed abnormal, isolated VPREB1 deletion adjacent to IGL locus, which we identified in 25% of B-ALL. CONCLUSIONS Our study demonstrates that the copy number profile of B-LBL is distinct from B-ALL, suggesting possible differences in pathogenesis between these closely related diseases.
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Affiliation(s)
- Julia A Meyer
- Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Delu Zhou
- Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Clinton C Mason
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Jonathan M Downie
- Department of Human Genetics, University of Utah, Salt Lake City, Utah
| | - Vladimir Rodic
- Department of Pathology, University of Utah, Salt Lake City, Utah
| | - Minnie Abromowitch
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, Nebraska
| | - Birte Wistinghausen
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amanda M Termuhlen
- Department of Pediatrics, Keck School of Medicine at the University of Southern California, Children's Hospital Los Angeles, Los Angeles, California
| | - Anne L Angiolillo
- Division of Oncology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, District of Columbia
| | - Sherrie L Perkins
- Department of Pathology, University of Utah, Salt Lake City, Utah
- ARUP Institute for Experimental Pathology, Salt Lake City, Utah
| | - Mark A Lones
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Phillip Barnette
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Joshua D Schiffman
- Department of Oncological Sciences, University of Utah, Salt Lake City, Utah
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Rodney R Miles
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Pathology, University of Utah, Salt Lake City, Utah
- ARUP Institute for Experimental Pathology, Salt Lake City, Utah
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27
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Meyer JA, Mason CC, Maese L, Pei D, Cheng C, Pui CH, Greaves M, Aplenc R, Mulligan CG, Raetz E, Miles RR, Rabin KR, Schiffman JD. Abstract 4884: Focal 22q11.22 deletions combined with IKZF1 alterations are associated with worse clinical outcome in acute lymphoblastic leukemia. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4884] [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: 11/16/2022]
Abstract
Abstract
Introduction: Prognostic biomarkers in childhood acute lymphoblastic leukemia (ALL) are vital for risk-stratification and intensifying therapy for children at high risk for remission induction failure or relapse. Copy number alterations in genes such as IKZF1 and VPREB1 have been shown to correlate with poor outcome in ALL, highlighting genetic alterations as prognostic markers (NEJM 360:470, 2009, Leukemia 28(1):216-20, 2014). A second focal deletion in chromosome 22q11.22, 200 kilobases (Kb) in length, occurs more frequently and in the same IGLL region as VPREB1 and is distinct from deletions associated with physiologic IGLL rearrangement. We further investigated this novel genomic lesion, 22q11.22, and the prevalence of co-occurrence with IKZF1.
Methods: 22q11.22 deletions were characterized in a compiled childhood ALL cohort (N=832) and correlated with available clinical outcome using multiple previously published studies (Clinical outcome total N=730; Utah Cohort [N=56], TARGET P9906 cohort [N=215], St. Jude Children's Research Hospital cohort [SJCRH, N=236], Children’s Hospital of Philadelphia cohort [CHOP, N=160], and Down Syndrome cohort [DS, N=63]). Microarray data was analyzed (Utah = Molecular Inversion Probe 330K [Affymetrix]; TARGET = SNP 500K [Affymetrix]; SJCRH = SNP 500K/6.0 [Affymetrix], CHOP = 850K, 610K, and Omni Quadv1 [Illumina], DS = SNP 500K, MIP 330K [Affymetrix]) by Nexus Copy Number (BioDiscovery, Inc.).
Results: ALL patients that harbored copy number deletion 22q11.22 were present in about 30-45% of each cohort: Utah = 42.8%, TARGET = 29%, SJCRH = 40%, CHOP = 34%, DS = 46.7%. The majority of deletions, 93%, had a common recurring region just under 12 Kb in length. The 12 Kb deleted segment encodes no known genes. Patients that harbored a combined deletion in both IKZF1 and 22q11.22 (IKZF1+22q) were present in about 10-15% of each cohort: Utah = 12.5%, TARGET = 18%, SJCRH = 8.4%, CHOP = 6.3%, DS = 14.4%. IKZF1+22q conferred worse event-free survival (N=730, P=0.0062) compared to those with only IKZF1 deletions and worse overall survival (N=507, P=0.0365). Additionally, those patients with IKZF1+22q losses had a median decrease in event-free survival compared to those patients with neither deletion (normal cases): TARGET (high risk cohort) = 0.63 years, P=<0.0001, SJCRH (standard, low risk cohort) = 10 years, P=<0.0001, DS = 2.3 years, P=<0.0001.
Conclusion: We present further evidence that non-physiological deletions within the IGLL locus is associated with worse outcome in pediatric ALL and combined with IKZF1, these double deletions identify a population of patients with very poor outcomes. These combined alterations may be useful to identify patients in the future for high risk stratification and further work is now needed to understand the mechanism and biological consequence of this common loss at 22q11.22 in childhood ALL.
Citation Format: Julia A. Meyer, Clint C. Mason, Luke Maese, Deqing Pei, Cheng Cheng, Ching-Hon Pui, Mel Greaves, Richard Aplenc, Charles G. Mulligan, Elizabeth Raetz, Rodney R. Miles, Karen R. Rabin, Joshua D. Schiffman. Focal 22q11.22 deletions combined with IKZF1 alterations are associated with worse clinical outcome in acute lymphoblastic leukemia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4884. doi:10.1158/1538-7445.AM2017-4884
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Affiliation(s)
| | | | | | - Deqing Pei
- 2St. Jude Children's Research Hospital, Memphis, TN
| | - Cheng Cheng
- 2St. Jude Children's Research Hospital, Memphis, TN
| | | | - Mel Greaves
- 3Institute of Cancer Research, London, United Kingdom
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Tharkar-Promod S, Johnson DP, Bennett SE, Dennis EM, Banowsky BG, Jones SS, Shearstone JR, Quayle SN, Min C, Jarpe M, Mosbruger T, Pomicter AD, Miles RR, Chen WY, Bhalla KN, Zweidler-McKay PA, Shrieve DC, Deininger MW, Chandrasekharan MB, Bhaskara S. HDAC1,2 inhibition and doxorubicin impair Mre11-dependent DNA repair and DISC to override BCR-ABL1-driven DSB repair in Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia. Leukemia 2017; 32:49-60. [PMID: 28579617 PMCID: PMC5716937 DOI: 10.1038/leu.2017.174] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/16/2017] [Accepted: 05/15/2017] [Indexed: 12/15/2022]
Abstract
Philadelphia chromosome-positive (Ph+) B-cell precursor acute lymphoblastic leukemia (ALL) expressing BCR-ABL1 oncoprotein is a major subclass of ALL with poor prognosis. BCR-ABL1-expressing leukemic cells are highly dependent on double-strand break (DSB) repair signals for their survival. Here we report that a first-in-class HDAC1,2 selective inhibitor and doxorubicin (a hyper-CVAD chemotherapy regimen component) impair DSB repair networks in Ph+ B-cell precursor ALL cells using common as well as distinct mechanisms. The HDAC1,2 inhibitor but not doxorubicin alters nucleosomal occupancy to impact chromatin structure, as revealed by MNase-Seq. Quantitative mass spectrometry of the chromatin proteome along with functional assays showed that the HDAC1,2 inhibitor and doxorubicin either alone or in combination impair the central hub of DNA repair, the Mre11–Rad51–DNA ligase 1 axis, involved in BCR-ABL1-specific DSB repair signaling in Ph+ B-cell precursor ALL cells. HDAC1,2 inhibitor and doxorubicin interfere with DISC (DNA damage-induced transcriptional silencing in cis)) or transcriptional silencing program in cis around DSB sites via chromatin remodeler-dependent and -independent mechanisms, respectively, to further impair DSB repair. HDAC1,2 inhibitor either alone or when combined with doxorubicin decreases leukemia burden in vivo in refractory Ph+ B-cell precursor ALL patient-derived xenograft mouse models. Overall, our novel mechanistic and preclinical studies together demonstrate that HDAC1,2 selective inhibition can overcome DSB repair ‘addiction’ and provide an effective therapeutic option for Ph+ B-cell precursor ALL.
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Affiliation(s)
- S Tharkar-Promod
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - D P Johnson
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - S E Bennett
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - E M Dennis
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - B G Banowsky
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - S S Jones
- Acetylon Pharmaceuticals Inc., Boston, MA, USA.,Regenacy Pharmaceuticals Inc., Boston, MA, USA
| | | | - S N Quayle
- Acetylon Pharmaceuticals Inc., Boston, MA, USA
| | - C Min
- Acetylon Pharmaceuticals Inc., Boston, MA, USA
| | - M Jarpe
- Regenacy Pharmaceuticals Inc., Boston, MA, USA
| | - T Mosbruger
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - A D Pomicter
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - R R Miles
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - W Y Chen
- Department of Cancer Biology, City of Hope National Medical Center, Duarte, CA, USA
| | - K N Bhalla
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P A Zweidler-McKay
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - D C Shrieve
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - M W Deininger
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - M B Chandrasekharan
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - S Bhaskara
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA.,Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
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Lee S, Day NS, Miles RR, Perkins SL, Lim MS, Ayello J, van de Ven C, Harrison L, El-Mallawany NK, Goldman S, Cairo MS. Comparative genomic expression signatures of signal transduction pathways and targets in paediatric Burkitt lymphoma: a Children's Oncology Group report. Br J Haematol 2017; 177:601-611. [PMID: 28474336 DOI: 10.1111/bjh.14604] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/01/2016] [Indexed: 02/02/2023]
Abstract
Burkitt lymphoma (BL) is the most common histological subtype of non-Hodgkin lymphoma (NHL) in children and adolescents. Through the introduction of short intensive multi-agent chemoimmunotherapy, survival has improved significantly over the past 30 years. However, this successful approach is limited by significant chemotherapy-induced acute toxicity and risk of developing resistant disease, demonstrating the need to identify less toxic and targeted therapies. We analysed the comparative genomic signature and targetable signalling pathways in paediatric BL (PEBL) samples from the Children's Oncology Group study (ANHL01P1) by genomic profiling and selected genes were confirmed by quantitative real time polymerase chain reaction. These results were compared to PEBL samples from public databases and utilised the Gene Expression Omnibus (GEO) Series (GSE) 10172 and 4475 (n = 16), and 4732 (n = 15). Three hundred and seventy-six genes (approximately 25%) were similarly expressed among three PEBL sample groups. Several target genes in Toll-like receptor signalling, JAK-STAT signalling and MAPK signalling were significantly overexpressed in PEBL. In addition, several tyrosine kinases, including Bruton tyrosine kinase, protein tyrosine phosphatase and histone deacetylase inhibitor were highly expressed in PEBL. These pre-clinical results suggest that specific signal transduction pathways are overly expressed in PEBL and several pathways could serve as potential future therapeutic targets.
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Affiliation(s)
- Sanghoon Lee
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA.,Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY, USA
| | - Nancy S Day
- Department of Pediatrics, Columbia University, New York, NY, USA
| | - Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Sherrie L Perkins
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Megan S Lim
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Janet Ayello
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | - Lauren Harrison
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | | | - Mitchell S Cairo
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA.,Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY, USA.,Departments of Medicine, Pathology, Microbiology and Immunology, New York Medical College, Valhalla, NY, USA
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Zhou D, Paxton CN, Kelley TW, Afify Z, South ST, Miles RR. Two Unrelated Burkitt Lymphomas Seven Years Apart in a Patient With X-Linked Lymphoproliferative Disease Type 1 (XLP1). Am J Clin Pathol 2016; 146:248-53. [PMID: 27287777 DOI: 10.1093/ajcp/aqw036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We describe a rare case of a male child with X-linked lymphoproliferative disease type 1 (XLP1) who presented with Burkitt lymphoma (BL) when he was 6 years old, achieved a complete response to therapy, and developed a second BL after seven years. METHODS Diagnostic H&E stained slides and ancillary studies were reviewed for both lymphomas. B-cell clonality by PCR and SNP array studies were performed on both specimens. RESULTS Both lymphomas were Epstein-Barr virus (EBV) negative. Flow cytometry showed λ light chain restriction in the initial BL and κ light chain restriction in the subsequent BL. B-cell clonality testing indicated that the two lymphomas are not clonally related. SNP array analysis of the second BL showed genomic changes that were not present in the first BL. CONCLUSIONS These results confirm that these two tumors represent unrelated BLs. Pathologists and clinicians should be aware that second lymphomas in XLP1 patients may represent new neoplasms rather than late relapses.
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Affiliation(s)
- Delu Zhou
- From the Department of Pathology, University of Utah, Salt Lake City
| | | | - Todd W Kelley
- From the Department of Pathology, University of Utah, Salt Lake City ARUP Laboratories, Salt Lake City, UT
| | - Zeinab Afify
- Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City
| | - Sarah T South
- From the Department of Pathology, University of Utah, Salt Lake City ARUP Laboratories, Salt Lake City, UT
| | - Rodney R Miles
- From the Department of Pathology, University of Utah, Salt Lake City ARUP Laboratories, Salt Lake City, UT Huntsman Cancer Institute, Salt Lake City, UT.
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Liew M, Rowe L, Clement PW, Miles RR, Salama ME. Validation of break-apart and fusion MYC probes using a digital fluorescence in situ hybridization capture and imaging system. J Pathol Inform 2016; 7:20. [PMID: 27217970 PMCID: PMC4872483 DOI: 10.4103/2153-3539.181764] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 11/13/2015] [Accepted: 03/15/2016] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Detection of MYC translocations using fluorescence in situ hybridization (FISH) is important in the evaluation of lymphomas, in particular, Burkitt lymphoma and diffuse large B-cell lymphoma. Our aim was to validate a digital FISH capture and imaging system for the detection of MYC 8q24 translocations using LSI-MYC (a break-apart probe) and MYC 8;14 translocation using IGH-MYC (a fusion probe). MATERIALS AND METHODS LSI-MYC probe was evaluated using tissue sections from 35 patients. IGH-MYC probe was evaluated using tissue sections from forty patients. Sections were processed for FISH and analyzed using traditional methods. FISH slides were then analyzed using the GenASIs capture and analysis system. RESULTS Results for LSI-MYC had a high degree of correlation between traditional method of FISH analysis and digital FISH analysis. Results for IGH-MYC had a 100% concordance between traditional method of FISH analysis and digital FISH analysis. CONCLUSION Annotated whole slide images of H and E and FISH sections can be digitally aligned, so that areas of tumor within a section can be matched and evaluated with a greater degree of accuracy. Images can be archived permanently, providing a means for examining the results retrospectively. Digital FISH imaging of the MYC translocations provides a better diagnostic tool compared to traditional methods for evaluating lymphomas.
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Affiliation(s)
- Michael Liew
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT 84108, USA
| | - Leslie Rowe
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT 84108, USA
| | - Parker W Clement
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT 84108, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Rodney R Miles
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT 84108, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Mohamed E Salama
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT 84108, USA; Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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Abstract
Molecular genetic abnormalities are ubiquitous in non-Hodgkin lymphoma (NHL), but genetic changes are not yet used to define specific lymphoma subtypes. Certain recurrent molecular genetic abnormalities in NHL underlie molecular pathogenesis and/or are associated with prognosis or represent potential therapeutic targets. Most molecular genetic studies of B- and T-NHL have been performed on adult patient samples, and the relevance of many of these findings for childhood, adolescent and young adult NHL remains to be demonstrated. In this review, we focus on NHL subtypes that are most common in young patients and emphasize features actually studied in younger NHL patients. This approach highlights what is known about NHL genetics in young patients but also points to gaps that remain, which will require cooperative efforts to collect and share biological specimens for genomic and genetic analyses in order to help predict outcomes and guide therapy in the future.
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Affiliation(s)
- Rodney R Miles
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
| | - Rikin K Shah
- Jimmy Everest Section of Pediatric Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - J Kimble Frazer
- E.L. and Thelma Gaylord Chair in Pediatric Oncology, Jimmy Everest Section of Pediatric Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Patel S, Mason CC, Glenn MJ, Paxton CN, South ST, Cessna MH, Asch J, Cobain EF, Bixby DL, Smith LB, Schiffman JD, Miles RR. Abstract 1723: IKZF1/CDKN2A co-deletion predicts shorter survival in adult B-ALL. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1723] [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: 11/16/2022]
Abstract
Abstract
B lymphoblastic leukemia (B-ALL) in adults has a higher risk of relapse and lower long-term survival than pediatric B-ALL. Prognostic biomarkers are needed for better risk-stratification and therapy selection. Microarray-based genome-wide profiling studies in pediatric patients have revealed recurrent abnormalities in B-cell development and cell cycle regulation. IKZF1 alterations convey a negative prognostic impact in pediatric B-ALL, but their significance is not well characterized in adult B-ALL. CDKN2A alterations have also been associated with a poorer prognosis in adult Ph+ ALL, possibly by mediating resistance to targeted therapy. The copy number landscape of adult B-ALL has not been fully assessed, and given its inferior prognosis, may be distinct from its pediatric counterpart. We identified 70 adult B-ALL patients (median age 45 years, range 18-83) from 1998-2013 at three institutions. DNA was isolated from formalin-fixed, paraffin-embedded (FFPE) diagnostic bone marrow clots and assessed with the OncoScan FFPE Express genome-wide single nucleotide polymorphism (SNP) assay (Affymetrix). Copy number alteration (CNA) analysis was performed using Nexus Software V7 (Biodiscovery) and in-house coding. The most frequent CNAs called by the software were manually verified for probe evidence. Clinical data available on this cohort included age, gender, hematologic laboratory values at presentation, CSF involvement, receipt of allogeneic transplant, cytogenetic profile, presence of t(9;22), event-free survival (EFS), and overall survival (OS). Estimated median survival time of the entire adult B-ALL patient cohort was 29 months. Recurrent deletions in the diagnostic samples were noted at several loci, including CDKN2A (47%), IKZF1 (40%), PAX5 (24%), BTG1 (17%), and BTLA (14%). Recurrent gains were identified at the following loci: ERG (30%), ETS2 (21%), MYB (20%), UBASH3B (20%), PRKCH (19%), CDK6 (17%), and ETV6 (16%). No individual CNA heralded a significant prognostic impact in the entire cohort or in subgroup analyses stratified by presence of t(9;22) for either EFS or OS, though this could be due to our relatively smaller sample size in contrast to pediatric studies that have observed a prognostic impact at some of these loci. However, the combination of both CDK2NA and IKZF1 deletions (26%) correlated with a significantly worse overall survival than having only one or neither of these deletions (both vs CDKN2A only: p = 0.028, both vs IKZF1 only: p = 0.027, both vs neither deleted: p = 0.048). Age was the only other covariate significant in univariate analyses for OS, yet IKZF1/CDKN2A co-deletion remained significant in multivariate analysis adjusting for age. Adult B-ALL demonstrates frequent CDKN2A deletions, IKZF1 deletions, and CDKN2A/IKZF1 co-deletions. To our knowledge, the negative prognostic impact of the CDKN2A/IKZF1 co-deletion is a novel finding in adult B-ALL and requires further validation in larger cohorts.
Citation Format: Shiven Patel, Clinton C. Mason, Martha J. Glenn, Christian N. Paxton, Sara T. South, Melissa H. Cessna, Julie Asch, Erin F. Cobain, Dale L. Bixby, Lauren B. Smith, Joshua D. Schiffman, Rodney R. Miles. IKZF1/CDKN2A co-deletion predicts shorter survival in adult B-ALL. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1723. doi:10.1158/1538-7445.AM2015-1723
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Affiliation(s)
- Shiven Patel
- 1Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Clinton C. Mason
- 1Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Martha J. Glenn
- 1Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | | | - Sara T. South
- 3University of Utah Department of Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Melissa H. Cessna
- 4Department of Pathology and Intermountain BioRepository, Salt Lake City, UT
| | - Julie Asch
- 5Intermountain Blood and Marrow Transplant/Acute Leukemia Program, Salt Lake City, UT
| | - Erin F. Cobain
- 6University of Michigan Department of Hematology, Ann Arbor, MI
| | - Dale L. Bixby
- 6University of Michigan Department of Hematology, Ann Arbor, MI
| | - Lauren B. Smith
- 7University of Michigan Department of Pathology, Ann Arbor, MI
| | - Joshua D. Schiffman
- 8Huntsman Cancer Institute, University of Utah Department of Pediatrics, Salt Lake City, UT
| | - Rodney R. Miles
- 9Huntsman Cancer Institute, University of Utah Department of Pathology, ARUP Laboratories, Salt Lake City, UT
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Shi DS, Smith MCP, Campbell RA, Zimmerman PW, Franks ZB, Kraemer BF, Machlus KR, Ling J, Kamba P, Schwertz H, Rowley JW, Miles RR, Liu ZJ, Sola-Visner M, Italiano JE, Christensen H, Kahr WHA, Li DY, Weyrich AS. Proteasome function is required for platelet production. J Clin Invest 2014; 124:3757-66. [PMID: 25061876 DOI: 10.1172/jci75247] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 06/05/2014] [Indexed: 01/03/2023] Open
Abstract
The proteasome inhibiter bortezomib has been successfully used to treat patients with relapsed multiple myeloma; however, many of these patients become thrombocytopenic, and it is not clear how the proteasome influences platelet production. Here we determined that pharmacologic inhibition of proteasome activity blocks proplatelet formation in human and mouse megakaryocytes. We also found that megakaryocytes isolated from mice deficient for PSMC1, an essential subunit of the 26S proteasome, fail to produce proplatelets. Consistent with decreased proplatelet formation, mice lacking PSMC1 in platelets (Psmc1(fl/fl) Pf4-Cre mice) exhibited severe thrombocytopenia and died shortly after birth. The failure to produce proplatelets in proteasome-inhibited megakaryocytes was due to upregulation and hyperactivation of the small GTPase, RhoA, rather than NF-κB, as has been previously suggested. Inhibition of RhoA or its downstream target, Rho-associated protein kinase (ROCK), restored megakaryocyte proplatelet formation in the setting of proteasome inhibition in vitro. Similarly, fasudil, a ROCK inhibitor used clinically to treat cerebral vasospasm, restored platelet counts in adult mice that were made thrombocytopenic by tamoxifen-induced suppression of proteasome activity in megakaryocytes and platelets (Psmc1(fl/fl) Pdgf-Cre-ER mice). These results indicate that proteasome function is critical for thrombopoiesis, and suggest inhibition of RhoA signaling as a potential strategy to treat thrombocytopenia in bortezomib-treated multiple myeloma patients.
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Smock KJ, Agarwal AM, Lim MS, Tripp SR, Miles RR, Patel JL, Abromowitch M, Lones MA, Cairo MS, Perkins SL. Expression of Notch1 and mTOR pathway proteins in pediatric lymphoblastic lymphoma; a Children’s Oncology Group report. J Hematop 2014. [DOI: 10.1007/s12308-014-0200-9] [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: 10/25/2022] Open
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Miles RR, Cairo MS. A pediatric translational perspective on the entity "progressive transformation of germinal centers (PTGC)". Pediatr Blood Cancer 2013; 60:3-4. [PMID: 22976884 DOI: 10.1002/pbc.24296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 08/02/2012] [Indexed: 12/26/2022]
Affiliation(s)
- Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
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Leventaki V, Rodic V, Tripp SR, Bayerl MG, Perkins SL, Barnette P, Schiffman JD, Miles RR. TP53 pathway analysis in paediatric Burkitt lymphoma reveals increased MDM4 expression as the only TP53 pathway abnormality detected in a subset of cases. Br J Haematol 2012; 158:763-71. [PMID: 22845047 DOI: 10.1111/j.1365-2141.2012.09243.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 06/15/2012] [Indexed: 12/21/2022]
Abstract
The TP53 (p53) pathway can be inhibited by TP53 mutation or deletion or by MDM2 overexpression. Both occur in Burkitt lymphoma (BL), but many cases lack either abnormality. Expression patterns of the TP53 inhibitor MDM4 have not been reported in BL, and increased MDM4 could deregulate the TP53 pathway in cases without TP53 or MDM2 abnormalities. We investigated TP53 pathway disruption in paediatric BL patient samples (n = 30) by studying MDM4, MDM2, and CDKN1A (p21) protein and mRNA expression; TP53 mutations; TP53 protein expression; and gene copy number abnormalities. MDM4 protein was expressed in 30/30 tumours, and MDM2 protein was weakly expressed in 7/30 (23%). All cases were negative for CDKN1A protein, and CDKN1A mRNA levels were decreased. TP53 mutations were detected in 5/28 (18%) cases and confirmed by sequencing. TP53 protein was expressed in 15/30 (50%) cases, including 7/8 with TP53 genetic alterations. MDM2 protein and mRNA expression levels did not correlate with lack of TP53 genetic changes or TP53 protein expression; however, there was an inverse relationship between detectable TP53 protein expression and MDM4 copy number gains and mRNA expression. The TP53 pathway is deregulated in paediatric BL cases, and increased MDM4 expression may be the primary mechanism in some cases.
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Affiliation(s)
- Vasiliki Leventaki
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT 84112-0565, USA
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Abstract
Composite lymphomas are rare and involve the concurrent evolution of 2 distinct lymphoma types within a single organ or tissue. This study describes 2 cases of composite mantle cell lymphoma (MCL) and diffuse large B-cell lymphoma (DLBCL), which has not previously been reported. Each case demonstrated distinct populations of CD20 positive small and large atypical B cells. In both cases, only the small lymphocytes were positive for CD5 and cyclin D1, and fluorescence in situ hybridization (FISH) showed a t(11;14) translocation in the small lymphocytes but not in the large cells. Molecular studies for B-cell clonality showed a possible clonal relationship between the 2 components in one case but not the other. This study describes in detail the morphology, immunophenotype, FISH, and molecular analysis of both components in each case. To the authors' knowledge, this represents the first report of juxtaposition of MCL with DLBCL that does not represent transformation of the mantle cell component.
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Affiliation(s)
- Albert K Ho
- University of Utah, Salt Lake City, UT, USA.
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Miles RR, Arnold S, Cairo MS. Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia. Br J Haematol 2012; 156:730-43. [DOI: 10.1111/j.1365-2141.2011.09024.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 11/29/2011] [Indexed: 12/31/2022]
Affiliation(s)
- Rodney R. Miles
- Department of Pathology; University of Utah; Salt Lake City; UT
| | - Staci Arnold
- Department of Pediatrics; NewYork-Presbyterian Morgan Stanley Children's Hospital; Columbia University; New York; NY
| | - Mitchell S. Cairo
- Departments of Pediatrics, Medicine, Pathology, Microbiology and Immunology and Cell Biology and Anatomy; New York Medical College; Valhalla; NY; USA
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Schiffman JD, Lorimer PD, Rodic V, Jahromi MS, Downie JM, Bayerl MG, Sanmann JN, Althof PA, Sanger WG, Barnette P, Perkins SL, Miles RR. Genome wide copy number analysis of paediatric Burkitt lymphoma using formalin-fixed tissues reveals a subset with gain of chromosome 13q and corresponding miRNA over expression. Br J Haematol 2011; 155:477-86. [PMID: 21981616 DOI: 10.1111/j.1365-2141.2011.08883.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The majority of paediatric Burkitt lymphoma (pBL) patients that relapse will die of disease, but markers for this high-risk subset are unknown. MYC translocations characterize pBL, but additional genetic changes may relate to prognosis and serve as potential biomarkers. We utilized a molecular inversion probe single nucleotide polymorphism assay to perform high resolution, genome-wide copy number analysis on archival formalin-fixed, paraffin-embedded pBL and germline tissues. We identified copy number abnormalities (CNAs) in 18/28 patients (64%) with a total of 62 CNAs that included 32 gains and 30 copy number losses. We identified seven recurrent CNAs including 1q gain (7/28, 25%), 13q gain (3/28, 11%), and 17p loss (4/28, 14%). The minimum common amplified region on 13q was at 13q31 and included the MIR17HG (MIR17-92) locus. Samples with this gain had higher levels of MIR17 RNA and showed a tendency for early relapse. Tumour-specific uniparental disomy was identified in 32% of cases and usually was recurrent. These results demonstrate that high-resolution copy number analysis can be performed on archival lymphoma tissue specimens, which has significance for the study of rare diseases.
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Affiliation(s)
- Joshua D Schiffman
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT 84112-0565, USA
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Abstract
Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare lymphoma that occurs predominantly in Asian adults. In this report, we describe the clinical and pathologic features of an unusual aggressive lymphoid neoplasm in a child and review the literature on NK/T-cell lymphoma in children. The patient was a 4-year-old Native American male with facial swelling, lymphadenopathy, and fevers. Biopsy demonstrated neoplastic lymphoid cells that expressed CD3, CD8, TIA-1, and EBV-encoded RNA without CD56. The patient failed multiagent chemotherapy and died of therapy-related complications. This case represents an extranodal NK/T-cell lymphoma, nasal type, with an unusual lack of CD56.
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Affiliation(s)
- Rodney R Miles
- Department of Pathology, University of Utah, Salt Lake City, Utah 84112, USA.
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Wei T, Kulkarni NH, Zeng QQ, Helvering LM, Lin X, Lawrence F, Hale L, Chambers MG, Lin C, Harvey A, Ma YL, Cain RL, Oskins J, Carozza MA, Edmondson DD, Hu T, Miles RR, Ryan TP, Onyia JE, Mitchell PG. Analysis of early changes in the articular cartilage transcriptisome in the rat meniscal tear model of osteoarthritis: pathway comparisons with the rat anterior cruciate transection model and with human osteoarthritic cartilage. Osteoarthritis Cartilage 2010; 18:992-1000. [PMID: 20434574 DOI: 10.1016/j.joca.2010.04.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 04/01/2010] [Accepted: 04/22/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to use microarray technology to: (1) understand the early molecular events underlying the damage of articular cartilage initiated by this surgical procedure, and (2) determine whether these changes mimic those that are occurring in human osteoarthritic (OA) cartilage. DESIGN Cartilage was harvested from both medial and lateral sides of the tibial plateaus and femoral condyles of both meniscal tear (MT) and sham surgery groups on days 3, 7 and 21 post-surgery. mRNA prepared from these rat cartilage samples was used for microarray analysis. RESULTS Statistical analysis identified 475 genes that were differentially expressed between the sham and MT groups, at one or more of the time points that were analyzed. By integrating these genes with OA-related genes reported previously in a rat OA model and in human OA array studies, we identified 20 commonly changed genes. Six out of these 20 genes (Col5A1, Col6A2, INHBA, LTBP2, NBL1 and SERPINA1) were differentially expressed in two animal models and in human OA. Pathway analysis identified some key features of OA pathology, namely cartilage extracellular matrix remodeling, angiogenesis, and chondrocyte cell death that were recapitulated in the animal models. The rat models suggested increased inflammation and cholesterol metabolic pathways may play important role in early cartilage degeneration. CONCLUSION We identified a large number of differentially expressed genes in the articular cartilage of the MT model. While there was lack of overall identity in cartilage gene expression between the rat models and human OA, several key biological processes were recapitulated in the rat MT OA model.
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Affiliation(s)
- T Wei
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
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Hussain S, Foreman O, Perkins SL, Witzig TE, Miles RR, van Deursen J, Galardy PJ. The de-ubiquitinase UCH-L1 is an oncogene that drives the development of lymphoma in vivo by deregulating PHLPP1 and Akt signaling. Leukemia 2010; 24:1641-55. [PMID: 20574456 DOI: 10.1038/leu.2010.138] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
De-ubiquitinating enzymes (DUBs) can reverse the modifications catalyzed by ubiquitin ligases and as such are believed to be important regulators of a variety of cellular processes. Several members of this protein family have been associated with human cancers; however, there is little evidence for a direct link between deregulated de-ubiquitination and neoplastic transformation. Ubiquitin C-terminal hydrolase (UCH)-L1 is a DUB of unknown function that is overexpressed in several human cancers, but whether it has oncogenic properties has not been established. To address this issue, we generated mice that overexpress UCH-L1 under the control of a ubiquitous promoter. Here, we show that UCH-L1 transgenic mice are prone to malignancy, primarily lymphomas and lung tumors. Furthermore, UCH-L1 overexpression strongly accelerated lymphomagenesis in Emu-myc transgenic mice. Aberrantly expressed UCH-L1 boosts signaling through the Akt pathway by downregulating the antagonistic phosphatase PHLPP1, an event that requires its de-ubiquitinase activity. These data provide the first in vivo evidence for DUB-driven oncogenesis and suggest that UCH-L1 hyperactivity deregulates normal Akt signaling.
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Affiliation(s)
- S Hussain
- Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN 55906, USA
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Miles RR, Mankey CC, Seiler CE, Smith LB, Teruya-Feldstein J, Hsi ED, Elenitoba-Johnson KS, Lim MS. Expression of Grb2 distinguishes classical Hodgkin lymphomas from primary mediastinal B-cell lymphomas and other diffuse large B-cell lymphomas. Hum Pathol 2009; 40:1731-7. [DOI: 10.1016/j.humpath.2009.05.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 05/20/2009] [Accepted: 05/22/2009] [Indexed: 10/20/2022]
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Miles RR, Raphael M, McCarthy K, Wotherspoon A, Lones MA, Terrier-Lacombe MJ, Patte C, Gerrard M, Auperin A, Sposto R, Davenport V, Cairo MS, Perkins SL. Pediatric diffuse large B-cell lymphoma demonstrates a high proliferation index, frequent c-Myc protein expression, and a high incidence of germinal center subtype: Report of the French-American-British (FAB) international study group. Pediatr Blood Cancer 2008; 51:369-74. [PMID: 18493992 PMCID: PMC2712231 DOI: 10.1002/pbc.21619] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) makes up 10-20% of pediatric non-Hodgkin lymphoma, and these patients have a significantly better prognosis than adults with DLBCL. The difference in prognosis may be related to clinical, phenotypic, and/or biological differences between adult and pediatric DLBCL. In adult DLBCL, the germinal center (GC) phenotype is associated with a better prognosis than the activated B-cell (ABC) phenotype. However, a high proliferative index and expression of Bcl2 and c-Myc protein have all been associated with worse outcomes. While multiple studies have addressed the phenotype and expression patterns of adult DLBCL, relatively little is known about these biological variables in pediatric DLBCL. The goal of this study was to investigate the proliferative index, the relative frequencies of the GC and non-GC subtypes, and the expression of Bcl2 and c-Myc protein in a cohort of children with DLBCL treated in a uniform manner. PROCEDURE We performed immunohistochemistry (IHC) for MIB1, CD10, Bcl6, MUM1, Bcl2, and c-Myc on DLBCL tissue from children treated uniformly in the FAB LMB96 trial (SFOP LMB96/CCG5961/UKCCSG/NHL 9600). RESULTS Compared to published adult DLBCL studies, pediatric DLBCL demonstrated moderate to high proliferation rates (83%), increased c-Myc protein expression (84%), decreased Bcl2 protein expression (28%), and an increased frequency of the GC phenotype (75%). CONCLUSIONS These findings suggest that there are significant biologic differences between pediatric and adult forms of DLBCL, which may contribute to the superior prognosis seen in the pediatric population relative to adult disease.
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Affiliation(s)
| | - Martine Raphael
- Univ Paris- Sud, INSERM U 802, -CHU Bicêtre AP-HP, Le Kremlin-Bicêtre F 94270, France
| | - Keith McCarthy
- Gloucestershire Hospitals, NHS Foundation Trust, Gloucestershire, UK
| | | | - Mark A. Lones
- Children's Hospital of Orange County/St. Joseph Hospital, Orange, CA, USA
| | | | | | | | - Anne Auperin
- Institut de Cancérologie Gustave Roussy, Villejuif, France
| | - Richard Sposto
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Mitchell S. Cairo
- Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY, USA
| | - Sherrie L. Perkins
- University of Utah Health Sciences Center, Salt Lake City, UT, USA,Address for Correspondence: Sherrie L. Perkins, M.D., Ph.D., Department of Pathology, University of Utah Health Sciences Center, 50 N Medical Drive Room A513, Salt Lake City, UT 84132, (801) 581-5854, Fax: (801) 585-3831,
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Miles RR, Cairo MS, Satwani P, Zwick DL, Lones MA, Sposto R, Abromovitch M, Tripp S, Angiolillo AL, Roman E, Davenport V, Perkins SL. Immunophenotypic identification of possible therapeutic targets in paediatric non-Hodgkin lymphomas: a children's oncology group report. Br J Haematol 2007; 138:506-12. [PMID: 17659054 DOI: 10.1111/j.1365-2141.2007.06689.x] [Citation(s) in RCA: 21] [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: 11/28/2022]
Abstract
Immunophenotypic analysis can identify protein epitopes in non-Hodgkin lymphomas (NHL) that may respond to targeted immunotherapies, such as anti-CD20 and anti-CD52. Recent studies suggest additional targets may provide therapeutic benefits in NHL. This study evaluated protein expression of CD25, CD52, CD74 and CD80 in paediatric NHL to determine possible targets for immune-based therapeutic approaches. Patient samples were derived from paediatric NHL clinical trials sponsored by the Children's Cancer Group (CCG, now the Children's Oncology Group, COG) and included Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), disseminated T- and B-cell lymphoblastic lymphoma (T-LBL and B-LBL) and anaplastic large cell (ALCL). Immunophenotypic studies were performed on formalin-fixed, paraffin-embedded diagnostic tissues. CD25 was expressed in 8% of T-LBL and 75% of ALCL cases, but not in BL, DLBCL, or B-LBL. CD52 was expressed in 99% of cases of paediatric NHL of all subtypes. CD74 was expressed in 100% of B-LBL, BL and DLBCL, but was absent in ALCL and T-LBL. CD80 was expressed in 12% of B-LBL, 6% of BL and 10% of DLBCL cases studied, but was not detected in T-cell NHL. These expression patterns suggest that CD25, CD52 and CD74 may represent potential new therapeutic targets in paediatric NHL.
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Affiliation(s)
- Rodney R Miles
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT, USA
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Kulkarni NH, Halladay DL, Miles RR, Gilbert LM, Frolik CA, Galvin RJS, Martin TJ, Gillespie MT, Onyia JE. Effects of parathyroid hormone on Wnt signaling pathway in bone. J Cell Biochem 2005; 95:1178-90. [PMID: 15962290 DOI: 10.1002/jcb.20506] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.2] [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: 11/06/2022]
Abstract
The Wnt signaling pathway has recently been demonstrated to play an important role in bone cell function. In previous studies using DNA microarray analyses, we observed a change in some of the molecular components of the canonical Wnt pathway namely, frizzled-1 (FZD-1) and axil, in response to continuous parathyroid hormone (PTH) treatment in rats. In the present study, we further explored other components of the Wnt signaling pathway in rat distal metaphyseal bone in vivo, and rat osteoblastic osteosarcoma cells (UMR 106) in culture. Several Wnt pathway components, including low-density lipoprotein-receptor-related protein 5 (LRP5), LRP6, FZD-1, Dickkopf-1 (Dkk-1), and Kremen-1 (KRM-1), were expressed in bone in vivo and in osteoblasts in vitro. Continuous exposure to PTH (1-38) both in vivo and in vitro upregulated the mRNA expression of LRP6 and FZD-1 and decreased LRP5 and Dkk-1. These effects in UMR 106 cells were associated with an increase in beta-catenin as measured by Western blots and resulted in functional activation (three to six-fold) of a downstream Wnt responsive TBE6-luciferase (TCF/LEF-binding element) reporter gene. Activation of the TBE6-luciferase reporter gene by PTH (1-38) in UMR 106 cells was inhibited by the protein kinase A (PKA) inhibitor, H89. Activation was mimicked by PTH (1-31), PTH-related protein (1-34), and forskolin, but both PTH (3-34) and (7-34) had no effect. These findings suggest that the effect of PTH on the canonical Wnt signaling pathway occurs at least in part via the cAMP-PKA pathway through the differential regulation of the receptor complex proteins (FZD-1/LRP5 or LRP6) and the antagonist (Dkk-1). Taken together, these results reveal a possible role for the Wnt signaling pathway in PTH actions in bone.
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Affiliation(s)
- N H Kulkarni
- Bone and Inflammation Division, Lilly Research Labs, Eli Lilly & Co., Indianapolis, Indiana 46285, USA
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Abstract
B-cell lymphoma 6 (BCL6) is a 95-kDa nuclear phosphoprotein and member of the Pox virus zinc finger/bric-a-brac, tramtrack, broad complex (POZ/BTB) family of transcription factors. BCL6 is a transcriptional repressor required for germinal center formation, and the gene encoding it is frequently altered in diffuse large B-cell and follicular lymphomas. The dysregulation of BCL6 has therefore been implicated in lymphomagenesis. A limited number of proteins is known to interact with BCL6 and modulate its activity or participate in its role in transcriptional regulation. Identification of additional BCL6-binding proteins could reveal potential signaling targets and previously undescribed functional roles for BCL6. We used a functional proteomic approach to determine the identity of proteins that interact with BCL6. Proteins were isolated by co-immunoprecipitation with an anti-BCL6 antibody and identified using MS/MS. We identified 61 proteins in the BCL6 immunocomplex from the following Gene Ontology categories: transcription regulator activity (n = 18), binding activity (n = 11), signal transducer activity (n = 10), catalytic activity (n = 8), structural molecule activity (n = 3), enzyme regulator activity (n = 3), transporter activity (n = 2), motor activity (n = 2), chaperone activity (n = 1), and unknown function (n = 3). Importantly we identified BCL6 and several previously reported BCL6-interacting proteins in the BCL6 immunocomplex. The remaining proteins have not been shown previously to be associated with BCL6. MS/MS results were validated on four proteins using immunoprecipitation and Western blotting. Two of these protein interactions were further confirmed by reciprocal immunoprecipitation. This study demonstrates the utility of antibody immunoprecipitation and subsequent peptide identification by MS/MS for the elucidation of BCL6-binding proteins. Many of the novel proteins identified in this study suggest additional functional roles for BCL6 beyond transcriptional repression.
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Affiliation(s)
- Rodney R Miles
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA
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Helvering LM, Adrian MD, Geiser AG, Estrem ST, Wei T, Huang S, Chen P, Dow ER, Calley JN, Dodge JA, Grese TA, Jones SA, Halladay DL, Miles RR, Onyia JE, Ma YL, Sato M, Bryant HU. Differential effects of estrogen and raloxifene on messenger RNA and matrix metalloproteinase 2 activity in the rat uterus. Biol Reprod 2004; 72:830-41. [PMID: 15576828 DOI: 10.1095/biolreprod.104.034595] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [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: 11/01/2022] Open
Abstract
A detailed analysis of the differential effects of estrogen (E) compared to raloxifene (Ral), a selective estrogen receptor modulator (SERM), following estrogen receptor (ER) binding in gynecological tissues was conducted using gene microarrays, Northern blot analysis, and matrix metalloproteinase (MMP) 2 activity studies. We profiled gene expression in the uterus following acute (1 day) and prolonged daily (5 wk) treatment of E and Ral in ovariectomized rats. Estrogen regulated twice as many genes as Ral, largely those associated with catalysis and metabolism, whereas Ral induced genes associated with cell death and negative cell regulation. Follow-up studies confirmed that genes associated with matrix integrity were differentially regulated by Ral and E at various time points in uterine and vaginal tissues. Additional experiments were conducted to determine the levels of MMP2 activity in uterus explants from ovariectomized rats following 2 wk of treatment with E, Ral, or one of two additional SERMs: lasofoxifene, and levormeloxifene. Both E and lasofoxifene stimulated uterine MMP2 activity to a level twofold that of Ral, whereas levormeloxifene elevated MMP2 activity to a level 12-fold that of Ral. These data show that one of the significant differences between E and Ral signaling in the uterus is the regulation of genes and proteins associated with matrix integrity. This may be a potential key difference between the action of SERMs in the uterus of postmenopausal women.
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Affiliation(s)
- L M Helvering
- Lilly Research Labs, Indianapolis, Indiana 46285, USA.
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